Strategic planning: the first step in the planning process.

PubMed

Gelinas, Marc A

2003-01-01

Strategic planning is a systematic process through which an organization builds commitment among key stakeholders to goals and priorities which are essential to its mission and vision, and responsive to the operating environment. Strategic planning is the first step in a comprehensive planning process that also includes business planning and implementation planning. If all three steps are carried out in sequence, strategic planning can be a very effective means of educating the stakeholders about where the cancer program is and where it is going, gaining support and commitment for the direction that the cancer program will take, and assuring that everyone's expectations can be managed effectively. Unfortunately, some organizations and cancer program leaders misunderstand the process. Too often, strategic planning is used as a stand-alone activity. This article will describe what strategic planning is, how it should smoothly lead into business planning and implementation planning, and how to avoid the pitfalls that sometimes arise during the strategic planning effort.

ActiveWV: a systematic approach to developing a physical activity plan for West Virginia.

PubMed

Elliott, Eloise; Jones, Emily; Bulger, Sean

2014-03-01

Modeled after the National Physical Activity Plan (NPAP), ActiveWV 2015: The West Virginia Physical Activity Plan was developed to provide strategic direction for physical activity promotion within the state. The purpose of this manuscript is to describe the systematic approach taken in developing ActiveWV. Plan development began with establishing capacity and leadership among key stakeholders representing all societal sectors. A multiphase, statewide decision-making process allowed for input across sectors and geographic regions. The process results identified five priority areas that served as the conceptual framework for ActiveWV. Sector teams, comprised of key organization stakeholders across the eight sectors, finalized the sector-specific strategies and tactics using the NPAP evidence-based recommendations, results from a formalized strategic process, and the teams' expertise and experience. ActiveWV was officially released on January 19, 2012 at the State Capitol in Charleston, West Virginia. Community events throughout the state surrounded the release and celebrated West Virginia Physical Activity Day. Ongoing implementation and dissemination efforts are underway at state and local levels. As the NPAP calls for states and communities to develop plans that meet the needs of their particular context, other states may find the lessons learned from West Virginia helpful in the development process.

Healthcare Strategic Planning as Part of National and Regional Development in the Israeli Galilee: A Case Study of the Planning Process.

PubMed

Peled, Ronit; Schenirer, Jerry

2009-10-01

This article describes a systematic process of geographic and strategic planning for healthcare services as a part of a regional development plan in the Israeli Galilee. The planning process consisted of three stages: (a) assessment of needs, demand and existing resources; (b) prioritisation of initiatives; and (c) scheduling of theoretical priorities. For many years the region has suffered from inequities and inequalities regarding the availability and accessibility of a regional healthcare system, resulting in high mortality and morbidity rates and low quality of life. The aim of the healthcare strategic plan was to suggest initiatives and actions to be taken in order to improve healthcare provision and the health and wellbeing of local residents.

Improving the Way Higher Education Institutions Study Themselves: Use and Impact of Academic Improvement Systems. Professional File. Number 118, Fall 2010

ERIC Educational Resources Information Center

Bender, Kim K.; Jonson, Jessica L.; Siller, Thomas J.

2010-01-01

Can higher education institutions continue using planning and self-evaluation processes that are decades old without any reform? Several recent monographs urge institutions to embrace continuous improvement processes that engage systematic planning and department self-evaluation across whole campuses, but they do not show institutions how to do…

Best Practices in Wraparound: A Multidimensional View of the Evidence

ERIC Educational Resources Information Center

Walter, Uta M.; Petr, Christopher G.

2011-01-01

This article presents a systematic review of the effectiveness of wraparound, a value-guided, widely used service planning process and philosophy of care originally developed for children with serious emotional disturbance and their families. In contrast to conventional systematic reviews, which concentrate on the empirical literature, this…

A practical overview of how to conduct a systematic review.

PubMed

Davis, Dilla

2016-11-16

With an increasing focus on evidence-based practice in health care, it is important that nurses understand the principles underlying systematic reviews. Systematic reviews are used in healthcare to present a comprehensive, policy-neutral, transparent and reproducible synthesis of evidence. This article provides a practical overview of the process of undertaking systematic reviews, explaining the rationale for each stage. It provides guidance on the standard methods applicable to every systematic review: writing and registering a protocol; planning a review; searching and selecting studies; data collection; assessing the risk of bias; and interpreting results.

Transmission Planning Analysis Tool

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

2015-06-23

Developed to solve specific problem: Assist transmission planning for regional transfers in interconnected power systems. This work was originated in a study for the U.S. Department of State, to recommend transmission reinforcements for the Central American regional system that interconnects 6 countries. Transmission planning analysis is currently performed by engineers with domainspecific and systemspecific knowledge without a unique methodology. The software codes of this disclosure assists engineers by defining systematic analysis procedures to help identify weak points and make decisions on transmission planning of regional interconnected power systems. Transmission Planning Analysis Tool groups PSS/E results of multiple AC contingency analysismore » and voltage stability analysis and QV analysis of many scenarios of study and arrange them in a systematic way to aid power system planning engineers or transmission operators in effective decision]making process or in the off]line study environment.« less

Strategic planning in healthcare organizations.

PubMed

Rodríguez Perera, Francisco de Paula; Peiró, Manel

2012-08-01

Strategic planning is a completely valid and useful tool for guiding all types of organizations, including healthcare organizations. The organizational level at which the strategic planning process is relevant depends on the unit's size, its complexity, and the differentiation of the service provided. A cardiology department, a hemodynamic unit, or an electrophysiology unit can be an appropriate level, as long as their plans align with other plans at higher levels. The leader of each unit is the person responsible for promoting the planning process, a core and essential part of his or her role. The process of strategic planning is programmable, systematic, rational, and holistic and integrates the short, medium, and long term, allowing the healthcare organization to focus on relevant and lasting transformations for the future. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Quantifying the process and outcomes of person-centered planning.

PubMed

Holburn, S; Jacobson, J W; Vietze, P M; Schwartz, A A; Sersen, E

2000-09-01

Although person-centered planning is a popular approach in the field of developmental disabilities, there has been little systematic assessment of its process and outcomes. To measure person-centered planning, we developed three instruments designed to assess its various aspects. We then constructed variables comprising both a Process and an Outcome Index using a combined rational-empirical method. Test-retest reliability and measures of internal consistency appeared adequate. Variable correlations and factor analysis were generally consistent with our conceptualization and resulting item and variable classifications. Practical implications for intervention integrity, program evaluation, and organizational performance are discussed.

Comparison between Kemp, Smith & Ragan, Dick & Carey's Instructional Design Models

ERIC Educational Resources Information Center

Birgili, Bengi

2013-01-01

Instructional design (ID) is systematic way of suggesting a structure and giving meaning to an instructional problem by helping to visualize the problem and breaking into discrete and manageable units. In addition, ID is a systematic reflective process of applying instructional principles into plans by material, activity, resources and evaluation…

DATA QUALITY OBJECTIVES-FOUNDATION OF A SUCCESSFUL MONITORING PROGRAM

EPA Science Inventory

The data quality objectives (DQO) process is a fundamental site characterization tool and the foundation of a successful monitoring program. The DQO process is a systematic planning approach based on the scientific method of inquiry. The process identifies the goals of data col...

The use of systematic reviews in the planning, design and conduct of randomised trials: a retrospective cohort of NIHR HTA funded trials.

PubMed

Jones, Ashley P; Conroy, Elizabeth; Williamson, Paula R; Clarke, Mike; Gamble, Carrol

2013-03-25

A systematic review, with or without a meta-analysis, should be undertaken to determine if the research question of interest has already been answered before a new trial begins. There has been limited research on how systematic reviews are used within the design of new trials, the aims of this study were to investigate how systematic reviews of earlier trials are used in the planning and design of new randomised trials. Documentation from the application process for all randomised trials funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) between 2006 and 2008 were obtained. This included the: commissioning brief (if appropriate), outline application, minutes of the Board meeting in which the outline application was discussed, full application, detailed project description, referee comments, investigator response to referee comments, Board minutes on the full application and the trial protocol. Data were extracted on references to systematic reviews and how any such reviews had been used in the planning and design of the trial. 50 randomised trials were funded by NIHR HTA during this period and documentation was available for 48 of these. The cohort was predominately individually randomised parallel trials aiming to detect superiority between two treatments for a single primary outcome. 37 trials (77.1%) referenced a systematic review within the application and 20 of these (i.e. 41.7% of the total) used information contained in the systematic review in the design or planning of the new trial. The main areas in which systematic reviews were used were in the selection or definition of an outcome to be measured in the trial (7 of 37, 18.9%), the sample size calculation (7, 18.9%), the duration of follow up (8, 21.6%) and the approach to describing adverse events (9, 24.3%). Boards did not comment on the presence/absence or use of systematic reviews in any application. Systematic reviews were referenced in most funded applications but just over half of these used the review to inform the design. There is an expectation from funders that applicants will use a systematic review to justify the need for a new trial but no expectation regarding further use of a systematic review to aid planning and design of the trial. Guidelines for applicants and funders should be developed to promote the use of systematic reviews in the design and planning of randomised trials, to optimise delivery of new studies informed by the most up-to-date evidence base and to minimise waste in research.

Does facilitated Advance Care Planning reduce the costs of care near the end of life? Systematic review and ethical considerations.

PubMed

Klingler, Corinna; in der Schmitten, Jürgen; Marckmann, Georg

2016-05-01

While there is increasing evidence that Advance Care Planning has the potential to strengthen patient autonomy and improve quality of care near the end of life, it remains unclear whether it could also reduce net costs of care. This study aims to describe the cost implications of Advance Care Planning programmes and discusses ethical conflicts arising in this context. We conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We systematically searched the databases PubMed, NHS EED, EURONHEED, Cochrane Library and EconLit. We included empirical studies (no limitation to study type) that investigated the cost implications of Advance Care Planning programmes involving professionally facilitated end-of-life discussions. Seven studies met our inclusion criteria. Four of them used a randomised controlled design, one used a before-after design and two were observational studies. Six studies found reductions in costs of care ranging from USD1041 to USD64,827 per patient, depending on the study period and the cost measurement. One study detected no differences in costs. Studies varied considerably regarding the Advance Care Planning intervention, patient selection and costs measured which may explain some of the variations in findings. Looking at the impact of Advance Care Planning on costs raises delicate ethical issues. Given the increasing pressure to reduce expenditures, there may be concerns that cost considerations could unduly influence the sensitive communication process, thus jeopardising patient autonomy. Safeguards are proposed to reduce these risks. The limited data indicate net cost savings may be realised with Advance Care Planning. Methodologically robust trials with clearly defined Advance Care Planning interventions are needed to make the costs and returns of Advance Care Planning transparent. © The Author(s) 2015.

"Learning to Play with New Friends": Systematic Quality Development Work in a Leisure-Time Centre

ERIC Educational Resources Information Center

Lager, Karin

2016-01-01

This article explores the recontextualisation of systematic quality development work (Sqdw) in a leisure-time centre. Two teachers' processes of planning, organisation, documentation and evaluation were investigated, the aim being to explore the recontextualisation of Sqdw in practice. The study is thus a case study of these teachers' practice…

Research Utilizing Problem Solving (RUPS) - Classroom Version. Description of Teacher Inservice Education Materials.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. Project on Utilization of Inservice Education R & D Outcomes.

The workshop instructional materials described here are designed to try out a systematic problem solving process as a way of working toward improvements in the school setting. Topics include diagnosis using force field technique, small group dynamics, planning for action, and planning a RUPS (Research Using Problem Solving) project. This…

Community-Based Financing of Family Planning in Developing Countries: A Systematic Review.

PubMed

Karra, Mahesh; Canning, David; Hu, Janice; Ali, Moazzam; Lissner, Craig

2016-12-01

In this systematic review, we gather evidence on community financing schemes and insurance programs for family planning in developing countries, and we assess the impact of these programs on primary outcomes related to contraceptive use. To identify and evaluate the research findings, we adopt a four-stage review process that employs a weight-of-evidence and risk-of-bias analytic approach. Out of 19,138 references that were identified, only four studies were included in our final analysis, and only one study was determined to be of high quality. In the four studies, the evidence on the impact of community-based financing on family planning and fertility outcomes is inconclusive. These limited and mixed findings suggest that either: 1) more high-quality evidence on community-based financing for family planning is needed before any conclusions can be made; or 2) community-based financing for family planning may, in fact, have little or no effect on family planning outcomes. © 2016 The Population Council, Inc.

Design and Simulation Plant Layout Using Systematic Layout Planning

NASA Astrophysics Data System (ADS)

Suhardini, D.; Septiani, W.; Fauziah, S.

2017-12-01

This research aims to design the factory layout of PT. Gunaprima Budiwijaya in order to increase production capacity. The problem faced by this company is inappropriate layout causes cross traffic on the production floor. The re-layout procedure consist of these three steps: analysing the existing layout, designing plant layout based on SLP and evaluation and selection of alternative layout using Simulation Pro model version 6. Systematic layout planning is used to re-layout not based on the initial layout. This SLP produces four layout alternatives, and each alternative will be evaluated based on two criteria, namely cost of material handling using Material Handling Evaluation Sheet (MHES) and processing time by simulation. The results showed that production capacity is increasing as much as 37.5% with the addition of the machine and the operator, while material handling cost was reduced by improvement of the layout. The use of systematic layout planning method reduces material handling cost of 10,98% from initial layout or amounting to Rp1.229.813,34.

Systematic synthesis of barriers and facilitators to service user-led care planning.

PubMed

Bee, Penny; Price, Owen; Baker, John; Lovell, Karina

2015-08-01

Service user (patient) involvement in care planning is a principle enshrined by mental health policy yet often attracts criticism from patients and carers in practice. To examine how user-involved care planning is operationalised within mental health services and to establish where, how and why challenges to service user involvement occur. Systematic evidence synthesis. Synthesis of data from 117 studies suggests that service user involvement fails because the patients' frame of reference diverges from that of providers. Service users and carers attributed highest value to the relational aspects of care planning. Health professionals inconsistently acknowledged the quality of the care planning process, tending instead to define service user involvement in terms of quantifiable service-led outcomes. Service user-involved care planning is typically operationalised as a series of practice-based activities compliant with auditor standards. Meaningful involvement demands new patient-centred definitions of care planning quality. New organisational initiatives should validate time spent with service users and display more tangible and flexible commitments to meeting their needs. © The Royal College of Psychiatrists 2015.

Systematic synthesis of barriers and facilitators to service user-led care planning

PubMed Central

Bee, Penny; Price, Owen; Baker, John; Lovell, Karina

2015-01-01

Background Service user (patient) involvement in care planning is a principle enshrined by mental health policy yet often attracts criticism from patients and carers in practice. Aims To examine how user-involved care planning is operationalised within mental health services and to establish where, how and why challenges to service user involvement occur. Method Systematic evidence synthesis. Results Synthesis of data from 117 studies suggests that service user involvement fails because the patients' frame of reference diverges from that of providers. Service users and carers attributed highest value to the relational aspects of care planning. Health professionals inconsistently acknowledged the quality of the care planning process, tending instead to define service user involvement in terms of quantifiable service-led outcomes. Conclusions Service user-involved care planning is typically operationalised as a series of practice-based activities compliant with auditor standards. Meaningful involvement demands new patient-centred definitions of care planning quality. New organisational initiatives should validate time spent with service users and display more tangible and flexible commitments to meeting their needs. PMID:26243762

Production layout improvement by using line balancing and Systematic Layout Planning (SLP) at PT. XYZ

NASA Astrophysics Data System (ADS)

Buchari; Tarigan, U.; Ambarita, M. B.

2018-02-01

PT. XYZ is a wood processing company which produce semi-finished wood with production system is make to order. In the production process, it can be seen that the production line is not balanced. The imbalance of the production line is caused by the difference in cycle time between work stations. In addition, there are other issues, namely the existence of material flow pattern is irregular so it resulted in the backtracking and displacement distance away. This study aimed to obtain the allocation of work elements to specific work stations and propose an improvement of the production layout based on the result of improvements in the line balancing. The method used in the balancing is Ranked Positional Weight (RPW) or also known as Helgeson Birnie method. While the methods used in the improvement of the layout is the method of Systematic Layout Planning (SLP). By using Ranked Positional Weight (RPW) obtained increase in line efficiency becomes 84,86% and decreased balance delay becomes 15,14%. Repairing the layout using the method of Systematic Layout Planning (SLP) also give good results with a reduction in path length becomes 133,82 meters from 213,09 meters previously or a decrease of 37.2%.

[The effectiveness of continuing care models in patients with chronic diseases: a systematic review].

PubMed

Chen, Hsiao-Mei; Han, Tung-Chen; Chen, Ching-Min

2014-04-01

Population aging has caused significant rises in the prevalence of chronic diseases and the utilization of healthcare services in Taiwan. The current healthcare delivery system is fragmented. Integrating medical services may increase the quality of healthcare, enhance patient and patient family satisfaction with healthcare services, and better contain healthcare costs. This article introduces two continuing care models: discharge planning and case management. Further, the effectiveness and essential components of these two models are analyzed using a systematic review method. Articles included in this systematic review were all original articles on discharge-planning or case-management interventions published between February 1999 and March 2013 in any of 6 electronic databases (Medline, PubMed, Cinahl Plus with full Text, ProQuest, Cochrane Library, CEPS and Center for Chinese Studies electronic databases). Of the 70 articles retrieved, only 7 were randomized controlled trial studies. Three types of continuity-of-care models were identified: discharge planning, case management, and a hybrid of these two. All three models used logical and systematic processes to conduct assessment, planning, implementation, coordination, follow-up, and evaluation activities. Both the discharge planning model and the case management model were positively associated with improved self-care knowledge, reduced length of stay, decreased medical costs, and better quality of life. This study cross-referenced all reviewed articles in terms of target clients, content, intervention schedules, measurements, and outcome indicators. Study results may be referenced in future implementations of continuity-care models and may provide a reference for future research.

Defining robustness protocols: a method to include and evaluate robustness in clinical plans

NASA Astrophysics Data System (ADS)

McGowan, S. E.; Albertini, F.; Thomas, S. J.; Lomax, A. J.

2015-04-01

We aim to define a site-specific robustness protocol to be used during the clinical plan evaluation process. Plan robustness of 16 skull base IMPT plans to systematic range and random set-up errors have been retrospectively and systematically analysed. This was determined by calculating the error-bar dose distribution (ebDD) for all the plans and by defining some metrics used to define protocols aiding the plan assessment. Additionally, an example of how to clinically use the defined robustness database is given whereby a plan with sub-optimal brainstem robustness was identified. The advantage of using different beam arrangements to improve the plan robustness was analysed. Using the ebDD it was found range errors had a smaller effect on dose distribution than the corresponding set-up error in a single fraction, and that organs at risk were most robust to the range errors, whereas the target was more robust to set-up errors. A database was created to aid planners in terms of plan robustness aims in these volumes. This resulted in the definition of site-specific robustness protocols. The use of robustness constraints allowed for the identification of a specific patient that may have benefited from a treatment of greater individuality. A new beam arrangement showed to be preferential when balancing conformality and robustness for this case. The ebDD and error-bar volume histogram proved effective in analysing plan robustness. The process of retrospective analysis could be used to establish site-specific robustness planning protocols in proton therapy. These protocols allow the planner to determine plans that, although delivering a dosimetrically adequate dose distribution, have resulted in sub-optimal robustness to these uncertainties. For these cases the use of different beam start conditions may improve the plan robustness to set-up and range uncertainties.

Environmental Scanning for Occupational Education. A Facilitator's Guide. A Model for Environmental Scanning to Systematically Assess Future Occupational Education and Training Needs of a Michigan Community College Service Area.

ERIC Educational Resources Information Center

Kellogg Foundation, Battle Creek, MI.

This manual is designed to facilitate the planning and implementation of an environmental scanning project in Michigan's community colleges. (Environmental scanning is a systematic process for gathering and analyzing information about the external environment and relating it to an organization's internal environment.) This facilitator's guide is…

Planning of reach-and-grasp movements: effects of validity and type of object information

NASA Technical Reports Server (NTRS)

Loukopoulos, L. D.; Engelbrecht, S. F.; Berthier, N. E.

2001-01-01

Individuals are assumed to plan reach-and-grasp movements by using two separate processes. In 1 of the processes, extrinsic (direction, distance) object information is used in planning the movement of the arm that transports the hand to the target location (transport planning); whereas in the other, intrinsic (shape) object information is used in planning the preshaping of the hand and the grasping of the target object (manipulation planning). In 2 experiments, the authors used primes to provide information to participants (N = 5, Experiment 1; N = 6, Experiment 2) about extrinsic and intrinsic object properties. The validity of the prime information was systematically varied. The primes were succeeded by a cue, which always correctly identified the location and shape of the target object. Reaction times were recorded. Four models of transport and manipulation planning were tested. The only model that was consistent with the data was 1 in which arm transport and object manipulation planning were postulated to be independent processes that operate partially in parallel. The authors suggest that the processes involved in motor planning before execution are primarily concerned with the geometric aspects of the upcoming movement but not with the temporal details of its execution.

Does facilitated Advance Care Planning reduce the costs of care near the end of life? Systematic review and ethical considerations

PubMed Central

Klingler, Corinna; in der Schmitten, Jürgen; Marckmann, Georg

2015-01-01

Background: While there is increasing evidence that Advance Care Planning has the potential to strengthen patient autonomy and improve quality of care near the end of life, it remains unclear whether it could also reduce net costs of care. Aim: This study aims to describe the cost implications of Advance Care Planning programmes and discusses ethical conflicts arising in this context. Design: We conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources: We systematically searched the databases PubMed, NHS EED, EURONHEED, Cochrane Library and EconLit. We included empirical studies (no limitation to study type) that investigated the cost implications of Advance Care Planning programmes involving professionally facilitated end-of-life discussions. Results and discussion: Seven studies met our inclusion criteria. Four of them used a randomised controlled design, one used a before-after design and two were observational studies. Six studies found reductions in costs of care ranging from USD1041 to USD64,827 per patient, depending on the study period and the cost measurement. One study detected no differences in costs. Studies varied considerably regarding the Advance Care Planning intervention, patient selection and costs measured which may explain some of the variations in findings. Normative appraisal: Looking at the impact of Advance Care Planning on costs raises delicate ethical issues. Given the increasing pressure to reduce expenditures, there may be concerns that cost considerations could unduly influence the sensitive communication process, thus jeopardising patient autonomy. Safeguards are proposed to reduce these risks. Conclusion: The limited data indicate net cost savings may be realised with Advance Care Planning. Methodologically robust trials with clearly defined Advance Care Planning interventions are needed to make the costs and returns of Advance Care Planning transparent. PMID:26294218

Reducing Operating Costs by Optimizing Space in Facilities

DTIC Science & Technology

2012-03-01

Base level 5 engineering units will provide facility floor plans, furniture layouts, and staffing documentation as necessary. One obstacle...due to the quantity and diverse locations. Base level engineering units provided facility floor plans, furniture layouts, and staffing documentation... furniture purchases and placement 5. Follow a quality systematic process in all decisions The per person costs can be better understood with a real

Does basing an intervention on behavioral theory enhance the efficacy/effectiveness on dietary change for obesity prevention among children? A systematic review and meta-analysis

USDA-ARS?s Scientific Manuscript database

Our purpose was to test whether interventions based on theory, multiple theories, or a formal planning process were more effective in changing fruit and vegetable (FV) consumption among children than interventions with no behavioral theoretical foundation or no formal planning. The authors conducted...

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

PubMed Central

2014-01-01

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

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

PubMed

Rutten, Geert M; Harting, Janneke; Bartholomew, Leona K; Braspenning, Jozé C; van Dolder, Rob; Heijmans, Marcel Fgj; Hendriks, Erik Jm; Kremers, Stef Pj; van Peppen, Roland Ps; Rutten, Steven Tj; Schlief, Angelique; de Vries, Nanne K; Oostendorp, Rob Ab

2014-01-15

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

A plan for structured management of the Systems Approach to Training (SAT) process

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

Schurman, D.L.

1987-01-01

This paper describes the plan and accomplishments for development of a Systematic Management Plan for the Systems Approach to Training (SMPSAT). This project is sponsored by the United States Marine Corps Headquarters training policy branch (HQMC(TAP)). Purpose of this effort is to develop a comprehensive plan for management of the Systems Approach to Training (SAT) system in the USMC. This management plan will allow HQMC to monitor the SAT system in order to provide maximum support to the SAT system in both the formal schools and the Fleet Marine Force.

The arrival of economic evidence in managed care formulary decisions: the unsolicited request process.

PubMed

Neumann, Peter J

2005-07-01

Managed care plans have traditionally resisted using economic evidence explicitly in drug formulary decisions, even as they used ever more aggressive and sophisticated processes for managing care. In recent years, this has changed as health plans have begun to adopt evidence-based and value-based formulary submission guidelines. The guidelines have the potential to serve as a national unifying template for pharmacy and therapeutics committees to consider clinical and economic information in a systematic and rigorous fashion. However, many questions remain about their use and about the nature of communications (called "unsolicited requests") from plans to drug companies for information. This article describes the unsolicited request process and its potential impact on the use of economic evidence in formulary decisions.

[Commitment and community participation towards health: knowledge creation from the systematization of social experiences].

PubMed

López-Bolaños, Lizbeth; Campos-Rivera, Marisol; Villanueva-Borbolla, María Ángeles

2018-01-01

Objective. To reflect on the process of committing to participation in the implementation of a health strategic plan, using Participative Systematization of Social Experiences as a tool. Our study was a qualitative research-intervention study, based on the Dialectical Methodological Conception approach. We designed and implemented a two-day workshop, six hours daily, using Systematization methodology with a Community Work Group (CWG). During the workshop, women systematized their experience, with compromise as axis of the process. Using Grounded Theory techniques, we applied micro-analysis to data in order to identify and strengthen categories that emerged during the systematization process. We completed open and axial coding. The CWG identified that commitment and participation itself is influenced by group dynamics and structural determinants. They also reconsidered the way they understood and exercised commitment and participation, and generated knowledge, empowering them to improve their future practice. Commitment and participation were determined by group dynamics and structural factors such as socioeconomic conditions and gender roles. These determinants must be visible and understood in order to generate proposals that are aimed at strengthening the participation and organization of groups.

The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review.

PubMed

Gray, Selena; Carmichael, Laurence; Barton, Hugh; Mytton, Julie; Lease, Helen; Joynt, Jennifer

2011-11-24

Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries.The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes), lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury) more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Research is needed to assess (i) the degree to which statutory plan appraisal processes (SA in the UK) incorporate health; (ii) whether recommendations arising from health appraisal translate into the development process and (iii) whether outcomes are as anticipated.

Organizing knowledge for tutoring fire loss prevention

Treesearch

Daniel L. Schmoldt

1989-01-01

The San Bernardino National Forest in southern California has recently developed a systematic approach to wildfire prevention planning. However, a comprehensive document or other mechanism for teaching this process to other prevention personnel does not exist. An intelligent tutorial expert system is being constructed to provide a means for learning the process and to...

Academy of Osseointegration's Summit on Clinical Practice Guidelines for the Edentulous Maxilla: Overview, Process, and Outcomes-Changing the Face of Implant Dentistry.

PubMed

Stanford, Clark M

2016-01-01

Starting in 2012, the Academy of Osseointegration initiated the planning process for an AO Summit to develop clinical practice guidelines (CPGs) for management of the edentulous maxilla. A planning committee led by Professor Clark Stanford and Dr Ole Jensen created a work plan based on five domain areas to be addressed by the summit. The five domain areas were defined as: (1) role of grafting for ridge development for implant placement, (2) role of implant design and systems in management of the edentulous maxilla, (3) role of imaging to guide implant placement, (4) role of biologics to assist in ridge development, and (5) role of prosthetic management. The summit was held in August 2014, and the results are presented in this overview. All of the supporting systematic reviews and the detailed CPGs are presented in this special edition of JOMI. While the evidence was observed to be weak in regard to the literature for most of the systematic reviews, the summit strived to establish the current best evidence and practical CPGs that will assist clinicians in practice.

Preparing for Educational Change: Incorporating the Support Curriculum into the Basic Curriculum.

ERIC Educational Resources Information Center

Hannifin, Michael J.; Barrett, Bradley K.

1983-01-01

Increased local control for support programs formerly federally funded will require planning and coordination. Curriculum systematization is a process for determining the compatibility of support programs with the existing local curriculum. (SK)

Guidance on Systematic Planning Using the Data Quality Objectives Process, EPA QA/G-4

EPA Pesticide Factsheets

Provides a standard working tool for project managers and planners to develop DQO for determining the type, quantity, and quality of data needed to reach defensible decisions or make credible estimates.

[Design of a HACCP Plan for the Gouda-type cheesemaking process in a milk processing plant].

PubMed

Dávila, Jacqueline; Reyes, Genara; Corzo, Otoniel

2006-03-01

The Hazard Analysis and Critical Control Point (HACCP) is a preventive and systematic method used to identify, assess and control of the hazards related with raw material, ingredients, processing, marketing and intended consumer in order to assure the safety of the food. The aim of this study was to design a HACCP plan for implementing in a Gouda-type cheese-making process in a dairy processing plant. The used methodology was based in the application of the seven principles of the HACCP, the information from the plant about the compliment of the pre-requisite programs (70-80%), the experience of the HACCP team and the sequence of stages settles down by the COVENIN standard 3802 for implementing the HACCP system. A HACCP plan was proposed with the scope, the selection of HACCP team, the description of the product and the intended use, the flow diagram of the process, the hazard analysis and the control table of the plan with the critical control points (CCP). The following CCP were identified in the process: pasteurization, coagulation and ripening.

Decision Support Model for Introduction of Gamification Solution Using AHP

PubMed Central

2014-01-01

Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform. PMID:24892075

Decision support model for introduction of gamification solution using AHP.

PubMed

Kim, Sangkyun

2014-01-01

Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform.

Modeling and analysis of power processing systems: Feasibility investigation and formulation of a methodology

NASA Technical Reports Server (NTRS)

Biess, J. J.; Yu, Y.; Middlebrook, R. D.; Schoenfeld, A. D.

1974-01-01

A review is given of future power processing systems planned for the next 20 years, and the state-of-the-art of power processing design modeling and analysis techniques used to optimize power processing systems. A methodology of modeling and analysis of power processing equipment and systems has been formulated to fulfill future tradeoff studies and optimization requirements. Computer techniques were applied to simulate power processor performance and to optimize the design of power processing equipment. A program plan to systematically develop and apply the tools for power processing systems modeling and analysis is presented so that meaningful results can be obtained each year to aid the power processing system engineer and power processing equipment circuit designers in their conceptual and detail design and analysis tasks.

Supporting adherence and healthy lifestyles in leg ulcer patients: systematic development of the Lively Legs program for dermatology outpatient clinics.

PubMed

Heinen, Maud M; Bartholomew, L Kay; Wensing, Michel; van de Kerkhof, Peter; van Achterberg, Theo

2006-05-01

The objective of our project was to develop a lifestyle program for leg ulcer patients at outpatient clinics for dermatology. We used the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. We started with a needs-assessment. A multidisciplinary project group of health care workers and patients was involved in all five IM steps; formulating proximal program objectives, selecting methods and strategies, producing program components, planning for adoption and implementation and planning for evaluation. Several systematic literature reviews and original studies were performed to support this process. Social Cognitive Theory was selected as the main theory behind the program 'Lively Legs' and was combined with elements of Goal-Setting Theory, the precaution adoption model and motivational interviewing. The program is conducted through health counseling by dermatology nurses and was successfully pre-tested. Also, an implementation and evaluation plan were made. Intervention mapping helped us to succeed in developing a lifestyle program with clear goals and methods, operational strategies and materials and clear procedures. Coaching leg ulcer patients towards adherence with compression therapy and healthy lifestyles should be taken on without delay. Systematic development of lifestyle programs for other patient groups should be encouraged.

A systematic policy approach to changing the food system and physical activity environments to prevent obesity.

PubMed

Sacks, Gary; Swinburn, Boyd A; Lawrence, Mark A

2008-06-05

As obesity prevention becomes an increasing health priority in many countries, including Australia and New Zealand, the challenge that governments are now facing is how to adopt a systematic policy approach to increase healthy eating and regular physical activity. This article sets out a structure for systematically identifying areas for obesity prevention policy action across the food system and full range of physical activity environments. Areas amenable to policy intervention can be systematically identified by considering policy opportunities for each level of governance (local, state, national, international and organisational) in each sector of the food system (primary production, food processing, distribution, marketing, retail, catering and food service) and each sector that influences physical activity environments (infrastructure and planning, education, employment, transport, sport and recreation). Analysis grids are used to illustrate, in a structured fashion, the broad array of areas amenable to legal and regulatory intervention across all levels of governance and all relevant sectors. In the Australian context, potential regulatory policy intervention areas are widespread throughout the food system, e.g., land-use zoning (primary production within local government), food safety (food processing within state government), food labelling (retail within national government). Policy areas for influencing physical activity are predominantly local and state government responsibilities including, for example, walking and cycling environments (infrastructure and planning sector) and physical activity education in schools (education sector). The analysis structure presented in this article provides a tool to systematically identify policy gaps, barriers and opportunities for obesity prevention, as part of the process of developing and implementing a comprehensive obesity prevention strategy. It also serves to highlight the need for a coordinated approach to policy development and implementation across all levels of government in order to ensure complementary policy action.

Integrating cultivation history into EBIPM

USDA-ARS?s Scientific Manuscript database

Ecologically based invasive plant management (EBIPM) is a systematic thinking and planning process to assist with applying the appropriate combination of tools and strategies to addrress the underlying cause of invasion rather than simply controlling invasive annual grass abundance. Cultivation his...

Statistical modeling of interfractional tissue deformation and its application in radiation therapy planning

NASA Astrophysics Data System (ADS)

Vile, Douglas J.

In radiation therapy, interfraction organ motion introduces a level of geometric uncertainty into the planning process. Plans, which are typically based upon a single instance of anatomy, must be robust against daily anatomical variations. For this problem, a model of the magnitude, direction, and likelihood of deformation is useful. In this thesis, principal component analysis (PCA) is used to statistically model the 3D organ motion for 19 prostate cancer patients, each with 8-13 fractional computed tomography (CT) images. Deformable image registration and the resultant displacement vector fields (DVFs) are used to quantify the interfraction systematic and random motion. By applying the PCA technique to the random DVFs, principal modes of random tissue deformation were determined for each patient, and a method for sampling synthetic random DVFs was developed. The PCA model was then extended to describe the principal modes of systematic and random organ motion for the population of patients. A leave-one-out study tested both the systematic and random motion model's ability to represent PCA training set DVFs. The random and systematic DVF PCA models allowed the reconstruction of these data with absolute mean errors between 0.5-0.9 mm and 1-2 mm, respectively. To the best of the author's knowledge, this study is the first successful effort to build a fully 3D statistical PCA model of systematic tissue deformation in a population of patients. By sampling synthetic systematic and random errors, organ occupancy maps were created for bony and prostate-centroid patient setup processes. By thresholding these maps, PCA-based planning target volume (PTV) was created and tested against conventional margin recipes (van Herk for bony alignment and 5 mm fixed [3 mm posterior] margin for centroid alignment) in a virtual clinical trial for low-risk prostate cancer. Deformably accumulated delivered dose served as a surrogate for clinical outcome. For the bony landmark setup subtrial, the PCA PTV significantly (p<0.05) reduced D30, D20, and D5 to bladder and D50 to rectum, while increasing rectal D20 and D5. For the centroid-aligned setup, the PCA PTV significantly reduced all bladder DVH metrics and trended to lower rectal toxicity metrics. All PTVs covered the prostate with the prescription dose.

[Application analysis of Nursing Care Systematization according to Horta's Conceptual Model].

PubMed

da Cunha, Sandra Maria Botelho; Barros, Alba Lúcia Botura Leite

2005-01-01

This study has as purpose to analyse the implementation of the Nursing Care Systematization in a private hospital in medical surgical units. Results evidenced that the Horta's Conceptual Model was present only in part of nursing hystory instrument, that the remaining phases of nursing process were not inter-related and that there was a lack of coherence of the prescribed actions in relation to the patient's health condition. From the results of the study it can be concluded that the model used for Nursing Care Systematization is eclectic, not obeying therefore, only to Horta's conceptual model; the totality of the data had not been collected in some phases of the nursing process; there is no correlation of the phases in the majority of analyzed patient records; diagnostic and planning phases do not comprise the phases of the nursing process as proposed by Horta.

Knowledge brokering on emissions modelling in Strategic Environmental Assessment of Estonian energy policy with special reference to the LEAP model

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

Kuldna, Piret, E-mail: piret.kuldna@seit.ee; Peterson, Kaja; Kuhi-Thalfeldt, Reeli

Strategic Environmental Assessment (SEA) serves as a platform for bringing together researchers, policy developers and other stakeholders to evaluate and communicate significant environmental and socio-economic effects of policies, plans and programmes. Quantitative computer models can facilitate knowledge exchange between various parties that strive to use scientific findings to guide policy-making decisions. The process of facilitating knowledge generation and exchange, i.e. knowledge brokerage, has been increasingly explored, but there is not much evidence in the literature on how knowledge brokerage activities are used in full cycles of SEAs which employ quantitative models. We report on the SEA process of the nationalmore » energy plan with reflections on where and how the Long-range Energy Alternatives Planning (LEAP) model was used for knowledge brokerage on emissions modelling between researchers and policy developers. Our main suggestion is that applying a quantitative model not only in ex ante, but also ex post scenario modelling and associated impact assessment can facilitate systematic and inspiring knowledge exchange process on a policy problem and capacity building of participating actors. - Highlights: • We examine the knowledge brokering on emissions modelling between researchers and policy developers in a full cycle of SEA. • Knowledge exchange process can evolve at any modelling stage within SEA. • Ex post scenario modelling enables systematic knowledge exchange and learning on a policy problem.« less

Understanding what helps or hinders asthma action plan use: a systematic review and synthesis of the qualitative literature.

PubMed

Ring, Nicola; Jepson, Ruth; Hoskins, Gaylor; Wilson, Caroline; Pinnock, Hilary; Sheikh, Aziz; Wyke, Sally

2011-11-01

To understand better what helps and/or hinders asthma action plan use from the professionals and patients/carers perspective. Systematic review and qualitative synthesis (using meta-ethnography). Nineteen studies (20 papers) were included in an analysis of patients/carers' and professionals' views. Seven main influences on action plan implementation were identified including perceived un-helpfulness and irrelevance of the plans. Translation and synthesis of the original authors' interpretations suggested that action plan promotion and use was influenced by professional and patient/carers' asthma beliefs and attitudes and patient/carer experiences of managing asthma. Action plan use is hindered because professionals and patients/carers have different explanatory models of asthma, its management and their respective roles in the management process. Patients/carers, based on their experiential knowledge of their condition, perceive themselves as capable, effective in managing their asthma, but health professionals do not always share this view. Professionally provided medically focused action plans that do not 'fit' with and incorporate the patients'/carers' views of asthma, and their management strategies, will continue to be under-utilised. Professionals need to develop a more patient-centred, partnership-based, approach to the joint development and review of action plans, recognising the experiential asthma knowledge of patients/carers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Beyond Staff Development: A Strategic Plan for School/Community Empowerment.

ERIC Educational Resources Information Center

Johnson, Daniel P.

At the beginning of his tenure in 1987, the superintendent of Clear Creek School District (Colorado) found that the district had no written K-12 curriculum, no ongoing process for developing such a curriculum, and no systematic process for staff development. To provide for change based on projected student needs for the 21st century, the…

The evolution of the cancer formulary review in Canada: Can centralization improve the use of economic evaluation?

PubMed

Wranik, W Dominika; Gambold, Liesl; Hanson, Natasha; Levy, Adrian

2017-04-01

Public reimbursement of drugs is a costly proposition for health care systems. Decisions to add drugs to the public formulary are often guided by review processes and committees. The evolution of the formulary review process in Canada's publicly funded health system is characterized by increased centralization and systematization. In the past, the review of evidence and recommendation was conducted at the regional level, but was replaced with the pan-Canadian Oncology Drug Review in 2011. We assess the extent to which centralization and systematization of the review process have responded to past challenges, focusing on the use of economic evaluation in the process. Past challenges with economic evaluation experienced by regionalized review committees were identified from literature and qualitative data collected in the province of Nova Scotia. We categorize these using a typology with a macro-, meso, and micro-level hierarchy, which provides a useful framework for understanding at which level change is required, and who has the authority to influence change. Using grounded theory methods, we identify approaches used by Nova Scotia past committee members to compensate for perceived shortcomings of the process. These include an undue reliance on other committee members, on the multidisciplinarity of the committee, and on past decisions. Using a policy analysis approach, we argue that centralization and systematization of the review process only partially address the shortcomings of the previous regionalized process. Lessons from Canada can inform policy discussions across all health systems, where similar challenges with the formulary review process have been identified. © 2016 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd. © 2016 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

23 CFR 627.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS VALUE ENGINEERING... construction. Value Engineering (VE) analysis. The systematic process of reviewing and assessing a project by a...; and (3) Reducing the time to develop and deliver the project. Value Engineering (VE) Job Plan. A...

23 CFR 627.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS VALUE ENGINEERING... construction. Value Engineering (VE) analysis. The systematic process of reviewing and assessing a project by a...; and (3) Reducing the time to develop and deliver the project. Value Engineering (VE) Job Plan. A...

Readiness factors for information system strategic planning among universities in developing countries: a systematic review

NASA Astrophysics Data System (ADS)

Irfan, M.; Putra, S. J.; Alam, C. N.; Subiyakto, A.; Wahana, A.

2018-03-01

The implementation of information system strategic planning (ISSP) in higher education institutions is to improve work efficiency, management effectiveness in order to improve organizational competitive advantage. However, the question of whether all universities are ready to implement ISSP as a way to achieve organizational goals has not been answered. This study aims to investigate the readiness phenomena through literature study. The method used is by using the Systematic Literature Review (SLR) instrument to identify readiness factors on the implementation of ISSP, especially among the institutions of higher education in developing countries. This study has identified 10 readiness measurement. There are three categories of measurement, namely people, processes and technologies that represent 11 factors of ISSP readiness measurement in universities.

The Mental Health Outcomes of Drought: A Systematic Review and Causal Process Diagram

PubMed Central

Vins, Holly; Bell, Jesse; Saha, Shubhayu; Hess, Jeremy J.

2015-01-01

Little is understood about the long term, indirect health consequences of drought (a period of abnormally dry weather). In particular, the implications of drought for mental health via pathways such as loss of livelihood, diminished social support, and rupture of place bonds have not been extensively studied, leaving a knowledge gap for practitioners and researchers alike. A systematic review of literature was performed to examine the mental health effects of drought. The systematic review results were synthesized to create a causal process diagram that illustrates the pathways linking drought effects to mental health outcomes. Eighty-two articles using a variety of methods in different contexts were gathered from the systematic review. The pathways in the causal process diagram with greatest support in the literature are those focusing on the economic and migratory effects of drought. The diagram highlights the complexity of the relationships between drought and mental health, including the multiple ways that factors can interact and lead to various outcomes. The systematic review and resulting causal process diagram can be used in both practice and theory, including prevention planning, public health programming, vulnerability and risk assessment, and research question guidance. The use of a causal process diagram provides a much needed avenue for integrating the findings of diverse research to further the understanding of the mental health implications of drought. PMID:26506367

Resolution of an Orbital Issue: A Designed Experiment

NASA Technical Reports Server (NTRS)

Huddleston, Lisa L.

2011-01-01

Design of Experiments (DOE) is a systematic approach to investigation of a system or process. A series of structured tests are designed in which planned changes are made to the input variables of a process or system. The effects of these changes on a pre-defined output are then assessed. DOE is a formal method of maximizing information gained while minimizing resources required.

A decision support system using analytical hierarchy process (AHP) for the optimal environmental reclamation of an open-pit mine

NASA Astrophysics Data System (ADS)

Bascetin, A.

2007-04-01

The selection of an optimal reclamation method is one of the most important factors in open-pit design and production planning. It also affects economic considerations in open-pit design as a function of plan location and depth. Furthermore, the selection is a complex multi-person, multi-criteria decision problem. The group decision-making process can be improved by applying a systematic and logical approach to assess the priorities based on the inputs of several specialists from different functional areas within the mine company. The analytical hierarchy process (AHP) can be very useful in involving several decision makers with different conflicting objectives to arrive at a consensus decision. In this paper, the selection of an optimal reclamation method using an AHP-based model was evaluated for coal production in an open-pit coal mine located at Seyitomer region in Turkey. The use of the proposed model indicates that it can be applied to improve the group decision making in selecting a reclamation method that satisfies optimal specifications. Also, it is found that the decision process is systematic and using the proposed model can reduce the time taken to select a optimal method.

RELAP-7 Code Assessment Plan and Requirement Traceability Matrix

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

Yoo, Junsoo; Choi, Yong-joon; Smith, Curtis L.

2016-10-01

The RELAP-7, a safety analysis code for nuclear reactor system, is under development at Idaho National Laboratory (INL). Overall, the code development is directed towards leveraging the advancements in computer science technology, numerical solution methods and physical models over the last decades. Recently, INL has also been putting an effort to establish the code assessment plan, which aims to ensure an improved final product quality through the RELAP-7 development process. The ultimate goal of this plan is to propose a suitable way to systematically assess the wide range of software requirements for RELAP-7, including the software design, user interface, andmore » technical requirements, etc. To this end, we first survey the literature (i.e., international/domestic reports, research articles) addressing the desirable features generally required for advanced nuclear system safety analysis codes. In addition, the V&V (verification and validation) efforts as well as the legacy issues of several recently-developed codes (e.g., RELAP5-3D, TRACE V5.0) are investigated. Lastly, this paper outlines the Requirement Traceability Matrix (RTM) for RELAP-7 which can be used to systematically evaluate and identify the code development process and its present capability.« less

Evidence development and publication planning: strategic process.

PubMed

Wittek, Michael R; Jo Williams, Mary; Carlson, Angeline M

2009-11-01

A number of decisions in the health care field rely heavily on published clinical evidence. A systematic approach to evidence development and publication planning is required to develop a portfolio of evidence that includes at minimum information on efficacy, safety, durability of effect, quality of life, and economic outcomes. The approach requires a critical assessment of available literature, identification of gaps in the literature, and a strategic plan to fill the gaps to ensure the availability of evidence demanded for clinical decisions, coverage/payment decisions and health technology assessments. The purpose of this manuscript is to offer a six-step strategic process leading to a portfolio of evidence that meets the informational needs of providers, payers, and governmental agencies concerning patient access to a therapy.

Health Workforce Planning

PubMed Central

Al-Sawai, Abdulaziz; Al-Shishtawy, Moeness M.

2015-01-01

In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested. PMID:25685381

Views and Experiences of Persons with Chronic Diseases about Strategies that Aim to Integrate and Re-Integrate Them into Work: A Systematic Review of Qualitative Studies.

PubMed

Esteban, Eva; Coenen, Michaela; Ito, Elizabeth; Gruber, Sonja; Scaratti, Chiara; Leonardi, Matilde; Roka, Olga; Vasilou, Evdokia; Muñoz-Murillo, Amalia; Ávila, Carolina C; Kovačič, Dare S; Ivandic, Ivana; Sabariego, Carla

2018-05-18

The effectiveness of strategies targeting professional integration and reintegration strongly depends on the experiences of participants. The aim of this systematic literature review is to synthesize European qualitative studies exploring views and experiences of persons with chronic conditions regarding strategies for integration and reintegration into work. The systematic search was conducted in Medline, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 24 studies published in English between January 2011 and April 2016 were included. Most studies were carried out in Nordic countries or in the UK, and most participants were persons with either mental or musculoskeletal disorders. Ten themes emerged: individual and holistic approach, clarity of strategy and processes, timing of rehabilitation processes, experience with professionals, at the workplace and with peer groups, changes in the understanding of health and work, active involvement in the process, competencies development and motivating aspects of work. Findings highlight, among others, the need to actively involve participants in the return to work process and to provide timely and clearly structured processes and interventions. This review provides stakeholders key information to develop, plan, implement and evaluate interventions to integrate and re-integrate persons with chronic conditions into work in Europe.

Views and Experiences of Persons with Chronic Diseases about Strategies that Aim to Integrate and Re-Integrate Them into Work: A Systematic Review of Qualitative Studies

PubMed Central

Ito, Elizabeth; Gruber, Sonja; Scaratti, Chiara; Roka, Olga; Vasilou, Evdokia; Muñoz-Murillo, Amalia; Ávila, Carolina C.; Kovačič, Dare S.; Ivandic, Ivana

2018-01-01

The effectiveness of strategies targeting professional integration and reintegration strongly depends on the experiences of participants. The aim of this systematic literature review is to synthesize European qualitative studies exploring views and experiences of persons with chronic conditions regarding strategies for integration and reintegration into work. The systematic search was conducted in Medline, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 24 studies published in English between January 2011 and April 2016 were included. Most studies were carried out in Nordic countries or in the UK, and most participants were persons with either mental or musculoskeletal disorders. Ten themes emerged: individual and holistic approach, clarity of strategy and processes, timing of rehabilitation processes, experience with professionals, at the workplace and with peer groups, changes in the understanding of health and work, active involvement in the process, competencies development and motivating aspects of work. Findings highlight, among others, the need to actively involve participants in the return to work process and to provide timely and clearly structured processes and interventions. This review provides stakeholders key information to develop, plan, implement and evaluate interventions to integrate and re-integrate persons with chronic conditions into work in Europe. PMID:29783671

A Guide to Writing a Qualitative Systematic Review Protocol to Enhance Evidence-Based Practice in Nursing and Health Care.

PubMed

Butler, Ashleigh; Hall, Helen; Copnell, Beverley

2016-06-01

The qualitative systematic review is a rapidly developing area of nursing research. In order to present trustworthy, high-quality recommendations, such reviews should be based on a review protocol to minimize bias and enhance transparency and reproducibility. Although there are a number of resources available to guide researchers in developing a quantitative review protocol, very few resources exist for qualitative reviews. To guide researchers through the process of developing a qualitative systematic review protocol, using an example review question. The key elements required in a systematic review protocol are discussed, with a focus on application to qualitative reviews: Development of a research question; formulation of key search terms and strategies; designing a multistage review process; critical appraisal of qualitative literature; development of data extraction techniques; and data synthesis. The paper highlights important considerations during the protocol development process, and uses a previously developed review question as a working example. This paper will assist novice researchers in developing a qualitative systematic review protocol. By providing a worked example of a protocol, the paper encourages the development of review protocols, enhancing the trustworthiness and value of the completed qualitative systematic review findings. Qualitative systematic reviews should be based on well planned, peer reviewed protocols to enhance the trustworthiness of results and thus their usefulness in clinical practice. Protocols should outline, in detail, the processes which will be used to undertake the review, including key search terms, inclusion and exclusion criteria, and the methods used for critical appraisal, data extraction and data analysis to facilitate transparency of the review process. Additionally, journals should encourage and support the publication of review protocols, and should require reference to a protocol prior to publication of the review results. © 2016 Sigma Theta Tau International.

From principles to practice: a spatial approach to systematic conservation planning in the deep sea.

PubMed

Wedding, L M; Friedlander, A M; Kittinger, J N; Watling, L; Gaines, S D; Bennett, M; Hardy, S M; Smith, C R

2013-12-22

Increases in the demand and price for industrial metals, combined with advances in technological capabilities have now made deep-sea mining more feasible and economically viable. In order to balance economic interests with the conservation of abyssal plain ecosystems, it is becoming increasingly important to develop a systematic approach to spatial management and zoning of the deep sea. Here, we describe an expert-driven systematic conservation planning process applied to inform science-based recommendations to the International Seabed Authority for a system of deep-sea marine protected areas (MPAs) to safeguard biodiversity and ecosystem function in an abyssal Pacific region targeted for nodule mining (e.g. the Clarion-Clipperton fracture zone, CCZ). Our use of geospatial analysis and expert opinion in forming the recommendations allowed us to stratify the proposed network by biophysical gradients, maximize the number of biologically unique seamounts within each subregion, and minimize socioeconomic impacts. The resulting proposal for an MPA network (nine replicate 400 × 400 km MPAs) covers 24% (1 440 000 km(2)) of the total CCZ planning region and serves as example of swift and pre-emptive conservation planning across an unprecedented area in the deep sea. As pressure from resource extraction increases in the future, the scientific guiding principles outlined in this research can serve as a basis for collaborative international approaches to ocean management.

From principles to practice: a spatial approach to systematic conservation planning in the deep sea

PubMed Central

Wedding, L. M.; Friedlander, A. M.; Kittinger, J. N.; Watling, L.; Gaines, S. D.; Bennett, M.; Hardy, S. M.; Smith, C. R.

2013-01-01

Increases in the demand and price for industrial metals, combined with advances in technological capabilities have now made deep-sea mining more feasible and economically viable. In order to balance economic interests with the conservation of abyssal plain ecosystems, it is becoming increasingly important to develop a systematic approach to spatial management and zoning of the deep sea. Here, we describe an expert-driven systematic conservation planning process applied to inform science-based recommendations to the International Seabed Authority for a system of deep-sea marine protected areas (MPAs) to safeguard biodiversity and ecosystem function in an abyssal Pacific region targeted for nodule mining (e.g. the Clarion–Clipperton fracture zone, CCZ). Our use of geospatial analysis and expert opinion in forming the recommendations allowed us to stratify the proposed network by biophysical gradients, maximize the number of biologically unique seamounts within each subregion, and minimize socioeconomic impacts. The resulting proposal for an MPA network (nine replicate 400 × 400 km MPAs) covers 24% (1 440 000 km2) of the total CCZ planning region and serves as example of swift and pre-emptive conservation planning across an unprecedented area in the deep sea. As pressure from resource extraction increases in the future, the scientific guiding principles outlined in this research can serve as a basis for collaborative international approaches to ocean management. PMID:24197407

Goal planning: a retrospective audit of rehabilitation process and outcome.

PubMed

Duff, Jane; Evans, Matthew J; Kennedy, Paul

2004-05-01

To consider the effectiveness of a goal planning programme for people with spinal cord injury (SCI) and address some of the current evidence gaps in goal setting. Retrospective audit. Consecutive series of 65 newly injured SCI patients. The Needs Assessment Checklist (NAC) has been specifically developed for the SCI population, and is used to assess patient attainment in core rehabilitation areas. A 'Goal Planning Progress' form was also used to specifically detail the goal planning process. Across the 65 patients, 396 goal planning meetings were held with 6176 goals set in total. Seventy-two per cent of the goals set at the first goal planning meeting were achieved by the second meeting. The rate of achievement at subsequent meetings was 68%. Significant differences in the number of planned rehabilitation days, number of goal planning meetings, and goals set were identified between injury categories. Significant positive correlations were found between the number of goals set and achievement, as measured by the NAC, in certain rehabilitation domains. The findings of this study demonstrate that the Needs Assessment and Goal Planning framework is effective in planning SCI rehabilitation. The capacity of this goal planning system to reflect individual need has also been established. Further systematic analyses of this process could potentially lead to more efficient rehabilitation and the identification of care pathways within clinical areas.

A Systematic Approach to Optimize Organizations Operating in Uncertain Environments: Design Methodology and Applications

DTIC Science & Technology

2002-09-01

sub-goal can lead to achieving different goals (e.g., automation of on-line order processing may lead to both reducing the storage cost and reducing...equipment Introduce new technology Find cheaper supplier Sign a contract Introduce cheaper materials Set up and automate on-line order processing Integrate... order processing with inventory and shipping Set up company’s website Freight consolidation Just-in-time versus pre-planned balance

CQI: using the Hoshin planning system to design an orientation process.

PubMed

Platt, D; Laird, C

1995-01-01

The Hoshin planning system, developed in Japan after World War II, includes management tools intended specifically for planning new processes. There are seven tools, which can be used individually or in any combination: affinity diagrams, interrelationship digraphs, systematic diagrams, matrix diagrams, process decision program charts, arrow diagrams and prioritization matrices. The radiology department at Carson-Tahoe Hospital formed a CQI team to improve the training of front office clerks. The team quickly discovered that a new orientation program was needed and decided to use Hoshin tools to create one. Using the tools, the team identified and prioritized all relevant factors, described specific tasks needed to complete the planning process and how long each would take, anticipated problems, and assigned areas of responsibility to members of the team. Each time the team grew weary or discouraged, the clarity and organization afforded by the tools helped them feel productive and in control of the process. The team was amazed at the creative ideas they generated through this 3-month-long process. Not only did they develop and implement a new orientation program, they also cultivated a stronger sense of pride and confidence in their work and each other.

A whole school approach: collaborative development of school health policies, processes, and practices.

PubMed

Hunt, Pete; Barrios, Lisa; Telljohann, Susan K; Mazyck, Donna

2015-11-01

The Whole School, Whole Community, Whole Child (WSCC) model shows the interrelationship between health and learning and the potential for improving educational outcomes by improving health outcomes. However, current descriptions do not explain how to implement the model. The existing literature, including scientific articles, programmatic guidance, and publications by national agencies and organizations, was reviewed and synthesized to describe an overview of interrelatedness of learning and health and the 10 components of the WSCC model. The literature suggests potential benefits of applying the WSCC model at the district and school level. But, the model lacks specific guidance as to how this might be made actionable. A collaborative approach to health and learning is suggested, including a 10-step systematic process to help schools and districts develop an action plan for improving health and education outcomes. Essential preliminary actions are suggested to minimize the impact of the challenges that commonly derail systematic planning processes and program implementation, such as lack of readiness, personnel shortages, insufficient resources, and competing priorities. All new models require testing and evidence to confirm their value. District and schools will need to test this model and put plans into action to show that significant, substantial, and sustainable health and academic outcomes can be achieved. © 2015 The Authors. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.

A systematic strategic planning process focused on improved community engagement by an academic health center: the University of Kansas Medical Center's story.

PubMed

Cook, David C; Nelson, Eve-Lynn; Ast, Cori; Lillis, Teresa

2013-05-01

A growing number of academic health centers (AHCs) are considering approaches to expand collaboration with their communities in order to address complex and multisystem health concerns. In 2010, internal leaders at the University of Kansas Medical Center undertook a strategic planning process to enhance both community engagement activities and the scholarship resulting from these engagement activities. The authors describe the strategic planning process, recommendations, and actions associated with elevating community engagement within the AHC's mission and priorities. The strategic planning process included conducting an inventory of community engagement activities within the AHC; analyzing strengths, weaknesses, opportunities, and threats for community engagement work; and identifying goals and strategies to improve future community engagement activities and scholarship. The resulting road map for enhancing community engagement at their institution through 2015 consists of four main strategies: emphasize scholarship in community engagement, revise organizational structures to better facilitate community engagement, prioritize current engagement activities to ensure appropriate use of resources, and enhance communication of engagement initiatives to further develop stakeholder relationships.The authors also discuss implementation of the plan to date and highlight lessons learned that may inform other AHCs as they enhance and expand similar endeavors.

Preventing infant abductions: an infant security program transitioned into an interdisciplinary model.

PubMed

Hiner, Jacqueline; Pyka, Jeanine; Burks, Colleen; Pisegna, Lily; Gador, Rachel Ann

2012-01-01

Ensuring the safety of infants born in a hospital is a top priority and, therefore, requires a solid infant security plan. Using an interdisciplinary approach and a systematic change process, nursing leadership in collaboration with clinical nurses and security personnel analyzed the infant security program at this community hospital to identify vulnerabilities. By establishing an interdisciplinary approach to infant security, participants were able to unravel a complicated concept, systematically analyze the gaps, and agree to a plan of action. This resulted in improved communication and clarification of roles between the nursing and security divisions. Supply costs decreased by 17.4% after the first year of implementation. Most importantly, this project enhanced and strengthened the existing infant abduction prevention measures, hard wired the importance of infant security, and minimized vulnerabilities.

Instructional Specifications for Sentence Combining.

ERIC Educational Resources Information Center

Lawlor, Joseph

With particular focus on the need to provide a practical, systematic introduction to the concept of sentence combining and to the signals used to control the various combining operations, this paper provides detailed specifications for including sentence combining as part of a comprehensive plan for teaching the composing process. The…

Hospital capacity planning: from measuring stocks to modelling flows

PubMed Central

Wright, Stephen; Barlow, James; McKee, Martin

2010-01-01

Abstract The metric of “bed numbers” is commonly used in hospital planning, but it fails to capture key aspects of how hospital services are delivered. Drawing on a study of innovative hospital projects in Europe, we argue that hospital capacity planning should not be based on beds, but rather on the ability to deliver processes. We propose using approaches that are based on manufacturing theory such as “lean thinking” that focuses on the value that different processes add for the primary customer, i.e. the patient. We argue that it is beneficial to look at the hospital, not from the perspective of beds or specialties, but rather from the path taken by the patients who are treated in them, the respective processes delivered by health professionals and the facilities appropriate to those processes. Systematized care pathways seem to offer one avenue for achieving these goals. However, they need to be underpinned by a better understanding of the flows of patients, work and goods within a hospital, the bottlenecks that occur, and translation of this understanding into new capacity planning tools. PMID:20680129

Ten things to get right for marine conservation planning in the Coral Triangle.

PubMed

Weeks, Rebecca; Pressey, Robert L; Wilson, Joanne R; Knight, Maurice; Horigue, Vera; Abesamis, Rene A; Acosta, Renerio; Jompa, Jamaluddin

2014-01-01

Systematic conservation planning increasingly underpins the conservation and management of marine and coastal ecosystems worldwide. Amongst other benefits, conservation planning provides transparency in decision-making, efficiency in the use of limited resources, the ability to minimise conflict between diverse objectives, and to guide strategic expansion of local actions to maximise their cumulative impact. The Coral Triangle has long been recognised as a global marine conservation priority, and has been the subject of huge investment in conservation during the last five years through the Coral Triangle Initiative on Coral Reefs, Fisheries and Food Security. Yet conservation planning has had relatively little influence in this region. To explore why this is the case, we identify and discuss 10 challenges that must be resolved if conservation planning is to effectively inform management actions in the Coral Triangle. These are: making conservation planning accessible; integrating with other planning processes; building local capacity for conservation planning; institutionalising conservation planning within governments; integrating plans across governance levels; planning across governance boundaries; planning for multiple tools and objectives; understanding limitations of data; developing better measures of progress and effectiveness; and making a long term commitment. Most important is a conceptual shift from conservation planning undertaken as a project, to planning undertaken as a process, with dedicated financial and human resources committed to long-term engagement.

Evaluation of participatory planning: Lessons from Hungarian Natura 2000 management planning processes.

PubMed

Kovács, Eszter; Kelemen, Eszter; Kiss, Gabriella; Kalóczkai, Ágnes; Fabók, Veronika; Mihók, Barbara; Megyesi, Boldizsár; Pataki, György; Bodorkós, Barbara; Balázs, Bálint; Bela, Györgyi; Margóczi, Katalin; Roboz, Ágnes; Molnár, Dániel

2017-12-15

Stakeholder participation in nature conservation policies and especially in the management of protected areas has gained importance in the last decades. These changes are underlined by democratic principles and the perceived contribution of stakeholder involvement to the effectiveness of conservation management. Evaluating participatory processes is essential to learn about the past and thus increase the quality of future processes. The evaluation can be useful for the organisations responsible for planning and management, stakeholders and policy makers as well. The present paper shows the results of a systematic evaluation of 25 participatory processes related to the development of management plans for Natura 2000 sites in Hungary between 2007 and 2015. A conceptual framework was developed to evaluate the process and outcome of participatory management planning processes. Criteria were based on the scientific literature on public participation and tailored to conservation-related management planning and stakeholder involvement. Evaluated processes were grouped in three cases based on their time range and financial sources. Overall, the analysed processes scored at a medium level, showing better performance in the process criteria than in the outcome criteria. The best case scored significantly higher in four criteria compared to the other cases: representativeness, resource availability for facilitation, new, creative ideas and impact on the plan. The main factors behind the success were (1) embeddedness of the planning process in a larger project, where the plan was a tool for conservation, (2) carrying out only one process at a time, (3) previous experience of facilitators and planners with participatory planning and (4) the opportunity and capacity to propose a payment scheme as an incentive. But even this case received low scores in some criteria: conflict resolution, early involvement and well defined goals. Based on the results we suggest that more data is needed to evaluate the implementation of the plans and, in many cases, the impact of the process on the plan. Performance can be improved with the assistance of policy makers by further developing guidelines, harmonising payment schemes with the conservation measures of the plans and providing training on conflict resolution. The evaluation framework proved to be suitable for the assessment of a large set of conservation related management planning processes, but it also had some limitations, e.g. concerning the incorporation of stakeholders' views in the evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multidisciplinary care planning in the primary care management of completed stroke: a systematic review

PubMed Central

Mitchell, Geoffrey K; Brown, Robyn M; Erikssen, Lars; Tieman, Jennifer J

2008-01-01

Background Chronic disease management requires input from multiple health professionals, both specialist and primary care providers. This study sought to assess the impact of co-ordinated multidisciplinary care in primary care, represented by the delivery of formal care planning by primary care teams or shared across primary-secondary teams, on outcomes in stroke, relative to usual care. Methods A Systematic review of Medline, EMBASE, CINAHL (all 1990–2006), Cochrane Library (Issue 1 2006), and grey literature from web based searching of web sites listed in the CCOHA Health Technology Assessment List Analysis used narrative analysis of findings of randomised and non-randomised trials, and observational and qualitative studies of patients with completed stroke in the primary care setting where care planning was undertaken by 1) a multi-disciplinary primary care team or 2) through shared care by primary and secondary providers. Results One thousand and forty-five citations were retrieved. Eighteen papers were included for analysis. Most care planning took part in the context of multidisciplinary team care based in hospitals with outreach to community patients. Mortality rates are not impacted by multidisciplinary care planning. Functional outcomes of the studies were inconsistent. It is uncertain whether the active engagement of GPs and other primary care professionals in the multidisciplinary care planning contributed to the outcomes in the studies showing a positive effect. There may be process benefits from multidisciplinary care planning that includes primary care professionals and GPs. Few studies actually described the tasks and roles GPs fulfilled and whether this matched what was presumed to be provided. Conclusion While multidisciplinary care planning may not unequivocally improve the care of patients with completed stroke, there may be process benefits such as improved task allocation between providers. Further study on the impact of active GP involvement in multidisciplinary care planning is warranted. PMID:18681977

Quasi-experimental Study of Systematic Screening for Family Planning Services among Postpartum Women Attending Village Health and Nutrition Days in Jharkhand, India.

PubMed

Balasubramaniam, Sudharsanam; Kumar, Somesh; Sethi, Reena; Charurat, Elaine; Lalchandani, Kamlesh; Schuster, Anne; Sood, Bulbul

2018-01-25

Systematic screening helps increase family planning uptake through integration with other services, including immunization. Though successfully demonstrated at health facilities, this strategy has not been demonstrated in communities. This study assessed the effectiveness of systematic screening to increase postpartum family planning use during community health days in India without adversely affecting immunization services. The study was conducted during 180 individual Village Health and Nutrition Days in Jharkhand, India. All health workers were trained in postpartum family planning counseling. Intervention providers were also trained in systematic screening. 217 postpartum women aged 15-49 years participated in baseline and endline exit interviews and routine service statistics were analyzed from 2,485 facility visits at affiliated health centers. No difference in family planning service use was found in the intervention group, but significantly fewer interviewed women reported receiving family planning services at endline in the comparison group (p = 0.014). Family planning acceptance at affiliated health centers increased significantly in intervention areas (p < 0.001) but not in comparison areas, while immunization service use increased in both groups (p = 0.002 intervention, p < 0.001 comparison). The use of the postpartum systematic screening tool appears to increase acceptance of family planning services when integrated with community-based services in Jharkhand.

Program Review: A Critical Analysis of Departmental Effectiveness. Revised.

ERIC Educational Resources Information Center

Huffman, Zoula; And Others

Describing the evaluation and planning process at Mississippi Gulf Coast Community College, this document presents guidelines, procedures, and indicators used at the college for the systematic review of academic departmental effectiveness. First, the five-column program review model used at the college is outlined and the purposes of review are…

Action Research Empowers School Librarians

ERIC Educational Resources Information Center

Robins, Jennifer

2015-01-01

Successful school library programs occur through careful planning and reflection. This reflective process is improved when it is applied in a systematic way through action research. The action research described in this paper enabled school librarians to reflect based on evidence, using data they had collected. This study presents examples of the…

Manchester College, Funderburg Library. Report of the Self-Study.

ERIC Educational Resources Information Center

Association of Research Libraries, Washington, DC. Office of Management Studies.

This report on the results of a new program to systematically examine and strengthen the role of the library in the college's instructional process is organized into three main sections: situational analysis, needs assessment, and action planning. The first section discusses current developments in higher education, including economic trends,…

Review of Education-Focused Health Impact Assessments Conducted in the United States

ERIC Educational Resources Information Center

Gase, Lauren N.; DeFosset, Amelia R.; Gakh, Maxim; Harris, Celia; Weisman, Susan R.; Dannenberg, Andrew L.

2017-01-01

Background: Health impact assessment (HIA) provides a structured process for examining the potential health impacts of proposed policies, plans, programs, and projects. This study systematically reviewed HIAs conducted in the United States on prekindergarten, primary, and secondary education-focused decisions. Methods: Relevant HIA reports were…

Nutzwertanalyse

Treesearch

A. Henne

1978-01-01

Nutzwertanalyse (NUWA) is a psychometric instrument for finding the test compromise in the multiple use planning of forestry, when the multiple objectives cannot be expressed in the same physical or monetary unit. It insures a systematic assessment of the consequences of proposed alternatives and thoroughly documents the decision process. The method leads to a ranking...

Case for Quality Assurance in ESP [English For Specific Purposes] Programmes.

ERIC Educational Resources Information Center

Tan San Yee, Christine

There is now a need, just like in industry, for quality assurance in education, for injecting systematically planned and formal processes, precise definitions, objectivity, and measurability in education. The demand for educational excellence in industry is "out there," and companies in more advanced countries are partnering educational…

Implementing Student-Centered Transition in Maine Schools: Guidelines for Developing Procedures and Practices.

ERIC Educational Resources Information Center

University of Southern Maine, Portland. Human Services Development Inst.

A deliberate, systematic approach is presented for assisting students with handicaps through the transition process from school to adult life. The key elements of transition are identified as: longitudinal vocational and independent living skills training; cooperative and interagency transition planning; parent, student, employer, and…

Conducting survey research at nursing conferences.

PubMed

Sleutel, M R

2001-01-01

Conferences can provide large numbers of potential subjects in one location, yet there is little published guidance on how to collect data at a conference site. A computer search revealed no citations on this topic. This article outlines a systematic strategy to plan and perform research at conferences. This article provides a step-by-step process to guide researchers in planning and conducting survey research at conferences. Initial components in planning data collection at a conference include making a timeline and getting permission. Detailed advanced planning involves specific strategies for attracting participants, and for distributing and collecting the questionnaires. Travel provisions and on-site logistical approaches are explained, followed by suggestions for post-conference activities.

Process Evaluation for Improving K12 Program Effectiveness: Case Study of a National Institutes of Health Building Interdisciplinary Research Careers in Women's Health Research Career Development Program.

PubMed

Raymond, Nancy C; Wyman, Jean F; Dighe, Satlaj; Harwood, Eileen M; Hang, Mikow

2018-06-01

Process evaluation is an important tool in quality improvement efforts. This article illustrates how a systematic and continuous evaluation process can be used to improve the quality of faculty career development programs by using the University of Minnesota's Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 program as an exemplar. Data from a rigorous process evaluation incorporating quantitative and qualitative measurements were analyzed and reviewed by the BIRCWH program leadership on a regular basis. Examples are provided of how this evaluation model and processes were used to improve many aspects of the program, thereby improving scholar, mentor, and advisory committee members' satisfaction and scholar outcomes. A rigorous evaluation plan can increase the effectiveness and impact of a research career development plan.

NASA's future plans for lunar astronomy and astrophysics

NASA Technical Reports Server (NTRS)

Stachnik, Robert V.; Kaplan, Michael S.

1994-01-01

An expanding scientific interest in astronomical observations from the Moon has led the National Aeronautics and Space Administration (NASA) to develop a two-part strategy for lunar-astrophysics planning. The strategy emphasizes a systematic review process involving both the external scientific community and internal NASA engineering teams, coupled with the rigorous exclusion of projects inappropriate to lunar emplacement. Five major candidate lunar-astronomy projects are described, together with a modest derivative of one of them that could be implemented early in the establishment of a lunar base.

Urban Climate Map System for Dutch spatial planning

NASA Astrophysics Data System (ADS)

Ren, Chao; Spit, Tejo; Lenzholzer, Sanda; Yim, Hung Lam Steve; Heusinkveld, Bert; van Hove, Bert; Chen, Liang; Kupski, Sebastian; Burghardt, René; Katzschner, Lutz

2012-08-01

Facing climate change and global warming, outdoor climatic environment is an important consideration factor for planners and policy makers because improving it can greatly contribute to achieve citizen's thermal comfort and create a better urban living quality for adaptation. Thus, the climatic information must be assessed systematically and applied strategically into the planning process. This paper presents a tool named Urban Climate Map System (UCMS) that has proven capable of helping compact cities to incorporate climate effects in planning processes in a systematic way. UCMS is developed and presented in a Geographic Information System (GIS) platform in which the lessons learned and experience gained from interdisciplinary studies can be included. The methodology of UCMS of compact cities, the construction procedure, and the basic input factors - including the natural climate resources and planning data - are described. Some literatures that shed light on the applicability of UMCS are reported. The Municipality of Arnhem is one of Dutch compact urban areas and still under fast urban development and urban renewal. There is an urgent need for local planners and policy makers to protect local climate and open landscape resources and make climate change adaptation in urban construction. Thus, Arnhem is chosen to carry out a case study of UCMS. Although it is the first work of Urban Climatic Mapping in The Netherlands, it serves as a useful climatic information platform to local planners and policy makers for their daily on-going works. We attempt to use a quick method to collect available climatic and planning data and create an information platform for planning use. It relies mostly on literature and theoretical understanding that has been well practiced elsewhere. The effort here is to synergize the established understanding for a case at hand and demonstrate how useful guidance can still be made for planners and policy makers.

[Systematization of nursing assistance to patients with diabetes mellitus and chronic renal failure].

PubMed

Mascarenhas, Nildo Batista; Pereira, Álvaro; da Silva, Rudval Souza; da Silva, Mary Gomes

2011-01-01

This is a clinical case study developed during the practical activities of the discipline Surgical Clinical Nursing I, of course of Graduation in Nursing of a public university of Bahia State, that aimed to report the application of the Systematization of Nursing Assistance in the assistance to a client whit Diabetes Mellitus and Chronic Renal Insufficiency. With the development of the study, especially after the positive improvement of the client, face to assistance planned and implemented and considering the reflections that emerged, it was possible to evidence the need for interface between Systematization of Nursing Assistance, the nursing staff and client in the care process, at the excellence and uniqueness of nursing care.

Spatio-Temporal Process Variability in Watershed Scale Wetland Restoration Planning

NASA Astrophysics Data System (ADS)

Evenson, G. R.

2012-12-01

Watershed scale restoration decision making processes are increasingly informed by quantitative methodologies providing site-specific restoration recommendations - sometimes referred to as "systematic planning." The more advanced of these methodologies are characterized by a coupling of search algorithms and ecological models to discover restoration plans that optimize environmental outcomes. Yet while these methods have exhibited clear utility as decision support toolsets, they may be critiqued for flawed evaluations of spatio-temporally variable processes fundamental to watershed scale restoration. Hydrologic and non-hydrologic mediated process connectivity along with post-restoration habitat dynamics, for example, are commonly ignored yet known to appreciably affect restoration outcomes. This talk will present a methodology to evaluate such spatio-temporally complex processes in the production of watershed scale wetland restoration plans. Using the Tuscarawas Watershed in Eastern Ohio as a case study, a genetic algorithm will be coupled with the Soil and Water Assessment Tool (SWAT) to reveal optimal wetland restoration plans as measured by their capacity to maximize nutrient reductions. Then, a so-called "graphical" representation of the optimization problem will be implemented in-parallel to promote hydrologic and non-hydrologic mediated connectivity amongst existing wetlands and sites selected for restoration. Further, various search algorithm mechanisms will be discussed as a means of accounting for temporal complexities such as post-restoration habitat dynamics. Finally, generalized patterns of restoration plan optimality will be discussed as an alternative and possibly superior decision support toolset given the complexity and stochastic nature of spatio-temporal process variability.

Systematic planning of disconnection to enhance conservation success in a modified world.

PubMed

Hermoso, Virgilio; Januchowski-Hartley, Stephanie R; Linke, Simon

2015-12-01

Maintaining spatial-temporal connectivity for conservation is necessary to allow the persistence of ecological processes and the biodiversity they sustain. However, conservation practice in human-modified environments can also benefit from prescribed disconnection through the implementation of barriers. Barriers, such as fences or dams, and buffer zones can be a cost-effective way of addressing threats caused by a globally connected world, such as the propagation of invasive species and diseases, creating refuge areas for native biodiversity and helping reduce economic losses caused by native wildlife or invasive species. Despite the global attention that disconnection has received, no clear framework exists to guide the allocation of barriers for conservation management. Here we propose that the implementation of barriers for conservation should be systematically planned, considering ecological trade-offs for multiple species (easing threats vs. interruption of ecosystem processes) and socio-economic cost-benefits (implementation cost vs. reduced human-wildlife conflicts), rather than using ad-hoc opportunistic criteria or accommodating conservation needs for individual species. Such a systematic approach is necessary to ensure both socially acceptable and ecologically effective use of disconnections as a conservation tool and ideally planned across different realms so co-benefits or trade-offs can be accounted for. However, any implementation of disconnection for conservation should be cautiously considered if uncertainty in effectiveness of the barrier and ecological impacts to other species are high. We also suggest the need for improved approaches to monitoring to learn from previous successes and failures. Our recommendations should guide the systematic evaluation and allocation of barriers to help enhance the value of this conservation tool in the face of increasing propagation of threats worldwide. However, new tools and collaborative frameworks across different realms are needed to help stakeholders make better informed decision. Copyright © 2015 Elsevier B.V. All rights reserved.

Systematic Planning for Educational Facilities.

ERIC Educational Resources Information Center

McGuffey, Carroll W.

This monograph provides a systematic approach to the problem of planning educational facilities. It first presents a conceptual framework for a general facilities planning and management system called Facilities Resource Allocation Management Evaluation System (FRAMES). The main components of FRAMES are identified as: (1) needs assessment, (2)…

SU-F-T-195: Systematic Constraining of Contralateral Parotid Gland Led to Improved Dosimetric Outcomes for Multi-Field Optimization with Scanning Beam Proton Therapy: Promising Results From a Pilot Study in Patients with Base of Tongue Carcinoma

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

Wu, R; Liu, A; Poenisch, F

Purpose: Treatment planning for Intensity Modulated Proton Therapy (IMPT) for head and neck cancer is time-consuming due to the large number of organs-at-risk (OAR) to be considered. As there are many competing objectives and also wide range of acceptable OAR constraints, the final approved plan may not be most optimal for the given structures. We evaluated the dose reduction to the contralateral parotid by implementing standardized constraints during optimization for scanning beam proton therapy planning. Methods: Twenty-four (24) consecutive patients previously treated for base of tongue carcinoma were retrospectively selected. The doses were 70Gy, 63Gy and 57Gy (SIB in 33more » fractions) for high-, intermediate-, and standard-risk clinical target volumes (CTV), respectively; the treatment included bilateral neck. Scanning beams using MFO with standardized bilateral anterior oblique and PA fields were applied. New plans where then developed and optimized by employing additional contralateral parotid constraints at multiple defined dose levels. Using a step-wise iterative process, the volume-based constraints at each level were then further reduced until known target coverages were compromised. The newly developed plans were then compared to the original clinically approved plans using paired student t-testing. Results: All 24 newly optimized treatment plans maintained initial plan quality as compared to the approved plans, and the 98% prescription dose coverage to the CTV’s were not compromised. Representative DVH comparison is shown in FIGURE 1. The contralateral parotid doses were reduced at all levels of interest when systematic constraints were applied to V10, V20, V30 and V40Gy (All P<0.0001; TABLE 1). Overall, the mean contralateral parotid doses were reduced by 2.26 Gy on average, a ∼13% relative improvement. Conclusion: Applying systematic and volume-based contralateral parotid constraints for IMPT planning significantly reduced the dose at all dosimetric levels for patients with base of tongue cancer.« less

Framework and components for effective discharge planning system: a delphi methodology

PubMed Central

2012-01-01

Background To reduce avoidable hospital readmissions, effective discharge planning and appropriate post discharge support care are key requirements. This study is a 3-staged process to develop, pretest and pilot a framework for an effective discharge planning system in Hong Kong. This paper reports on the methodology of Delphi approach and findings of the second stage on pre-testing the framework developed so as to validate and attest to its applicability and practicability in which consensus was sought on the key components of discharge planning. Methods Delphi methodology was adopted to engage a group of experienced healthcare professionals to rate and discuss the framework and components of an effective discharge planning. The framework was consisted 36 statements under 5 major themes: initial screening, discharge planning process, coordination of discharge, implementation of discharge, and post discharge follow-up. Each statement was rated independently based on 3 aspects including clarity, validity and applicability on a 5-point Likert-scale. Statement with 75% or above of participants scoring 4–5 on all 3 aspects would be included in the discharge planning framework. For those statements not reaching 75% of consensus in any one of the aspect, it would be revised or discarded following the group discussion, and be re-rated in another round. Results A total of 24 participants participated in the consensus-building process. In round one rating, consensus was achieved in 25 out of 36 statements. Among those 11 statements not reaching consensus, the major concern was related to the “applicability” of the statements. The participants expressed a lack of manpower, skills and time in particular during weekends and long holidays in carrying out assessment and care plans within 24 h after admission. There were also timeliness and availability issue in providing transportation and necessary equipment to the patients. To make the statements more applicable, the wordings of some of the statements were revised to provide greater flexibility. Due to the lack of a statement in clarifying the role of the members of the healthcare professional team, one additional statement on the role and responsibility of the multidisciplinary team members was added. The first theme on “initial screening” was further revised to “initial screening and assessment” to better reflect the first stage of discharge planning process. After two rounds of rating process, all the 36 statements and the newly added statement reached consensus Conclusions A structured, systematic and coordinated system of hospital discharge system is required to facilitate the discharge process to ensure a smooth patient transition from the hospital to the community and improve patient health outcome in both clinical and social aspect. The findings of this paper provide a reference framework helping policymakers and hospital managers to facilitate the development of a coherent and systematized discharge planning process. Adopting a Delphi approach also demonstrates the values of the method as a pre-test (before the clinical run) of the components and requirements of a discharge planning system taking into account of the local context and system constraints, which would lead to improvements to its applicability and practicability. To confirm the applicability and practicability of this consensus framework for discharge planning system, the third stage of process of development of the discharge planning framework is to apply and pilot the framework in a hospital setting to evaluate its feasibility, applicability and impact in hospital including satisfaction from both the perspectives of staff and patients. PMID:23151173

Planning Multitechnology Access Networks with Performance Constraints

NASA Astrophysics Data System (ADS)

Chamberland, Steven

Considering the number of access network technologies and the investment needed for the “last mile” of a solution, in today’s highly competitive markets, planning tools are crucial for the service providers to optimize the network costs and accelerate the planning process. In this paper, we propose to tackle the problem of planning access networks composed of four technologies/architectures: the digital subscriber line (xDSL) technologies deployed directly from the central office (CO), the fiber-to-the-node (FTTN), the fiber-to-the-micro-node (FTTn) and the fiber-to-the-premises (FTTP). A mathematical programming model is proposed for this planning problem that is solved using a commercial implementation of the branch-and-bound algorithm. Next, a detailed access network planning example is presented followed by a systematic set of experiments designed to assess the performance of the proposed approach.

Ten things to get right for marine conservation planning in the Coral Triangle

PubMed Central

Weeks, Rebecca; Pressey, Robert L.; Wilson, Joanne R.; Knight, Maurice; Horigue, Vera; Abesamis, Rene A.; Acosta, Renerio; Jompa, Jamaluddin

2015-01-01

Systematic conservation planning increasingly underpins the conservation and management of marine and coastal ecosystems worldwide. Amongst other benefits, conservation planning provides transparency in decision-making, efficiency in the use of limited resources, the ability to minimise conflict between diverse objectives, and to guide strategic expansion of local actions to maximise their cumulative impact. The Coral Triangle has long been recognised as a global marine conservation priority, and has been the subject of huge investment in conservation during the last five years through the Coral Triangle Initiative on Coral Reefs, Fisheries and Food Security. Yet conservation planning has had relatively little influence in this region. To explore why this is the case, we identify and discuss 10 challenges that must be resolved if conservation planning is to effectively inform management actions in the Coral Triangle. These are: making conservation planning accessible; integrating with other planning processes; building local capacity for conservation planning; institutionalising conservation planning within governments; integrating plans across governance levels; planning across governance boundaries; planning for multiple tools and objectives; understanding limitations of data; developing better measures of progress and effectiveness; and making a long term commitment. Most important is a conceptual shift from conservation planning undertaken as a project, to planning undertaken as a process, with dedicated financial and human resources committed to long-term engagement. PMID:25110579

Langley Research Center's Unitary Plan Wind Tunnel: Testing Capabilities and Recent Modernization Activities

NASA Technical Reports Server (NTRS)

Micol, John R.

2001-01-01

Description, capabilities, initiatives, and utilization of the NASA Langley Research Center's Unitary Plan Wind Tunnel are presented. A brief overview of the facility's operational capabilities and testing techniques is provided. A recent Construction of Facilities (CoF) project to improve facility productivity and efficiency through facility automation has been completed and is discussed. Several new and maturing thrusts are underway that include systematic efforts to provide credible assessment for data quality, modifications to the new automation control system for increased compatibility with the Modern Design Of Experiments (MDOE) testing methodology, and process improvements for better test coordination, planning, and execution.

Langley Research Center's Unitary Plan Wind Tunnel: Testing Capabilities and Recent Modernization Activities

NASA Technical Reports Server (NTRS)

Micol, John R.

2001-01-01

Description, capabilities, initiatives, and utilization of the NASA Langley Research Center's Unitary Plan Wind Tunnel are presented. A brief overview of the facility's operational capabilities and testing techniques is provided. A recent Construction of Facilities (Car) project to improve facility productivity and efficiency through facility automation has been completed and is discussed. Several new and maturing thrusts are underway that include systematic efforts to provide credible assessment for data quality, modifications to the new automation control system for increased compatibility with the Modern Design of Experiments (MDOE) testing methodology, and process improvements for better test coordination, planning, and execution.

The Prevalence of Service Excellence and the Use of Business Process Improvement Methodologies in Australian Universities

ERIC Educational Resources Information Center

Ciancio, Sharone

2018-01-01

Service transformation is an increasingly common pursuit in the higher education sector, with university strategic plans frequently featuring a "service excellence" objective and the adoption of leaner and more sustainable service models. Previous studies agree that service excellence is intentional not incidental, and systematic not…

School Effectiveness: Problem-Solving and Managing Conflict.

ERIC Educational Resources Information Center

Minnesota State Dept. of Education, St. Paul.

This module discusses the theory and practice of school improvement and outlines a nine-step systematic problem-solving process for developing an action plan addressing school improvement goals. The first section describes a general model for the study of the school as a social system, as developed by Getzels and Thelen (1960). The second section…

School and Public Library Relationships: Deja Vu or New Beginnings.

ERIC Educational Resources Information Center

Fitzgibbons, Shirley A.

2001-01-01

Discusses school and public library relationships and maintains that an integrated, coordinated, and systematic planning process at both local and state levels will meet the needs of children and young adults. Topics include developments in the 1990s, barriers to cooperative efforts, examples of cooperative projects, and combined school-public…

Guidelines for designing short-term bird monitoring projects

Treesearch

Jonathan Bart

2005-01-01

The Coordinated Bird Monitoring Program (Bart and Ralph, this volume) program is helping biologists around the country design short-term monitoring projects for birds. We have found that addressing a series of questions (table 1), in a systematic way, helps insure that projects are well planned. The process is being used by several States and...

Transition Choices Program: Preparing To Participate in Life's Choices. Teaching Guide and Curriculum.

ERIC Educational Resources Information Center

Stowitschek, Joseph J.; And Others

The Transition Choices Program (TCP) is designed to increase the ability of young persons with disabilities to participate more fully in the school-to-adult life process through systematic instruction in six skills: exploring choices and developing preferences; planning goals and following through; seeking assistance when needed; recognizing and…

A Guide to Facilitating Action Research for Youth

ERIC Educational Resources Information Center

Goldwasser, Matthew

2004-01-01

What is "action research" and how is it relevant to urban youth activists? Action research is a systematic process of inquiry, which involves gathering information about an issue or problem, analyzing the findings, and developing practical plans for affecting positive change. It is motivated by the desire to investigate in order to better…

Reducing violent injuries: priorities for pediatrician advocacy.

PubMed

Dolins, J C; Christoffel, K K

1994-10-01

A basic framework for developing an advocacy plan must systematically break down the large task of policy development implementation into manageable components. The basic framework described in detail in this paper includes three steps: Setting policy objectives by narrowing the scope of policy, by reviewing policy options, and by examining options against selected criteria. Developing strategies for educating the public and for approaching legislative/regulatory bodies. Evaluating the effectiveness of the advocacy action plan as a process and as an agent for change. To illustrate the variety of ways in which pediatricians can be involved in the policy process to reduce violent injuries among children and adolescents, we apply this systematic approach to three priority areas. Prohibiting the use of corporal punishment in schools is intended to curb the institutionalized legitimacy of violence that has been associated with future use of violence. Efforts to remove handguns from the environments of children and adolescents are aimed at reducing the numbers of firearm injuries inflicted upon and by minors. Comprehensive treatment of adolescent victims of assault is intended to decrease the reoccurrence of violent injuries.

Speak Up Speak Out Coalition Survey Results | Science ...

EPA Pesticide Factsheets

Comprehensive planning is a visionary planning process that integrates community values and land use policy. The Mayor of Duluth, Minnesota, directed the inclusion of two new values into the City’s comprehensive planning process to direct the community’s future, process: health and fairness. In order to understand the meanings of health and fairness that residents of the city hold, the Community Planning Department included questions in a city-wide survey of planning priorities. As a community organization reviewed the survey results that would inform the new directives, they realized that overburdened communities were underrepresented in the survey responses. To address this deficiency, the community organization asked the City of Duluth if they could conduct a survey of the underrepresented voices to ensure their input was included in the process. The Health in All Policies Coalition contacted the USEPA Office of Research and Development in Duluth, MN at the advice of the Planning Department. The support USEPA provided ensured that the Coalition could make recommendations to the City of Duluth based on systematically collected and analyzed data. This presentation will share the results of the survey. This presentation of the Speak Up Speak Out survey data represents support for local decision-making, technical assistance and data analysis. The data were collected and analyzed through advice and consultation with USEPA Office of Research and Development, an

A case study of printing industry plant layout for effective production

NASA Astrophysics Data System (ADS)

Viswajit, T.; Teja, T. Ravi; Deepthi, Y. P.

2017-07-01

This paper presents the overall picture of the processes happening in printing industry. This research is aimed to improve the plant layout of existing plant. The travel time was reduced by relocating machinery. Relocation is based on systematic layout planning (SLP). The complete process of raw material entering the industry to dispatching of finished product is shown in 3-D Flow diagram. The process happening in each floor explained in detail using Flow Process chart. Travel time is reduced by 25% after modifying existing plant layout.

Developing a taxonomy for mission architecture definition

NASA Technical Reports Server (NTRS)

Neubek, Deborah J.

1990-01-01

The Lunar and Mars Exploration Program Office (LMEPO) was tasked to define candidate architectures for the Space Exploration Initiative to submit to NASA senior management and an externally constituted Outreach Synthesis Group. A systematic, structured process for developing, characterizing, and describing the alternate mission architectures, and applying this process to future studies was developed. The work was done in two phases: (1) national needs were identified and categorized into objectives achievable by the Space Exploration Initiative; and (2) a program development process was created which both hierarchically and iteratively describes the program planning process.

The ontology model of FrontCRM framework

NASA Astrophysics Data System (ADS)

Budiardjo, Eko K.; Perdana, Wira; Franshisca, Felicia

2013-03-01

Adoption and implementation of Customer Relationship Management (CRM) is not merely a technological installation, but the emphasis is more on the application of customer-centric philosophy and culture as a whole. CRM must begin at the level of business strategy, the only level that thorough organizational changes are possible to be done. Changes agenda can be directed to each departmental plans, and supported by information technology. Work processes related to CRM concept include marketing, sales, and services. FrontCRM is developed as framework to guide in identifying business processes related to CRM in which based on the concept of strategic planning approach. This leads to processes and practices identification in every process area related to marketing, sales, and services. The Ontology model presented on this paper by means serves as tools to avoid framework misunderstanding, to define practices systematically within process area and to find CRM software features related to those practices.

Pyrotechnic hazards classification and evaluation program. Phase 2, segment 3: Test plan for determining hazards associated with pyrotechnic manufacturing processes

NASA Technical Reports Server (NTRS)

1971-01-01

A comprehensive test plan for determining the hazards associated with pyrotechnic manufacturing processes is presented. The rationale for each test is based on a systematic analysis of historical accounts of accidents and a detailed study of the characteristics of each manufacturing process. The most hazardous manufacturing operations have been determined to be pressing, mixing, reaming, and filling. The hazard potential of a given situation is evaluated in terms of the probabilities of initiation, communication, and transition to detonation (ICT). The characteristics which affect the ICT probabilities include the ignition mechanisms which are present either in normal or abnormal operation, the condition and properties of the pyrotechnic material, and the configuration of the processing equipment. Analytic expressions are derived which describe the physical conditions of the system, thus permitting a variety of processes to be evaluated in terms of a small number of experiments.

Provider Tools for Advance Care Planning and Goals of Care Discussions: A Systematic Review.

PubMed

Myers, Jeff; Cosby, Roxanne; Gzik, Danusia; Harle, Ingrid; Harrold, Deb; Incardona, Nadia; Walton, Tara

2018-01-01

Advance care planning and goals of care discussions involve the exploration of what is most important to a person, including their values and beliefs in preparation for health-care decision-making. Advance care planning conversations focus on planning for future health care, ensuring that an incapable person's wishes are known and can guide the person's substitute decision maker for future decision-making. Goals of care discussions focus on preparing for current decision-making by ensuring the person's goals guide this process. To provide evidence regarding tools and/or practices available for use by health-care providers to effectively facilitate advance care planning conversations and/or goals of care discussions. A systematic review was conducted focusing on guidelines, randomized trials, comparative studies, and noncomparative studies. Databases searched included MEDLINE, EMBASE, and the proceedings of the International Advance Care Planning Conference and the American Society of Clinical Oncology Palliative Care Symposium. Although several studies report positive findings, there is a lack of consistent patient outcome evidence to support any one clinical tool for use in advance care planning or goals of care discussions. Effective advance care planning conversations at both the population and the individual level require provider education and communication skill development, standardized and accessible documentation, quality improvement initiatives, and system-wide coordination to impact the population level. There is a need for research focused on goals of care discussions, to clarify the purpose and expected outcomes of these discussions, and to clearly differentiate goals of care from advance care planning.

A comprehensive scoring system to measure healthy community design in land use plans and regulations.

PubMed

Maiden, Kristin M; Kaplan, Marina; Walling, Lee Ann; Miller, Patricia P; Crist, Gina

2017-02-01

Comprehensive land use plans and their corresponding regulations play a role in determining the nature of the built environment and community design, which are factors that influence population health and health disparities. To determine the level in which a plan addresses healthy living and active design, there is a need for a systematic, reliable and valid method of analyzing and scoring health-related content in plans and regulations. This paper describes the development and validation of a scoring tool designed to measure the strength and comprehensiveness of health-related content found in land use plans and the corresponding regulations. The measures are scored based on the presence of a specific item and the specificity and action-orientation of language. To establish reliability and validity, 42 land use plans and regulations from across the United States were scored January-April 2016. Results of the psychometric analysis indicate the scorecard is a reliable scoring tool for land use plans and regulations related to healthy living and active design. Intraclass correlation coefficients (ICC) scores showed strong inter-rater reliability for total strength and comprehensiveness. ICC scores for total implementation scores showed acceptable consistency among scorers. Cronbach's alpha values for all focus areas were acceptable. Strong content validity was measured through a committee vetting process. The development of this tool has far-reaching implications, bringing standardization of measurement to the field of land use plan assessment, and paving the way for systematic inclusion of health-related design principles, policies, and requirements in land use plans and their corresponding regulations. Copyright © 2016 Elsevier Inc. All rights reserved.

The systematic review as a research process in music therapy.

PubMed

Hanson-Abromeit, Deanna; Sena Moore, Kimberly

2014-01-01

Music therapists are challenged to present evidence on the efficacy of music therapy treatment and incorporate the best available research evidence to make informed healthcare and treatment decisions. Higher standards of evidence can come from a variety of sources including systematic reviews. To define and describe a range of research review methods using examples from music therapy and related literature, with emphasis on the systematic review. In addition, the authors provide a detailed overview of methodological processes for conducting and reporting systematic reviews in music therapy. The systematic review process is described in five steps. Step 1 identifies the research plan and operationalized research question(s). Step 2 illustrates the identification and organization of the existing literature related to the question(s). Step 3 details coding of data extracted from the literature. Step 4 explains the synthesis of coded findings and analysis to answer the research question(s). Step 5 describes the strength of evidence evaluation and results presentation for practice recommendations. Music therapists are encouraged to develop and conduct systematic reviews. This methodology contributes to review outcome credibility and can determine how information is interpreted and used by clinicians, clients or patients, and policy makers. A systematic review is a methodologically rigorous research method used to organize and evaluate extant literature related to a clinical problem. Systematic reviews can assist music therapists in managing the ever-increasing literature, making well-informed evidence based practice and research decisions, and translating existing music-based and nonmusic based literature to clinical practice and research development. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Linking Acquisition Decisionmaking With National Military Strategy

DTIC Science & Technology

1990-10-01

DTIC CONTAINED A SIGNIFICANT NUMBER OF COLOR PAGES WHICH DO NOT REPRODUCE LEGIBLY ON BLACK AND WHITE MICROFICHE, L i REPORT DOCUMENTATION PAGE Form...objectives I within the planning process. A fourth issue was the pace of change in enchancing the joint role in the acquisition g process. The former CJCS...goals, the roadmap, and PPOs. Hence, the DPG provides a VI-22 5 I systematic institutional memory , incorporating decisions as they are made, and thus

A practical and systematic approach to organisational capacity strengthening for research in the health sector in Africa.

PubMed

Bates, Imelda; Boyd, Alan; Smith, Helen; Cole, Donald C

2014-03-03

Despite increasing investment in health research capacity strengthening efforts in low and middle income countries, published evidence to guide the systematic design and monitoring of such interventions is very limited. Systematic processes are important to underpin capacity strengthening interventions because they provide stepwise guidance and allow for continual improvement. Our objective here was to use evidence to inform the design of a replicable but flexible process to guide health research capacity strengthening that could be customized for different contexts, and to provide a framework for planning, collecting information, making decisions, and improving performance. We used peer-reviewed and grey literature to develop a five-step pathway for designing and evaluating health research capacity strengthening programmes, tested in a variety of contexts in Africa. The five steps are: i) defining the goal of the capacity strengthening effort, ii) describing the optimal capacity needed to achieve the goal, iii) determining the existing capacity gaps compared to the optimum, iv) devising an action plan to fill the gaps and associated indicators of change, and v) adapting the plan and indicators as the programme matures. Our paper describes three contrasting case studies of organisational research capacity strengthening to illustrate how our five-step approach works in practice. Our five-step pathway starts with a clear goal and objectives, making explicit the capacity required to achieve the goal. Strategies for promoting sustainability are agreed with partners and incorporated from the outset. Our pathway for designing capacity strengthening programmes focuses not only on technical, managerial, and financial processes within organisations, but also on the individuals within organisations and the wider system within which organisations are coordinated, financed, and managed. Our five-step approach is flexible enough to generate and utilise ongoing learning. We have tested and critiqued our approach in a variety of organisational settings in the health sector in sub-Saharan Africa, but it needs to be applied and evaluated in other sectors and continents to determine the extent of transferability.

NASA Procurement Career Development Program

NASA Technical Reports Server (NTRS)

1987-01-01

The NASA Procurement Career Development Program establishes an agency-wide framework for the management of career development activity in the procurement field. Within this framework, installations are encouraged to modify the various components to meet installation-specific mission and organization requirements. This program provides a systematic process for the assessment of and planning for the development, training, and education required to increase the employees' competence in the procurement work functions. It includes the agency-wide basic knowledge and skills by career field and level upon which individual and organizational development plans are developed. Also, it provides a system that is compatible with other human resource management and development systems, processes, and activities. The compatibility and linkage are important in fostering the dual responsibility of the individual and the organization in the career development process.

A process evaluation of systematic risk and needs assessment for caregivers in specialised palliative care.

PubMed

Thomsen, Kia Toft; Guldin, Mai-Britt; Nielsen, Mette Kjærgaard; Ollars, Chaitali Laura; Jensen, Anders Bonde

2017-04-08

Caregiving is strenuous and it may be associated with adverse psychological outcomes. During the palliative care trajectory, there are unique opportunities for providing support and preventing poor bereavement outcome. However, the tasks of palliative care staff in relation to caregivers are often unclear in the daily practice. Assessment is recommended to establish risk and needs and standards for caregiver support are available. Still, the feasibility of applying these standards among caregivers in everyday clinical practice has not been tested so far. This study tested the feasibility of an intervention based on key elements of the "Bereavement support standards for specialist palliative care services" in a Danish specialised palliative home care team. We followed the UK Medical Research Council's guidelines for the process evaluation of complex interventions. The intervention consisted of: 1. Systematic risk and needs assessment for caregivers at care entry; 2. Interdisciplinary conference to prepare a support plan; 3. Targeted support; 4. The establishment of an electronic medical record for caregivers to document targeted support. Outcomes included the reach, fidelity and acceptability of the intervention as well as the assessment of contextual factors. The intervention reached 76 of 164 caregivers (46%). The interdisciplinary risk assessment and documentation of a support plan was conducted in 57 (75%) of the enrolled caregivers. Finally, a separate medical record was established according to the intervention blueprint for 62% of caregivers receiving targeted support. After managing initial challenges, palliative care staff reported that the intervention was useful and acceptable. The intervention proved feasible and useful. Still, we identified barriers to the implementation which should be taken into consideration when planning implementation of a systematic risk and needs assessment and in the establishment of medical records for caregivers.

The Trajectory of Dispersal Research in Conservation Biology. Systematic Review

PubMed Central

Driscoll, Don A.; Banks, Sam C.; Barton, Philip S.; Ikin, Karen; Lentini, Pia; Lindenmayer, David B.; Smith, Annabel L.; Berry, Laurence E.; Burns, Emma L.; Edworthy, Amanda; Evans, Maldwyn J.; Gibson, Rebecca; Heinsohn, Rob; Howland, Brett; Kay, Geoff; Munro, Nicola; Scheele, Ben C.; Stirnemann, Ingrid; Stojanovic, Dejan; Sweaney, Nici; Villaseñor, Nélida R.; Westgate, Martin J.

2014-01-01

Dispersal knowledge is essential for conservation management, and demand is growing. But are we accumulating dispersal knowledge at a pace that can meet the demand? To answer this question we tested for changes in dispersal data collection and use over time. Our systematic review of 655 conservation-related publications compared five topics: climate change, habitat restoration, population viability analysis, land planning (systematic conservation planning) and invasive species. We analysed temporal changes in the: (i) questions asked by dispersal-related research; (ii) methods used to study dispersal; (iii) the quality of dispersal data; (iv) extent that dispersal knowledge is lacking, and; (v) likely consequences of limited dispersal knowledge. Research questions have changed little over time; the same problems examined in the 1990s are still being addressed. The most common methods used to study dispersal were occupancy data, expert opinion and modelling, which often provided indirect, low quality information about dispersal. Although use of genetics for estimating dispersal has increased, new ecological and genetic methods for measuring dispersal are not yet widely adopted. Almost half of the papers identified knowledge gaps related to dispersal. Limited dispersal knowledge often made it impossible to discover ecological processes or compromised conservation outcomes. The quality of dispersal data used in climate change research has increased since the 1990s. In comparison, restoration ecology inadequately addresses large-scale process, whilst the gap between knowledge accumulation and growth in applications may be increasing in land planning. To overcome apparent stagnation in collection and use of dispersal knowledge, researchers need to: (i) improve the quality of available data using new approaches; (ii) understand the complementarities of different methods and; (iii) define the value of different kinds of dispersal information for supporting management decisions. Ambitious, multi-disciplinary research programs studying many species are critical for advancing dispersal research. PMID:24743447

The trajectory of dispersal research in conservation biology. Systematic review.

PubMed

Driscoll, Don A; Banks, Sam C; Barton, Philip S; Ikin, Karen; Lentini, Pia; Lindenmayer, David B; Smith, Annabel L; Berry, Laurence E; Burns, Emma L; Edworthy, Amanda; Evans, Maldwyn J; Gibson, Rebecca; Heinsohn, Rob; Howland, Brett; Kay, Geoff; Munro, Nicola; Scheele, Ben C; Stirnemann, Ingrid; Stojanovic, Dejan; Sweaney, Nici; Villaseñor, Nélida R; Westgate, Martin J

2014-01-01

Dispersal knowledge is essential for conservation management, and demand is growing. But are we accumulating dispersal knowledge at a pace that can meet the demand? To answer this question we tested for changes in dispersal data collection and use over time. Our systematic review of 655 conservation-related publications compared five topics: climate change, habitat restoration, population viability analysis, land planning (systematic conservation planning) and invasive species. We analysed temporal changes in the: (i) questions asked by dispersal-related research; (ii) methods used to study dispersal; (iii) the quality of dispersal data; (iv) extent that dispersal knowledge is lacking, and; (v) likely consequences of limited dispersal knowledge. Research questions have changed little over time; the same problems examined in the 1990s are still being addressed. The most common methods used to study dispersal were occupancy data, expert opinion and modelling, which often provided indirect, low quality information about dispersal. Although use of genetics for estimating dispersal has increased, new ecological and genetic methods for measuring dispersal are not yet widely adopted. Almost half of the papers identified knowledge gaps related to dispersal. Limited dispersal knowledge often made it impossible to discover ecological processes or compromised conservation outcomes. The quality of dispersal data used in climate change research has increased since the 1990s. In comparison, restoration ecology inadequately addresses large-scale process, whilst the gap between knowledge accumulation and growth in applications may be increasing in land planning. To overcome apparent stagnation in collection and use of dispersal knowledge, researchers need to: (i) improve the quality of available data using new approaches; (ii) understand the complementarities of different methods and; (iii) define the value of different kinds of dispersal information for supporting management decisions. Ambitious, multi-disciplinary research programs studying many species are critical for advancing dispersal research.

Theoretical orientations in environmental planning: An inquiry into alternative approaches

NASA Astrophysics Data System (ADS)

Briassoulis, Helen

1989-07-01

In the process of devising courses of action to resolve problems arising at the society-environment interface, a variety of planning approaches are followed, whose adoption is influenced by—among other things—the characteristics of environmental problems, the nature of the decision-making context, and the intellectual traditions of the disciplines contributing to the study of these problems. This article provides a systematic analysis of six alternative environmental planning approaches—comprehensive/rational, incremental, adaptive, contingency, advocacy, and participatory/consensual. The relative influence of the abovementioned factors is examined, the occurrence of these approaches in real-world situations is noted, and their environmental soundness and political realism is evaluated. Because of the disparity between plan formulation and implementation and between theoretical form and empirical reality, a synthetic view of environmental planning approaches is taken and approaches in action are identified, which characterize the totality of the planning process from problem definition to plan implementation, as well as approaches in the becoming, which may be on the horizon of environmental planning of tomorrow. The suggested future research directions include case studies to verify and detail the presence of the approaches discussed, developing measures of success of a given approach in a given decision setting, and an intertemporal analysis of environmental planning approaches.

Statistical process control analysis for patient-specific IMRT and VMAT QA.

PubMed

Sanghangthum, Taweap; Suriyapee, Sivalee; Srisatit, Somyot; Pawlicki, Todd

2013-05-01

This work applied statistical process control to establish the control limits of the % gamma pass of patient-specific intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) quality assurance (QA), and to evaluate the efficiency of the QA process by using the process capability index (Cpml). A total of 278 IMRT QA plans in nasopharyngeal carcinoma were measured with MapCHECK, while 159 VMAT QA plans were undertaken with ArcCHECK. Six megavolts with nine fields were used for the IMRT plan and 2.5 arcs were used to generate the VMAT plans. The gamma (3%/3 mm) criteria were used to evaluate the QA plans. The % gamma passes were plotted on a control chart. The first 50 data points were employed to calculate the control limits. The Cpml was calculated to evaluate the capability of the IMRT/VMAT QA process. The results showed higher systematic errors in IMRT QA than VMAT QA due to the more complicated setup used in IMRT QA. The variation of random errors was also larger in IMRT QA than VMAT QA because the VMAT plan has more continuity of dose distribution. The average % gamma pass was 93.7% ± 3.7% for IMRT and 96.7% ± 2.2% for VMAT. The Cpml value of IMRT QA was 1.60 and VMAT QA was 1.99, which implied that the VMAT QA process was more accurate than the IMRT QA process. Our lower control limit for % gamma pass of IMRT is 85.0%, while the limit for VMAT is 90%. Both the IMRT and VMAT QA processes are good quality because Cpml values are higher than 1.0.

Developing talent for operational excellence.

PubMed

Theadore, Jason C; O'Brien, Thaddeus J

2012-01-01

Many organizations have the expectation that their employees will prepare for their own professional development without much support or guidance. To achieve operational excellence, development of the people in an organization is just as important as the development of technologies and processes. Ohio Health Ambulatory Division in Columbus, OH created a plan to develop its people systematically in three distinct pillars: management development, staff engagement, and clinical excellence. Much was learned about talent development since work began on "The People Plan", perhaps the most critical lesson learned has been the importance of not giving up on the effort.

Indicator-driven conservation planning across terrestrial, freshwater aquatic, and marine ecosystems of the south Atlantic, USA

USGS Publications Warehouse

Pickens, Bradley A.; Mordecai, Rua S.; Drew, C. Ashton; Alexander-Vaughn, Louise B.; Keister, Amy S.; Morris, Hilary L.C.; Collazo, Jaime A.

2017-01-01

Systematic conservation planning, a widely used approach to identify priority lands and waters, uses efficient, defensible, and transparent methods aimed at conserving biodiversity and ecological systems. Limited financial resources and competing land uses can be major impediments to conservation; therefore, participation of diverse stakeholders in the planning process is advantageous to help address broad-scale threats and challenges of the 21st century. Although a broad extent is needed to identify core areas and corridors for fish and wildlife populations, a fine-scale resolution is needed to manage for multiple, interconnected ecosystems. Here, we developed a conservation plan using a systematic approach to promote landscape-level conservation within the extent of the South Atlantic Landscape Conservation Cooperative. Our objective was to identify the highest-ranked 30% of lands and waters within the South Atlantic deemed necessary to conserve ecological and cultural integrity for the 10 primary ecosystems of the southeastern United States. These environments varied from terrestrial, freshwater aquatic, and marine. The planning process was driven by indicators of ecosystem integrity at a 4-ha resolution. We used the program Zonation and 28 indicators to optimize the identification of lands and waters to meet the stated objective. A novel part of our study was the prioritization of multiple ecosystems, and we discuss the advantages and disadvantages of this approach. The evaluation of indicator representation within prioritizations was a useful method to show where improvements could be made; some indicators dictated hotspots, some had a limited extent and were well represented, and others had a limited effect. Overall, we demonstrate that a broad-scale (408,276 km2 of terrestrial and 411,239 km2 of marine environments) conservation plan can be realized at a fine-scale resolution, which will allow implementation of the regional plan at a local level relevant to decision making.

Preparing strategic information management plans for hospitals: a practical guideline SIM plans for hospitals: a guideline.

PubMed

Brigl, B; Ammenwerth, E; Dujat, C; Gräber, S; Grosse, A; Häber, A; Jostes, C; Winter, A

2005-01-01

Systematic information management in hospitals demands for a strategic information management plan (SIM plan). As preparing a SIM plan is a considerable challenge we provide a practical guideline that is directly applicable when a SIM plan is going to be prepared. The guideline recommends a detailed structure of a SIM plan and gives advice about its content and the preparation process. It may be used as template, which can be adapted to the individual demands of any hospital. The guideline was used in several hospitals preparing a SIM plan. Experiences showed that the SIM plans could be prepared very efficiently and timely using the guideline, that the proposed SIM plan structure suited well, that the guideline offers enough flexibility to meet the requirements of the individual hospitals and that the specific recommendations of the guideline were very helpful. Nevertheless, we must strive for a more comprehensive theory of strategic information management planning which -- in the sense of enterprise architecture planning -- represents the intrinsic correlations of the different parts of a SIM plan to a greater extent.

Improving Human Services: Methods for Systematic Planning, Evaluation, and Staff Development.

ERIC Educational Resources Information Center

Jones, G. Brian; And Others

This monograph speaks to the basic problems confronting human services programs, and offers suggestions for improving guidance services. Specific concerns addressed are: (1) the need for more systematic program planning and evaluation; (2) an approach to effective planning and evaluation; (3) development of staff skills for use in the…

Frontiers in planning optimization for lung SBRT.

PubMed

Giglioli, Francesca Romana; Clemente, Stefania; Esposito, Marco; Fiandra, Christian; Marino, Carmelo; Russo, Serenella; Strigari, Lidia; Villaggi, Elena; Stasi, Michele; Mancosu, Pietro

2017-12-01

Emerging data are showing the safety and the efficacy of Stereotactic Body Radiation therapy (SBRT) in lung cancer management. In this context, the very high doses delivered to the Planning Target Volume, make the planning phase essential for achieving high dose levels conformed to the shape of the target in order to have a good prognosis for tumor control and to avoid an overdose in relevant healthy adjacent tissue. In this non-systematic review we analyzed the technological and the physics aspects of SBRT planning for lung cancer. In particular, the aims of the study were: (i) to evaluate prescription strategies (homogeneous or inhomogeneous), (ii) to outline possible geometrical solutions by comparing the dosimetric results (iii) to describe the technological possibilities for a safe and effective treatment, (iv) to present the issues concerning radiobiological planning and the automation of the planning process. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Technology of combined chemical-mechanical fabrication of durable coatings

NASA Astrophysics Data System (ADS)

Smolentsev, V. P.; Ivanov, V. V.; Portnykh, A. I.

2018-03-01

The article presents the scientific fundamentals of methodology for calculating the modes and structuring the technological processes of combined chemical-mechanical fabrication of durable coatings. It is shown that they are based on classical patterns, describing the processes of simultaneous chemical and mechanical impact. The paper demonstrates the possibility of structuring a technological process, taking into account the systematic approach to impact management and strengthening the reciprocal positive influence of each impact upon the combined process. The combined processes have been planned for fabricating the model types of chemical-mechanical coatings of durable products in machine construction. The planning methodology is underpinned by a scientific hypothesis of a single source of impact management through energy potential of process components themselves, or by means of external energy supply through mechanical impact. The control of it is fairly thoroughly studied in the case of pulsed external strikes of hard pellets, similar to processes of vibroimpact hardening, thoroughly studied and mastered in many scientific schools of Russia.

A Capacity Forecast Model for Volatile Data in Maintenance Logistics

NASA Astrophysics Data System (ADS)

Berkholz, Daniel

2009-05-01

Maintenance, repair and overhaul processes (MRO processes) are elaborate and complex. Rising demands on these after sales services require reliable production planning and control methods particularly for maintaining valuable capital goods. Downtimes lead to high costs and an inability to meet delivery due dates results in severe contract penalties. Predicting the required capacities for maintenance orders in advance is often difficult due to unknown part conditions unless the goods are actually inspected. This planning uncertainty results in extensive capital tie-up by rising stock levels within the whole MRO network. The article outlines an approach to planning capacities when maintenance data forecasting is volatile. It focuses on the development of prerequisites for a reliable capacity planning model. This enables a quick response to maintenance orders by employing appropriate measures. The information gained through the model is then systematically applied to forecast both personnel capacities and the demand for spare parts. The improved planning reliability can support MRO service providers in shortening delivery times and reducing stock levels in order to enhance the performance of their maintenance logistics.

The Effect of Hidden Curriculum on Character Education Process of Primary School Students

ERIC Educational Resources Information Center

Cubukcu, Zuhal

2012-01-01

Character education is defined as a planned and systematical approach in terms of self- respect, responsibility and honesty etc. for being a good citizen. The elements of hidden curriculum possessed in schools are values, beliefs, attitudes, and norms and values which are important parts of school function, ceremonies and the quality of…

Case Study in the Power of Collaboration: Planning Process for the Kansas Educational Leadership Institute

ERIC Educational Resources Information Center

Devin, Mary

2013-01-01

This article reports on the collaborative efforts undertaken for systematic statewide support for the recruitment, development, and retention of quality leaders in schools and school districts in Kansas, USA. The author presents the case of a strong sense of "collaboration" that made the difference and stimulated movement from vision…

The Alternative to Progressive Education and Mastery Learning Practices.

ERIC Educational Resources Information Center

Veatch, Jeannette

The concept of open or progressive education has come to mean that to learn one needs no discipline, no systematic organization, no planning. However, there is a middle, or at least another ground, between the ends of laissez faire and authoritarianism. It has to do with the structure of process. For example, the Key Vocabulary of Sylvia…

Impact of Multimedia Based Instructional Design on the College Students

ERIC Educational Resources Information Center

Ramganesh, E.; Amutha, S.

2011-01-01

Preparing the technology proficient learners to meet the needs of 21st century has emerged as a critical challenge facing education in our country. The teacher has to prepare the young generation to fit in to the technology intensive society of the 21st century. Instructional design (ID) is the systematic process of planning events to facilitate…

An Evaluation Model To Select an Integrated Learning System in a Large, Suburban School District.

ERIC Educational Resources Information Center

Curlette, William L.; And Others

The systematic evaluation process used in Georgia's DeKalb County School System to purchase comprehensive instructional software--an integrated learning system (ILS)--is described, and the decision-making model for selection is presented. Selection and implementation of an ILS were part of an instructional technology plan for the DeKalb schools…

Effect of patient setup errors on simultaneously integrated boost head and neck IMRT treatment plans

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

Siebers, Jeffrey V.; Keall, Paul J.; Wu Qiuwen

2005-10-01

Purpose: The purpose of this study is to determine dose delivery errors that could result from random and systematic setup errors for head-and-neck patients treated using the simultaneous integrated boost (SIB)-intensity-modulated radiation therapy (IMRT) technique. Methods and Materials: Twenty-four patients who participated in an intramural Phase I/II parotid-sparing IMRT dose-escalation protocol using the SIB treatment technique had their dose distributions reevaluated to assess the impact of random and systematic setup errors. The dosimetric effect of random setup error was simulated by convolving the two-dimensional fluence distribution of each beam with the random setup error probability density distribution. Random setup errorsmore » of {sigma} = 1, 3, and 5 mm were simulated. Systematic setup errors were simulated by randomly shifting the patient isocenter along each of the three Cartesian axes, with each shift selected from a normal distribution. Systematic setup error distributions with {sigma} = 1.5 and 3.0 mm along each axis were simulated. Combined systematic and random setup errors were simulated for {sigma} = {sigma} = 1.5 and 3.0 mm along each axis. For each dose calculation, the gross tumor volume (GTV) received by 98% of the volume (D{sub 98}), clinical target volume (CTV) D{sub 90}, nodes D{sub 90}, cord D{sub 2}, and parotid D{sub 50} and parotid mean dose were evaluated with respect to the plan used for treatment for the structure dose and for an effective planning target volume (PTV) with a 3-mm margin. Results: Simultaneous integrated boost-IMRT head-and-neck treatment plans were found to be less sensitive to random setup errors than to systematic setup errors. For random-only errors, errors exceeded 3% only when the random setup error {sigma} exceeded 3 mm. Simulated systematic setup errors with {sigma} = 1.5 mm resulted in approximately 10% of plan having more than a 3% dose error, whereas a {sigma} = 3.0 mm resulted in half of the plans having more than a 3% dose error and 28% with a 5% dose error. Combined random and systematic dose errors with {sigma} = {sigma} = 3.0 mm resulted in more than 50% of plans having at least a 3% dose error and 38% of the plans having at least a 5% dose error. Evaluation with respect to a 3-mm expanded PTV reduced the observed dose deviations greater than 5% for the {sigma} = {sigma} = 3.0 mm simulations to 5.4% of the plans simulated. Conclusions: Head-and-neck SIB-IMRT dosimetric accuracy would benefit from methods to reduce patient systematic setup errors. When GTV, CTV, or nodal volumes are used for dose evaluation, plans simulated including the effects of random and systematic errors deviate substantially from the nominal plan. The use of PTVs for dose evaluation in the nominal plan improves agreement with evaluated GTV, CTV, and nodal dose values under simulated setup errors. PTV concepts should be used for SIB-IMRT head-and-neck squamous cell carcinoma patients, although the size of the margins may be less than those used with three-dimensional conformal radiation therapy.« less

Comprehensive Smart Grid Planning in a Regulated Utility Environment

NASA Astrophysics Data System (ADS)

Turner, Matthew; Liao, Yuan; Du, Yan

2015-06-01

This paper presents the tools and exercises used during the Kentucky Smart Grid Roadmap Initiative in a collaborative electric grid planning process involving state regulators, public utilities, academic institutions, and private interest groups. The mandate of the initiative was to assess the existing condition of smart grid deployments in Kentucky, to enhance understanding of smart grid concepts by stakeholders, and to develop a roadmap for the deployment of smart grid technologies by the jurisdictional utilities of Kentucky. Through involvement of many important stakeholder groups, the resultant Smart Grid Deployment Roadmap proposes an aggressive yet achievable strategy and timetable designed to promote enhanced availability, security, efficiency, reliability, affordability, sustainability and safety of the electricity supply throughout the state while maintaining Kentucky's nationally competitive electricity rates. The models and methods developed for this exercise can be utilized as a systematic process for the planning of coordinated smart grid deployments.

Action history influences subsequent movement via two distinct processes

PubMed Central

Poh, Eugene; de Rugy, Aymar

2017-01-01

The characteristics of goal-directed actions tend to resemble those of previously executed actions, but it is unclear whether such effects depend strictly on action history, or also reflect context-dependent processes related to predictive motor planning. Here we manipulated the time available to initiate movements after a target was specified, and studied the effects of predictable movement sequences, to systematically dissociate effects of the most recently executed movement from the movement required next. We found that directional biases due to recent movement history strongly depend upon movement preparation time, suggesting an important contribution from predictive planning. However predictive biases co-exist with an independent source of bias that depends only on recent movement history. The results indicate that past experience influences movement execution through a combination of temporally-stable processes that are strictly use-dependent, and dynamically-evolving and context-dependent processes that reflect prediction of future actions. PMID:29058670

[Systematization of nursing care in the obstetrical center].

PubMed

dos Santos, Raquel Bezerra; Ramos, Karla da Silva

2012-01-01

This is a descriptive and exploratory study with a quantitative approach, aiming to propose a protocol for the systematization of nursing care to women in the process of giving birth in the Obstetrical Center of a public hospital in Recife, Pernambuco, Brazil. A semi-structured instrument was applied to forty women in the process of giving birth, in order to obtaining the nursing history; from which the nursing diagnoses were identified, having as a basis the International Classification for Nursing Practice (ICNP®), version 1, and their respective results and nursing interventions were established. The protocol consists in two stages: the first one is the nursing consultation, which involves the anamnesis and physical examination; and the second, involves the judicious identification of the nursing diagnoses, which will guide the planning of the nursing care to provide the individualized attention to women in the process of giving birth, using a universal terminology.

Development and evaluation of an aged care specific Advance Care Plan.

PubMed

Silvester, William; Parslow, Ruth A; Lewis, Virginia J; Fullam, Rachael S; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Hudson, Rosalie

2013-06-01

To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents' values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans. Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector.

Making evolutionary history count: biodiversity planning for coral reef fishes and the conservation of evolutionary processes

NASA Astrophysics Data System (ADS)

von der Heyden, Sophie

2017-03-01

Anthropogenic activities are having devastating impacts on marine systems with numerous knock-on effects on trophic functioning, species interactions and an accelerated loss of biodiversity. Establishing conservation areas can not only protect biodiversity, but also confer resilience against changes to coral reefs and their inhabitants. Planning for protection and conservation in marine systems is complex, but usually focuses on maintaining levels of biodiversity and protecting special and unique landscape features while avoiding negative impacts to socio-economic benefits. Conversely, the integration of evolutionary processes that have shaped extant species assemblages is rarely taken into account. However, it is as important to protect processes as it is to protect patterns for maintaining the evolutionary trajectories of populations and species. This review focuses on different approaches for integrating genetic analyses, such as phylogenetic diversity, phylogeography and the delineation of management units, temporal and spatial monitoring of genetic diversity and quantification of adaptive variation for protecting evolutionary resilience, into marine spatial planning, specifically for coral reef fishes. Many of these concepts are not yet readily applied to coral reef fish studies, but this synthesis highlights their potential and the importance of including historical processes into systematic biodiversity planning for conserving not only extant, but also future, biodiversity and its evolutionary potential.

Nebula observations. Catalogues and archive of photoplates

NASA Astrophysics Data System (ADS)

Shlyapnikov, A. A.; Smirnova, M. A.; Elizarova, N. V.

2017-12-01

A process of data systematization based on "Academician G.A. Shajn's Plan" for studying the Galaxy structure related to nebula observations is considered. The creation of digital versions of catalogues of observations and publications is described, as well as their presentation in HTML, VOTable and AJS formats and basic principles of work in the interactive application of International Virtual Observatory the Aladin Sky Atlas.

Systematic Program Design: A Handbook for Volunteers. Appropriate Technologies for Development. Fourth Edition. Reprint R-44A.

ERIC Educational Resources Information Center

Peace Corps, Washington, DC. Information Collection and Exchange Div.

This manual is intended to assist volunteers and staff of volunteer organizations in the design of projects in various community and social service areas. The first section of the manual is a guidebook that addresses such aspects of the planning, implementation, and evaluation process as situational analysis, needs assessment, task-oriented…

Challenges in the Implementation of Outcomes-Based Assessment Program Review in a California Community College District

ERIC Educational Resources Information Center

Bresciani, Marilee J.

2011-01-01

The purpose of this study was to explore the manner in which a community college district planned to implement a systematic outcomes-based assessment program review process in order to have results inform institutional, district, and state policy discussions. Data derived from this grounded theory study indicated that there was not a shared…

Homeland Security and Capabilities-Based Planning: Improving National Preparedness

DTIC Science & Technology

2005-09-01

Caudle 2004; NEMA 2004; ASTHO 2004). Their concerns emphasized proceeding with what one called a fatally flawed process following artificially... norm for a number of years, a systematic collection, evaluation, and dissemination of lessons learned and better practices has only recently picked...intergovernmental relations for homeland security. National Emergency Management Association ( NEMA ). (2004). Letter to Sue Mencer. Lexington, KY: October 29

Governance for public health and health equity: The Tröndelag model for public health work.

PubMed

Lillefjell, Monica; Magnus, Eva; Knudtsen, Margunn SkJei; Wist, Guri; Horghagen, Sissel; Espnes, Geir Arild; Maass, Ruca; Anthun, Kirsti Sarheim

2018-06-01

Multi-sectoral governance of population health is linked to the realization that health is the property of many societal systems. This study aims to contribute knowledge and methods that can strengthen the capacities of municipalities regarding how to work more systematically, knowledge-based and multi-sectoral in promoting health and health equity in the population. Process evaluation was conducted, applying a mixed-methods research design, combining qualitative and quantitative data collection methods. Processes strengthening systematic and multi-sectoral development, implementation and evaluation of research-based measures to promote health, quality of life, and health equity in, for and with municipalities were revealed. A step-by-step model, that emphasizes the promotion of knowledge-based, systematic, multi-sectoral public health work, as well as joint ownership of local resources, initiatives and policies has been developed. Implementation of systematic, knowledge-based and multi-sectoral governance of public health measures in municipalities demand shared understanding of the challenges, updated overview of the population health and impact factors, anchoring in plans, new skills and methods for selection and implementation of measures, as well as development of trust, ownership, shared ethics and goals among those involved.

[Nursing as a situative activity. A realistic concept for the assurance of quality and efficiency in geriatric care].

PubMed

Böhle, F; Brater, M; Maurus, A

1997-02-01

In institutional care for the elderly effective and efficient professional action is needed as well as in acute care settings. That means rational-systematic acting. This includes the establishment of goals, systematic planning and realization of these plans, deductive-logical thinking, objective perception and gaining an unbiased objective relationship towards the work to be done. However, an explorative investigation of the ways, how successful and experienced nurses do their job-being viewed by their colleagues as qualitatively effective and efficient concerning their time budget-provides the following results. In direct care procedures which go beyond rational-systematic action prove to be more economic and successful. This type of action is characterized by interactive procedures of dialogical nature, the patterns of rationality tend to be associative, the perception of the elderly to be taken care of can be considered as intuitive-subjective and the relationship towards them as personal-empathic. Those patterns of professional action we refer to as "subjectifying" or "situative" patterns of action. They can also be found in the process of an artist's work. The consequences of this change of paradigma concerning training and cost-effective nursing are discussed in this paper.

Applying lessons learned from the USAID family planning graduation experience to the GAVI graduation process.

PubMed

Shen, Angela K; Farrell, Marguerite M; Vandenbroucke, Mary F; Fox, Elizabeth; Pablos-Mendez, Ariel

2015-07-01

As low income countries experience economic transition, characterized by rapid economic growth and increased government spending potential in health, they have increased fiscal space to support and sustain more of their own health programmes, decreasing need for donor development assistance. Phase out of external funds should be systematic and efforts towards this end should concentrate on government commitments towards country ownership and self-sustainability. The 2006 US Agency for International Development (USAID) family planning (FP) graduation strategy is one such example of a systematic phase-out approach. Triggers for graduation were based on pre-determined criteria and programme indicators. In 2011 the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunizations) which primarily supports financing of new vaccines, established a graduation policy process. Countries whose gross national income per capita exceeds $1570 incrementally increase their co-financing of new vaccines over a 5-year period until they are no longer eligible to apply for new GAVI funding, although previously awarded support will continue. This article compares and contrasts the USAID and GAVI processes to apply lessons learned from the USAID FP graduation experience to the GAVI process. The findings of the review are 3-fold: (1) FP graduation plans served an important purpose by focusing on strategic needs across six graduation plan foci, facilitating graduation with pre-determined financial and technical benchmarks, (2) USAID sought to assure contraceptive security prior to graduation, phasing out of contraceptive donations first before phasing out from technical assistance in other programme areas and (3) USAID sought to sustain political support to assure financing of products and programmes continue after graduation. Improving sustainability more broadly beyond vaccine financing provides a more comprehensive approach to graduation. The USAID FP experience provides a window into understanding one approach to graduation from donor assistance. The process itself-involving transparent country-level partners well in advance of graduation-appears a valuable lesson towards success. Published by Oxford University Press 2014. This work is written by US Government employees and is in the public domain in the US.

TH-AB-BRA-04: Dosimetric Evaluation of MR-Guided HDR Brachytherapy Planning for Cervical Cancer

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

Kamio, Y; Barkati, M; Beliveau-Nadeau, D

2016-06-15

Purpose: To perform a retrospective study on 16 patients that had both CT and T2-weighted MR scans done at first fraction using the Utrecht CT/MR applicator (Elekta Brachytherapy) in order to evaluate uncertainties associated with an MR-only planning workflow. Methods: MR-workflow uncertainties were classified in three categories: reconstruction, registration and contouring. A systematic comparison of the CT and MR contouring, manual reconstruction and optimization process was performed to evaluate the impact of these uncertainties on the recommended GEC ESTRO DVH parameters: D90% and V100% for HR-CTV as well as D2cc for bladder, rectum, sigmoid colon and small bowel. This comparisonmore » was done using the following four steps: 1. Catheter reconstruction done on MR images with original CT-plan contours and dwell times. 2. OAR contours adjusted on MR images with original CT-plan reconstruction and dwell times. 3. Both reconstruction and contours done on MR images with original CT-plan dwell times. 4. Entire MR-based workflow optimized dwell times reimported to the original CT-plan. Results: The MR-based reconstruction process showed average D2cc deviations of 4.5 ± 3.0%, 1.5 ± 2.0%, 2.5 ± 2.0% and 2.0 ± 1.0% for the bladder, rectum, sigmoid colon and small bowels respectively with a maximum of 10%, 6%, 6% and 4%. The HR-CTV’s D90% and V100% average deviations was found to be 4.0 ± 3.0%, and 2.0 ± 2.0% respectively with a maximum of 10% and 6%. Adjusting contours on MR-images was found to have a similar impact. Finally, the optimized MR-based workflow dwell times were found to still give acceptable plans when re-imported to the original CT-plan which validated the entire workflow. Conclusion: This work illustrates a systematic validation method for centers wanting to move towards an MR-only workflow. This work will be expanded to model based reconstruction, PD-weighted images and other types of applicators.« less

Load Forecasting in Electric Utility Integrated Resource Planning

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

Carvallo, Juan Pablo; Larsen, Peter H.; Sanstad, Alan H

Integrated resource planning (IRP) is a process used by many vertically-integrated U.S. electric utilities to determine least-cost/risk supply and demand-side resources that meet government policy objectives and future obligations to customers and, in many cases, shareholders. Forecasts of energy and peak demand are a critical component of the IRP process. There have been few, if any, quantitative studies of IRP long-run (planning horizons of two decades) load forecast performance and its relationship to resource planning and actual procurement decisions. In this paper, we evaluate load forecasting methods, assumptions, and outcomes for 12 Western U.S. utilities by examining and comparing plansmore » filed in the early 2000s against recent plans, up to year 2014. We find a convergence in the methods and data sources used. We also find that forecasts in more recent IRPs generally took account of new information, but that there continued to be a systematic over-estimation of load growth rates during the period studied. We compare planned and procured resource expansion against customer load and year-to-year load growth rates, but do not find a direct relationship. Load sensitivities performed in resource plans do not appear to be related to later procurement strategies even in the presence of large forecast errors. These findings suggest that resource procurement decisions may be driven by other factors than customer load growth. Our results have important implications for the integrated resource planning process, namely that load forecast accuracy may not be as important for resource procurement as is generally believed, that load forecast sensitivities could be used to improve the procurement process, and that management of load uncertainty should be prioritized over more complex forecasting techniques.« less

A primer on systematic reviews in toxicology.

PubMed

Hoffmann, Sebastian; de Vries, Rob B M; Stephens, Martin L; Beck, Nancy B; Dirven, Hubert A A M; Fowle, John R; Goodman, Julie E; Hartung, Thomas; Kimber, Ian; Lalu, Manoj M; Thayer, Kristina; Whaley, Paul; Wikoff, Daniele; Tsaioun, Katya

2017-07-01

Systematic reviews, pioneered in the clinical field, provide a transparent, methodologically rigorous and reproducible means of summarizing the available evidence on a precisely framed research question. Having matured to a well-established approach in many research fields, systematic reviews are receiving increasing attention as a potential tool for answering toxicological questions. In the larger framework of evidence-based toxicology, the advantages and obstacles of, as well as the approaches for, adapting and adopting systematic reviews to toxicology are still being explored. To provide the toxicology community with a starting point for conducting or understanding systematic reviews, we herein summarized available guidance documents from various fields of application. We have elaborated on the systematic review process by breaking it down into ten steps, starting with planning the project, framing the question, and writing and publishing the protocol, and concluding with interpretation and reporting. In addition, we have identified the specific methodological challenges of toxicological questions and have summarized how these can be addressed. Ultimately, this primer is intended to stimulate scientific discussions of the identified issues to fuel the development of toxicology-specific methodology and to encourage the application of systematic review methodology to toxicological issues.

Systematic Clinical Reasoning in Physical Therapy (SCRIPT): Tool for the Purposeful Practice of Clinical Reasoning in Orthopedic Manual Physical Therapy.

PubMed

Baker, Sarah E; Painter, Elizabeth E; Morgan, Brandon C; Kaus, Anna L; Petersen, Evan J; Allen, Christopher S; Deyle, Gail D; Jensen, Gail M

2017-01-01

Clinical reasoning is essential to physical therapist practice. Solid clinical reasoning processes may lead to greater understanding of the patient condition, early diagnostic hypothesis development, and well-tolerated examination and intervention strategies, as well as mitigate the risk of diagnostic error. However, the complex and often subconscious nature of clinical reasoning can impede the development of this skill. Protracted tools have been published to help guide self-reflection on clinical reasoning but might not be feasible in typical clinical settings. This case illustrates how the Systematic Clinical Reasoning in Physical Therapy (SCRIPT) tool can be used to guide the clinical reasoning process and prompt a physical therapist to search the literature to answer a clinical question and facilitate formal mentorship sessions in postprofessional physical therapist training programs. The SCRIPT tool enabled the mentee to generate appropriate hypotheses, plan the examination, query the literature to answer a clinical question, establish a physical therapist diagnosis, and design an effective treatment plan. The SCRIPT tool also facilitated the mentee's clinical reasoning and provided the mentor insight into the mentee's clinical reasoning. The reliability and validity of the SCRIPT tool have not been formally studied. Clinical mentorship is a cornerstone of postprofessional training programs and intended to develop advanced clinical reasoning skills. However, clinical reasoning is often subconscious and, therefore, a challenging skill to develop. The use of a tool such as the SCRIPT may facilitate developing clinical reasoning skills by providing a systematic approach to data gathering and making clinical judgments to bring clinical reasoning to the conscious level, facilitate self-reflection, and make a mentored physical therapist's thought processes explicit to his or her clinical mentor. © 2017 American Physical Therapy Association

Systematic development of a self-help and motivational enhancement intervention to promote sexual health in HIV-positive men who have sex with men.

PubMed

Van Kesteren, Nicole M C; Kok, Gerjo; Hospers, Harm J; Schippers, Jan; De Wildt, Wencke

2006-12-01

The objective of this study was to describe the application of a systematic process-Intervention Mapping-to developing a theory- and evidence-based intervention to promote sexual health in HIV-positive men who have sex with men (MSM). Intervention Mapping provides a framework that gives program planners a systematic method for decision-making in each phase of intervention development. In Step 1, we focused on the improvement of two health-promoting behaviors: satisfactory sexual functioning and safer sexual behavior. These behaviors were then linked with selected personal and external determinants, such as attitudes and social support, to produce a set of proximal program objectives. In Step 2, theoretical methods were identified to influence the proximal program objectives and were translated into practical strategies. Although theoretical methods were derived from various theories, self-regulation theory and a cognitive model of behavior change provided the main framework for selecting the intervention methods. The main strategies chosen were bibliotherapy (i.e., the use of written material to help people solve problems or change behavior) and motivational interviewing. In Step 3, the theoretical methods and practical strategies were applied in a program that comprised a self-help guide, a motivational interviewing session and a motivational interviewing telephone call, both delivered by specialist nurses in HIV treatment centers. In Step 4, implementation was anticipated by developing a linkage group to ensure involvement of program users in the planning process and conducting additional research to understand how to implement our program better. In Step 5, program evaluation was anticipated based on the planning process from the previous Intervention Mapping steps.

Integrating interprofessional education into continuing education: a planning process for continuing interprofessional education programs.

PubMed

Owen, John A; Schmitt, Madeline H

2013-01-01

Informal continuing interprofessional education (CIPE) can be traced back decades in the United States; however, interest in formal CIPE is recent. Interprofessional education (IPE) now is recognized as an important component of new approaches to continuing education (CE) that are needed to increase health professionals' ability to improve outcomes of care. Although there are examples of CIPE programs that are being successfully implemented, a clearly articulated, step-by-step planning process to help guide educators in providing effective CIPE programs is lacking. This lack of guidance poses a significant barrier to increasing the number of CIPE programs in the United States. In this article, we describe a process for developing, implementing, and evaluating CIPE programs using the familiar systematic CE planning process. Limitations of traditional CE also are addressed, and the relationship between CIPE and other new approaches to CE is clarified. Four examples of CIPE programs are provided to illustrate how the planning process can be adapted to include IPE, while implementing recommended changes in traditional CE offerings. The article is concluded with a discussion of some of the challenges that will face CE educators in moving toward a new vision of CE integrated with IPE. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

The economic evidence for advance care planning: Systematic review of evidence.

PubMed

Dixon, Josie; Matosevic, Tihana; Knapp, Martin

2015-12-01

Advance care planning is a process of discussion and review concerning future care in the event of losing capacity. Aimed at improving the appropriateness and quality of care, it is also often considered a means of making better use of healthcare resources at the end of life. To review and summarise economic evidence on advance care planning. A systematic review of the academic literature. We searched for English language, peer-reviewed journal articles, 1990-2014, using relevant research databases: PubMed, ProQuest, CINAHL Plus with Full Text; EconLit, PsycINFO, SocINDEX with Full Text and International Bibliography of the Social Sciences. Empirical studies using statistical methods in which advance care planning and costs are variables were included. There are no published cost-effectiveness studies. Included studies focus on healthcare savings, usually associated with reduced demand for hospital care. Advance care planning appears to be associated with healthcare savings for some people in some circumstances, such as people living with dementia in the community, people in nursing homes or in areas with high end-of-life care spending. There is no evidence that advance care planning is likely to be more expensive. There is need for clearer articulation of the likely mechanisms by which advance care planning can lead to reduced care costs or improved cost-effectiveness, particularly for people who retain capacity. There is also a need to consider wider costs, including the costs of advance care planning facilitation or interventions and the costs of substitute health, social and informal care. Economic outcomes need to be considered in the context of quality benefits. © The Author(s) 2015.

[Systematization of nursing assistance: subsidies for implementation].

PubMed

Hermida, Patrícia Madalena Vieira; Araújo, Izilda Esmênia Muglia

2006-01-01

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

Survivorship care plan preferences of cancer survivors and health care providers: a systematic review and quality appraisal of the evidence.

PubMed

Klemanski, Dori L; Browning, Kristine K; Kue, Jennifer

2016-02-01

The purpose of this systematic review was to describe and examine the current use of treatment summaries and survivorship care plans (TSs/SCPs) for cancer survivors, as well as to summarize and critically assess relevant literature regarding their preferences and usefulness. There is a knowledge gap regarding the preferences of stakeholders as to what is useful on a treatment summary or survivorship care plan. A systematic review of eligible manuscripts was conducted using preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Relevant studies were identified via PubMed, CINAHL Plus, and the Cochrane Library from 2005 through 2013. Eligible studies were critically appraised with qualitative and quantitative appraisal tools. There were 29 studies included in this review; 19 were quantitative. Survivors and primary care physicians preferred a printable format delivered 0 to 6 months posttreatment and highlighting signs and symptoms of recurrence, late, and long-term effects, and recommendations for healthy living. Oncology providers supported the concept of treatment summary and survivorship care plan but reported significant barriers to their provision. No studies incorporated caregiver perspectives of treatment summary and survivorship care plan. This systematic review did not reveal conclusive evidence regarding the needs of survivors or providers regarding treatment summaries and survivorship care plans. A lack of rigorous studies contributed to this. Treatment summaries and survivorship care plans are useful for cancer survivors; however, future rigorous studies should be conducted to identify and prioritize the preferences of survivors regarding these.

Planning in Education--A Systematic Approach

ERIC Educational Resources Information Center

Barker, L. J.

1977-01-01

Presents a case for and poses a procedure including techniques for a systematic approach to planning in education as a means of improving efficiency and effectiveness. Available from: Australian College of Education, 916 Swanston Street, Carlton, Victoria 3053, Australia, $2.50 single copy. (Author/MLF)

Use of Intervention Mapping to Enhance Health Care Professional Practice: A Systematic Review.

PubMed

Durks, Desire; Fernandez-Llimos, Fernando; Hossain, Lutfun N; Franco-Trigo, Lucia; Benrimoj, Shalom I; Sabater-Hernández, Daniel

2017-08-01

Intervention Mapping is a planning protocol for developing behavior change interventions, the first three steps of which are intended to establish the foundations and rationales of such interventions. This systematic review aimed to identify programs that used Intervention Mapping to plan changes in health care professional practice. Specifically, it provides an analysis of the information provided by the programs in the first three steps of the protocol to determine their foundations and rationales of change. A literature search was undertaken in PubMed, Scopus, SciELO, and DOAJ using "Intervention Mapping" as keyword. Key information was gathered, including theories used, determinants of practice, research methodologies, theory-based methods, and practical applications. Seventeen programs aimed at changing a range of health care practices were included. The social cognitive theory and the theory of planned behavior were the most frequently used frameworks in driving change within health care practices. Programs used a large variety of research methodologies to identify determinants of practice. Specific theory-based methods (e.g., modelling and active learning) and practical applications (e.g., health care professional training and facilitation) were reported to inform the development of practice change interventions and programs. In practice, Intervention Mapping delineates a three-step systematic, theory- and evidence-driven process for establishing the theoretical foundations and rationales underpinning change in health care professional practice. The use of Intervention Mapping can provide health care planners with useful guidelines for the theoretical development of practice change interventions and programs.

Ethical Guidance for Disaster Response, Specifically Around Crisis Standards of Care: A Systematic Review.

PubMed

Leider, Jonathon P; DeBruin, Debra; Reynolds, Nicole; Koch, Angelica; Seaberg, Judy

2017-09-01

Terrorism, disease outbreaks, and other natural disasters and mass casualty events have pushed health care and public health systems to identify and refine emergency preparedness protocols for disaster response. Ethical guidance, alongside legal and medical frameworks, are increasingly common components of disaster response plans. To systematically review the prevalence and content of ethical guidance offered for disaster response, specifically around crisis standards of care (CSCs). We systematically indexed academic literature from PubMed, Google Scholar, and ISI Web of Science from 2012 to 2016. We searched for peer-reviewed articles that substantively engaged in discussion of ethical guidance for CSCs. Researchers screened potential articles for identification and discussion of ethical issues in CSC planning. We categorized and cataloged ethical concepts and principles. Of 580 peer-reviewed articles mentioning ethics and CSCs or disaster planning, 38 (6%) met selection criteria. The systematic review of the CSC ethics literature since 2012 showed that authors were primarily focused on the ethical justifications for CSC (n = 20) as well as a need for ethics guidelines for implementing CSCs; the ethical justifications for triage (n = 19), both as to which criteria to use and the appropriate processes by which to employ triage; and international issues (n = 17). In addition to these areas of focus, the scholarly literature included discussion of a number of other ethical issues, including duty to care (n = 11), concepts of a duty to plan (n = 8), utilitarianism (n = 5), moral distress (n = 4), professional norms (n = 3), reciprocity (n = 2), allocation criteria (n = 4), equity (n = 4), research ethics (n = 2), duty to steward resources (n = 2), social utility and social worth (n = 2), and a number of others (n = 20). Although public health preparedness efforts have paid increasing attention to CSCs in recent years, CSC plans have rarely been implemented within the United States to date, although some components are common (e.g., triage is used in US emergency departments regularly). Conversely, countries outside the United States more commonly implement CSCs within a natural disaster or humanitarian crisis response, and may offer significant insight into ethics and disaster response for US-based practitioners. This systematic review identifies the most oft-used and -discussed ethical concepts and principles used in disaster planning around CSCs. Although discussion of more nuanced issues (e.g., health equity) are present, the majority of items substantively engaging in ethical discussion around disaster planning do so regarding triage and why ethics is needed in disaster response generally. Public health implications. A significant evolution in disaster planning has occurred within the past decade; ethical theories and frameworks have been put to work. For ethical guidance to be useful, it must be practical and implementable. Although high-level, abstract frameworks were once prevalent in disaster planning-especially in the early days of pandemic planning-concerns about the ethically difficult concept of CSCs pervade scholarly articles. Ethical norms must be clearly stated and justified and practical guidelines ought to follow from them. Ethical frameworks should guide clinical protocols, but this requires that ethical analysis clarifies what strategies to use to honor ethical commitments and achieve ethical objectives. Such implementation issues must be considered well ahead of a disaster. As governments and health care systems plan for mass casualty events, ethical guidance that is theoretically sound and practically useful can-and should-form an important foundation from which to build practical guidance for responding to disasters with morally appropriate means.

Creating windows of opportunity for policy change: Incorporating evidence into decentralized planning in Kenya.

PubMed Central

Ashford, Lori S.; Smith, Rhonda R.; De Souza, Roger-Mark; Fikree, Fariyal F.; Yinger, Nancy V.

2006-01-01

PROBLEM: Because researchers and policy-makers work in different spheres, policy decisions in the health arena are often not based on available scientific evidence. APPROACH: We describe a model that illustrates the policy process and how to work strategically to translate knowledge into policy actions. Several types of activity--agenda-setting, coalition building and policy learning--together can create a window of opportunity for policy change. LOCAL SETTING: Activities were undertaken as part of the Kenyan Ministry of Health's new decentralized planning-process. The objective was to ensure that the results of a national assessment of health services were used in the preparation of district-level health plans. RELEVANT CHANGES: Following the intervention, 70 district-level, evidence-based work plans were developed and approved by the Kenyan Ministry of Health. LESSONS LEARNED: Substantial investment and effort are needed to bring stakeholders together to work towards policy change. More in-depth evaluation of these efforts can aid understanding of how systematic approaches to policy change can be replicated elsewhere. PMID:16917657

The relationship of ecosystem management to NEPA and its goals

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

Phillips, C.G.; Randolph, J.

The National Environmental Policy Act of 1969 (NEPA) was intended to promote a systematic, comprehensive, interdisciplinary approach to planning and decision making, including the integration of the natural and social sciences and the design arts. NEPA critics have cited three key shortcomings in its implementation: (1) a lack of engagement with the NEPA process early in the planning process through interdisciplinary collaboration; (2) a lack of rigorous science and the incorporation of ecological principles and techniques; and (3) a lack of emphasis on the Act's substantive goals and objectives. In recent years and independent of NEPA, a policy of ecosystemmore » management has been developed, which represents a fundamental change from a fragmented, incremental planning and management approach to a holistic, comprehensive, interdisciplinary land and resource management effort. The authors postulate that by incorporating ecosystem management principles in their planning and decisionmaking, federal agencies can address the shortcomings in NEPA implementation and move closes to NEPA's intent. A case analysis of EISs prepared by the USDA Forest Service before and after adopting an ecosystem management approach supports their hypothesis.« less

Applying graphics user interface ot group technology classification and coding at the Boeing aerospace company

NASA Astrophysics Data System (ADS)

Ness, P. H.; Jacobson, H.

1984-10-01

The thrust of 'group technology' is toward the exploitation of similarities in component design and manufacturing process plans to achieve assembly line flow cost efficiencies for small batch production. The systematic method devised for the identification of similarities in component geometry and processing steps is a coding and classification scheme implemented by interactive CAD/CAM systems. This coding and classification scheme has led to significant increases in computer processing power, allowing rapid searches and retrievals on the basis of a 30-digit code together with user-friendly computer graphics.

Exploring governance learning: How policymakers draw on evidence, experience and intuition in designing participatory flood risk planning.

PubMed

Newig, Jens; Kochskämper, Elisa; Challies, Edward; Jager, Nicolas W

2016-01-01

The importance of designing suitable participatory governance processes is generally acknowledged. However, less emphasis has been put on how decision-makers design such processes, and how they learn about doing so. While the policy learning literature has tended to focus on the substance of policy, little research is available on learning about the design of governance. Here, we explore different approaches to learning among German policymakers engaged in implementing the European Floods Directive. We draw on official planning documents and expert interviews with state-level policymakers to focus on learning about the procedural aspects of designing and conducting participatory flood risk management planning. Drawing on the policy learning and evidence-based governance literatures, we conceptualise six types of instrumental 'governance learning' according to sources of learning (endogenous and exogenous) and modes of learning (serial and parallel). We empirically apply this typology in the context of diverse participatory flood risk management planning processes currently unfolding across the German federal states. We find that during the first Floods Directive planning cycle, policymakers have tended to rely on prior experience in their own federal states with planning under the Water Framework Directive to inform the design and carrying out of participatory processes. In contrast, policymakers only sporadically look to experiences from other jurisdictions as a deliberate learning strategy. We argue that there is scope for more coordinated and systematic learning on designing effective governance, and that the latter might benefit from more openness to experimentation and learning on the part of policymakers.

Interhemispheric comparison of atmospheric circulation features as evaluated from Nimbus satellite data

NASA Technical Reports Server (NTRS)

Reiter, E. R.; Vonderhaar, T. H.; Lovill, J. E.; Adler, R.; Srivatsangam, S.; Fields, A.

1972-01-01

The report includes a complete analyses of O3 data inferred from Nimbus-3 measurements, a discussion of future areas of study, description of the regression and inversion methods developed to infer atmospheric temperature and tropopause characteristics, as well as the plan to process the satellite data for a systematic study of the relative circulation differences between Northern and Southern Hemispheres.

Product Definition Data Interface (PDDI) Product Specification

DTIC Science & Technology

1991-07-01

syntax of the language gives a precise specification of the data without interpretation of it. M - Constituent Read Block. CSECT - Control Section, the...to conform to the PDDI Access Software’s internal data representation so that it may be further processed. JCL - Job Control Language - IBM language...software development and life cycle * phases. OUALITY CONTROL - The planned and systematic application of all actions (management/technical) necessary to

JPRS Report, Soviet Union, International Affairs.

DTIC Science & Technology

1987-08-10

centers to help maintain sold equipment; organize joint-stock companies ; open technical-commercial buros, etc. We plan to reorganize our patent...systematically. The successes of the CEMA countries are especially tangible against the background of the economic situation which has taken shape in the...the Unilever Fleysgrup firm they showed us a kielbasa and sausage production line which uses the process of coextrusion. It can produce one and a

Outcome-Focused Market Intelligence: Extracting Better Value and Effectiveness from Strategic Sourcing

DTIC Science & Technology

2013-04-01

disseminating information are not systematically taught or developed in the government’s acquisition workforce. However, a study of 30 large firms ...to keep themselves abreast of changes in the marketplace, such as technological advances, process improvements, and available sources of supply. The...and performance measurement (Monczka & Petersen, 2008). Firms that develop supply management strategic plans typically set three-to-five year

A practical and systematic approach to organisational capacity strengthening for research in the health sector in Africa

PubMed Central

2014-01-01

Background Despite increasing investment in health research capacity strengthening efforts in low and middle income countries, published evidence to guide the systematic design and monitoring of such interventions is very limited. Systematic processes are important to underpin capacity strengthening interventions because they provide stepwise guidance and allow for continual improvement. Our objective here was to use evidence to inform the design of a replicable but flexible process to guide health research capacity strengthening that could be customized for different contexts, and to provide a framework for planning, collecting information, making decisions, and improving performance. Methods We used peer-reviewed and grey literature to develop a five-step pathway for designing and evaluating health research capacity strengthening programmes, tested in a variety of contexts in Africa. The five steps are: i) defining the goal of the capacity strengthening effort, ii) describing the optimal capacity needed to achieve the goal, iii) determining the existing capacity gaps compared to the optimum, iv) devising an action plan to fill the gaps and associated indicators of change, and v) adapting the plan and indicators as the programme matures. Our paper describes three contrasting case studies of organisational research capacity strengthening to illustrate how our five-step approach works in practice. Results Our five-step pathway starts with a clear goal and objectives, making explicit the capacity required to achieve the goal. Strategies for promoting sustainability are agreed with partners and incorporated from the outset. Our pathway for designing capacity strengthening programmes focuses not only on technical, managerial, and financial processes within organisations, but also on the individuals within organisations and the wider system within which organisations are coordinated, financed, and managed. Conclusions Our five-step approach is flexible enough to generate and utilise ongoing learning. We have tested and critiqued our approach in a variety of organisational settings in the health sector in sub-Saharan Africa, but it needs to be applied and evaluated in other sectors and continents to determine the extent of transferability. PMID:24581148

A Nursing Intelligence System to Support Secondary Use of Nursing Routine Data

PubMed Central

Rauchegger, F.; Ammenwerth, E.

2015-01-01

Summary Background Nursing care is facing exponential growth of information from nursing documentation. This amount of electronically available data collected routinely opens up new opportunities for secondary use. Objectives To present a case study of a nursing intelligence system for reusing routinely collected nursing documentation data for multiple purposes, including quality management of nursing care. Methods The SPIRIT framework for systematically planning the reuse of clinical routine data was leveraged to design a nursing intelligence system which then was implemented using open source tools in a large university hospital group following the spiral model of software engineering. Results The nursing intelligence system is in routine use now and updated regularly, and includes over 40 million data sets. It allows the outcome and quality analysis of data related to the nursing process. Conclusions Following a systematic approach for planning and designing a solution for reusing routine care data appeared to be successful. The resulting nursing intelligence system is useful in practice now, but remains malleable for future changes. PMID:26171085

Use of technology to support information needs for continuity of operations planning in public health: a systematic review.

PubMed

Reeder, Blaine; Turner, Anne; Demiris, George

2010-01-01

Continuity of operations planning focuses on an organization's ability to deliver essential services before, during and after an emergency. Public health leaders must make decisions based on information from many sources and their information needs are often facilitated or hindered by technology. The aim of this study is to provide a systematic review of studies of technology projects that address public health continuity of operations planning information needs and to discuss patterns, themes, and challenges to inform the design of public health continuity of operations information systems. To return a comprehensive results set in an under-explored area, we searched broadly in the Medline and EBSCOHost bibliographic databases using terms from prior work in public health emergency management and continuity of operations planning in other domains. In addition, we manually searched the citation lists of publications included for review. A total of 320 publications were reviewed. Twenty studies were identified for inclusion (twelve risk assessment decision support tools, six network and communications-enabled decision support tools, one training tool and one dedicated video-conferencing tool). Levels of implementation for information systems in the included studies range from proposed frameworks to operational systems. There is a general lack of documented efforts in the scientific literature for technology projects about public health continuity of operations planning. Available information about operational information systems suggest inclusion of public health practitioners in the design process as a factor in system success.

Organizing knowledge for tutoring fire loss prevention

NASA Astrophysics Data System (ADS)

Schmoldt, Daniel L.

1989-09-01

The San Bernardino National Forest in southern California has recently developed a systematic approach to wildfire prevention planning. However, a comprehensive document or other mechanism for teaching this process to other prevention personnel does not exist. An intelligent tutorial expert system is being constructed to provide a means for learning the process and to assist in the creation of specific prevention plans. An intelligent tutoring system (ITS) contains two types of knowledge—domain and tutoring. The domain knowledge for wildfire prevention is structured around several foci: (1) individual concepts used in prevention planning; (2) explicitly specified interrelationships between concepts; (3) deductive methods that contain subjective judgment normally unavailable to less-experienced users; (4) analytical models of fire behavior used for identification of hazard areas; (5) how-to guidance needed for performance of planning tasks; and (6) expository information that provides a rationale for planning steps and ideas. Combining analytical, procedure, inferential, conceptual, and expositional knowledge into a tutoring environment provides the student and/or user with a multiple perspective of the subject matter. A concept network provides a unifying framework for structuring and utilizing these diverse forms of prevention planning knowledge. This network structure borrows from and combines semantic networks and frame-based knowledge representations. The flexibility of this organization facilitates an effective synthesis and organization of multiple knowledge forms.

Neurocognitive Enhancement or Impairment? A Systematic Meta-Analysis of Prescription Stimulant Effects on Processing Speed, Decision-Making, Planning, and Cognitive Perseveration

PubMed Central

Marraccini, Marisa E.; Weyandt, Lisa L.; Rossi, Joseph S.; Gudmundsdottir, Bergljot Gyda

2016-01-01

Increasing numbers of adults, particularly college students, are misusing prescription stimulants primarily for cognitive/academic enhancement, so it is critical to explore whether empirical findings support neurocognitive benefits of prescription stimulants. Previous meta-analytic studies have supported small benefits from prescription stimulants for the cognitive domains of inhibitory control and memory; however, no meta-analytic studies have examined the effects on processing speed or the potential impairment on other domains of cognition, including planning, decision-making, and cognitive perseveration. Therefore, the present study conducted a meta-analysis of the available literature examining the effects of prescription stimulants on specific measures of processing speed, planning, decision-making, and cognitive perseveration among healthy adult populations. The meta-analysis results indicated a positive influence of prescription stimulant medication on processing speed accuracy, with an overall mean effect size of g = 0.282 (95% CI 0.077, 0.488; n = 345). Neither improvements nor impairments were revealed for planning time, planning accuracy, advantageous decision-making, or cognitive perseveration; however findings are limited by the small number of studies examining these outcomes. Findings support that prescription stimulant medication may indeed act as a neurocognitive enhancer for accuracy measures of processing speed without impeding other areas of cognition. Considering that adults are already engaging in illegal use of prescription stimulants for academic enhancement, as well as the potential for stimulant misuse to have serious side effects, the establishment of public policies informed by interdisciplinary research surrounding this issue, whether restrictive or liberal, is of critical importance. PMID:27454675

COMET-LICSAR: Systematic Deformation Monitoring of Fault Zones and Volcanoes with the Sentinel-1 Constellation

NASA Astrophysics Data System (ADS)

Spaans, K.; Wright, T. J.; Hooper, A. J.; Hatton, E. L.; González, P. J.; Bhattarai, S.; Biggs, J.; Crippa, P.; Ebmeier, S. K.; Elliott, J.; Gaddes, M.; Li, Z.; Parsons, B.; Qiu, Q.; McDougall, A.; Walters, R. J.; Weiss, J. R.; Ziebart, M.

2017-12-01

The Sentinel-1 constellation represents a major advance in our ability to monitor our planet's hazardous tectonic and volcanic zones. Here we present the latest progress from COMET (*), where we are now providing deformation results to the community for volcanoes and the tectonic belts (**). COMET now responds routinely to most significant continental earthquakes - Sentinel-1 allows us to do this within a few days for most earthquakes. For example, after the M7.8 Kaikoura (New Zealand) earthquake we supplied a processed interferogram to the community just 5 hours and 37 minutes after the Sentinel-1 acquisition. By the end of 2017, we will be producing interferogram products systematically for all earthquakes larger than M 6.0. For deformation data to be useful for preparedness, we need accuracy on the order of 1 mm/yr or better. This requires mass processing of long time series of radar acquisitions. We are currently (July 2017) processing interferograms systematically for the entire Alpine-Himalayan belt ( 9000 x 2000 km) using our LiCSAR chain, making interferograms and coherence products available to the community. By December 2017, we plan to process a wider tectonic area and the majority of subaerial volcanoes. We currently serve displacement and coherence grids, but plan to provide average deformation rates and time series. Results are available through our dedicated portal (**), and are being linked to the ESA G-TEP and EPOS during 2017. We will show the latest results for tectonics and volcanism, and discuss how these can be used to build value-added products, including (i) maps of tectonic strain (ii) maps of seismic hazard (iii) volcano deformation alerts. The accuracy of these products will improve as the number of data products acquired by Sentinel-1 increases, and as the time series lengthen. *http://comet.nerc.ac.uk**http://comet.nerc.ac.uk/COMET-LiCS-portal/

COMET-LICSAR: Systematic Deformation Monitoring of Fault Zones and Volcanoes with the Sentinel-1 Constellation

NASA Astrophysics Data System (ADS)

Spaans, K.; Wright, T. J.; Hooper, A. J.; Hatton, E. L.; González, P. J.; Bhattarai, S.; Biggs, J.; Crippa, P.; Ebmeier, S. K.; Elliott, J.; Gaddes, M.; Li, Z.; Parsons, B.; Qiu, Q.; McDougall, A.; Walters, R. J.; Weiss, J. R.; Ziebart, M.

2016-12-01

The Sentinel-1 constellation represents a major advance in our ability to monitor our planet's hazardous tectonic and volcanic zones. Here we present the latest progress from COMET (*), where we are now providing deformation results to the community for volcanoes and the tectonic belts (**). COMET now responds routinely to most significant continental earthquakes - Sentinel-1 allows us to do this within a few days for most earthquakes. For example, after the M7.8 Kaikoura (New Zealand) earthquake we supplied a processed interferogram to the community just 5 hours and 37 minutes after the Sentinel-1 acquisition. By the end of 2017, we will be producing interferogram products systematically for all earthquakes larger than M 6.0. For deformation data to be useful for preparedness, we need accuracy on the order of 1 mm/yr or better. This requires mass processing of long time series of radar acquisitions. We are currently (July 2017) processing interferograms systematically for the entire Alpine-Himalayan belt ( 9000 x 2000 km) using our LiCSAR chain, making interferograms and coherence products available to the community. By December 2017, we plan to process a wider tectonic area and the majority of subaerial volcanoes. We currently serve displacement and coherence grids, but plan to provide average deformation rates and time series. Results are available through our dedicated portal (**), and are being linked to the ESA G-TEP and EPOS during 2017. We will show the latest results for tectonics and volcanism, and discuss how these can be used to build value-added products, including (i) maps of tectonic strain (ii) maps of seismic hazard (iii) volcano deformation alerts. The accuracy of these products will improve as the number of data products acquired by Sentinel-1 increases, and as the time series lengthen. *http://comet.nerc.ac.uk**http://comet.nerc.ac.uk/COMET-LiCS-portal/

A senior manager with a knowledge management portfolio: the Santa Clara County experience.

PubMed

Lindberg, Arley

2012-01-01

The agency director sought to create a systematically coordinated department that utilizes knowledge management strategies to promote evidence-informed practice. In his view, the organization was not providing needed information or organizational supports for practitioners to use knowledge effectively. To address this issue, he created a Director of Development and Operational Planning (DDOP) position with the responsibility to build structures and facilitate processes that support knowledge management. The DDOP oversees research and planning, government relations, legislative development and support, Board of Supervisors communications, staff development and training, community contracts, public information and in-house communication. The DDOP is reorganizing units under her supervision to create a knowledge management matrix that will implement new knowledge sharing strategies related to evaluation, contracts, legislation, organizational development, policy and planning, and staff development. The case study describes challenges and strategies related to: government regulations, size and complexity of the agency, staff resistance, and the developmental nature of the process. Copyright © Taylor & Francis Group, LLC

Patient- and family-centered performance measures focused on actionable processes of care for persistent and chronic critical illness: protocol for a systematic review.

PubMed

Rose, Louise; Istanboulian, Laura; Allum, Laura; Burry, Lisa; Dale, Craig; Hart, Nicholas; Kydonaki, Claire; Ramsay, Pam; Pattison, Natalie; Connolly, Bronwen

2017-04-17

Approximately 5 to 10% of critically ill patients transition from acute critical illness to a state of persistent and in some cases chronic critical illness. These patients have unique and complex needs that require a change in the clinical management plan and overall goals of care to a focus on rehabilitation, symptom relief, discharge planning, and in some cases, end-of-life care. However, existing indicators and measures of care quality, and tools such as checklists, that foster implementation of best practices, may not be sufficiently inclusive in terms of actionable processes of care relevant to these patients. Therefore, the aim of this systematic review is to identify the processes of care, performance measures, quality indicators, and outcomes including reports of patient/family experience described in the current evidence base relevant to patients with persistent or chronic critical illness and their family members. Two authors will independently search from inception to November 2016: MEDLINE, Embase, CINAHL, Web of Science, the Cochrane Library, PROSPERO, the Joanna Briggs Institute and the International Clinical Trials Registry Platform. We will include all study designs except case series/reports of <10 patients describing their study population (aged 18 years and older) using terms such as persistent critical illness, chronic critical illness, and prolonged mechanical ventilation. Two authors will independently perform data extraction and complete risk of bias assessment. Our primary outcome is to determine actionable processes of care and interventions deemed relevant to patients experiencing persistent or chronic critical illness and their family members. Secondary outcomes include (1) performance measures and quality indicators considered relevant to our population of interest and (2) themes related to patient and family experience. We will use our systematic review findings, with data from patient, family member and clinician interviews, and a subsequent consensus building process to inform the development of quality metrics and tools to measure processes of care, outcomes and experience for patients experiencing persistent or chronic critical illness and their family members. PROSPERO CRD42016052715.

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

PubMed Central

Tessema, Gizachew Assefa; Streak Gomersall, Judith; Mahmood, Mohammad Afzal; Laurence, Caroline O.

2016-01-01

Background Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa. Methods Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings. Results From 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client’s waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as ‘pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers’ behaviour. Conclusion There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking contraceptive methods are important to improve the quality of care in family planning services. Strategies to improve provider behavior and competency are important. Moreover, strategies that minimize client waiting time and ensure client confidentiality should be implemented to ensure quality of care in family planning services. However, no strong evidence based conclusions and recommendations may be drawn from the evidence. Future studies are needed to identify the most important factors associated with quality of care in family planning services in a wider range of African countries. PMID:27812124

Apprehensions and Expectations of the Adoption of Systematically Planned, Outcome-Oriented Practice

ERIC Educational Resources Information Center

Savaya, Riki; Altschuler, Dorit; Melamed, Sharon

2013-01-01

Objectives: The study examined social workers' apprehensions and expectations of the impending adoption of systematically planned, empirically based, outcome-oriented practice (SEOP). Method: Employing a mixed methods longitudinal design, the study used concept mapping to identify and map workers' apprehensions and expectations and a self-reported…

Assumption-Based Planning; A Planning Tool for Very Uncertain Times

DTIC Science & Technology

1993-01-01

Ansoff , Igor H,, "Conceptual Underpinnings of Systematic Strategic Management," European Journal of Operational Research, Vol. 1, 1985, pp. 2-19...2Ansoff, Igor fI., *Conceptual Underpinnings of Systematic Strategic Management," European Journal ofOperational Resarch, Vol. 1, 1995, pp. 2-19. 72

Parental disclosure of assisted reproductive technology (ART) conception to their children: a systematic and meta-analytic review.

PubMed

Tallandini, Maria Anna; Zanchettin, Liviana; Gronchi, Giorgio; Morsan, Valentina

2016-06-01

Does a genetic link and/or a child's age influence a parent's willingness to talk to a child about how they were conceived? The presence/absence of a biological link and the child's age clearly influences the disclosure process. The research published to date has yielded diverse findings on autologous and donor assisted reproductive technology (ART) parents' disclosure of the conception method to their children and on the ages at which the children are informed, if told. A systematic review and meta-analysis were carried out. A search of MEDLINE and PUBMED was run for English-language studies published from January 1996 through January 2015. A total of 26 studies were included in the systematic review, 19 of which were included in the meta-analysis. A total of 2814 parent responses were included in the systematic review. Two authors independently assessed the studies for review inclusion. Selection criteria were: peer-reviewed studies, quantitative studies only, research conducted after the birth of ART-conceived children, number of parent responses on disclosure status reported in terms of Told, Plan to tell, Uncertain, Plan to not tell. Thirty-two (32) study-level effect size statistics were included in the meta-analysis. Three authors independently assessed the risk of bias. Among parents who responded, 23% of the total number of parent responses indicated that they had already Told; 44% were Planning to tell; 13% were Uncertain and 20% were Planning to not tell their children about their ART conception. Meta-analysis gave no statistically significant differences between autologous and donor ART in the <10 years age group, when comparing Told versus Planning to tell/Uncertain/Planning to not tell. In both cases, the probability of disclosure was <50% (P < 0.05). Conversely, in the older age group (≥10 years old), a statistically significant difference was observed for autologous ART (Cohen's h = 0.86): Planning to tell showed a higher probability in the 10 years age group for the autologous ART subsample, than in the donor ART subsample (Cohen's h = 0.89). All parents participated voluntarily in the studies and may have influenced the data in the direction of disclosure thereby. The reviewed studies, moreover, differed in terms of methodology, type of sample and data categorization method. The number of studies analyzing disclosure for children ≥10 years was quite limited; and lastly, most of the data examined were not collected longitudinally. The high number of non-disclosing parents treated by donor ART points to an underestimation of the medical risks for the offspring (the presence of genetic illnesses, inadvertent consanguinity) and suggests that these children's rights may not be given due consideration. The decision to disclose may become more difficult over time, and ART parents need greater psychological support throughout the process. The study was funded by the University of Trieste. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Utilizing a Health Impact Assessment (HIA) to Connect Natural ...

EPA Pesticide Factsheets

Marrying scientific and health research with natural resource management should be a straightforward process. However, differences in purpose, goals, language, levels of detail and implementation authority between the scientists who conduct research and resource managers who plan and implement projects make it difficult for resource managers to include information not specific to the problem at hand. One method to overcome this barrier is a Health Impact Assessment (HIA) or process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making process. An HIA informs decision makers and stakeholders of the potential health effects of a proposed program, policy, project or plan through a systematic investigation of impacts to health and health determinants and deliberative engagement of community members and other stakeholders throughout the HIA process. USEPA will be conducting an HIA on the Minnesota Department of Natural Resources’ sediment remediation and habitat restoration project at Kingsbury Bay and Grassy Point. This poster outlines the HIA process, illustrates how technical and stakeholder committees inform the process, and presents the determinants of health that will be explored in the HIA. not applicable

The TAME Project: Towards improvement-oriented software environments

NASA Technical Reports Server (NTRS)

Basili, Victor R.; Rombach, H. Dieter

1988-01-01

Experience from a dozen years of analyzing software engineering processes and products is summarized as a set of software engineering and measurement principles that argue for software engineering process models that integrate sound planning and analysis into the construction process. In the TAME (Tailoring A Measurement Environment) project at the University of Maryland, such an improvement-oriented software engineering process model was developed that uses the goal/question/metric paradigm to integrate the constructive and analytic aspects of software development. The model provides a mechanism for formalizing the characterization and planning tasks, controlling and improving projects based on quantitative analysis, learning in a deeper and more systematic way about the software process and product, and feeding the appropriate experience back into the current and future projects. The TAME system is an instantiation of the TAME software engineering process model as an ISEE (integrated software engineering environment). The first in a series of TAME system prototypes has been developed. An assessment of experience with this first limited prototype is presented including a reassessment of its initial architecture.

Propellant injection systems and processes

NASA Technical Reports Server (NTRS)

Ito, Jackson I.

1995-01-01

The previous 'Art of Injector Design' is maturing and merging with the more systematic 'Science of Combustion Device Analysis.' This technology can be based upon observation, correlation, experimentation and ultimately analytical modeling based upon basic engineering principles. This methodology is more systematic and far superior to the historical injector design process of 'Trial and Error' or blindly 'Copying Past Successes.' The benefit of such an approach is to be able to rank candidate design concepts for relative probability of success or technical risk in all the important combustion device design requirements and combustion process development risk categories before committing to an engine development program. Even if a single analytical design concept cannot be developed to predict satisfying all requirements simultaneously, a series of risk mitigation key enabling technologies can be identified for early resolution. Lower cost subscale or laboratory experimentation to demonstrate proof of principle, critical instrumentation requirements, and design discriminating test plans can be developed based on the physical insight provided by these analyses.

Conducting a multicentre and multinational qualitative study on patient transitions.

PubMed

Johnson, Julie K; Barach, Paul; Vernooij-Dassen, Myrra

2012-12-01

A multicentre, multinational research study requires careful planning and coordination to accomplish the aims of the study and to ensure systematic and rigorous examination of all project methods and data collected. The aim of this paper is to describe the approach we used during the HANDOVER Project to develop a multicentre, multinational research project for studying transitions of patient care while creating a community of practice for the researchers. We highlight the process used to assure the quality of a multicentre qualitative study and to create a codebook for data analysis as examples of attending to the community of practice while conducting rigorous qualitative research. Essential elements for the success of this multinational, multilanguage research project included recruiting a strong research team, explicit planning for decision-making processes to be used throughout the project, acknowledging the differences among the study settings and planning the protocols to capitalise upon those differences. Although not commonly discussed in reports of large research projects, there is an underlying, concurrent stream of activities to develop a cohesive team that trusts and respects one another's skills and that engage independent researchers in a group process that contributes to achieving study goals. We discuss other lessons learned and offer recommendations for other teams planning multicentre research.

A new methodology to integrate planetary quarantine requirements into mission planning, with application to a Jupiter orbiter

NASA Technical Reports Server (NTRS)

Howard, R. A.; North, D. W.; Pezier, J. P.

1975-01-01

A new methodology is proposed for integrating planetary quarantine objectives into space exploration planning. This methodology is designed to remedy the major weaknesses inherent in the current formulation of planetary quarantine requirements. Application of the methodology is illustrated by a tutorial analysis of a proposed Jupiter Orbiter mission. The proposed methodology reformulates planetary quarantine planning as a sequential decision problem. Rather than concentrating on a nominal plan, all decision alternatives and possible consequences are laid out in a decision tree. Probabilities and values are associated with the outcomes, including the outcome of contamination. The process of allocating probabilities, which could not be made perfectly unambiguous and systematic, is replaced by decomposition and optimization techniques based on principles of dynamic programming. Thus, the new methodology provides logical integration of all available information and allows selection of the best strategy consistent with quarantine and other space exploration goals.

[Orthodontic and orthognathic protocoles: systematization of the consultation of announcement and contribution of integrative medicine].

PubMed

Racy, Emmanuel; Le Norcy, Elvire

2017-12-01

The consultation of announcement is one of the key periods in an orthodontic and surgical process. The aim of this consultation is not only to make an aesthetic and orthodontic diagnosis but also a fine psychological analysis of the patient and his family before proposing a treatment plan. Integrative medical therapies, a recent evolution of medicine within the framework of the doctor-patient relation, have shown the positive impact on the treatment success of a good relationship. The preliminary collection of information on the patient's psyches is now part of the treatment guidelines and has a positive impact on treatment observance, management of pre- and post-operative care or more simply surgery acceptance. Therefore, a systematized patient record process including global medical assessment of the patient and not only orthodontic and cephalometric diagnosis is a key factor for the treatment outcome. © EDP Sciences, SFODF, 2017.

Measuring the Impact of Employment-Related Social Programs. A Primer on the Evaluation of Employment and Training, Vocational Education, Vocational Rehabilitation, and Other Job-Oriented Programs.

ERIC Educational Resources Information Center

Borus, Michael E.

An approach and methodology for the systematic measurement of the impact of employment-related social programs is presented in this primer. Chapter 1 focuses on evaluation as the third step (the first two being planning and operation) in the process of program implementation. Chapter 2 examines the impacts of social programs. Topics include…

Review of Research on Teachers’ Pedagogical Judgments, Plans, and Decisions,

DTIC Science & Technology

1982-11-01

simulation studies; and (3) training studies. Four laboratory and classroom studies have examined the degree to which reading clinicians and classroom teachers...clinicians who diagnosed the same cases. Finally, training teachers to conduct a systematic diagnosis of a reading problem increased the accuracy of their...evidence that training can overcome these inaccuracies to some degree, additional research on teachers’ judgmental processes is needed. Such research

Key principles to improve programmes and interventions in complementary feeding.

PubMed

Lutter, Chessa K; Iannotti, Lora; Creed-Kanashiro, Hilary; Guyon, Agnes; Daelmans, Bernadette; Robert, Rebecca; Haider, Rukhsana

2013-09-01

Although there are some examples of successful complementary feeding programmes to promote healthy growth and prevent stunting at the community level, to date there are few, if any, examples of successful programmes at scale. A lack of systematic process and impact evaluations on pilot projects to generate lessons learned has precluded scaling up of effective programmes. Programmes to effect positive change in nutrition rarely follow systematic planning, implementation, and evaluation (PIE) processes to enhance effectiveness over the long term. As a result a set of programme-oriented key principles to promote healthy growth remains elusive. The purpose of this paper is to fill this gap by proposing a set of principles to improve programmes and interventions to promote healthy growth and development. Identifying such principles for programme success has three requirements: rethinking traditional paradigms used to promote improved infant and young child feeding; ensuring better linkages to delivery platforms; and, improving programming. Following the PIE model for programmes and learning from experiences from four relatively large-scale programmes described in this paper, 10 key principles are identified in the areas of programme planning, programme implementation, programme evaluation, and dissemination, replication, and scaling up. Nonetheless, numerous operational research questions remain, some of which are highlighted in this paper. © 2013 John Wiley & Sons Ltd.

Prevention of falls, malnutrition and pressure ulcers among older persons - nursing staff's experiences of a structured preventive care process.

PubMed

Lannering, Christina; Ernsth Bravell, Marie; Johansson, Linda

2017-05-01

A structured and systematic care process for preventive work, aimed to reduce falls, pressure ulcers and malnutrition among older people, has been developed in Sweden. The process involves risk assessment, team-based interventions and evaluation of results. Since development, this structured work process has become web-based and has been implemented in a national quality registry called 'Senior Alert' and used countrywide. The aim of this study was to describe nursing staff's experience of preventive work by using the structured preventive care process as outlined by Senior Alert. Eight focus group interviews were conducted during 2015 including staff from nursing homes and home-based nursing care in three municipalities. The interview material was subjected to qualitative content analysis. In this study, both positive and negative opinions were expressed about the process. The systematic and structured work flow seemed to only partly facilitate care providers to improve care quality by making better clinical assessments, performing team-based planned interventions and learning from results. Participants described lack of reliability in the assessments and varying opinions about the structure. Furthermore, organisational structures limited the preventive work. © 2016 John Wiley & Sons Ltd.

Using ILIAC to Systematically Plan and Implement a Library Information Literacy Assessment Program for Freshman Classes

ERIC Educational Resources Information Center

Gustavson, Amy

2012-01-01

In order to prepare for the 2013 SACS reaffirmation, the Joyner Library instruction librarians developed a systematic assessment program using Oakleaf's Information Literacy Instruction Assessment Cycle (ILIAC) to plan for instruction, assess student learning and improve future student learning by reviewing data and enacting changes. The paper…

Use of Intervention Mapping to Enhance Health Care Professional Practice: A Systematic Review

ERIC Educational Resources Information Center

Durks, Desire; Fernandez-Llimos, Fernando; Hossain, Lutfun N.; Franco-Trigo, Lucia; Benrimoj, Shalom I.; Sabater-Hernández, Daniel

2017-01-01

Background: Intervention Mapping is a planning protocol for developing behavior change interventions, the first three steps of which are intended to establish the foundations and rationales of such interventions. Aim: This systematic review aimed to identify programs that used Intervention Mapping to plan changes in health care professional…

Teaching Treatment Planning.

ERIC Educational Resources Information Center

Seligman, Linda

1993-01-01

Describes approach to teaching treatment planning that author has used successfully in both seminars and graduate courses. Clarifies nature and importance of systematic treatment planning, then describes context in which treatment planning seems more effectively taught, and concludes with step-by-step plan for teaching treatment planning.…

SPIRIT: Systematic Planning of Intelligent Reuse of Integrated Clinical Routine Data. A Conceptual Best-practice Framework and Procedure Model.

PubMed

Hackl, W O; Ammenwerth, E

2016-01-01

Secondary use of clinical routine data is receiving an increasing amount of attention in biomedicine and healthcare. However, building and analysing integrated clinical routine data repositories are nontrivial, challenging tasks. As in most evolving fields, recognized standards, well-proven methodological frameworks, or accurately described best-practice approaches for the systematic planning of solutions for secondary use of routine medical record data are missing. We propose a conceptual best-practice framework and procedure model for the systematic planning of intelligent reuse of integrated clinical routine data (SPIRIT). SPIRIT was developed based on a broad literature overview and further refined in two case studies with different kinds of clinical routine data, including process-oriented nursing data from a large hospital group and high-volume multimodal clinical data from a neurologic intensive care unit. SPIRIT aims at tailoring secondary use solutions to specific needs of single departments without losing sight of the institution as a whole. It provides a general conceptual best-practice framework consisting of three parts: First, a secondary use strategy for the whole organization is determined. Second, comprehensive analyses are conducted from two different viewpoints to define the requirements regarding a clinical routine data reuse solution at the system level from the data perspective (BOTTOM UP) and at the strategic level from the future users perspective (TOP DOWN). An obligatory clinical context analysis (IN BETWEEN) facilitates refinement, combination, and integration of the different requirements. The third part of SPIRIT is dedicated to implementation, which comprises design and realization of clinical data integration and management as well as data analysis solutions. The SPIRIT framework is intended to be used to systematically plan the intelligent reuse of clinical routine data for multiple purposes, which often was not intended when the primary clinical documentation systems were implemented. SPIRIT helps to overcome this gap. It can be applied in healthcare institutions of any size or specialization and allows a stepwise setup and evolution of holistic clinical routine data reuse solutions.

[Coordination among healthcare levels: systematization of tools and measures].

PubMed

Terraza Núñez, Rebeca; Vargas Lorenzo, Ingrid; Vázquez Navarrete, María Luisa

2006-01-01

Improving healthcare coordination is a priority in many healthcare systems, particularly in chronic health problems in which a number of professionals and services intervene. There is an abundance of coordination strategies and mechanisms that should be systematized so that they can be used in the most appropriate context. The present article aims to analyse healthcare coordination and its instruments using the organisational theory. Coordination mechanisms can be classified according to two basic processes used to coordinate activities: programming and feedback. The optimal combination of mechanisms will depend on three factors: the degree to which healthcare activities are differentiated, the volume and type of interdependencies, and the level of uncertainty. Historically, healthcare services have based coordination on skills standardization and, most recently, on processes standardization, through clinical guidelines, maps, and plans. Their utilisation is unsatisfactory in chronic diseases involving intervention by several professionals with reciprocal interdependencies, variability in patients' response to medical interventions, and a large volume of information to be processed. In this case, mechanisms based on feedback, such as working groups, linking professionals and vertical information systems, are more effective. To date, evaluation of healthcare coordination has not been conducted systematically, using structure, process and results indicators. The different strategies and instruments have been applied mainly to long-term care and mental health and one of the challenges to healthcare coordination is to extend and evaluate their use throughout the healthcare continuum.

Health System Advance Care Planning Culture Change for High-Risk Patients: The Promise and Challenges of Engaging Providers, Patients, and Families in Systematic Advance Care Planning.

PubMed

Reidy, Jennifer; Halvorson, Jennifer; Makowski, Suzana; Katz, Delila; Weinstein, Barbara; McCluskey, Christine; Doering, Alex; DeCarli, Kathryn; Tjia, Jennifer

2017-04-01

The success of a facilitator-based model for advance care planning (ACP) in LaCrosse, Wisconsin, has inspired health systems to aim for widespread documentation of advance directives, but limited resources impair efforts to replicate this model. One promising strategy is the development of interactive, Internet-based tools that might increase access to individualized ACP at minimal cost. However, widespread adoption and implementation of Internet-based ACP efforts has yet to be described. We describe our early experiences in building a systematic, population-based ACP initiative focused on health system-wide deployment of an Internet-based tool as an adjunct to a facilitator-based model. With the sponsorship of our healthcare system's population health leadership, we engaged a diverse group of clinical stakeholders as champions to design an Internet-based ACP tool and facilitate local practice change. We describe how we simultaneously began to train clinicians in ACP conversations, engage patients and health system employees in thinking about ACP, redesign clinic workflows to accommodate ACP discussions, and integrate the Internet-based tool into the electronic medical record (EMR). Over 18 months, our project engaged two subspecialty clinics in a systematic ACP process and began work with a large primary care practice with a large Medicare Accountable Care Organization at-risk population. Overall, 807 people registered at the Internet site and 85% completed ACPs. We learned that changing culture and systems to promote ACP requires a comprehensive vision with simultaneous, interconnected strategies targeting patient education, clinician training, EMR documentation, and community awareness.

Explanation-based generalization of partially ordered plans

NASA Technical Reports Server (NTRS)

Kambhampati, Subbarao; Kedar, Smadar

1991-01-01

Most previous work in analytic generalization of plans dealt with totally ordered plans. These methods cannot be directly applied to generalizing partially ordered plans, since they do not capture all interactions among plan operators for all total orders of such plans. We introduce a new method for generalizing partially ordered plans. This method is based on providing explanation-based generalization (EBG) with explanations which systematically capture the interactions among plan operators for all the total orders of a partially-ordered plan. The explanations are based on the Modal Truth Criterion which states the necessary and sufficient conditions for ensuring the truth of a proposition at any point in a plan, for a class of partially ordered plans. The generalizations obtained by this method guarantee successful and interaction-free execution of any total order of the generalized plan. In addition, the systematic derivation of the generalization algorithms from the Modal Truth Criterion obviates the need for carrying out a separate formal proof of correctness of the EBG algorithms.

Systematizing the production of environmental plans: an Australian example

NASA Astrophysics Data System (ADS)

Davis, J. Richard

1985-09-01

Environmental planning legislation in New South Wales now requires local government authorities to draw up statutory plans that take into account, among other concerns, both the biophysical and the social environmental issues within their jurisdictions. The SIRO-PLAN method of plan production provides a systematic mechanism for fulfilling this requirement. This article describes the application of the method by planning researchers over 18 months to the production of a Local Environmental Plan for a rural local government in New South Wales. The policy formulation, the purposive data collection, and the deliberate adjustment of plans in order to recognize interest group requirements were all found to be valuable features of the method, while the translation of the ultimately chosen land-use plan into the explicit regulatory controls available to the local government authority was found to require further refinement. The capacity of SIRO-PLAN to quantify the resolution of competing environmental concerns in the final plan, although of value to planning researchers, proved too arcane for traditionally trained planners.

Using a modified intervention mapping approach to develop and refine a single-session motivational intervention for methamphetamine-using men who have sex with men.

PubMed

Zule, William A; Coomes, Curtis M; Karg, Rhonda; Harris, Jennie L; Orr, Alex; Wechsberg, Wendee M

2010-05-14

There is an ongoing need for the development and adaptation of behavioral interventions to address behaviors related to acquisition and transmission of infectious diseases and for preventing the onset of chronic diseases. This paper describes the application of an established systematic approach to the development of a behavioral intervention to reduce sexual risk behaviors for HIV among men who have sex with men and who use methamphetamine. The approach includes six steps: (1) a needs assessment; (2) preparing matrices of proximal program objectives; (3) selecting theory-based methods and practical strategies; (4) producing program components and materials; (5) planning for program adoption, implementation, and sustainability; and (6) planning for evaluation. The focus of this article is on the intervention development process; therefore the article does not describe steps 5 and 6. Overall the process worked well, although it had to be adapted to fit the sequence of events associated with a funded research project. This project demonstrates that systematic approaches to intervention development can be applied even in research projects where some of the steps occur during the proposal writing process rather than during the actual project. However, intervention developers must remain flexible and be prepared to adapt the process to the situation. This includes being ready to make choices regarding intervention efficacy versus feasibility and being willing to select the best intervention that is likely to be delivered with available resources rather than an ideal intervention that may not be practical.

Benefits and Challenges of Scaling Up Expansion of Marine Protected Area Networks in the Verde Island Passage, Central Philippines.

PubMed

Horigue, Vera; Pressey, Robert L; Mills, Morena; Brotánková, Jana; Cabral, Reniel; Andréfouët, Serge

2015-01-01

Locally-established marine protected areas (MPAs) have been proven to achieve local-scale fisheries and conservation objectives. However, since many of these MPAs were not designed to form ecologically-connected networks, their contributions to broader-scale goals such as complementarity and connectivity can be limited. In contrast, integrated networks of MPAs designed with systematic conservation planning are assumed to be more effective--ecologically, socially, and economically--than collections of locally-established MPAs. There is, however, little empirical evidence that clearly demonstrates the supposed advantages of systematic MPA networks. A key reason is the poor record of implementation of systematic plans attributable to lack of local buy-in. An intermediate scenario for the expansion of MPAs is scaling up of local decisions, whereby locally-driven MPA initiatives are coordinated through collaborative partnerships among local governments and their communities. Coordination has the potential to extend the benefits of individual MPAs and perhaps to approach the potential benefits offered by systematic MPA networks. We evaluated the benefits of scaling up local MPAs to form networks by simulating seven expansion scenarios for MPAs in the Verde Island Passage, central Philippines. The scenarios were: uncoordinated community-based establishment of MPAs; two scenarios reflecting different levels of coordinated MPA expansion through collaborative partnerships; and four scenarios guided by systematic conservation planning with different contexts for governance. For each scenario, we measured benefits through time in terms of achievement of objectives for representation of marine habitats. We found that: in any governance context, systematic networks were more efficient than non-systematic ones; systematic networks were more efficient in broader governance contexts; and, contrary to expectations but with caveats, the uncoordinated scenario was slightly more efficient than the coordinated scenarios. Overall, however, coordinated MPA networks have the potential to be more efficient than the uncoordinated ones, especially when coordinated planning uses systematic methods.

Benefits and Challenges of Scaling Up Expansion of Marine Protected Area Networks in the Verde Island Passage, Central Philippines

PubMed Central

Horigue, Vera; Pressey, Robert L.; Mills, Morena; Brotánková, Jana; Cabral, Reniel; Andréfouët, Serge

2015-01-01

Locally-established marine protected areas (MPAs) have been proven to achieve local-scale fisheries and conservation objectives. However, since many of these MPAs were not designed to form ecologically-connected networks, their contributions to broader-scale goals such as complementarity and connectivity can be limited. In contrast, integrated networks of MPAs designed with systematic conservation planning are assumed to be more effective—ecologically, socially, and economically—than collections of locally-established MPAs. There is, however, little empirical evidence that clearly demonstrates the supposed advantages of systematic MPA networks. A key reason is the poor record of implementation of systematic plans attributable to lack of local buy-in. An intermediate scenario for the expansion of MPAs is scaling up of local decisions, whereby locally-driven MPA initiatives are coordinated through collaborative partnerships among local governments and their communities. Coordination has the potential to extend the benefits of individual MPAs and perhaps to approach the potential benefits offered by systematic MPA networks. We evaluated the benefits of scaling up local MPAs to form networks by simulating seven expansion scenarios for MPAs in the Verde Island Passage, central Philippines. The scenarios were: uncoordinated community-based establishment of MPAs; two scenarios reflecting different levels of coordinated MPA expansion through collaborative partnerships; and four scenarios guided by systematic conservation planning with different contexts for governance. For each scenario, we measured benefits through time in terms of achievement of objectives for representation of marine habitats. We found that: in any governance context, systematic networks were more efficient than non-systematic ones; systematic networks were more efficient in broader governance contexts; and, contrary to expectations but with caveats, the uncoordinated scenario was slightly more efficient than the coordinated scenarios. Overall, however, coordinated MPA networks have the potential to be more efficient than the uncoordinated ones, especially when coordinated planning uses systematic methods. PMID:26288089

Neurocognitive enhancement or impairment? A systematic meta-analysis of prescription stimulant effects on processing speed, decision-making, planning, and cognitive perseveration.

PubMed

Marraccini, Marisa E; Weyandt, Lisa L; Rossi, Joseph S; Gudmundsdottir, Bergljot Gyda

2016-08-01

Increasing numbers of adults, particularly college students, are misusing prescription stimulants primarily for cognitive/academic enhancement, so it is critical to explore whether empirical findings support neurocognitive benefits of prescription stimulants. Previous meta-analytic studies have supported small benefits from prescription stimulants for the cognitive domains of inhibitory control and memory; however, no meta-analytic studies have examined the effects on processing speed or the potential impairment on other domains of cognition, including planning, decision-making, and cognitive perseveration. Therefore, the present study conducted a meta-analysis of the available literature examining the effects of prescription stimulants on specific measures of processing speed, planning, decision-making, and cognitive perseveration among healthy adult populations. The meta-analysis results indicated a positive influence of prescription stimulant medication on processing speed accuracy, with an overall mean effect size of g = 0.282 (95% CI [0.077, 0.488]; n = 345). Neither improvements nor impairments were revealed for planning time, planning accuracy, advantageous decision-making, or cognitive perseveration; however, findings are limited by the small number of studies examining these outcomes. Findings support that prescription stimulant medication may indeed act as a neurocognitive enhancer for accuracy measures of processing speed without impeding other areas of cognition. Considering that adults are already engaging in illegal use of prescription stimulants for academic enhancement, as well as the potential for stimulant misuse to have serious side effects, the establishment of public policies informed by interdisciplinary research surrounding this issue, whether restrictive or liberal, is of critical importance. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The Active plus protocol: systematic development of two theory- and evidence-based tailored physical activity interventions for the over-fifties.

PubMed

van Stralen, Maartje M; Kok, Gerjo; de Vries, Hein; Mudde, Aart N; Bolman, Catherine; Lechner, Lilian

2008-12-04

Limited data are available on the development, implementation and evaluation processes of physical activity promotion programmes among older adults. More integrative insights into interventions describing the planned systematic development, implementation and evaluation are needed. The purpose of this study is to give an integrative insight into the development of the Active plus programme applying the six-step Intervention Mapping protocol. The Active plus programme consisted of two theory- and evidence-based tailored physical activity promotion interventions, both comprising three tailored letters delivered over four months and aimed at raising awareness of insufficient physical activity, and stimulating physical activity initiation and maintenance among the over-fifties. The first intervention, the basic tailored intervention, provided tailored letters that intervened on the psychosocial determinants of physical activity. The second intervention, the intervention plus, provided the same tailored information but additionally provided tailored information about physical activity opportunities in the specific environment in which the older adults lived. This environment-based component also provided access to a forum and e-buddy system on a website. A plan for implementation and evaluation is also described. The planned development of the Active plus programme resulted in two theory- and evidence-based tailored physical activity interventions targeted at the over-fifties. Dutch Trial Register NTR 920.

Systematic Conservation Planning in the Face of Climate Change: Bet-Hedging on the Columbia Plateau

PubMed Central

Schloss, Carrie A.; Lawler, Joshua J.; Larson, Eric R.; Papendick, Hilary L.; Case, Michael J.; Evans, Daniel M.; DeLap, Jack H.; Langdon, Jesse G. R.; Hall, Sonia A.; McRae, Brad H.

2011-01-01

Systematic conservation planning efforts typically focus on protecting current patterns of biodiversity. Climate change is poised to shift species distributions, reshuffle communities, and alter ecosystem functioning. In such a dynamic environment, lands selected to protect today's biodiversity may fail to do so in the future. One proposed approach to designing reserve networks that are robust to climate change involves protecting the diversity of abiotic conditions that in part determine species distributions and ecological processes. A set of abiotically diverse areas will likely support a diversity of ecological systems both today and into the future, although those two sets of systems might be dramatically different. Here, we demonstrate a conservation planning approach based on representing unique combinations of abiotic factors. We prioritize sites that represent the diversity of soils, topographies, and current climates of the Columbia Plateau. We then compare these sites to sites prioritized to protect current biodiversity. This comparison highlights places that are important for protecting both today's biodiversity and the diversity of abiotic factors that will likely determine biodiversity patterns in the future. It also highlights places where a reserve network designed solely to protect today's biodiversity would fail to capture the diversity of abiotic conditions and where such a network could be augmented to be more robust to climate-change impacts. PMID:22174897

Systematic Review of Physical Activity Objectives in Extension Strategic Plans: Findings and Implications for Improved Public Health Impact

ERIC Educational Resources Information Center

Harden, Samantha M.; Lindsay, Anne; Everette, Alicia; Gunter, Katherine B.

2016-01-01

Extension programming that incorporates both physical activity and dietary behaviors is necessary for the prevention of certain chronic diseases, including obesity. The purpose of the study presented here was to systematically identify the presence of physical activity objectives in the strategic plan for each Extension system in the United…

Integrating Enterprise Resource Planning (SAP) in the Accounting Curriculum: A Systematic Literature Review and Case Study

ERIC Educational Resources Information Center

Blount, Yvette; Abedin, Babak; Vatanasakdakul, Savanid; Erfani, Seyedezahra

2016-01-01

This study investigates how an enterprise resource planning (ERP) software package SAP was integrated into the curriculum of an accounting information systems (AIS) course in an Australian university. Furthermore, the paper provides a systematic literature review of articles published between 1990 and 2013 to understand how ERP systems were…

Systematic testing of flood adaptation options in urban areas through simulations

NASA Astrophysics Data System (ADS)

Löwe, Roland; Urich, Christian; Sto. Domingo, Nina; Mark, Ole; Deletic, Ana; Arnbjerg-Nielsen, Karsten

2016-04-01

While models can quantify flood risk in great detail, the results are subject to a number of deep uncertainties. Climate dependent drivers such as sea level and rainfall intensities, population growth and economic development all have a strong influence on future flood risk, but future developments can only be estimated coarsely. In such a situation, robust decision making frameworks call for the systematic evaluation of mitigation measures against ensembles of potential futures. We have coupled the urban development software DAnCE4Water and the 1D-2D hydraulic simulation package MIKE FLOOD to create a framework that allows for such systematic evaluations, considering mitigation measures under a variety of climate futures and urban development scenarios. A wide spectrum of mitigation measures can be considered in this setup, ranging from structural measures such as modifications of the sewer network over local retention of rainwater and the modification of surface flow paths to policy measures such as restrictions on urban development in flood prone areas or master plans that encourage compact development. The setup was tested in a 300 ha residential catchment in Melbourne, Australia. The results clearly demonstrate the importance of considering a range of potential futures in the planning process. For example, local rainwater retention measures strongly reduce flood risk a scenario with moderate increase of rain intensities and moderate urban growth, but their performance strongly varies, yielding very little improvement in situations with pronounced climate change. The systematic testing of adaptation measures further allows for the identification of so-called adaptation tipping points, i.e. levels for the drivers of flood risk where the desired level of flood risk is exceeded despite the implementation of (a combination of) mitigation measures. Assuming a range of development rates for the drivers of flood risk, such tipping points can be translated into anticipated time spans over which a measure will be effective. While the new simulation setup is limited to situations where the planner is able to define realistic ranges for the development of drivers of flood risk, it certainly contributes to an improved consideration of deep uncertainties in the planning process. Future work will particularly focus on the application of the framework in a variety of urban development contexts.

Shared decision making in designing new healthcare environments-time to begin improving quality.

PubMed

Elf, Marie; Fröst, Peter; Lindahl, Göran; Wijk, Helle

2015-03-21

Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users' perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

Applying systematic review search methods to the grey literature: a case study examining guidelines for school-based breakfast programs in Canada.

PubMed

Godin, Katelyn; Stapleton, Jackie; Kirkpatrick, Sharon I; Hanning, Rhona M; Leatherdale, Scott T

2015-10-22

Grey literature is an important source of information for large-scale review syntheses. However, there are many characteristics of grey literature that make it difficult to search systematically. Further, there is no 'gold standard' for rigorous systematic grey literature search methods and few resources on how to conduct this type of search. This paper describes systematic review search methods that were developed and applied to complete a case study systematic review of grey literature that examined guidelines for school-based breakfast programs in Canada. A grey literature search plan was developed to incorporate four different searching strategies: (1) grey literature databases, (2) customized Google search engines, (3) targeted websites, and (4) consultation with contact experts. These complementary strategies were used to minimize the risk of omitting relevant sources. Since abstracts are often unavailable in grey literature documents, items' abstracts, executive summaries, or table of contents (whichever was available) were screened. Screening of publications' full-text followed. Data were extracted on the organization, year published, who they were developed by, intended audience, goal/objectives of document, sources of evidence/resources cited, meals mentioned in the guidelines, and recommendations for program delivery. The search strategies for identifying and screening publications for inclusion in the case study review was found to be manageable, comprehensive, and intuitive when applied in practice. The four search strategies of the grey literature search plan yielded 302 potentially relevant items for screening. Following the screening process, 15 publications that met all eligibility criteria remained and were included in the case study systematic review. The high-level findings of the case study systematic review are briefly described. This article demonstrated a feasible and seemingly robust method for applying systematic search strategies to identify web-based resources in the grey literature. The search strategy we developed and tested is amenable to adaptation to identify other types of grey literature from other disciplines and answering a wide range of research questions. This method should be further adapted and tested in future research syntheses.

Sustaining a Mature Risk Management Process: Ensuring the International Space Station for a Vibrant Future

NASA Technical Reports Server (NTRS)

Raftery, Michael; Carter-Journet, Katrina

2013-01-01

The International Space Station (ISS) risk management methodology is an example of a mature and sustainable process. Risk management is a systematic approach used to proactively identify, analyze, plan, track, control, communicate, and document risks to help management make risk-informed decisions that increase the likelihood of achieving program objectives. The ISS has been operating in space for over 14 years and permanently crewed for over 12 years. It is the longest surviving habitable vehicle in low Earth orbit history. Without a mature and proven risk management plan, it would be increasingly difficult to achieve mission success throughout the life of the ISS Program. A successful risk management process must be able to adapt to a dynamic program. As ISS program-level decision processes have evolved, so too has the ISS risk management process continued to innovate, improve, and adapt. Constant adaptation of risk management tools and an ever-improving process is essential to the continued success of the ISS Program. Above all, sustained support from program management is vital to risk management continued effectiveness. Risk management is valued and stressed as an important process by the ISS Program.

School-Based Technology Use Planning.

ERIC Educational Resources Information Center

Cradler, John

1994-01-01

Describes how to conduct systematic planning for technology use. The components of an effective technology use plan, derived from a comprehensive study of school-based technology, are given. Planning development, implementation, and evaluation steps are provided. Ten planning resource books are listed. (Contains five references.) (KRN)

[Nurse-Led Care Models in the Context of Community Elders With Chronic Disease Management: A Systematic Review].

PubMed

Hsieh, Pei-Lun; Chen, Ching-Min

2016-08-01

Longer average life expectancies have caused the rapid growth of the elderly as a percentage of Taiwan's population and, as a result of the number of elders with chronic diseases and disability. Providing continuing-care services in community settings for elderly with multiple chronic conditions has become an urgent need. To review the nurse-led care models that are currently practiced among elders with chronic disease in the community and to further examine the effectiveness and essential components of these models using a systematic review method. Twelve original articles on chronic disease-care planning for the elderly or on nurse-led care management interventions that were published between 2000 and 2015 in any of five electronic databases: MEDLINE, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus with Full Text, Cochrane Library, and CEPS (Chinese Electronic Periodicals Service）were selected and analyzed systematically. Four types of nurse-led community care models, including primary healthcare, secondary prevention care, cross-boundary models, and case management, were identified. Chronic disease-care planning, case management, and disease self-management were found to be the essential components of the services that were provided. The care models used systematic processes to conduct assessment, planning, implementation, coordination, and follow-up activities as well as to deliver services and to evaluate disease status. The results revealed that providing continuing-care services through the nurse-led community chronic disease-care model and cross-boundary model enhanced the ability of the elderly to self-manage their chronic diseases, improved healthcare referrals, provided holistic care, and maximized resource utilization efficacy. The present study cross-referenced all reviewed articles in terms of target clients, content, intervention, measurements, and outcome indicators. Study results may be referenced in future implementations of nurse-led community care models as well as in future research.

JPRS Report, Soviet Union, Economic Affairs

DTIC Science & Technology

1988-10-05

for a more detailed and systematic approach to working up data on the GNP. We should mention that today the national income is computed within the...process of reproduction. This approach imposes a strict sequence in the develop- ment and analysis of data on the various phases of movement of the...variants for reorganization. The plans were reviewed on a competitive basis and this made it easier to select the best one. There was still one other

Increasing advance personal planning: the need for action at the community level.

PubMed

Waller, Amy; Sanson-Fisher, Rob; Ries, Nola; Bryant, Jamie

2018-05-09

Advance personal planning is the process by which people consider, document and communicate their preferences for personal, financial and health matters in case they lose the ability to make decisions or express their wishes in the future. Advance personal planning is most often undertaken by individuals who are seriously ill, often in the context of a medical crisis and/or at the time of admission to hospital. However, the clinical utility and legal validity of the planning process may be compromised in these circumstances. Patients may lack sufficient capacity to meaningfully engage in advance personal planning; there may be insufficient time to adequately reflect on and discuss wishes with key others; and there may also be limited opportunity for inter-professional input and collaboration in the process. Here, we propose an agenda for research to advance the science of advance personal planning by promoting a 'whole community' approach. Adoption of advance personal planning at a community level may be achieved using a variety of strategies including public media campaigns, intervening with professionals across a range of health care and legal settings, and mobilising support from influential groups and local government. One potentially promising method for encouraging earlier adoption of advance personal planning among a broader population involves a community action approach, whereby multiple evidence-based strategies are integrated across multiple access points. Community action involves calling on community members, professionals, community and/or government organisations to work collaboratively to design and systematically implement intervention strategies with the aim of bringing about desired behaviour change. An example of a community action trial to improving uptake and quality of advance personal planning is described. While promising, there is a need for rigorous evidence to demonstrate whether a community action approach is effective in establishing whole community adoption of advance personal planning.

The Crowded Sea: Incorporating Multiple Marine Activities in Conservation Plans Can Significantly Alter Spatial Priorities

PubMed Central

Mazor, Tessa; Possingham, Hugh P.; Edelist, Dori; Brokovich, Eran; Kark, Salit

2014-01-01

Successful implementation of marine conservation plans is largely inhibited by inadequate consideration of the broader social and economic context within which conservation operates. Marine waters and their biodiversity are shared by a host of stakeholders, such as commercial fishers, recreational users and offshore developers. Hence, to improve implementation success of conservation plans, we must incorporate other marine activities while explicitly examining trade-offs that may be required. In this study, we test how the inclusion of multiple marine activities can shape conservation plans. We used the entire Mediterranean territorial waters of Israel as a case study to compare four planning scenarios with increasing levels of complexity, where additional zones, threats and activities were added (e.g., commercial fisheries, hydrocarbon exploration interests, aquaculture, and shipping lanes). We applied the marine zoning decision support tool Marxan to each planning scenario and tested a) the ability of each scenario to reach biodiversity targets, b) the change in opportunity cost and c) the alteration of spatial conservation priorities. We found that by including increasing numbers of marine activities and zones in the planning process, greater compromises are required to reach conservation objectives. Complex plans with more activities incurred greater opportunity cost and did not reach biodiversity targets as easily as simplified plans with less marine activities. We discovered that including hydrocarbon data in the planning process significantly alters spatial priorities. For the territorial waters of Israel we found that in order to protect at least 10% of the range of 166 marine biodiversity features there would be a loss of ∼15% of annual commercial fishery revenue and ∼5% of prospective hydrocarbon revenue. This case study follows an illustrated framework for adopting a transparent systematic process to balance biodiversity goals and economic considerations within a country's territorial waters. PMID:25102177

A systematic review of the process of regionalization of Brazil's Unified Health System, SUS.

PubMed

Mello, Guilherme Arantes; Pereira, Ana Paula Chancharulo de Morais; Uchimura, Liza Yurie Teruya; Iozzi, Fabíola Lana; Demarzo, Marcelo Marcos Piva; Viana, Ana Luiza d'Ávila

2017-04-01

This review focuses only on specific studies into the SUS regionalization process, which were based on empirical results and published since 2006, when the SUS was already under the aegis of the Pact for Health framework. It was found that the regionalization process is now underway in all spheres of government, subject to a set of challenges common to the different realities of the country. These include, primarily, that committee-structured entities are valued as spaces for innovation, yet also strive to overcome the bureaucratic and clientelist political culture. Regional governance is further hampered by the fragmentation of the system and, in particular, by the historical deficiency in planning, from the local level to the strategic policies for technology incorporation. The analyses enabled the identification of a culture of broad privilege for political negotiation, to the detriment of planning, as one of the main factors responsible for a vicious circle that sustains technical deficiency in management.

Expert nurses' clinical reasoning under uncertainty: representation, structure, and process.

PubMed Central

Fonteyn, M. E.; Grobe, S. J.

1992-01-01

How do expert nurses reason when planning care and making clinical decisions for a patient who is at risk, and whose outcome is uncertain? In this study, a case study involving a critically ill elderly woman whose condition deteriorated over time, was presented in segments to ten expert critical care nurses. Think aloud method was used to elicit knowledge from these experts to provide conceptual information about their knowledge and to reveal their reasoning processes and problem-solving strategies. The verbatim transcripts were then analyzed using a systematic three-step method that makes analysis easier and adds creditability to study findings by providing a means of retracing and explaining analysis results. Findings revealed information about how patient problems were represented during reasoning, the manner in which experts subjects structured their plan of care, and the reasoning processes and heuristics they used to formulate solutions for resolving the patient's problems and preventing deterioration in the patient's condition. PMID:1482907

How to use Gagne's model of instructional design in teaching psychomotor skills

PubMed Central

Rostami, Kamran; Ishaq, Sauid

2011-01-01

Gagne's model of instructional design is based on the information processing model of the mental events that occur when adults are presented with various stimuli and focuses on the learning outcomes and how to arrange specific instructional events to achieve those outcomes. Applying Gagne's nine-step model is an excellent way to ensure an effective and systematic learning program as it gives structure to the lesson plans and a holistic view to the teaching. In this paper, we have chosen a routine practical procedure that junior doctors need to learn: insertion of a peritoneal (ascitic) drain and we use Gagne's “events of instruction” to design a lesson plan for this subject. PMID:24834168

How to use Gagne's model of instructional design in teaching psychomotor skills.

PubMed

Khadjooi, Kayvan; Rostami, Kamran; Ishaq, Sauid

2011-01-01

Gagne's model of instructional design is based on the information processing model of the mental events that occur when adults are presented with various stimuli and focuses on the learning outcomes and how to arrange specific instructional events to achieve those outcomes. Applying Gagne's nine-step model is an excellent way to ensure an effective and systematic learning program as it gives structure to the lesson plans and a holistic view to the teaching. In this paper, we have chosen a routine practical procedure that junior doctors need to learn: insertion of a peritoneal (ascitic) drain and we use Gagne's "events of instruction" to design a lesson plan for this subject.

Knowledge management in health: a systematic literature review.

PubMed

Rocha, Elyrose Sousa Brito; Nagliate, Patricia; Furlan, Claudia Elisangela Bis; Rocha, Kerson; Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia Costa

2012-01-01

Knowledge has been used as a resource for intelligent and effective action planning in organizations. Interest in research on knowledge management processes has intensified in different areas. A systematic literature review was accomplished, based on the question: what are the contributions of Brazilian and international journal publications on knowledge management in health? The sample totaled 32 items that complied with the inclusion criteria. The results showed that 78% of journals that published on the theme are international, 77% of researchers work in higher education and 65% have a Ph.D. The texts gave rise to five thematic categories, mainly: development of knowledge management systems in health (37.5%), discussion of knowledge management application in health (28.1%) and nurses' function in knowledge management (18.7%).

Neighbourhood Built Environment Influences on Physical Activity among Adults: A Systematized Review of Qualitative Evidence

PubMed Central

Salvo, Grazia; Doyle-Baker, Patricia K.; McCormack, Gavin R.

2018-01-01

Qualitative studies can provide important information about how and why the built environment impacts physical activity decision-making—information that is important for informing local urban policies. We undertook a systematized literature review to synthesize findings from qualitative studies exploring how the built environment influences physical activity in adults. Our review included 36 peer-reviewed qualitative studies published from 1998 onwards. Our findings complemented existing quantitative evidence and provided additional insight into how functional, aesthetic, destination, and safety built characteristics influence physical activity decision-making. Sociodemographic characteristics (age, sex, ethnicity, and socioeconomic status) also impacted the BE’s influence on physical activity. Our review findings reinforce the need for synergy between transportation planning, urban design, landscape architecture, road engineering, parks and recreation, bylaw enforcement, and public health to be involved in creating neighbourhood environments that support physical activity. Our findings support a need for local neighbourhood citizens and associations with representation from individuals and groups with different sociodemographic backgrounds to have input into neighbourhood environment planning process. PMID:29724048

Study of spin-scan imaging for outer planets missions. [imaging techniques for Jupiter orbiter missions

NASA Technical Reports Server (NTRS)

Russell, E. E.; Chandos, R. A.; Kodak, J. C.; Pellicori, S. F.; Tomasko, M. G.

1974-01-01

The constraints that are imposed on the Outer Planet Missions (OPM) imager design are of critical importance. Imager system modeling analyses define important parameters and systematic means for trade-offs applied to specific Jupiter orbiter missions. Possible image sequence plans for Jupiter missions are discussed in detail. Considered is a series of orbits that allow repeated near encounters with three of the Jovian satellites. The data handling involved in the image processing is discussed, and it is shown that only minimal processing is required for the majority of images for a Jupiter orbiter mission.

Automated Hazard Analysis

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

Riddle, F. J.

2003-06-26

The Automated Hazard Analysis (AHA) application is a software tool used to conduct job hazard screening and analysis of tasks to be performed in Savannah River Site facilities. The AHA application provides a systematic approach to the assessment of safety and environmental hazards associated with specific tasks, and the identification of controls regulations, and other requirements needed to perform those tasks safely. AHA is to be integrated into existing Savannah River site work control and job hazard analysis processes. Utilization of AHA will improve the consistency and completeness of hazard screening and analysis, and increase the effectiveness of the workmore » planning process.« less

Surveys of the earth's resources and environment by satellites

NASA Technical Reports Server (NTRS)

Nordberg, W.; Tiedemann, H.; Bohn, C.

1975-01-01

The potential and promise of observing the earth from the vantage point of space is discussed. The systematic surveying of processes and phenomena occurring on the surface of the earth by Landsat 1 and Nimbus 5 is considered to be useful in the following areas: assessment of water resources; mineral and petroleum exploration; land use planning; crop, forest, and rangeland inventory; assessment of flood, earthquake, and other environmental hazards; monitoring coastal processes; environmental effects of industrial effluents and of air pollution; mapping the distribution and types of ice covering the earth's polar caps and global soil moisture distributions.

Qumquad: a UML-based approach for remodeling of legacy systems in health care.

PubMed

Garde, Sebastian; Knaup, Petra; Herold, Ralf

2003-07-01

Health care information systems still comprise legacy systems to a certain extent. For reengineering legacy systems a thorough remodeling is inalienable. Current modeling techniques like the Unified Modeling Language (UML) do not offer a systematic and comprehensive process-oriented method for remodeling activities. We developed a systematic method for remodeling legacy systems in health care called Qumquad. Qumquad consists of three major steps: (i) modeling the actual state of the application system, (ii) systematic identification of weak points in this model and (iii) development of a target concept for the reimplementation considering the identified weak points. We applied Qumquad for remodeling a documentation and therapy planning system for pediatric oncology (DOSPO). As a result of our remodeling activities we regained an abstract model of the system, an analysis of the current weak points of DOSPO and possible (partly alternative) solutions to overcome the weak points. Qumquad proved to be very helpful in the reengineering process of DOSPO since we now have at our disposal a comprehensive model for the reimplementation of DOSPO that current users of the system agree on. Qumquad can easily be applied to other reengineering projects in health care.

Administration by Objectives: A Systematic Approach to Educational Planning in Virginia. Report of a Study.

ERIC Educational Resources Information Center

Holmes, George W., III; Seawell, William H.

This report presents (1) details of a program for educational administration by objectives and (2) the results of such a program developed by the Virginia State Department of Education to upgrade the quality of education in the public schools of that State. Administration by objectives is a systematic approach to education planning using…

A systematic review of nursing research priorities on health system and services in the Americas.

PubMed

Garcia, Alessandra Bassalobre; Cassiani, Silvia Helena De Bortoli; Reveiz, Ludovic

2015-03-01

To systematically review literature on priorities in nursing research on health systems and services in the Region of the Americas as a step toward developing a nursing research agenda that will advance the Regional Strategy for Universal Access to Health and Universal Health Coverage. This was a systematic review of the literature available from the following databases: Web of Science, PubMed, LILACS, and Google. Documents considered were published in 2008-2014; in English, Spanish, or Portuguese; and addressed the topic in the Region of the Americas. The documents selected had their priority-setting process evaluated according to the "nine common themes for good practice in health research priorities." A content analysis collected all study questions and topics, and sorted them by category and subcategory. Of 185 full-text articles/documents that were assessed for eligibility, 23 were selected: 12 were from peer-reviewed journals; 6 from nursing publications; 4 from Ministries of Health; and 1 from an international organization. Journal publications had stronger methodological rigor; the majority did not present a clear implementation or evaluation plan. After compiling the 444 documents' study questions and topics, the content analysis resulted in a document with 5 categories and 16 subcategories regarding nursing research priorities on health systems and services. Research priority-setting is a highly important process for health services improvement and resources optimization, but implementation and evaluation plans are rarely included. The resulting document will serve as basis for the development of a new nursing research agenda focused on health systems and services, and shaped to advance universal health coverage and universal access to health.

Process evaluation of the Enabling Mothers toPrevent Pediatric Obesity Through Web-Based Learning and Reciprocal Determinism (EMPOWER) randomized control trial.

PubMed

Knowlden, Adam P; Sharma, Manoj

2014-09-01

Family-and-home-based interventions are an important vehicle for preventing childhood obesity. Systematic process evaluations have not been routinely conducted in assessment of these interventions. The purpose of this study was to plan and conduct a process evaluation of the Enabling Mothers to Prevent Pediatric Obesity Through Web-Based Learning and Reciprocal Determinism (EMPOWER) randomized control trial. The trial was composed of two web-based, mother-centered interventions for prevention of obesity in children between 4 and 6 years of age. Process evaluation used the components of program fidelity, dose delivered, dose received, context, reach, and recruitment. Categorical process evaluation data (program fidelity, dose delivered, dose exposure, and context) were assessed using Program Implementation Index (PII) values. Continuous process evaluation variables (dose satisfaction and recruitment) were assessed using ANOVA tests to evaluate mean differences between groups (experimental and control) and sessions (sessions 1 through 5). Process evaluation results found that both groups (experimental and control) were equivalent, and interventions were administered as planned. Analysis of web-based intervention process objectives requires tailoring of process evaluation models for online delivery. Dissemination of process evaluation results can advance best practices for implementing effective online health promotion programs. © 2014 Society for Public Health Education.

Benchmarking study of corporate research management and planning practices

NASA Astrophysics Data System (ADS)

McIrvine, Edward C.

1992-05-01

During 1983-84, Xerox Corporation was undergoing a change in corporate style through a process of training and altered behavior known as Leadership Through Quality. One tenet of Leadership Through Quality was benchmarking, a procedure whereby all units of the corporation were asked to compare their operation with the outside world. As a part of the first wave of benchmark studies, Xerox Corporate Research Group studied the processes of research management, technology transfer, and research planning in twelve American and Japanese companies. The approach taken was to separate `research yield' and `research productivity' (as defined by Richard Foster) and to seek information about how these companies sought to achieve high- quality results in these two parameters. The most significant findings include the influence of company culture, two different possible research missions (an innovation resource and an information resource), and the importance of systematic personal interaction between sources and targets of technology transfer.

Gender inequality in Russia: the perspective of participatory gender budgeting.

PubMed

Zakirova, Venera

2014-11-01

Gender-based discrimination is found in all economies in the world. Women's unpaid work accounts for about half of the world GDP, yet women remain under-valued and under-represented in national policies worldwide. The question of gender budgeting and citizens' participation in budgeting and governance processes has gained attention in recent years, but Russia is far from implementing these. Instead, blindness to gender issues dominates in national strategies and budgets. This paper explores these issues and looks in-depth at them in the decentralisation process in Bashkortostan, a central Russian republic. Civil society institutions whose role is to strengthen the links between government, civil society and the community in Bashkortostan, such as Public Chambers and Municipalities, lack the capacity to introduce participatory gender budgeting. As a result, no systematic participatory planning, let alone planning that is gender-sensitive, has taken place there. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Using cognitive concept mapping to understand what health care means to the elderly: an illustrative approach for planning and marketing.

PubMed

Shewchuk, Richard; O'Connor, Stephen J

2002-01-01

This article describes a process that can be used for eliciting and systematically organizing perceptions held by key stakeholders. An example using a limited sample of older Medicare recipients is developed to illustrate how this approach can be used. Internally, a nominal group technique (NGT) meeting was conducted to identify an array of health care issues that were perceived as important by this group. These perceptions were then used as stimuli to develop an unforced card sort task. Data from the card sorts were analyzed using multidimensional scaling and hierarchical cluster analysis to demonstrate how qualitative input of participants can be organized. The results of these analyses are described to illustrate an example of an interpretive framework that might be used when seeking input from relevant constituents. Suggestions for how this process might be extended to health care planning/marketing efforts are provided.

SciBox, an end-to-end automated science planning and commanding system

NASA Astrophysics Data System (ADS)

Choo, Teck H.; Murchie, Scott L.; Bedini, Peter D.; Steele, R. Josh; Skura, Joseph P.; Nguyen, Lillian; Nair, Hari; Lucks, Michael; Berman, Alice F.; McGovern, James A.; Turner, F. Scott

2014-01-01

SciBox is a new technology for planning and commanding science operations for Earth-orbital and planetary space missions. It has been incrementally developed since 2001 and demonstrated on several spaceflight projects. The technology has matured to the point that it is now being used to plan and command all orbital science operations for the MErcury Surface, Space ENvironment, GEochemistry, and Ranging (MESSENGER) mission to Mercury. SciBox encompasses the derivation of observing sequences from science objectives, the scheduling of those sequences, the generation of spacecraft and instrument commands, and the validation of those commands prior to uploading to the spacecraft. Although the process is automated, science and observing requirements are incorporated at each step by a series of rules and parameters to optimize observing opportunities, which are tested and validated through simulation and review. Except for limited special operations and tests, there is no manual scheduling of observations or construction of command sequences. SciBox reduces the lead time for operations planning by shortening the time-consuming coordination process, reduces cost by automating the labor-intensive processes of human-in-the-loop adjudication of observing priorities, reduces operations risk by systematically checking constraints, and maximizes science return by fully evaluating the trade space of observing opportunities to meet MESSENGER science priorities within spacecraft recorder, downlink, scheduling, and orbital-geometry constraints.

Using the Consolidated Framework for Implementation Research to implement and evaluate national surgical planning

PubMed Central

Saluja, Saurabh; Silverstein, Allison; Mukhopadhyay, Swagoto; Lin, Yihan; Raykar, Nakul; Keshavjee, Salmaan; Samad, Lubna; Meara, John G

2017-01-01

The Lancet Commission on Global Surgery defined six surgical indicators and a framework for a national surgical plan that aimed to incorporate surgical care as a part of global public health. Multiple countries have since begun national surgical planning; each faces unique challenges in doing so. Implementation science can be used to more systematically explain this heterogeneous process, guide implementation efforts and ultimately evaluate progress. We describe our intervention using the Consolidated Framework for Implementation Research. This framework requires identifying characteristics of the intervention, the individuals involved, the inner and outer setting of the intervention, and finally describing implementation processes. By hosting a consultative symposium with clinicians and policy makers from around the world, we are able to specify key aspects of each element of this framework. We define our intervention as the incorporation of surgical care into public health planning, identify local champions as the key individuals involved, and describe elements of the inner and outer settings. Ultimately we describe top-down and bottom-up models that are distinct implementation processes. With the Consolidated Framework for Implementation Research, we are able to identify specific strategic models that can be used by implementers in various settings. While the integration of surgical care into public health throughout the world may seem like an insurmountable challenge, this work adds to a growing effort that seeks to find a way forward. PMID:29225930

Processing of Mars Exploration Rover Imagery for Science and Operations Planning

NASA Technical Reports Server (NTRS)

Alexander, Douglass A.; Deen, Robert G.; Andres, Paul M.; Zamani, Payam; Mortensen, Helen B.; Chen, Amy C.; Cayanan, Michael K.; Hall, Jeffrey R.; Klochko, Vadim S.; Pariser, Oleg;

Planning for Disaster.

ERIC Educational Resources Information Center

Lewis, Steven

1996-01-01

Disaster recovery planning need not be expensive nor complete to be effective. Systematic planning involves several crucial steps, including outlining the final plan, understanding the nature of a disaster's effects and the stages of disaster recovery, prioritizing appropriately, and learning how to test the plan in a practical way for the…

Adopting hybrid pension plans: financial and communication issues.

PubMed

Clark, R L; Haley, J J; Schieber, S J

2001-01-01

This article provides a systematic framework for the evaluation of the movement toward hybrid pension plans by examining the reasons given by firms for converting their existing pension plans to hybrid plans, illustrating the impact of plan changes on expected pension benefits, and identifying winners and losers.

A District Level Planning Model.

ERIC Educational Resources Information Center

McHenry, W. E.; Achilles, C. M.

This report examines school district planning models in South Carolina. It focuses on three questions: (1) Of those school districts conducting some type of systematic planning, how many are producing strategic plans? Long-range plans? Accountability reports? (2) In those same districts, how many are preparing adequate program-management…

The patient reporting and action for a safe environment (PRASE) intervention: a feasibility study.

PubMed

O'Hara, Jane K; Lawton, Rebecca J; Armitage, Gerry; Sheard, Laura; Marsh, Claire; Cocks, Kim; McEachan, Rosie R C; Reynolds, Caroline; Watt, Ian; Wright, John

2016-11-28

There is growing interest in the role of patients in improving patient safety. One such role is providing feedback on the safety of their care. Here we describe the development and feasibility testing of an intervention that collects patient feedback on patient safety, brings together staff to consider this feedback and to plan improvement strategies. We address two research questions: i) to explore the feasibility of the process of systematically collecting feedback from patients about the safety of care as part of the PRASE intervention; and, ii) to explore the feasibility and acceptability of the PRASE intervention for staff, and to understand more about how staff use the patient feedback for service improvement. We conducted a feasibility study using a wait-list controlled design across six wards within an acute teaching hospital. Intervention wards were asked to participate in two cycles of the PRASE (Patient Reporting & Action for a Safe Environment) intervention across a six-month period. Participants were patients on participating wards. To explore the acceptability of the intervention for staff, observations of action planning meetings, interviews with a lead person for the intervention on each ward and recorded researcher reflections were analysed thematically and synthesised. Recruitment of patients using computer tablets at their bedside was straightforward, with the majority of patients willing and able to provide feedback. Randomisation of the intervention was acceptable to staff, with no evidence of differential response rates between intervention and control groups. In general, ward staff were positive about the use of patient feedback for service improvement and were able to use the feedback as a basis for action planning, although engagement with the process was variable. Gathering a multidisciplinary team together for action planning was found to be challenging, and implementing action plans was sometimes hindered by the need to co-ordinate action across multiple services. The PRASE intervention was found to be acceptable to staff and patients. However, before proceeding to a full cluster randomised controlled trial, the intervention requires adaptation to account for the difficulties in implementing action plans within three months, the need for a facilitator to support the action planning meetings, and the provision of training and senior management support for participating ward teams. The PRASE intervention represents a promising method for the systematic collection of patient feedback about the safety of hospital care.

Up on the Roof: A Systematic Approach to Roof Maintenance.

ERIC Educational Resources Information Center

Burd, William

1979-01-01

A systematic roof maintenance program is characterized by carefully prepared long- and short-range plans. An essential feature of a systematic approach to roof maintenance is the stress on preventive measures rather than the patching of leaks. (Author)

Nursing home nurses' perceptions of emergency transfers from nursing homes to hospital: A review of qualitative studies using systematic methods.

PubMed

O'Neill, Barbara; Parkinson, Lynne; Dwyer, Trudy; Reid-Searl, Kerry

2015-01-01

The aim is to describe nursing home nurses' perceptions around emergency transfers to hospital. Transfers are costly and traumatic for residents, and efforts are underway to avoid hospitalization. Nurses play a key role in transfers, yet their views are underreported. A systematic review of qualitative studies was undertaken, guided by Joanna Briggs Institute methods. From seven reviewed studies, it was clear nursing home nurses are challenged by the complexity of the transfer process and understand their need for appropriate clinical knowledge, skills and resources. Communication is important, yet nurses often use persuasive and targeted communication. Ambiguity, strained relationships and negative perceptions of residents' experiences around hospitalization contribute to conflict and uncertainty. Nurses are more confident when there is a plan. Transferring a resident is a complex process and special skills, knowledge and resources are required, but may be lacking. Efforts to formalize the transfer process and improve communication and collaboration amongst all stakeholders is needed and would be well received. Copyright © 2015 Elsevier Inc. All rights reserved.

[Lean thinking and brain-dead patient assistance in the organ donation process].

PubMed

Pestana, Aline Lima; dos Santos, José Luís Guedes; Erdmann, Rolf Hermann; da Silva, Elza Lima; Erdmann, Alacoque Lorenzini

2013-02-01

Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.

SimBRS: A University/Industry Consortium Focused on Simulation Based Solutions for Ground Vehicles

DTIC Science & Technology

2009-07-29

plan is to use the SimBRS contract mechanism to streamline a process that applies research funds into a managed program, that is cognizant to the... designs . Therefore, the challenge for the SimBRS team is to establish an approach based on the capacity of measured data and simulations to support ...by systematically relating appropriate results from measurements and applied research in engineering and science. In turn, basic research and

Guideline for Performing Systematic Approach to Evaluate and Qualify Legacy Documents that Support Advanced Reactor Technology Activity

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

Honma, George

The establishment of a systematic process for the evaluation of historic technology information for use in advanced reactor licensing is described. Efforts are underway to recover and preserve Experimental Breeder Reactor II and Fast Flux Test Facility historical data. These efforts have generally emphasized preserving information from data-acquisition systems and hard-copy reports and entering it into modern electronic formats suitable for data retrieval and examination. The guidance contained in this document has been developed to facilitate consistent and systematic evaluation processes relating to quality attributes of historic technical information (with focus on sodium-cooled fast reactor (SFR) technology) that will bemore » used to eventually support licensing of advanced reactor designs. The historical information may include, but is not limited to, design documents for SFRs, research-and-development (R&D) data and associated documents, test plans and associated protocols, operations and test data, international research data, technical reports, and information associated with past U.S. Nuclear Regulatory Commission (NRC) reviews of SFR designs. The evaluation process is prescribed in terms of SFR technology, but the process can be used to evaluate historical information for any type of advanced reactor technology. An appendix provides a discussion of typical issues that should be considered when evaluating and qualifying historical information for advanced reactor technology fuel and source terms, based on current light water reactor (LWR) requirements and recent experience gained from Next Generation Nuclear Plant (NGNP).« less

The Use of Intervention Mapping to Develop a Tailored Web-Based Intervention, Condom-HIM

PubMed Central

2017-01-01

Background Many HIV (human immunodeficiency virus) prevention interventions are currently being implemented and evaluated, with little information published on their development. A framework highlighting the method of development of an intervention can be used by others wanting to replicate interventions or develop similar interventions to suit other contexts and settings. It provides researchers with a comprehensive development process of the intervention. Objective The objective of this paper was to describe how a systematic approach, intervention mapping, was used to develop a tailored Web-based intervention to increase condom use among HIV-positive men who have sex with men. Methods The intervention was developed in consultation with a multidisciplinary team composed of academic researchers, community members, Web designers, and the target population. Intervention mapping involved a systematic process of 6 steps: (1) needs assessment; (2) identification of proximal intervention objectives; (3) selection of theory-based intervention methods and practical strategies; (4) development of intervention components and materials; (5) adoption, implementation, and maintenance; and (6) evaluation planning. Results The application of intervention mapping resulted in the development of a tailored Web-based intervention for HIV-positive men who have sex with men, called Condom-HIM. Conclusions Using intervention mapping as a systematic process to develop interventions is a feasible approach that specifically integrates the use of theory and empirical findings. Outlining the process used to develop a particular intervention provides clarification on the conceptual use of experimental interventions in addition to potentially identifying reasons for intervention failures. PMID:28428162

Strategic Planning for Higher Education.

ERIC Educational Resources Information Center

Kotler, Philip; Murphy, Patrick E.

1981-01-01

The framework necessary for achieving a strategic planning posture in higher education is outlined. The most important benefit of strategic planning for higher education decision makers is that it forces them to undertake a more market-oriented and systematic approach to long- range planning. (Author/MLW)

Planning Marine Reserve Networks for Both Feature Representation and Demographic Persistence Using Connectivity Patterns

PubMed Central

Bode, Michael; Williamson, David H.; Weeks, Rebecca; Jones, Geoff P.; Almany, Glenn R.; Harrison, Hugo B.; Hopf, Jess K.; Pressey, Robert L.

2016-01-01

Marine reserve networks must ensure the representation of important conservation features, and also guarantee the persistence of key populations. For many species, designing reserve networks is complicated by the absence or limited availability of spatial and life-history data. This is particularly true for data on larval dispersal, which has only recently become available. However, systematic conservation planning methods currently incorporate demographic processes through unsatisfactory surrogates. There are therefore two key challenges to designing marine reserve networks that achieve feature representation and demographic persistence constraints. First, constructing a method that efficiently incorporates persistence as well as complementary feature representation. Second, incorporating persistence using a mechanistic description of population viability, rather than a proxy such as size or distance. Here we construct a novel systematic conservation planning method that addresses both challenges, and parameterise it to design a hypothetical marine reserve network for fringing coral reefs in the Keppel Islands, Great Barrier Reef, Australia. For this application, we describe how demographic persistence goals can be constructed for an important reef fish species in the region, the bar-cheeked trout (Plectropomus maculatus). We compare reserve networks that are optimally designed for either feature representation or demographic persistence, with a reserve network that achieves both goals simultaneously. As well as being practically applicable, our analyses also provide general insights into marine reserve planning for both representation and demographic persistence. First, persistence constraints for dispersive organisms are likely to be much harder to achieve than representation targets, due to their greater complexity. Second, persistence and representation constraints pull the reserve network design process in divergent directions, making it difficult to efficiently achieve both constraints. Although our method can be readily applied to the data-rich Keppel Islands case study, we finally consider the factors that limit the method’s utility in information-poor contexts common in marine conservation. PMID:27168206

Reserve network planning for fishes in the middle and lower Yangtze River basin by systematic conservation approaches.

PubMed

Huang, Xinyi; Li, Fan; Chen, Jiakuan

2016-03-01

Although China has established more than 600 wetland nature reserves, conservation gaps still exist for many species, especially for freshwater fishes. Underlying this problem is the fact that top-level planning is missing in the construction of nature reserves. To promote the development of nature reserves for fishes, this study took the middle and lower reaches of the Yangtze River basin (MLYRB) as an example to carry out top-level reserve network planning for fishes using approaches of systematic conservation planning. Typical fish species living in freshwater habitats were defined and considered in the planning. Based on sample data collected from large quantities of literatures, continuous distribution patterns of 142 fishes were obtained with species distribution modeling and subsequent processing, and the distributions of another eleven species were artificially designated. With the distribution pattern of species, Marxan was used to carry out conservation planning. To obtain ideal solutions with representativeness, persistence, and efficiency, parameters were set with careful consideration regarding existing wetland reserves, human disturbances, hydrological connectivity, and representation targets of species. Marxan produced the selection frequency of planning units (PUs) and a best solution. Selection frequency indicates the relative protection importance of a PU. The best solution is a representative of ideal fish reserve networks. Both of the PUs with high selection frequency and those in the best solution have low proportions included in existing wetland nature reserves, suggesting that there are significant conservation gaps for fish species in MLYRB. The best solution could serve as a reference for establishing a fish reserve network in the MLYRB. There is great flexibility for replacing selected PUs in the solution, and such flexibility facilitates the implementation of the solution in reality in case of unexpected obstacles. Further, we suggested adopting a freshwater management framework in the implementation of such solution.

PLAN2L: a web tool for integrated text mining and literature-based bioentity relation extraction.

PubMed

Krallinger, Martin; Rodriguez-Penagos, Carlos; Tendulkar, Ashish; Valencia, Alfonso

2009-07-01

There is an increasing interest in using literature mining techniques to complement information extracted from annotation databases or generated by bioinformatics applications. Here we present PLAN2L, a web-based online search system that integrates text mining and information extraction techniques to access systematically information useful for analyzing genetic, cellular and molecular aspects of the plant model organism Arabidopsis thaliana. Our system facilitates a more efficient retrieval of information relevant to heterogeneous biological topics, from implications in biological relationships at the level of protein interactions and gene regulation, to sub-cellular locations of gene products and associations to cellular and developmental processes, i.e. cell cycle, flowering, root, leaf and seed development. Beyond single entities, also predefined pairs of entities can be provided as queries for which literature-derived relations together with textual evidences are returned. PLAN2L does not require registration and is freely accessible at http://zope.bioinfo.cnio.es/plan2l.

Barriers to Advance Care Planning at the End of Life: An Explanatory Systematic Review of Implementation Studies

PubMed Central

Lund, Susi; Richardson, Alison; May, Carl

2015-01-01

Context Advance Care Plans (ACPs) enable patients to discuss and negotiate their preferences for the future including treatment options at the end of life. Their implementation poses significant challenges. Objective To investigate barriers and facilitators to the implementation of ACPs, focusing on their workability and integration in clinical practice. Design An explanatory systematic review of qualitative implementation studies. Data sources Empirical studies that reported interventions designed to support ACP in healthcare. Web of Knowledge, Ovid MEDLINE, CINAHL, PsycINFO, British Nursing Index and PubMed databases were searched. Methods Direct content analysis, using Normalization Process Theory, to identify and characterise relevant components of implementation processes. Results 13 papers identified from 166 abstracts were included in the review. Key factors facilitating implementation were: specially prepared staff utilizing a structured approach to interactions around ACPs. Barriers to implementation were competing demands of other work, the emotional and interactional nature of patient-professional interactions around ACPs, problems in sharing decisions and preferences within and between healthcare organizations. Conclusions This review demonstrates that doing more of the things that facilitate delivery of ACPs will not reduce the effects of those things that undermine them. Structured tools are only likely to be partially effective and the creation of a specialist cadre of ACP facilitators is unlikely to be a sustainable solution. The findings underscore both the challenge and need to find ways to routinely incorporate ACPs in clinical settings where multiple and competing demands impact on practice. Interventions most likely to meet with success are those that make elements of Advance Care Planning workable within complex and time pressured clinical workflows. PMID:25679395

Ants as a measure of effectiveness of habitat conservation planning in southern California

USGS Publications Warehouse

Mitrovich, Milan J.; Matsuda, Tritia; Pease, Krista H.; Fisher, Robert N.

2010-01-01

In the United States multispecies habitat conservation plans were meant to be the solution to conflicts between economic development and protection of biological diversity. Although now widely applied, questions exist concerning the scientific credibility of the conservation planning process and effectiveness of the plans. We used ants to assess performance of one of the first regional conservation plans developed in the United States, the Orange County Central-Coastal Natural Community Conservation Plan (NCCP), in meeting its broader conservation objectives of biodiversity and ecosystem-level protection. We collected pitfall data on ants for over 3 years on 172 sites established across a network of conservation lands in coastal southern California. Although recovered native ant diversity for the study area was high, site-occupancy models indicated the invasive and ecologically disruptive Argentine ant ( Linepithema humile) was present at 29% of sites, and sites located within 200 m of urban and agricultural areas were more likely to have been invaded. Within invaded sites, native ants were largely displaced, and their median species richness declined by more than 60% compared with uninvaded sites. At the time of planning, 24% of the 15,133-ha reserve system established by Orange County NCCP fell within 200 m of an urban or agricultural edge. With complete build out of lands surrounding the reserve, the proportion of the reserve system vulnerable to invasion will grow to 44%. Our data indicate that simply protecting designated areas from development is not enough. If habitat conservation plans are to fulfill their conservation promise of ecosystem-level protection, a more-integrated and systematic approach to the process of habitat conservation planning is needed.

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

Chen, X; Wang, J; Hu, W

Purpose: The Varian RapidPlan™ is a commercial knowledge-based optimization process which uses a set of clinically used treatment plans to train a model that can predict individualized dose-volume objectives. The purpose of this study is to evaluate the performance of RapidPlan to generate intensity modulated radiation therapy (IMRT) plans for cervical cancer. Methods: Totally 70 IMRT plans for cervical cancer with varying clinical and physiological indications were enrolled in this study. These patients were all previously treated in our institution. There were two prescription levels usually used in our institution: 45Gy/25 fractions and 50.4Gy/28 fractions. 50 of these plans weremore » selected to train the RapidPlan model for predicting dose-volume constraints. After model training, this model was validated with 10 plans from training pool(internal validation) and additional other 20 new plans(external validation). All plans used for the validation were re-optimized with the original beam configuration and the generated priorities from RapidPlan were manually adjusted to ensure that re-optimized DVH located in the range of the model prediction. DVH quantitative analysis was performed to compare the RapidPlan generated and the original manual optimized plans. Results: For all the validation cases, RapidPlan based plans (RapidPlan) showed similar or superior results compared to the manual optimized ones. RapidPlan increased the result of D98% and homogeneity in both two validations. For organs at risk, the RapidPlan decreased mean doses of bladder by 1.25Gy/1.13Gy (internal/external validation) on average, with p=0.12/p<0.01. The mean dose of rectum and bowel were also decreased by an average of 2.64Gy/0.83Gy and 0.66Gy/1.05Gy,with p<0.01/ p<0.01and p=0.04/<0.01 for the internal/external validation, respectively. Conclusion: The RapidPlan model based cervical cancer plans shows ability to systematically improve the IMRT plan quality. It suggests that RapidPlan has great potential to make the treatment planning process more efficient.« less

[Nursing care systematization according to the nurses' view: a methodological approach based on grounded theory].

PubMed

de Medeiros, Ana Lúcia; dos Santos, Sérgio Ribeiro; de Cabral, Rômulo Wanderley Lima

2012-09-01

This study was aimed at understanding, from the nurses' perspective, the experience of going through the Systematization of nursing care (SNC) in an obstetric service unit. We used grounded theory as the theoretical and methodological framework. The subjects of this study consisted of thirteen nurses from a public hospital in the city of João Pessoa, in the state of Paraíba. The data analysis resulted in the following phenomenon. "perceiving SNC as a working method that organizes, directs and improves the quality of care by bringing visibility and providing security for the nursing staff" The nurses expressed the extent of knowledge about the SNC experienced in obstetrics as well as considered the nursing process as a decision-making process, which guides the reasoning of nurses in the planning of nursing care in obstetrics. It was concluded that nurses perceive the SNC as an instrument of theoretical-practical articulation leading to personalized assistance.

Urban Planning by Le Corbusier According to Praxeological Knowledge

NASA Astrophysics Data System (ADS)

Dzwierzynska, Jolanta; Prokopska, Aleksandra

2017-12-01

The city is formed as a mosaic of various elements which affect its attractiveness. These elements range from location attributes, through economic opportunities, to social aspects. Therefore, urbanity and urban planning should be considered in a multi-dimensional context. In the paper we address the problem of urban planning by Le Corbusier according to praxeological and system knowledge. From praxeological point of view an active human being takes his/her choice between various possibilities by preferring one of these possibilities to the others, and by manifesting it by her actions. The same applies to the design process. Due to this fact, the scientific design process can be treated as a systematic rational reconstruction of the designer’s behaviour. Such a reconstruction requires previous reflection on designer’s work, as well as some consideration and design experience, thus know-how knowledge based on methodological knowledge. In the paper several city visions of Le Corbusier, as well as the characteristics and organisation of his design process are analysed. Le Corbusier’s innovative design ideas resulted from industrialisation changes and motorisation accelerating progress, which gave foundation to a new urban array. This array based on strict geometric forms, regularity and repetition determining standard. Thanks to his theories, Le Corbusier established principles of modern city construction and planning. Although some doubts were expressed as to the scale of centralisation of the cities designed by him and his class-based conception, he was awarded that overall welfare of the individual living in a city was the quality of built environment. Therefore, his designed creations were not only functional but they also produced emotions. The analysis of his prolific design activities allows us to state that the organisation of his architectural and urban planning process was very efficient and complex. The city concepts proposed by him were the subject of analysis by generations of designers. Also now, they can still be the basis for modelling virtual and navigable cities by modern planners. Le Corbusier’s comprehensive approach to modern city planning showed that research activities, that is theoretical thinking, and production activities, that is practice, are linked methodically. Therefore, urban planning should be understood not only as a projection of the possibilities of architecture, but as a multidisciplinary process. Due to this fact, an urban plan, as a result of that process, should be a synthesis of various social, industrial and economic aspects.

Effect of MLC leaf position, collimator rotation angle, and gantry rotation angle errors on intensity-modulated radiotherapy plans for nasopharyngeal carcinoma

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

Bai, Sen; Li, Guangjun; Wang, Maojie

The purpose of this study was to investigate the effect of multileaf collimator (MLC) leaf position, collimator rotation angle, and accelerator gantry rotation angle errors on intensity-modulated radiotherapy plans for nasopharyngeal carcinoma. To compare dosimetric differences between the simulating plans and the clinical plans with evaluation parameters, 6 patients with nasopharyngeal carcinoma were selected for simulation of systematic and random MLC leaf position errors, collimator rotation angle errors, and accelerator gantry rotation angle errors. There was a high sensitivity to dose distribution for systematic MLC leaf position errors in response to field size. When the systematic MLC position errors weremore » 0.5, 1, and 2 mm, respectively, the maximum values of the mean dose deviation, observed in parotid glands, were 4.63%, 8.69%, and 18.32%, respectively. The dosimetric effect was comparatively small for systematic MLC shift errors. For random MLC errors up to 2 mm and collimator and gantry rotation angle errors up to 0.5°, the dosimetric effect was negligible. We suggest that quality control be regularly conducted for MLC leaves, so as to ensure that systematic MLC leaf position errors are within 0.5 mm. Because the dosimetric effect of 0.5° collimator and gantry rotation angle errors is negligible, it can be concluded that setting a proper threshold for allowed errors of collimator and gantry rotation angle may increase treatment efficacy and reduce treatment time.« less

Remodeling of legacy systems in health care using UML.

PubMed

Garde, Sebastian; Knaup, Petra; Herold, Ralf

2002-01-01

Research projects in the field of Medical Informatics often involve the development of application systems. Usually they are developed over a longer period of time, so that at a certain point of time a systematically planned reimplementation is necessary. The first step of reimplementation should be a systematic and comprehensive remodeling. When using UML for this task a systematic approach for remodeling activities is missing. Therefore, we developed a method for remodeling of legacy systems (Qumquad) and applied it to DOSPO, a documentation and therapy planning system for pediatric oncology. Qumquad helps to systematically carry out three steps: the modeling of the current actual state of the application system, the systematic identification of weak points and the development of a target concept for reimplementation considering the identified weak points. Results show that this approach is valuable and feasible and could be applied to various application systems in health care.

Application of Intervention Mapping to the Development of a Complex Physical Therapist Intervention.

PubMed

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

2016-12-01

Physical therapist interventions, such as those designed to change physical activity behavior, are often complex and multifaceted. In order to facilitate rigorous evaluation and implementation of these complex interventions into clinical practice, the development process must be comprehensive, systematic, and transparent, with a sound theoretical basis. Intervention Mapping is designed to guide an iterative and problem-focused approach to the development of complex interventions. The purpose of this case report is to demonstrate the application of an Intervention Mapping approach to the development of a complex physical therapist intervention, a remote self-management program aimed at increasing physical activity after acquired brain injury. Intervention Mapping consists of 6 steps to guide the development of complex interventions: (1) needs assessment; (2) identification of outcomes, performance objectives, and change objectives; (3) selection of theory-based intervention methods and practical applications; (4) organization of methods and applications into an intervention program; (5) creation of an implementation plan; and (6) generation of an evaluation plan. The rationale and detailed description of this process are presented using an example of the development of a novel and complex physical therapist intervention, myMoves-a program designed to help individuals with an acquired brain injury to change their physical activity behavior. The Intervention Mapping framework may be useful in the development of complex physical therapist interventions, ensuring the development is comprehensive, systematic, and thorough, with a sound theoretical basis. This process facilitates translation into clinical practice and allows for greater confidence and transparency when the program efficacy is investigated. © 2016 American Physical Therapy Association.

A clinical nurse specialist-led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement.

PubMed

Russell, Cynthia L

2010-01-01

A clinical nurse specialist-led intervention to improve medication adherence in chronically ill adults using renal transplant recipients as an exemplar population is proposed. Meta-analyses and systematic reviews of chronically ill and transplant patients indicate that patient-specific characteristics not only are poor and inconsistent predictors for medication nonadherence but also are not amenable to intervention. Adherence has not meaningfully improved, despite meta-analyses and systematic narrative reviews of randomized controlled trials (RCTs) dealing with medication nonadherence in acutely and chronically ill persons and RCTs dealing with transplant patients. Interventions with a superior potential to enhance medication adherence must be developed. Use of a clinical nurse specialist-led continuous self-improvement intervention with adult renal transplant recipients is proposed. Continuous self-improvement focuses on improving personal systems thinking and behavior using the plan-do-check-act process. Electronic medication monitoring reports, one of several objective measures of medication adherence, are used by the clinician to provide patient feedback during the check process on medication-taking patterns. Continuous self-improvement as an intervention holds promise in supporting patient self-management and diminishing the blame that clinicians place on patients for medication nonadherence. Using an objective measure of medication adherence such as an electronic monitoring report fosters collaborative patient-clinician discussions of daily medication-taking patterns. Through collaboration, ideas for improving medication taking can be explored. Changes can be followed and evaluated for effectiveness through the continuous self-improvement process. Future studies should include RCTs comparing educational and/or behavioral interventions to improve medication adherence.

Product development public-private partnerships for public health: a systematic review using qualitative data.

PubMed

De Pinho Campos, Katia; Norman, Cameron D; Jadad, Alejandro R

2011-10-01

Almost a decade ago, public health initiated a number of innovative ventures to attract investments from multinational drug companies for the development of new drugs and vaccines to tackle neglected diseases (NDs). These ventures - known as product development public-private partnerships (PD PPPs) - represent the participation of the public and private actors toward the discovery and development of essential medicines to reduce the suffering of over one billion people worldwide living with NDs. This systematic review aimed to identify empirical-based descriptive articles to understand critical elements in the partnership process, and propose a framework to shed light on future guidelines to support better planning, design and management of existing and new forms of PPPs for public health. Ten articles met the inclusion criteria and were analyzed and synthesized using qualitative content analysis. The findings show that the development stage of PD PPPs requires a careful initiation and planning process including discussion on values and shared goals, agreement on mutual interests & equality of power relation, exchange of expertise & resources, stakeholder engagement, and assessment of the local health capacity. The management stage of PD PPPs entails transparency, extensive communication and participatory decision-making among partner organizations. This review illustrates the difficulties, challenges and effective responses during the partnering process. This model of collaboration may offer a way to advance population health at present, while creating streams of innovation that can yield future social and financial dividends in enhancing the public's health more widely. Copyright © 2011 Elsevier Ltd. All rights reserved.

Systematic Treatment Selection (STS): A Review and Future Directions

ERIC Educational Resources Information Center

Nguyen, Tam T.; Bertoni, Matteo; Charvat, Mylea; Gheytanchi, Anahita; Beutler, Larry E.

2007-01-01

Systematic Treatment Selection (STS) is a form of technical eclectism that develops and plans treatments using empirically founded principles of psychotherapy. It is a model that provides systematic guidelines for the utilization of different psychotherapeutic strategies based on patient qualities and problem characteristics. Historically, it…

Motion planning for an adaptive wing structure with macro-fiber composite actuators

NASA Astrophysics Data System (ADS)

Schröck, J.; Meurer, T.; Kugi, A.

2009-05-01

A systematic approach for flatness-based motion planning and feedforward control is presented for the transient shaping of a piezo-actuated rectangular cantilevered plate modeling an adaptive wing. In the first step the consideration of an idealized infinite-dimensional input allows to determine the state and input parametrization in terms of a flat or basic output, which is used for a systematic motion planning approach. Subsequently, the obtained idealized input function is projected onto a finite number of suitably placed Macro-fiber Composite (MFC) patch actuators. The tracking performance of the proposed approach is evaluated in a simulation scenario.

Coupling systematic planning and expert judgement enhances the efficiency of river restoration.

PubMed

Langhans, Simone D; Gessner, Jörn; Hermoso, Virgilio; Wolter, Christian

2016-08-01

Ineffectiveness of current river restoration practices hinders the achievement of ecological quality targets set by country-specific regulations. Recent advances in river restoration help planning efforts more systematically to reach ecological targets at the least costs. However, such approaches are often desktop-based and overlook real-world constraints. We argue that combining two techniques commonly used in the conservation arena - expert judgement and systematic planning - will deliver cost-effective restoration plans with a high potential for implementation. We tested this idea targeting the restoration of spawning habitat, i.e. gravel bars, for 11 rheophilic fish species along a river system in Germany (Havel-Spree rivers). With a group of local fish experts, we identified the location and extent of potential gravel bars along the rivers and necessary improvements to migration barriers to ensure fish passage. Restoration cost of each gravel bar included the cost of the action itself plus a fraction of the cost necessary to ensure longitudinal connectivity by upgrading or building fish passages located downstream. We set restoration targets according to the EU Water Framework Directive, i.e. relative abundance of 11 fish species in the reference community and optimised a restoration plan by prioritising a subset of restoration sites from the full set of identified sites, using the conservation planning software Marxan. Out of the 66 potential gravel bars, 36 sites which were mainly located in the downstream section of the system were selected, reflecting their cost-effectiveness given that fewer barriers needed intervention. Due to the limited overall number of sites that experts identified as being suitable for restoring spawning habitat, reaching abundance-targets was challenged. We conclude that coupling systematic river restoration planning with expert judgement produces optimised restoration plans that account for on-the-ground implementation constraints. If applied, this approach has a high potential to enhance overall efficiency of future restoration efforts. Copyright © 2016 Elsevier B.V. All rights reserved.

Uncertainty reduction in intensity modulated proton therapy by inverse Monte Carlo treatment planning

NASA Astrophysics Data System (ADS)

Morávek, Zdenek; Rickhey, Mark; Hartmann, Matthias; Bogner, Ludwig

2009-08-01

Treatment plans for intensity-modulated proton therapy may be sensitive to some sources of uncertainty. One source is correlated with approximations of the algorithms applied in the treatment planning system and another one depends on how robust the optimization is with regard to intra-fractional tissue movements. The irradiated dose distribution may substantially deteriorate from the planning when systematic errors occur in the dose algorithm. This can influence proton ranges and lead to improper modeling of the Braggpeak degradation in heterogeneous structures or particle scatter or the nuclear interaction part. Additionally, systematic errors influence the optimization process, which leads to the convergence error. Uncertainties with regard to organ movements are related to the robustness of a chosen beam setup to tissue movements on irradiation. We present the inverse Monte Carlo treatment planning system IKO for protons (IKO-P), which tries to minimize the errors described above to a large extent. Additionally, robust planning is introduced by beam angle optimization according to an objective function penalizing paths representing strongly longitudinal and transversal tissue heterogeneities. The same score function is applied to optimize spot planning by the selection of a robust choice of spots. As spots can be positioned on different energy grids or on geometric grids with different space filling factors, a variety of grids were used to investigate the influence on the spot-weight distribution as a result of optimization. A tighter distribution of spot weights was assumed to result in a more robust plan with respect to movements. IKO-P is described in detail and demonstrated on a test case and a lung cancer case as well. Different options of spot planning and grid types are evaluated, yielding a superior plan quality with dose delivery to the spots from all beam directions over optimized beam directions. This option shows a tighter spot-weight distribution and should therefore be less sensitive to movements compared to optimized directions. But accepting a slight loss in plan quality, the latter choice could potentially improve robustness even further by accepting only spots from the most proper direction. The choice of a geometric grid instead of an energy grid for spot positioning has only a minor influence on the plan quality, at least for the investigated lung case.

Identification, assessment, and control of hazards in water supply: experiences from Water Safety Plan implementations in Germany.

PubMed

Mälzer, H-J; Staben, N; Hein, A; Merkel, W

2010-01-01

According to the recommendations of the World Health Organization (WHO) for Water Safety Plans (WSP), a Technical Risk Management was developed, which considers standard demands in drinking water treatment in Germany. It was already implemented at several drinking water treatment plants of different size and treatment processes in Germany. Hazards affecting water quality, continuity, and the reliability of supply from catchment to treatment and distribution could be identified by a systematic approach, and suitable control measures were defined. Experiences are presented by detailed examples covering methods, practical consequences, and further outcomes. The method and the benefits for the water suppliers are discussed and an outlook on the future role of WSPs in German water supply is given.

Utilizing a Health Impact Assessment (HIA) to Connect Natural ...

EPA Pesticide Factsheets

Marrying scientific and health research with natural resource management should be a straightforward process. However, differences in purpose, goals, language, levels of detail and implementation authority between the scientists who conduct research and resource managers who plan and implement projects make it difficult for resource managers to include information not specific to the problem at hand. One method to overcome this barrier is a Health Impact Assessment (HIA) or process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making process. An HIA informs decision makers and stakeholders of the potential health effects of a proposed program, policy, project or plan through a systematic investigation of impacts to health and health determinants and deliberative engagement of community members and other stakeholders throughout the HIA process. USEPA will be conducting an HIA on the Minnesota Department of Natural Resources’ sediment remediation and habitat restoration project at Kingsbury Bay and Grassy Point. This poster outlines the HIA process, illustrates how technical and stakeholder committees inform the process, and presents the determinants of health that will be explored in the HIA. This poster will illustrate how a Health Impact Assessment, a process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making proces

Social marketing campaign promoting the use of respiratory protection devices among farmers.

PubMed

Pounds, Lea; Duysen, Ellen; Romberger, Debra; Cramer, Mary E; Wendl, Mary; Rautiainen, Risto

2014-01-01

This article describes the formal use of marketing concepts in a systematic approach to influence farmers to voluntarily increase respiratory protective device (RPD) use. The planning process for the project incorporated six key decision or action points, each informed by formative research or health behavior theory. The planning process included developing behavior change strategies based on a 4P model (product, price, place, and promotion). The resulting campaign elements included print and e-mail messages that leveraged motivators related to family and health in order to increase farmers' knowledge about the risks of exposure to dusty environments, four instructional videos related to the primary barriers identified in using RPDs, and a brightly colored storage bag to address barriers to using RPDs related to mask storage. Campaign implementation included a series of e-mails using a bulk e-mail subscription service, use of social media in the form of posting instructional videos on a YouTube channel, and in-person interactions with members of the target audience at farm shows throughout the Central States Center for Agricultural Safety and Health seven-state region. Evaluation of the e-mail campaigns indicated increased knowledge about RPD use and intent to use RPDs in dusty conditions. YouTube analytic data indicated continuing exposure of the instructional videos beyond the life of the campaign. The project demonstrates the efficacy of a planning process that incorporates formative research and clear decision points throughout. This process could be used to plan health behavior change interventions to address other agriculture-related health and safety issues.

Using a Theory-Driven Approach to Manage the Relocation of an Intensive Care Unit: An Exemplar.

PubMed

Lin, Frances; Marshall, Andrea; Hervey, Lucy; Foster, Michelle; Hancock, Jane; Chaboyer, Wendy

Proactive planning and managing moving from old to newly built hospitals, and the relocation process of patients for complex specialized units such as intensive care units, are necessary for both patient safety and staff well-being. This article provides an exemplar for how theory can be used to facilitate a positive relocation experience. Using change management theory, a systematic approach to cocreate implementation strategy among researchers and clinicians was critical to the success of this project.

Academic-practice collaboration in nursing education: service-learning for injury prevention.

PubMed

Alexander, Gina K; Canclini, Sharon B; Krauser, Debbie L

2014-01-01

Teams of senior-level baccalaureate nursing students at a private, urban university complete a population-focused public health nursing practicum through service-learning partnerships. Recently, students collaborated with local service agencies for Safe Communities America, a program of the National Safety Council in affiliation with the World Health Organization. This article describes the student-led process of community assessment, followed by systematic planning, implementation, and evaluation of evidence-based interventions to advance prescription drug overdose/poisoning prevention efforts in the community.

Virtual planning in orthognathic surgery.

PubMed

Stokbro, K; Aagaard, E; Torkov, P; Bell, R B; Thygesen, T

2014-08-01

Numerous publications regarding virtual surgical planning protocols have been published, most reporting only one or two case reports to emphasize the hands-on planning. None have systematically reviewed the data published from clinical trials. This systematic review analyzes the precision and accuracy of three-dimensional (3D) virtual surgical planning of orthognathic procedures compared with the actual surgical outcome following orthognathic surgery reported in clinical trials. A systematic search of the current literature was conducted to identify clinical trials with a sample size of more than five patients, comparing the virtual surgical plan with the actual surgical outcome. Search terms revealed a total of 428 titles, out of which only seven articles were included, with a combined sample size of 149 patients. Data were presented in three different ways: intra-class correlation coefficient, 3D surface area with a difference <2mm, and linear and angular differences in three dimensions. Success criteria were set at 2mm mean difference in six articles; 125 of the 133 patients included in these articles were regarded as having had a successful outcome. Due to differences in the presentation of data, meta-analysis was not possible. Virtual planning appears to be an accurate and reproducible method for orthognathic treatment planning. A more uniform presentation of the data is necessary to allow the performance of a meta-analysis. Currently, the software system most often used for 3D virtual planning in clinical trials is SimPlant (Materialise). More independent clinical trials are needed to further validate the precision of virtual planning. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. All rights reserved.

Community Education for Family Planning in the U.S.: A Systematic Review.

PubMed

Carter, Marion W; Tregear, Michelle L; Moskosky, Susan B

2015-08-01

Community education may involve activities that seek to raise awareness and promote behavior change, using mass media, social media, and other media or interpersonal methods in community settings. This systematic review evaluated the evidence of the effects of community education on select short- and medium-term family planning outcomes. Using an analytic approach drawn from the U.S. Preventive Services Task Force, multiple databases were searched for articles published from January 1985 through February 2011 describing studies of community education related to family planning in the U.S. Included articles were reviewed and assessed for potential bias using a standardized process in 2011. An updated, targeted review for the 2011-2014 period was conducted in early 2015. Seventeen papers were identified. Most (nine) related to mass media interventions; three involved targeted print media, two involved text messaging or e-mail, two described outcome workers conducting community education, and one involved community theater. Study designs, strength of evidence, and levels of possible bias varied widely. Twelve of 15 studies that addressed outcomes such as increased awareness found positive associations with those outcomes, with six also reporting null findings. Seven of eight studies that addressed use of services reported positive associations, with two also reporting null findings. The targeted, additional review identified two other studies. Evidence related to community education for family planning purposes is limited and highly variable. As goals of community education are usually limited to shorter-term outcomes, the evidence suggests that a range of approaches may be effective. Published by Elsevier Inc.

An Overview of the Quality Function Deployment (QFD) Technique

NASA Technical Reports Server (NTRS)

Sherif, Josef S.; Tran, Tuyet-Lan

1995-01-01

QFD is a product planning tool and a process methodology that enables all organizations, departments, and individuals in a business or a project to systematically focus on the critical performance, functions, and/or characteristics of a product that are the most important to the customer. It is part of the Total Quality Management (TQM) concept.. This presentation describes the objectives of QFD, the process for implementing the technique, the benefits derived from proper implementation, the kinds of systems where QFD is best utilized, what the success factors are, how QFD works, some guidelines for selection of a QFD team, and the functional roles of key team members.

Ten key principles for successful health systems integration.

PubMed

Suter, Esther; Oelke, Nelly D; Adair, Carol E; Armitage, Gail D

2009-01-01

Integrated health systems are considered part of the solution to the challenge of sustaining Canada's healthcare system. This systematic literature review was undertaken to guide decision-makers and others to plan for and implement integrated health systems. This review identified 10 universal principles of successfully integrated healthcare systems that may be used by decision-makers to assist with integration efforts. These principles define key areas for restructuring and allow organizational flexibility and adaptation to local context. The literature does not contain a one-size-fits-all model or process for successful integration, nor is there a firm empirical foundation for specific integration strategies and processes.

Risk Management Structured for Today's Environment

NASA Technical Reports Server (NTRS)

Greenfield, Michael A.

1998-01-01

In NPG (NASA Procedures and Guidelines) 7120.5A, we define risk management as "an organized, systematic decision-making process that efficiently identifies, analyzes, plans, tracks, controls, and communicates and documents risk in order to increase the likelihood of achieving program/project goals." Effective risk management depends upon a thorough understanding of the concept of risk, the principles of risk management and the formation of a disciplined risk management process. In human spaceflight programs, NASA has always maintained a rigorous and highly structured risk management effort. When lives are at stake, NASA's missions must be 100% safe; the risk management approach used in human spaceflight has always been comprehensive.

Clinical audit in dentistry: From a concept to an initiation.

PubMed

Malleshi, Suchetha N; Joshi, Mahasweta; Nair, Soumya K; Ashraf, Irshad

2012-11-01

Clinical audit is a quality improvement process that aims to improve patient care through a systematic review of care against explicit criteria. It is a cyclic and multidisciplinary process which involves a series of steps from planning the audit through measuring the performance to implementing and sustaining the change. Although audit contains some facets of research, it is essential to understand the difference between the two. Auditing can be done right from the record maintaining, diagnosis and treatment and postoperative evaluation and follow-up. The immense potential of clinical audit can be utilized only when open-mindedness and innovativeness are encouraged and evidence-based work culture is cultivated.

Data-Driven Planning: Using Assessment in Strategic Planning

ERIC Educational Resources Information Center

Bresciani, Marilee J.

2010-01-01

Data-driven planning or evidence-based decision making represents nothing new in its concept. For years, business leaders have claimed they have implemented planning informed by data that have been strategically and systematically gathered. Within higher education and student affairs, there may be less evidence of the actual practice of…

Recruitment for exercise or physical activity interventions: a protocol for systematic review.

PubMed

Hoover, Jeffrey C; Alenazi, Aqeel M; Alothman, Shaima; Alshehri, Mohammed M; Rucker, Jason; Kluding, Patricia

2018-03-27

Recruiting participants into research trials is essential for the advancement of scientific knowledge that depends on clinical research studies. For the field of exercise and physical activity, there is an added difficulty in recruiting participants because participants must be willing to participate in an intervention that requires a significant commitment of both time and physical effort. Therefore, we have planned a systematic review to analyse how methodological factors, intervention characteristics and participant demographics impact recruitment rates in specific populations. This information will help researchers improve the design and recruitment approach in future studies. A mixed methods systematic review will be performed on studies that implement physical activity interventions and present data on participant recruitment. We plan on searching the Pubmed, Cumulative Index to Nursing and Allied Health Literature and Online Resource for Recruitment research in Clinical Trials databases for potentially eligible articles from database inception through 10 February 2017. A standardised approach will be used to identify studies through a review of titles, abstracts and reference lists. The process for each eligible study is to determine their eligibility, extract data from eligible studies and rate each eligible study's methodological quality. Exploratory multivariate regression models will be used to determine the effects of methodological factors, intervention characteristics and participant demographics on the recruitment variables of interest. Because all of the data used in this systematic review has been published, this review does not require ethical approval. The results of this review will be disseminated through peer-reviewed publication as well as through conference presentations. CRD42017057284. © 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.

[Planning With Nanda, Noc, Nic Taxonomies In Neurologic Rehabilitation. A clinical study].

PubMed

Iori, Alessandra; Foracchia, Marco; Gradellini, Cinzia

2015-01-01

Nursing classifications identify a specific professional responsibility, increase nursing visibility, according with nursing evolution of these last years. To evaluate care planning with NANDA taxonomy in neurologic rehabilitation context. Care plan managing with NANDA taxonomy, regarding diagnosis of constipation and impaired skin integrity, using a computerized tool for systematically observation, organized in check list. Registered data with taxonomy planning are higher in quantitative and qualitative terms. For most of patients (87%) one diagnosis has been opened, both diagnosis for 60% of them. Nursing care plan with NANDA taxonomy can be considered a valid methodology of care for neurologic patient, this since it requests a deep and complete registration of first assessment a systematically registration of each monitoring, it increases visibility of nursing job, and it underlines specific autonomy and responsibility in prevention and management of problems.

Dengue Contingency Planning: From Research to Policy and Practice.

PubMed

Runge-Ranzinger, Silvia; Kroeger, Axel; Olliaro, Piero; McCall, Philip J; Sánchez Tejeda, Gustavo; Lloyd, Linda S; Hakim, Lokman; Bowman, Leigh R; Horstick, Olaf; Coelho, Giovanini

2016-09-01

Dengue is an increasingly incident disease across many parts of the world. In response, an evidence-based handbook to translate research into policy and practice was developed. This handbook facilitates contingency planning as well as the development and use of early warning and response systems for dengue fever epidemics, by identifying decision-making processes that contribute to the success or failure of dengue surveillance, as well as triggers that initiate effective responses to incipient outbreaks. Available evidence was evaluated using a step-wise process that included systematic literature reviews, policymaker and stakeholder interviews, a study to assess dengue contingency planning and outbreak management in 10 countries, and a retrospective logistic regression analysis to identify alarm signals for an outbreak warning system using datasets from five dengue endemic countries. Best practices for managing a dengue outbreak are provided for key elements of a dengue contingency plan including timely contingency planning, the importance of a detailed, context-specific dengue contingency plan that clearly distinguishes between routine and outbreak interventions, surveillance systems for outbreak preparedness, outbreak definitions, alert algorithms, managerial capacity, vector control capacity, and clinical management of large caseloads. Additionally, a computer-assisted early warning system, which enables countries to identify and respond to context-specific variables that predict forthcoming dengue outbreaks, has been developed. Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensified vector control as their outbreak response, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication. The Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response seeks to provide countries with evidence-based best practices to justify the declaration of an outbreak and the mobilization of the resources required to implement an effective dengue contingency plan.

Systematic dissemination of a preschool physical activity intervention to the control preschools

PubMed Central

Howie, Erin K.; Brewer, Alisa E.; Brown, William H.; Saunders, Ruth P.; Pate, Russell R.

2016-01-01

For public health interventions to have a meaningful impact on public health, they must be disseminated to the wider population. Systematic planning and evaluation of dissemination efforts can aid translation from experimental trials to larger dissemination programs. The Study of Health and Activity in Preschool Environments (SHAPES) was a group-randomized intervention trial conducted in 16 preschools that successfully increased the physical activity of preschool age children. Following the completion of the research study protocol, the intervention was abbreviated, modified and implemented in four preschools who participated as control preschools in the original research study. The purposes of the current study were to describe the process of refining the intervention for dissemination to the control preschools, and to assess the acceptability of the resulting abbreviated intervention delivery. Five overarching behavioral objectives, informed by process evaluation, data from the original trial and collaboration with intervention teachers, were used to guide the implementation. Teachers in the dissemination classrooms reported high levels of acceptability, potential for sustainability of the program, and positive results in knowledge, skills, and child outcomes. Researchers can include a systematic approach to dissemination of effective intervention elements to the control participants in experimental studies to inform future dissemination efforts and begin to bridge the dissemination gap. PMID:27107302

Using narrative as a bridge: linking language processing models with real-life communication.

PubMed

Whitworth, Anne

2010-02-01

In chronic aphasia, maximizing generalization of improved language abilities from clinical tasks to everyday communication can require the same systematic planning process as the early stages of therapy, often drawing on additional areas of knowledge and successes from other clinical populations. The use of narrative structure is shown here to be a useful framework for building on the developments within sentence processing impairments in aphasia and creating a bridge to more real-life language tasks. An intervention based on narrative structure is described with two people with different language profiles and at different stages of the chronic aphasia spectrum. The insights gained in assessing language ability, underpinning intervention, and capturing therapeutic changes are demonstrated. Thieme Medical Publishers.

A strategic approach for Water Safety Plans implementation in Portugal.

PubMed

Vieira, Jose M P

2011-03-01

Effective risk assessment and risk management approaches in public drinking water systems can benefit from a systematic process for hazards identification and effective management control based on the Water Safety Plan (WSP) concept. Good results from WSP development and implementation in a small number of Portuguese water utilities have shown that a more ambitious nationwide strategic approach to disseminate this methodology is needed. However, the establishment of strategic frameworks for systematic and organic scaling-up of WSP implementation at a national level requires major constraints to be overcome: lack of legislation and policies and the need for appropriate monitoring tools. This study presents a framework to inform future policy making by understanding the key constraints and needs related to institutional, organizational and research issues for WSP development and implementation in Portugal. This methodological contribution for WSP implementation can be replicated at a global scale. National health authorities and the Regulator may promote changes in legislation and policies. Independent global monitoring and benchmarking are adequate tools for measuring the progress over time and for comparing the performance of water utilities. Water utilities self-assessment must include performance improvement, operational monitoring and verification. Research and education and resources dissemination ensure knowledge acquisition and transfer.

A systematic review of discontinued trials suggested that most reasons for recruitment failure were preventable.

PubMed

Briel, Matthias; Olu, Kelechi Kalu; von Elm, Erik; Kasenda, Benjamin; Alturki, Reem; Agarwal, Arnav; Bhatnagar, Neera; Schandelmaier, Stefan

2016-12-01

To collect and classify reported reasons for recruitment failure in discontinued randomized controlled trials (RCTs) and to assess reporting quality. We systematically searched MEDLINE and EMBASE (2010-2014) and a previous cohort of RCTs for published RCTs reporting trial discontinuation due to poor recruitment. Teams of two investigators selected eligible RCTs working independently and extracted information using standardized forms. We used an iterative approach to classify reasons for poor recruitment. We included 172 RCTs discontinued due to poor recruitment (including 26 conference abstracts and 63 industry-funded RCTs). Of those, 131 (76%) reported one or more reasons for discontinuation due to poor recruitment. We identified 28 different reasons for recruitment failure; most frequently mentioned were overestimation of prevalence of eligible participants and prejudiced views of recruiters and participants on trial interventions. Few RCTs reported relevant details about the recruitment process such as how eligible participants were identified, the number of patients assessed for eligibility, and who actually recruited participants. Our classification could serve as a checklist to assist investigators in the planning of RCTs. Most reasons for recruitment failure seem preventable with a pilot study that applies the planned informed consent procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

The Use of Intervention Mapping to Develop a Tailored Web-Based Intervention, Condom-HIM.

PubMed

Miranda, Joyal; Côté, José

2017-04-19

Many HIV (human immunodeficiency virus) prevention interventions are currently being implemented and evaluated, with little information published on their development. A framework highlighting the method of development of an intervention can be used by others wanting to replicate interventions or develop similar interventions to suit other contexts and settings. It provides researchers with a comprehensive development process of the intervention. The objective of this paper was to describe how a systematic approach, intervention mapping, was used to develop a tailored Web-based intervention to increase condom use among HIV-positive men who have sex with men. The intervention was developed in consultation with a multidisciplinary team composed of academic researchers, community members, Web designers, and the target population. Intervention mapping involved a systematic process of 6 steps: (1) needs assessment; (2) identification of proximal intervention objectives; (3) selection of theory-based intervention methods and practical strategies; (4) development of intervention components and materials; (5) adoption, implementation, and maintenance; and (6) evaluation planning. The application of intervention mapping resulted in the development of a tailored Web-based intervention for HIV-positive men who have sex with men, called Condom-HIM. Using intervention mapping as a systematic process to develop interventions is a feasible approach that specifically integrates the use of theory and empirical findings. Outlining the process used to develop a particular intervention provides clarification on the conceptual use of experimental interventions in addition to potentially identifying reasons for intervention failures. ©Joyal Miranda, José Côté. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 19.04.2017.

Strategic Planning and Fiscal Benefits: Is There a Link? ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Swenk, Jean M.

This study attempted to determine whether strategic planning would enhance a higher education institution's fiscal condition. It also systematically evaluated the extent of institution-wide strategic planning among private four-year postsecondary institutions in the United States. A definition of strategic planning and a conceptual framework based…

The preservice microteaching course and science teachers' instructional decisions: A qualitative analysis

NASA Astrophysics Data System (ADS)

Gess-Newsome, Julie; Lederman, Norman G.

The purpose of this investigation was to qualitatively investigate the effects of a microteaching course on preservice science teachers' perceptions of teaching, instructional decisions, and changes in beliefs which occur throughout the course. A total of 17 preservice teachers constituted the sample for this investigation. In addition to viewing and self-critiquing the videotapes of their lessons, students received both oral and written feedback from peers and instructors. Subjects were also required to complete a reaction questionnaire concerning their beliefs/perceptions prior to the first presentation as well as following each of the four required presentations. Systematic comparisons among students' self-critiques and reaction questionnaires yielded a total of 12 categories of concerns/beliefs about teaching. These categories pertained to either Concerns for Self or Concerns for Students. Although the subjects appeared to proceed through a developmental process beginning with concerns for self and moving toward concerns for students, analyses of subjects' comments about students revealed that such remarks were actually egocentric. Additionally, the data indicated that preservice teachers view planning as a complex, two-component process (i.e., the physical act of writing a plan and the subsequent mental rehearsal of that plan.).

Systematic Academic Instruction for Students with EBD: The Construction and Use of a Tool for Teachers

ERIC Educational Resources Information Center

van der Worp-van der Kamp, Lidy; Pijl, Sip Jan; Post, Wendy J.; Bijstra, Jan O.; van den Bosch, Els J.

2017-01-01

Educating students with behavioural, emotional and social difficulties requires a thorough systematic approach with the focus on academic instruction. This study addresses the development of a tool, consisting of two questionnaires, for measuring systematic academic instruction. The questionnaires cover the Plan-Do-Check-Act cycle and academic…

Nurse manager succession planning: synthesis of the evidence.

PubMed

Titzer, Jennifer; Phillips, Tracy; Tooley, Stephanie; Hall, Norma; Shirey, Maria

2013-10-01

The literature supporting nurse manager succession planning is reviewed and synthesised to discover best practice for identifying and developing future nurse managers. Healthcare succession planning practices are lacking. Nurse managers are historically selected based on clinical skills and lack formal leadership preparation. A systematic literature search appraises and summarises the current literature supporting nurse manager succession planning. Multiple reviewers were used to increase the reliability and validity of article selection and analysis. New nurse managers require months to adapt to their positions. Deliberate nurse manager succession planning should be integrated in the organisation's strategic plan and provide a proactive method for identifying and developing potential leaders. Organisations that identify and develop internal human capital can improve role transition, reduce nurse manager turnover rates and decrease replacement costs. Despite the clear benefits of succession planning, studies show that resource allocation for proactive, deliberate development of current and future nurse leaders is lacking. Additionally, systematic evaluation of succession planning is limited. Deliberate succession planning efforts and appropriate resource allocation require strategic planning and evaluation methods. Detailed evaluation methods demonstrating a positive return on investment utilising a cost-benefit analysis and empirical outcomes are necessary. © 2013 John Wiley & Sons Ltd.

Advancing the integration of hospital IT. Pitfalls and perspectives when replacing specialized software for high-risk environments with enterprise system extensions.

PubMed

Engelmann, Carsten; Ametowobla, Dzifa

2017-05-17

Planning and controlling surgical operations hugely impacts upon productivity, patient safety, and surgeons' careers. Established, specialized software for this task is being increasingly replaced by "Operating Room (OR)-modules" appended to enterprise-wide resource planning (ERP) systems. As a result, usability problems are re-emerging and require developers' attention. Systematic evaluation of the functionality and social repercussions of a global, market-leading IT business control system (SAP R3, Germany), adapted for real-time OR process steering. Field study involving document analyses, interviews, and a 73-item survey addressed to 77 qualified (> 1-year system experience) senior planning executives (end users; "planners") working in surgical departments of university hospitals. Planners reported that 57% of electronic operation requests contained contradictory information. Key screens contained clinically irrelevant areas (36 +/- 29%). Compared to the legacy system, users reported either no improvements or worse performance, in regard to co-ordination of OR stakeholders, intra-day program changes, and safety. Planners concluded that the ERP-planning module was "non-intuitive" (66%), increased planning work (56%, p=0.002), and did not impact upon either organizational mishap spectrum or frequency. Interviews evidenced intra-institutional power shifts due to increased system complexity. Planners resented e.g. a trend towards increased personal culpability for mishap. Highly complex enterprise system extensions may not be directly suited to specific process steering tasks in a high risk/low error-environment like the OR. In view of surgeons' high primary task load, the repeated call for simpler IT is an imperative for ERP extensions. System design should consider a) that current OR IT suffers from an input limitation regarding planning-relevant real-time data, and b) that there are social processes that strongly affect planning and particularly ERP use beyond algorithms. Real improvement of clinical IT tools requires their independent evaluation according to standards developed for pharmaceutical subjects.

Customization of ¹³C-MFA strategy according to cell culture system.

PubMed

Quek, Lake-Ee; Nielsen, Lars K

2014-01-01

(13)C-MFA is far from being a simple assay for quantifying metabolic activity. It requires considerable up-front experimental planning and familiarity with the cell culture system in question, as well as optimized analytics and adequate computation frameworks. The success of a (13)C-MFA experiment is ultimately rated by the ability to accurately quantify the flux of one or more reactions of interest. In this chapter, we describe the different (13)C-MFA strategies that have been developed for the various fermentation or cell culture systems, as well as the limitations of the respective strategies. The strategies are affected by many factors and the (13)C-MFA modeling and experimental strategy must be tailored to conditions. The prevailing philosophy in the computation process is that any metabolic processes that produce significant systematic bias in the labeling pattern of the metabolites being measured must be described in the model. It is equally important to plan a labeling strategy by analytical screening or by heuristics.

Simulations using patient data to evaluate systematic errors that may occur in 4D treatment planning: a proof of concept study.

PubMed

St James, Sara; Seco, Joao; Mishra, Pankaj; Lewis, John H

2013-09-01

The purpose of this work is to present a framework to evaluate the accuracy of four-dimensional treatment planning in external beam radiation therapy using measured patient data and digital phantoms. To accomplish this, 4D digital phantoms of two model patients were created using measured patient lung tumor positions. These phantoms were used to simulate a four-dimensional computed tomography image set, which in turn was used to create a 4D Monte Carlo (4DMC) treatment plan. The 4DMC plan was evaluated by simulating the delivery of the treatment plan over approximately 5 min of tumor motion measured from the same patient on a different day. Unique phantoms accounting for the patient position (tumor position and thorax position) at 2 s intervals were used to represent the model patients on the day of treatment delivery and the delivered dose to the tumor was determined using Monte Carlo simulations. For Patient 1, the tumor was adequately covered with 95.2% of the tumor receiving the prescribed dose. For Patient 2, the tumor was not adequately covered and only 74.3% of the tumor received the prescribed dose. This study presents a framework to evaluate 4D treatment planning methods and demonstrates a potential limitation of 4D treatment planning methods. When systematic errors are present, including when the imaging study used for treatment planning does not represent all potential tumor locations during therapy, the treatment planning methods may not adequately predict the dose to the tumor. This is the first example of a simulation study based on patient tumor trajectories where systematic errors that occur due to an inaccurate estimate of tumor motion are evaluated.

Selecting reasonable future land use scenarios

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

Allred, W.E.; Smith, R.W.

1995-12-31

This paper examines a process to help select the most reasonable future land use scenarios for hazardous waste and/or low-level radioactive waste disposal sites. The process involves evaluating future land use scenarios by applying selected criteria currently used by commercial mortgage companies to determine the feasibility of obtaining a loan for purchasing such land. The basis for the process is that only land use activities for which a loan can be obtained will be considered. To examine the process, a low-level radioactive waste site, the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory, is used as an example.more » The authors suggest that the process is a very precise, comprehensive, and systematic (common sense) approach for determining reasonable future use of land. Implementing such a process will help enhance the planning, decisionmaking, safe management, and cleanup of present and future disposal facilities.« less

Deformable Medical Image Registration: A Survey

PubMed Central

Sotiras, Aristeidis; Davatzikos, Christos; Paragios, Nikos

2013-01-01

Deformable image registration is a fundamental task in medical image processing. Among its most important applications, one may cite: i) multi-modality fusion, where information acquired by different imaging devices or protocols is fused to facilitate diagnosis and treatment planning; ii) longitudinal studies, where temporal structural or anatomical changes are investigated; and iii) population modeling and statistical atlases used to study normal anatomical variability. In this paper, we attempt to give an overview of deformable registration methods, putting emphasis on the most recent advances in the domain. Additional emphasis has been given to techniques applied to medical images. In order to study image registration methods in depth, their main components are identified and studied independently. The most recent techniques are presented in a systematic fashion. The contribution of this paper is to provide an extensive account of registration techniques in a systematic manner. PMID:23739795

Social workers' involvement in advance care planning: a systematic narrative review.

PubMed

Wang, Chong-Wen; Chan, Cecilia L W; Chow, Amy Y M

2017-07-10

Advance care planning is a process of discussion that enables competent adults to express their wishes about end-of-life care through periods of decisional incapacity. Although a number of studies have documented social workers' attitudes toward, knowledge about, and involvement in advance care planning, the information is fragmented. The purpose of this review was to provide a narrative synthesis of evidence on social workers' perspectives and experiences regarding implementation of advance care planning. Six databases were searched for peer-reviewed research papers from their respective inception through December 2016. All of the resulting studies relevant to both advance care planning and social worker were examined. The findings of relevant studies were synthesized thematically. Thirty-one articles met the eligibility criteria. Six research themes were identified: social workers' attitudes toward advance care planning; social workers' knowledge, education and training regarding advance care planning; social workers' involvement in advance care planning; social workers' perceptions of their roles; ethical issues relevant to advance care planning; and the effect of social work intervention on advance care planning engagement. The findings suggest that there is a consensus among social workers that advance care planning is their duty and responsibility and that social workers play an important role in promoting and implementing advance care planning through an array of activities. This study provides useful knowledge for implementing advance care planning through illustrating social workers' perspectives and experiences. Further studies are warranted to understand the complexity inherent in social workers' involvement in advance care planning for different life-limiting illnesses or within different socio-cultural contexts.

Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition

PubMed Central

O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C

2016-01-01

Background Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. Objective The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Methods Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. Results The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Conclusions Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible. PMID:27489143

Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition.

PubMed

O'Brien, Nicola; Heaven, Ben; Teal, Gemma; Evans, Elizabeth H; Cleland, Claire; Moffatt, Suzanne; Sniehotta, Falko F; White, Martin; Mathers, John C; Moynihan, Paula

2016-08-03

Integrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders. The intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example. Evidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation. The evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process. Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible.

Using Concept Mapping in the Development of a School of Public Health.

PubMed

Hsu, Laura J; Pacheco, Misty Y; Crabtree, Christopher; Maddock, Jay E

2015-07-01

Schools of Public Health have a wide variety of essential stakeholders. Broad input in program planning should assist in ensuring well-developed plans and strong community buy-in. The planning of a school can better address the needs of multiple stakeholders from systematic broad-based input from these constituents using concept mapping. In this study, we used concept mapping to prioritize a set of recommendations from diverse stakeholders to assist in the process of planning a school. A set of statements was generated on essential elements for the proposed school from a broad group of stakeholders. The statements were then distilled into unique themes, which were then rated on importance and feasibility. Cluster maps and pattern matches were used to analyze the ratings. Unique themes (N = 147) were identified and grouped into 12 clusters. Cluster themes included leadership, faculty, culture, school, and curriculum. Pattern matches revealed a significant, modest correlation between importance and feasibility (r = 0.27). A broad range of perspectives was used to identify relevant areas to address in the development of a school.

Goal setting and action planning in the rehabilitation setting: development of a theoretically informed practice framework.

PubMed

Scobbie, Lesley; Dixon, Diane; Wyke, Sally

2011-05-01

Setting and achieving goals is fundamental to rehabilitation practice but has been criticized for being a-theoretical and the key components of replicable goal-setting interventions are not well established. To describe the development of a theory-based goal setting practice framework for use in rehabilitation settings and to detail its component parts. Causal modelling was used to map theories of behaviour change onto the process of setting and achieving rehabilitation goals, and to suggest the mechanisms through which patient outcomes are likely to be affected. A multidisciplinary task group developed the causal model into a practice framework for use in rehabilitation settings through iterative discussion and implementation with six patients. Four components of a goal-setting and action-planning practice framework were identified: (i) goal negotiation, (ii) goal identification, (iii) planning, and (iv) appraisal and feedback. The variables hypothesized to effect change in patient outcomes were self-efficacy and action plan attainment. A theory-based goal setting practice framework for use in rehabilitation settings is described. The framework requires further development and systematic evaluation in a range of rehabilitation settings.

Office design and health: a systematic review.

PubMed

Richardson, Ann; Potter, John; Paterson, Margaret; Harding, Thomas; Tyler-Merrick, Gaye; Kirk, Ray; Reid, Kate; McChesney, Jane

2017-12-15

To carry out a systematic review of recent research into the effects of workplace design, comparing individual with shared workspaces, on the health of employees. The research question was "Does workplace design (specifically individual offices compared with shared workspaces) affect the health of workers?" A literature search limited to articles published between 2000 and 2017 was undertaken. A systematic review was carried out, and the findings of the reviewed studies grouped into themes according to the primary outcomes measured in the studies. The literature search identified 15 relevant studies addressing health effects of shared or open-plan offices compared with individual offices. Our systematic review found that, compared with individual offices, shared or open-plan office space is not beneficial to employees' health, with consistent findings of deleterious effects on staff health, wellbeing and productivity. Our findings are also consistent with those of earlier reviews. These findings have public health implications for the New Zealand workforce. Decisions about workplace design should include weighing the short-term financial benefits of open-plan or shared workspaces against the significant harms, including increased sickness absence, lower job satisfaction and productivity, and possible threats to recruitment and retention of staff.

Aligning incentives in health care: physician practice and health system partnership.

PubMed

Levin, L Scott; Gustave, Lori

2013-06-01

The key to successfully aligning hospitals and physicians is financial integration and joint incentives for academic, quality, and clinical productivity. Many physician practices and health systems are moving toward closer integration, but mainly through consolidation and employment strategies. We describe a fully integrated physician and hospital relationship including an overview of an aligned funds flow process that affords the department support for clinical services and teaching, research, and administrative activity. We also describe a physician compensation model that provides incentive not only for increased clinical performance, but also quality and academic objectives. The content of this article was acquired through our own experience in managing the Department of Orthopaedic Surgery at the University of Pennsylvania Health System including the health system's funds flow process. Based on input from both health system leaders and the faculty, the department's compensation plan was totally redesigned to create a line-of-sight plan that credits clinical performance and academic productivity. Our model is multifactorial and provides sustainable support for the department and a compensation plan that is competitive within the local market and nationally. The health system's funds flow process has enhanced alignment of the faculty and hospitals by providing compensation for nonclinical time and assists the department's growth strategies by providing funding for new faculty and gain-sharing of improved hospital margin. The implementation of the compensation plan increased productivity by 8% in its first year with no additional resources. Academic productivity in that same year was arguably at or above any other year in the department's history in terms of accepted publications, national presentations, and research grants awarded. A model of complete integration between an academic department and a health system is achievable through a systematic process of mission-based support.

Pathologic Analysis of Control Plans for Air Pollution Management in Tehran Metropolis: A Cross-Sectional Study

PubMed Central

Salehi Shahrabi, Narges; Pourezzat, Aliasghar; Mobaraki, Hossein; Mafimoradi, Shiva

2013-01-01

Abstract Background The centralization of human activities is associated with different pollutants which enter into environment easily and cause the urban environment more vulnerable. Regarding the importance of air pollution issue for Tehran metropolis, many plans and regulations have been developed. However, most of them failed to decline the pollution. The purpose of this study was to pathologically analyze air-pollution control plans to offer effective solutions for Tehran metropolis. Methods A Qualitative content analysis in addition to a semi-structured interview with 14 practicing professional were used to identify 1) key sources of Tehran’s air pollution, 2) recognize challenges towards effective performance of pertinent plans and 3), offer effective solutions. Results Related challenges to air-pollution control plans can be divided into two major categories including lack of integrated and organized stewardship and PEST challenges. Conclusion For controlling the air pollution of Tehran effectively, various controlling alternatives were identified as systematization of plan preparation process, standardization and utilization of new technologies & experts, infrastructural development, realization of social justice, developing coordination mechanisms, improving citizens’ participatory capacity and focusing on effective management of fuel and energy. Controlling air pollution in Tehran needs a serious attention of policymakers to make enforcements through applying a systemic cycle of preparation comprehensive plans. Further, implement the enforcements and evaluate the environmental impact of the plans through involving all stakeholders. PMID:26171340

Clinical nursing leaders' perceptions of nutrition quality indicators in Swedish stroke wards: a national survey.

PubMed

Persenius, Mona; Hall-Lord, Marie-Louise; Wilde-Larsson, Bodil; Carlsson, Eva

2015-09-01

To describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards. A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality. Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants. Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results. Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed. The use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework. © 2013 John Wiley & Sons Ltd.

Dental Students' Use of AMSTAR to Critically Appraise Systematic Reviews.

PubMed

Teich, Sorin T; Heima, Masahiro; Lang, Lisa

2015-09-01

The idea of basing clinical procedures upon evidence gathered by observation is less than 200 years old, with the first set of evidence-based position papers dating back only to the early 1970s. The relationship between evidence-based education and health outcomes is difficult to test and may be indirect, but teaching critical appraisal skills may be beneficial in developing knowledge. Systematic reviews have a central role in the process of clinical decision making in practice and therefore should be of high quality, following a rigorous protocol that can be evaluated with validated tools. The aim of this study was to assess how dental students utilized the Assessment of Multiple Systematic Reviews (AMSTAR) appraisal tool to evaluate systematic reviews in the context of a treatment planning course. During the in-class final exam, students were required to appraise the quality of a systematic review and to justify their answers. Of the 74 third-year students who took the exam, 100% answered all questions on the AMSTAR form. The mean number of correct answers was nine (SD=1.047, Min=6, Max=10), with no student providing all 11 correct answers. The fact that nearly 90% of the students provided eight or more correct answers suggests that AMSTAR can be used by students to evaluate the methodological quality of systematic reviews. It also was evident that although the AMSTAR tool requires less than 15 minutes to complete an evaluation, using it requires extensive training and repetition to achieve consistent and reliable results.

Not all great minds think alike: systematic and intuitive cognitive styles.

PubMed

Sagiv, Lilach; Amit, Adi; Ein-Gar, Danit; Arieli, Sharon

2014-10-01

Individuals process information and make decisions in different ways. Some plan carefully and analyze information systematically, whereas others follow their instincts and do what "feels right." We aimed to deepen our understanding of the meaning of the intuitive versus systematic cognitive styles. Study 1 (N = 130, 39% female, M(age)  = 24) compared cognitive styles of arts, accounting, and mathematics students. Cognitive styles were associated with values (Study 2: N = 154, 123, 78; female = 59%, 49%, 85.9%; M(age)  = 22, 23, 27) and traits (Study 3: N = 77, 140, 151; female = 59%, 66%, 46%; M(age)  = 22, 25, 23), and they interacted with experience in predicting performance (Study 4: N = 63, 48% female, M(age)  = 23; Study 5: N = 44, 39% female, M(age)  = 23). All participants were Caucasian Israeli students. The systematic style was most frequent among accountants, and the intuitive style was most frequent among artists, validating the meaning of the styles. Systematic style was positively correlated with Conscientiousness and with security values and negatively correlated with stimulation values. The intuitive style had the opposite pattern and was also positively correlated with Extraversion. Experience improved rule-based performance among systematic individuals but had no effect on intuitive ones. Cognitive style is consistent with other personal attributes (traits and values), with implications for decision making and task performance. © 2013 Wiley Periodicals, Inc.

Vocational Planning: The Great Swindle

ERIC Educational Resources Information Center

Baumgardner, Steve R.; And Others

1977-01-01

The first article argues that systematic career planning should be abandoned, and replaced by a "good theory of non-rationality." That is, counselors should consider what actually influences career decisions, instead of bemoaning their lack of logical planning. Several other authors respond to this idea in separate articles. (Author/BP)

Clinical audit in dentistry: From a concept to an initiation

PubMed Central

Malleshi, Suchetha N; Joshi, Mahasweta; Nair, Soumya K; Ashraf, Irshad

2012-01-01

Clinical audit is a quality improvement process that aims to improve patient care through a systematic review of care against explicit criteria. It is a cyclic and multidisciplinary process which involves a series of steps from planning the audit through measuring the performance to implementing and sustaining the change. Although audit contains some facets of research, it is essential to understand the difference between the two. Auditing can be done right from the record maintaining, diagnosis and treatment and postoperative evaluation and follow-up. The immense potential of clinical audit can be utilized only when open-mindedness and innovativeness are encouraged and evidence-based work culture is cultivated. PMID:23559939

Application of systematic review methodology to the field of nutrition.

PubMed

Lichtenstein, Alice H; Yetley, Elizabeth A; Lau, Joseph

2008-12-01

Systematic reviews represent a rigorous and transparent approach to synthesizing scientific evidence that minimizes bias. They evolved within the medical community to support development of clinical and public health practice guidelines, set research agendas, and formulate scientific consensus statements. The use of systematic reviews for nutrition-related topics is more recent. Systematic reviews provide independently conducted comprehensive and objective assessments of available information addressing precise questions. This approach to summarizing available data is a useful tool for identifying the state of science including knowledge gaps and associated research needs, supporting development of science-based recommendations and guidelines, and serving as the foundation for updates as new data emerge. Our objective is to describe the steps for performing systematic reviews and highlight areas unique to the discipline of nutrition that are important to consider in data assessment. The steps involved in generating systematic reviews include identifying staffing and planning for outside expert input, forming a research team, developing an analytic framework, developing and refining research questions, defining eligibility criteria, identifying search terms, screening abstracts according to eligibility criteria, retrieving articles for evaluation, constructing evidence and summary tables, assessing methodological quality and applicability, and synthesizing results including performing meta-analysis, if appropriate. Unique and at times challenging, nutrition-related considerations include baseline nutrient exposure, nutrient status, bioequivalence of bioactive compounds, bioavailability, multiple and interrelated biological functions, undefined nature of some interventions, and uncertainties in intake assessment. Systematic reviews are a valuable and independent component of decision-making processes by groups responsible for developing science-based recommendations and policies.

Evidence for the use PET for radiation therapy planning in patients with cervical cancer: a systematic review.

PubMed

Salem, A; Salem, A F; Al-Ibraheem, A; Lataifeh, I; Almousa, A; Jaradat, I

2011-01-01

In recent years, the role of positron emission tomography (PET) in the staging and management of gynecological cancers has been increasing. The aim of this study was to systematically review the role of PET in radiotherapy planning and brachytherapy treatment optimization in patients with cervical cancer. Systematic literature review. Systematic review of relevant literature addressing the utilization of PET and/or PET-computed tomography (CT) in external-beam radiotherapy planning and brachytherapy treatment optimization. We performed an extensive PubMed database search on 20 April 2011. Nineteen studies, including 759 patients, formed the basis of this systematic review. PET/ PET-CT is the most sensitive imaging modality for detecting nodal metastases in patients with cervical cancer and has been shown to impact external-beam radiotherapy planning by modifying the treatment field and customizing the radiation dose. This particularly applies to detection of previously uncovered para-aortic and inguinal nodal metastases. Furthermore, PET/ PET-CT guided intensity-modulated radiation therapy (IMRT) allows delivery of higher doses of radiation to the primary tumor, if brachytherapy is unsuitable, and to grossly involved nodal disease while minimizing treatment-related toxicity. PET/ PET-CT based brachytherapy optimization allows improved tumor-volume dose distribution and detailed 3D dosimetric evaluation of risk organs. Sequential PET/ PET-CT imaging performed during the course of brachytherapy form the basis of “adaptive” brachytherapy in cervical cancer. This review demonstrates the effectiveness of pretreatment PET/ PET-CT in cervical cancer patients treated by radiotherapy. Further prospective studies are required to define the group of patients who would benefit the most from this procedure.

Adaptation Design Tool for Climate-Smart Management of Coral Reefs and Other Natural Resources.

PubMed

West, Jordan M; Courtney, Catherine A; Hamilton, Anna T; Parker, Britt A; Gibbs, David A; Bradley, Patricia; Julius, Susan H

2018-06-22

Scientists and managers of natural resources have recognized an urgent need for improved methods and tools to enable effective adaptation of management measures in the face of climate change. This paper presents an Adaptation Design Tool that uses a structured approach to break down an otherwise overwhelming and complex process into tractable steps. The tool contains worksheets that guide users through a series of design considerations for adapting their planned management actions to be more climate-smart given changing environmental stressors. Also provided with other worksheets is a framework for brainstorming new adaptation options in response to climate threats not yet addressed in the current plan. Developed and tested in collaboration with practitioners in Hawai'i and Puerto Rico using coral reefs as a pilot ecosystem, the tool and associated reference materials consist of worksheets, instructions and lessons-learned from real-world examples. On the basis of stakeholder feedback from expert consultations during tool development, we present insights and recommendations regarding how to maximize tool efficiency, gain the greatest value from the thought process, and deal with issues of scale and uncertainty. We conclude by reflecting on how the tool advances the theory and practice of assessment and decision-making science, informs higher level strategic planning, and serves as a platform for a systematic, transparent and inclusive process to tackle the practical implications of climate change for management of natural resources.

Validating FMEA output against incident learning data: A study in stereotactic body radiation therapy.

PubMed

Yang, F; Cao, N; Young, L; Howard, J; Logan, W; Arbuckle, T; Sponseller, P; Korssjoen, T; Meyer, J; Ford, E

2015-06-01

Though failure mode and effects analysis (FMEA) is becoming more widely adopted for risk assessment in radiation therapy, to our knowledge, its output has never been validated against data on errors that actually occur. The objective of this study was to perform FMEA of a stereotactic body radiation therapy (SBRT) treatment planning process and validate the results against data recorded within an incident learning system. FMEA on the SBRT treatment planning process was carried out by a multidisciplinary group including radiation oncologists, medical physicists, dosimetrists, and IT technologists. Potential failure modes were identified through a systematic review of the process map. Failure modes were rated for severity, occurrence, and detectability on a scale of one to ten and risk priority number (RPN) was computed. Failure modes were then compared with historical reports identified as relevant to SBRT planning within a departmental incident learning system that has been active for two and a half years. Differences between FMEA anticipated failure modes and existing incidents were identified. FMEA identified 63 failure modes. RPN values for the top 25% of failure modes ranged from 60 to 336. Analysis of the incident learning database identified 33 reported near-miss events related to SBRT planning. Combining both methods yielded a total of 76 possible process failures, of which 13 (17%) were missed by FMEA while 43 (57%) identified by FMEA only. When scored for RPN, the 13 events missed by FMEA ranked within the lower half of all failure modes and exhibited significantly lower severity relative to those identified by FMEA (p = 0.02). FMEA, though valuable, is subject to certain limitations. In this study, FMEA failed to identify 17% of actual failure modes, though these were of lower risk. Similarly, an incident learning system alone fails to identify a large number of potentially high-severity process errors. Using FMEA in combination with incident learning may render an improved overview of risks within a process.

5 CFR 412.202 - Systematic training and development of supervisors, managers, and executives.

Code of Federal Regulations, 2011 CFR

2011-01-01

... MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE DEVELOPMENT Succession Planning... the agencies' succession plans. Agencies also must issue written policies to ensure they: (a) Design...

5 CFR 412.202 - Systematic training and development of supervisors, managers, and executives.

Code of Federal Regulations, 2012 CFR

2012-01-01

... MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE DEVELOPMENT Succession Planning... the agencies' succession plans. Agencies also must issue written policies to ensure they: (a) Design...

5 CFR 412.202 - Systematic training and development of supervisors, managers, and executives.

Code of Federal Regulations, 2013 CFR

2013-01-01

... MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE DEVELOPMENT Succession Planning... the agencies' succession plans. Agencies also must issue written policies to ensure they: (a) Design...

5 CFR 412.202 - Systematic training and development of supervisors, managers, and executives.

Code of Federal Regulations, 2014 CFR

2014-01-01

... MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE DEVELOPMENT Succession Planning... the agencies' succession plans. Agencies also must issue written policies to ensure they: (a) Design...

Methodology of a systematic review.

PubMed

Linares-Espinós, E; Hernández, V; Domínguez-Escrig, J L; Fernández-Pello, S; Hevia, V; Mayor, J; Padilla-Fernández, B; Ribal, M J

2018-05-03

The objective of evidence-based medicine is to employ the best scientific information available to apply to clinical practice. Understanding and interpreting the scientific evidence involves understanding the available levels of evidence, where systematic reviews and meta-analyses of clinical trials are at the top of the levels-of-evidence pyramid. The review process should be well developed and planned to reduce biases and eliminate irrelevant and low-quality studies. The steps for implementing a systematic review include (i) correctly formulating the clinical question to answer (PICO), (ii) developing a protocol (inclusion and exclusion criteria), (iii) performing a detailed and broad literature search and (iv) screening the abstracts of the studies identified in the search and subsequently of the selected complete texts (PRISMA). Once the studies have been selected, we need to (v) extract the necessary data into a form designed in the protocol to summarise the included studies, (vi) assess the biases of each study, identifying the quality of the available evidence, and (vii) develop tables and text that synthesise the evidence. A systematic review involves a critical and reproducible summary of the results of the available publications on a particular topic or clinical question. To improve scientific writing, the methodology is shown in a structured manner to implement a systematic review. Copyright © 2018 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

[Input on monitoring and evaluation practices of government management of Brazilian Municipal Health Departments].

PubMed

Miranda, Alcides Silva de; Carvalho, André Luis Bonifácio de; Cavalcante, Caio Garcia Correia Sá

2012-04-01

What do the leaders of the Municipal Health Service (SMS) report and say about the systematic monitoring and evaluation of their own government management? The purpose of this paper is to provide input for the formulation of plausible hypotheses about such institutional processes and practices based on information produced in an exploratory study. This is a multiple case study with quantitative and qualitative analysis of answers to a semi-structured questionnaire given to government officials of a systematic sample of 577 Municipal Health Services (10.4% of the total in Brazil). They were selected and stratified by proportional distribution among states and by the population size of municipalities. In general, it shows that approximately half of the respondents use information from Health Monitoring Evaluations to orient decision-making, planning and other management approaches. This proportion tends to decrease in cities with smaller populations. There are specific and significant gaps in financial, personnel and crisis management. The evidence from the hypotheses highlights the fact that these processes are still at an early stage.

The Large Area Crop Inventory Experiment (LACIE). Part 3: A systematic approach to the practical application of remote-sensing technology

NASA Technical Reports Server (NTRS)

Murphy, J. D.; Dideriksen, R. I.

1975-01-01

The application of remote sensing technology by the U.S. Department of Agriculture (USDA) is examined. The activities of the USDA Remote-Sensing User Requirement Task Force which include cataloging USDA requirements for earth resources data, determining those requirements that would return maximum benefits by using remote sensing technology and developing a plan for acquiring, processing, analyzing, and distributing data to satisfy those requirements are described. Emphasis is placed on the large area crop inventory experiment and its relationship to the task force.

How healthcare systems evaluate their advance care planning initiatives: Results from a systematic review.

PubMed

Biondo, Patricia D; Lee, Lydia D; Davison, Sara N; Simon, Jessica E

2016-09-01

Advance care planning initiatives are being implemented across healthcare systems around the world, but how best to evaluate their implementation is unknown. To identify gaps and/or redundancies in current evaluative strategies to help healthcare systems develop future evaluative frameworks for ACP. Systematic review. Peer-reviewed and gray literature searches were conducted till February 2015 to answer: "What methods have healthcare systems used to evaluate implementation of advance care planning initiatives?" A PICOS framework was developed to identify articles describing the implementation and evaluation of a health system-level advance care planning initiative. Outcome measures were mapped onto a conceptual quality indicator framework based on the Institute of Medicine and Donabedian models of healthcare quality. A total of 46 studies met inclusion criteria for analysis. Most articles reported on single parts of a healthcare system (e.g. continuing care). The most common outcome measures pertained to document completion, followed by healthcare resource use. Patient-, family-, or healthcare provider-reported outcomes were less commonly measured. Concordance measures (e.g. dying in place of choice) were reported by only 26% of studies. The conceptual quality indicator framework identified gaps and redundancies in measurement and is presented as a potential foundation from which to develop a comprehensive advance care planning evaluation framework. Document completion is frequently used to evaluate advance care planning program implementation; capturing the quality of care appears to be more difficult. This systematic review provides health system administrators with a comprehensive summary of measures used to evaluate advance care planning and may identify gaps in evaluation within their local context. © The Author(s) 2016.

WFIRST: Simulating the Wide-Field Sky

NASA Astrophysics Data System (ADS)

Peeples, Molly; WFIRST Wide Field Imager Simulations Working Group

2018-01-01

As astronomy’s first high-resolution wide-field multi-mode instrument, simulated data will play a vital role in the planning for and analysis of data from WFIRST’s WFI (Wide Field Imager) instrument. Part of the key to WFIRST’s scientific success lies in our ability to push the systematics limit, but in order to do so, the WFI pipeline will need to be able to measure and take out said systematics. The efficacy of this pipeline can only be verified with large suites of synthetic data; these data must include both the range of astrophysical sky scenes (from crowded starfields to high-latitude grism data observations) and the systematics from the detector and telescope optics the WFI pipeline aims to mitigate. We summarize here(1) the status of current and planned astrophysical simulations in support of the WFI,(2) the status of current WFI instrument simulators and requirements on future generations thereof, and(3) plans, methods, and requirements on interfacing astrophysical simulations and WFI instrument simulators.

Academic Unit Planning and Management. Technical Report No. 75.

ERIC Educational Resources Information Center

Miyataki, Glenn K.; Byers, Maureen L.

Intended to provide a systematic aid for planning and managing academic units (schools, colleges, departments, or divisions) within an institution, the Academic Unit Planning and Management (AUPM) manual consists of a multifaceted set of techniques and procedures that can be used by academic unit administrators. Data regarding academic unit…

Pre-Demolition Planning

EPA Pesticide Factsheets

Developing a systematic approach to demolition can help manage liability, control, and costs. Careful planning can minimize the release of toxic chemicals and other harmful substances into the environment, and protect the health of workers and the public.

Implementation Plan for Qualification of Sodium-Cooled Fast Reactor Technology Information

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

Moe, Wayne; Honma, George

This document identifies and discusses implementation elements that can be used to facilitate consistent and systematic evaluation processes relating to quality attributes of technical information (with focus on SFR technology) that will be used to support licensing of advanced reactor designs. Information may include, but is not limited to, design documents for SFRs, research-and-development (R&D) data and associated documents, test plans and associated protocols, operations and test data, international research data, technical reports, and information associated with past U.S. Nuclear Regulatory Commission (NRC) reviews of SFR designs. The approach for determining acceptability of test data, analysis, and/or other technical informationmore » is based on guidance provided in INL/EXT-15-35805, “Guidance on Evaluating Historic Technology Information for Use in Advanced Reactor Licensing.” The implementation plan can be adopted into a working procedure at each of the national laboratories performing data qualification, or by applicants seeking future license application for advanced reactor technology.« less

Robotic Billiards: Understanding Humans in Order to Counter Them.

PubMed

Nierhoff, Thomas; Leibrandt, Konrad; Lorenz, Tamara; Hirche, Sandra

2016-08-01

Ongoing technological advances in the areas of computation, sensing, and mechatronics enable robotic-based systems to interact with humans in the real world. To succeed against a human in a competitive scenario, a robot must anticipate the human behavior and include it in its own planning framework. Then it can predict the next human move and counter it accordingly, thus not only achieving overall better performance but also systematically exploiting the opponent's weak spots. Pool is used as a representative scenario to derive a model-based planning and control framework where not only the physics of the environment but also a model of the opponent is considered. By representing the game of pool as a Markov decision process and incorporating a model of the human decision-making based on studies, an optimized policy is derived. This enables the robot to include the opponent's typical game style into its tactical considerations when planning a stroke. The results are validated in simulations and real-life experiments with an anthropomorphic robot playing pool against a human.

Completing advance directives for health care decisions: getting to yes.

PubMed

Shewchuk, T R

1998-09-01

The concept of advance directives for health care decision making has been judicially condoned, legislatively promoted, and systematically implemented by health care institutions, yet the execution rate of advance directives remains low. Physicians should discuss with their patients advance care planning generally and end-of-life issues specifically, preferably when patients are in good health and not when they face an acute medical crisis. The physician-hospital relationship poses particular challenges for the optimal implementation of advance directives that must be addressed. Hospital administrators must improve education of patients and physicians on the value of such documents as well as internal mechanisms to ensure better implementation of directives. Health insurance plans may be better able to ensure optimal gathering and implementation of directives. Patients must become more familiar and more comfortable with advance care planning and the reality of death and dying issues. Full acceptance of the value of directives ultimately rests on achieving full participation of all involved--providers, patients, families, and payors--in this most profound process.

A Systematic Review to Uncover a Universal Protocol for Accuracy Assessment of 3-Dimensional Virtually Planned Orthognathic Surgery.

PubMed

Gaber, Ramy M; Shaheen, Eman; Falter, Bart; Araya, Sebastian; Politis, Constantinus; Swennen, Gwen R J; Jacobs, Reinhilde

2017-11-01

The aim of this study was to systematically review methods used for assessing the accuracy of 3-dimensional virtually planned orthognathic surgery in an attempt to reach an objective assessment protocol that could be universally used. A systematic review of the currently available literature, published until September 12, 2016, was conducted using PubMed as the primary search engine. We performed secondary searches using the Cochrane Database, clinical trial registries, Google Scholar, and Embase, as well as a bibliography search. Included articles were required to have stated clearly that 3-dimensional virtual planning was used and accuracy assessment performed, along with validation of the planning and/or assessment method. Descriptive statistics and quality assessment of included articles were performed. The initial search yielded 1,461 studies. Only 7 studies were included in our review. An important variability was found regarding methods used for 1) accuracy assessment of virtually planned orthognathic surgery or 2) validation of the tools used. Included studies were of moderate quality; reviewers' agreement regarding quality was calculated to be 0.5 using the Cohen κ test. On the basis of the findings of this review, it is evident that the literature lacks consensus regarding accuracy assessment. Hence, a protocol is suggested for accuracy assessment of virtually planned orthognathic surgery with the lowest margin of error. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Systematic teaching method to enhance the effectiveness of training for paragonimiasis.

PubMed

Zhang, Jian; Zhang, Xilin; Huang, Fusheng; Xu, Wenyue

2013-01-01

The clinical symptoms of human paragonimiasis are complex and variable, and patients can easily be misdiagnosed. Pagumogonimus skrjabini is the species causing this disease found only in China. A 2002 epidemiological survey showed that the rate of paragonimiasis was 21·96% in the migration areas of the Three-Gorge Reservoir, Chongqing, China. Therefore, there is a need to train medical workers to treat individuals in these areas. The Third Military Medical University (TMMU) in Chongqing built a comprehensive and systematic teaching method, which included teaching students about the basic biology of the organism, guiding students to use appropriate diagnostic tests and participate in scientific research to develop diagnostic kits, and visiting endemic areas to provide on-site teaching. The use of on-site teaching is an innovative approach for training undergraduate medical students in human parasitology. Three improvements were implemented during the on-site teaching component of the program: (1) systematizing the learning process; (2) integrating formal knowledge with clinical experience; and (3) enhancing students' knowledge of medical ethics. Based on a survey, 95% of students believed that this systematic teaching system gave them a more comprehensive grasp of knowledge on P. skrjabini, and graduate students were able to provide early diagnosis of P. skrjabini cases in this remote region. Students also participated in the research and development of a P. skrjabini diagnostic kit, for which a patent has been applied, and during the on-site teaching process, data were collected for the government and health sector to assist in public-health planning and decision-making for this disease.

Summary of long-baseline systematics session at CETUP*2014

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

Cherdack, Daniel; Worcester, Elizabeth

2015-10-15

A session studying systematics in long-baseline neutrino oscillation physics was held July 14-18, 2014 as part of CETUP* 2014. Systematic effects from flux normalization and modeling, modeling of cross sections and nuclear interactions, and far detector effects were addressed. Experts presented the capabilities of existing and planned tools. A program of study to determine estimates of and requirements for the size of these effects was designed. This document summarizes the results of the CETUP* systematics workshop and the current status of systematic uncertainty studies in long-baseline neutrino oscillation measurements.

Application of failure mode and effects analysis to treatment planning in scanned proton beam radiotherapy

PubMed Central

2013-01-01

Background A multidisciplinary and multi-institutional working group applied the Failure Mode and Effects Analysis (FMEA) approach to the actively scanned proton beam radiotherapy process implemented at CNAO (Centro Nazionale di Adroterapia Oncologica), aiming at preventing accidental exposures to the patient. Methods FMEA was applied to the treatment planning stage and consisted of three steps: i) identification of the involved sub-processes; ii) identification and ranking of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system, iii) identification of additional safety measures to be proposed for process quality and safety improvement. RPN upper threshold for little concern of risk was set at 125. Results Thirty-four sub-processes were identified, twenty-two of them were judged to be potentially prone to one or more failure modes. A total of forty-four failure modes were recognized, 52% of them characterized by an RPN score equal to 80 or higher. The threshold of 125 for RPN was exceeded in five cases only. The most critical sub-process appeared related to the delineation and correction of artefacts in planning CT data. Failures associated to that sub-process were inaccurate delineation of the artefacts and incorrect proton stopping power assignment to body regions. Other significant failure modes consisted of an outdated representation of the patient anatomy, an improper selection of beam direction and of the physical beam model or dose calculation grid. The main effects of these failures were represented by wrong dose distribution (i.e. deviating from the planned one) delivered to the patient. Additional strategies for risk mitigation, easily and immediately applicable, consisted of a systematic information collection about any known implanted prosthesis directly from each patient and enforcing a short interval time between CT scan and treatment start. Moreover, (i) the investigation of dedicated CT image reconstruction algorithms, (ii) further evaluation of treatment plan robustness and (iii) implementation of independent methods for dose calculation (such as Monte Carlo simulations) may represent novel solutions to increase patient safety. Conclusions FMEA is a useful tool for prospective evaluation of patient safety in proton beam radiotherapy. The application of this method to the treatment planning stage lead to identify strategies for risk mitigation in addition to the safety measures already adopted in clinical practice. PMID:23705626

34 CFR 406.1 - What is the State-Administered Tech-Prep Education Program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... provides financial assistance for— (a) Planning and developing four-year or six-year programs designed to...) Planning and developing, in a systematic manner, strong, comprehensive links between secondary schools and...

Guidelines for developing transportation management plans in Virginia.

DOT National Transportation Integrated Search

2005-01-01

A transportation management plan (TMP) is a comprehensive program of traffic control, communication, operation, and demand management strategies designed to maintain acceptable levels of traffic flow in work zones. A systematic procedure and/or check...

[Principles for the evaluation of telemedicine applications: Results of a systematic review and consensus process].

PubMed

Arnold, Katrin; Scheibe, Madlen; Müller, Olaf; Schmitt, Jochen

2016-11-01

The limited number of telemedicine applications being transferred to standard medical care in Germany may to some extent be explained by deficits in the current evaluation practice. Effectiveness and cost effectiveness can only be demonstrated to decision makers and potential users with methodologically sound and fully published evaluations. There is a lack of well-founded and mandatory standards for adequate, comparable evaluations of telemedicine applications. As part of the project CCS Telehealth Eastern Saxony (CCS THOS), a systematic review on evaluation concepts for telemedicine applications (search period until September 2014, databases Medline, Embase, HTA-Database, DARE, NHS EED) as well as an additional selective literature search were conducted. Suggestions for evaluation fundamentals were derived from the results. These suggestions were subjected to a formal consensus process (nominal group process) with relevant stakeholder groups (healthcare payers, healthcare providers, health policy representatives, researchers). 19 papers were included in the systematic review. In accordance with the predefined inclusion criteria, each presented an evaluation concept for telemedicine applications that was based upon a systematic review and/or a consensus process. Via a formal consensus process, the suggestions for evaluation principles derived from the review and the selective literature search (23 papers) resulted in ten agreed evaluation principles. Eight of them were unanimously agreed upon, two were arrived at with one abstention each. The principles enclose criteria for the planning, conduct and reporting of telemedicine evaluations. Adherence to them is obligatory for users of the telemedical infrastructure provided by CCS THOS. Furthermore, right from the beginning the intention was very much for these principles to be seized upon by other projects and initiatives. The agreed evaluation principles for telemedicine applications are the first in Germany to be based both upon evidence and consensus. Due to the methodology of development, they have a strong scientific and health policy legitimation. Therefore, and because of their general applicability, adherence to these principles beyond the context of the telemedicine platform developed within CCS THOS is recommended, namely throughout the German telemedicine scene. Copyright © 2016. Published by Elsevier GmbH.

A systematic approach for watershed ecological restoration strategy making: An application in the Taizi River Basin in northern China.

PubMed

Li, Mengdi; Fan, Juntao; Zhang, Yuan; Guo, Fen; Liu, Lusan; Xia, Rui; Xu, Zongxue; Wu, Fengchang

2018-05-15

Aiming to protect freshwater ecosystems, river ecological restoration has been brought into the research spotlight. However, it is challenging for decision makers to set appropriate objectives and select a combination of rehabilitation acts from numerous possible solutions to meet ecological, economic, and social demands. In this study, we developed a systematic approach to help make an optimal strategy for watershed restoration, which incorporated ecological security assessment and multi-objectives optimization (MOO) into the planning process to enhance restoration efficiency and effectiveness. The river ecological security status was evaluated by using a pressure-state-function-response (PSFR) assessment framework, and MOO was achieved by searching for the Pareto optimal solutions via Non-dominated Sorting Genetic Algorithm II (NSGA-II) to balance tradeoffs between different objectives. Further, we clustered the searched solutions into three types in terms of different optimized objective function values in order to provide insightful information for decision makers. The proposed method was applied in an example rehabilitation project in the Taizi River Basin in northern China. The MOO result in the Taizi River presented a set of Pareto optimal solutions that were classified into three types: I - high ecological improvement, high cost and high benefits solution; II - medial ecological improvement, medial cost and medial economic benefits solution; III - low ecological improvement, low cost and low economic benefits solution. The proposed systematic approach in our study can enhance the effectiveness of riverine ecological restoration project and could provide valuable reference for other ecological restoration planning. Copyright © 2018 Elsevier B.V. All rights reserved.

Self-care and HIV/AIDS patients: nursing care systematization.

PubMed

Caetano, Joselany Afio; Pagliuca, Lorita Marlena Freitag

2006-01-01

This research aimed at systematizing nursing care to HIV/aids patients in view of Orem's Self-care Deficit Nursing Theory, using the convergent-care method and the Self-Care Nursing Process. Subjects were thirteen HIV/AIDS patients attended at a non-governmental organization in Fortaleza/CE, Brazil. We used interview techniques, physical examination, observation and information records, with a structured instrument, addressing requisites related to universal self-care, development and health alterations. Self-care deficits corresponded to nineteen nursing diagnoses, named according to NANDA's Taxonomy II, ten of which were based on the requisites for universal self-care, five on the requisites for self-care related to development and four on the requisites for self-care related to health deviations. In care planning, goals were established and the system and health methods were selected, prioritizing support-education actions in order to engage HIV/aids patients in self-care.

Music-Based Training for Pediatric CI Recipients: A Systematic Analysis of Published Studies

PubMed Central

Gfeller, Kate

2016-01-01

In recent years, there has been growing interest in the use of music-based training to enhance speech and language development in children with normal hearing and some forms of communication disorders, including pediatric CI users. The use of music training for CI users may initially seem incongruous given that signal processing for CIs presents a degraded version of pitch and timbre, both key elements in music. Furthermore, empirical data of systematic studies of music training, particularly in relation to transfer to speech skills are limited. This study describes the rationale for music training of CI users, describes key features of published studies of music training with CI users, and highlights some developmental and logistical issues that should be taken into account when interpreting or planning studies of music training and speech outcomes with pediatric CI recipients. PMID:27246744

Filtering Methods for Error Reduction in Spacecraft Attitude Estimation Using Quaternion Star Trackers

NASA Technical Reports Server (NTRS)

Calhoun, Philip C.; Sedlak, Joseph E.; Superfin, Emil

2011-01-01

Precision attitude determination for recent and planned space missions typically includes quaternion star trackers (ST) and a three-axis inertial reference unit (IRU). Sensor selection is based on estimates of knowledge accuracy attainable from a Kalman filter (KF), which provides the optimal solution for the case of linear dynamics with measurement and process errors characterized by random Gaussian noise with white spectrum. Non-Gaussian systematic errors in quaternion STs are often quite large and have an unpredictable time-varying nature, particularly when used in non-inertial pointing applications. Two filtering methods are proposed to reduce the attitude estimation error resulting from ST systematic errors, 1) extended Kalman filter (EKF) augmented with Markov states, 2) Unscented Kalman filter (UKF) with a periodic measurement model. Realistic assessments of the attitude estimation performance gains are demonstrated with both simulation and flight telemetry data from the Lunar Reconnaissance Orbiter.

NOTE: Optimization of megavoltage CT scan registration settings for thoracic cases on helical tomotherapy

NASA Astrophysics Data System (ADS)

Woodford, Curtis; Yartsev, Slav; Van Dyk, Jake

2007-08-01

This study aims to investigate the settings that provide optimum registration accuracy when registering megavoltage CT (MVCT) studies acquired on tomotherapy with planning kilovoltage CT (kVCT) studies of patients with lung cancer. For each experiment, the systematic difference between the actual and planned positions of the thorax phantom was determined by setting the phantom up at the planning isocenter, generating and registering an MVCT study. The phantom was translated by 5 or 10 mm, MVCT scanned, and registration was performed again. A root-mean-square equation that calculated the residual error of the registration based on the known shift and systematic difference was used to assess the accuracy of the registration process. The phantom study results for 18 combinations of different MVCT/kVCT registration options are presented and compared to clinical registration data from 17 lung cancer patients. MVCT studies acquired with coarse (6 mm), normal (4 mm) and fine (2 mm) slice spacings could all be registered with similar residual errors. No specific combination of resolution and fusion selection technique resulted in a lower residual error. A scan length of 6 cm with any slice spacing registered with the full image fusion selection technique and fine resolution will result in a low residual error most of the time. On average, large corrections made manually by clinicians to the automatic registration values are infrequent. Small manual corrections within the residual error averages of the registration process occur, but their impact on the average patient position is small. Registrations using the full image fusion selection technique and fine resolution of 6 cm MVCT scans with coarse slices have a low residual error, and this strategy can be clinically used for lung cancer patients treated on tomotherapy. Automatic registration values are accurate on average, and a quick verification on a sagittal MVCT slice should be enough to detect registration outliers.

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods.

PubMed

Odaga, John; Henriksson, Dorcus K; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K; Valadez, Joseph J

2016-01-01

Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

PubMed Central

Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.

2016-01-01

Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival. PMID:27225791

Computer‐assisted surgical planning and intraoperative guidance in fetal surgery: a systematic review†

PubMed Central

Deprest, Jan; Vercauteren, Tom; Ourselin, Sebastien; David, Anna L.

2015-01-01

Abstract Fetal surgery has become a clinical reality, with interventions for twin‐to‐twin transfusion syndrome (TTTS) and spina bifida demonstrated to improve outcome. Fetal imaging is evolving, with the use of 3D ultrasound and fetal MRI becoming more common in clinical practise. Medical imaging analysis is also changing, with technology being developed to assist surgeons by creating 3D virtual models that improve understanding of complex anatomy, and prove powerful tools in surgical planning and intraoperative guidance. We introduce the concept of computer‐assisted surgical planning, and present the results of a systematic review of image reconstruction for fetal surgical planning that identified six articles using such technology. Indications from other specialities suggest a benefit of surgical planning and guidance to improve outcomes. There is therefore an urgent need to develop fetal‐specific technology in order to improve fetal surgical outcome. © 2015 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd. PMID:26235960

Results from a national survey on chronic care management by health plans.

PubMed

Mattke, Soeren; Higgins, Aparna; Brook, Robert

2015-05-01

The growing burden of chronic disease necessitates innovative approaches to help patients and to ensure the sustainability of our healthcare system. Health plans have introduced chronic care management models, but systematic data on the type and prevalence of different approaches are lacking. Our goal was to conduct a systematic examination of chronic care management programs offered by health plans in the commercial market (ie, in products sold to employers and individuals. We undertook a national survey of a representative sample of health plans (70 plans, 36% response rate) and 6 case studies on health plans' programs to improve chronic care in the commercial market. The data underwent descriptive and bivariate analyses. All plans, regardless of size, location, and ownership, offer chronic care management programs, which identify eligible members from claims data and match them to interventions based on overall risk and specific care gaps. Plans then report information on care gaps to providers and offer self-management support to their members. While internal evaluations suggest that the interventions improve care and reduce cost, plans report difficulties in engaging members and providers. To overcome those obstacles, plans are integrating their programs into provider work flow, collaborating with providers on care redesign and leveraging patient support technologies. Our study shows that chronic care management programs have become a standard component of the overall approach used by health plans to manage the health of their members.

Net Zero Energy Military Installations: A Guide to Assessment and Planning

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

Booth, S.; Barnett, J.; Burman, K.

2010-08-01

The U.S. Department of Defense (DoD) recognizes the strategic importance of energy to its mission, and is working to reduce energy consumption and enhance energy self-sufficiency by drawing on local clean energy sources. A joint initiative formed between DoD and the U.S. Department of Energy (DOE) in 2008 to address military energy use led to a task force to examine the potential for net zero energy military installations, which would produce as much energy on site as they consume in buildings, facilities, and fleet vehicles. This report presents an assessment and planning process to examine military installations for net zeromore » energy potential. Net Zero Energy Installation Assessment (NZEIA) presents a systematic framework to analyze energy projects at installations while balancing other site priorities such as mission, cost, and security.« less

Building human resources capability in health care: a global analysis of best practice--Part III.

PubMed

Zairi, M

1998-01-01

This is the last part of a series of three papers which discussed very comprehensively best practice applications in human resource management by drawing special inferences to the healthcare context. It emerged from parts I and II that high performing organisations plan and intend to build sustainable capability through a systematic consideration of the human element as the key asset and through a continuous process of training, developing, empowering and engaging people in all aspects of organisational excellence. Part III brings this debate to a close by demonstrating what brings about organisational excellence and proposes a road map for effective human resource development and management, based on world class standards. Healthcare human resource professionals can now rise to the challenge and plan ahead for building organisational capability and sustainable performance.

75 FR 341 - FY 2010-FY 2011 Broad Agency Announcement

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

... Agency's strategic plan and mission goals, as well as to provide the general public with information and... and programs associated with the Agency's strategic plan and mission goals, as well as to provide the... systematic approach that links our strategic goals through multi-year plans to the daily activities of our...

A Guide to Systematic Planning for Vocational and Technical Schools. Research 22.

ERIC Educational Resources Information Center

Meckley, Richard F.; And Others

A school planning scheme involving 46 principle activities which occur over a 38-month period is presented. This scheme was developed for individuals responsible for the planning of vocational and technical schools, i.e., supervisors, state staff, university school plant planners, architects, and local school administrators. The activities…

Understanding and Articulating Effective Succession Planning: A Means for Infusing Influence by NAITTE Constituencies

ERIC Educational Resources Information Center

Geroy, Gary D.; Caleb, Denise; Wright, Phillip C.

2005-01-01

Human resource succession planning (HRSP) is "a deliberate and systematic effort by an organization to ensure critical personnel continuity in key positions and encourage individual advancement". Succession planning allows an organization to prepare for the absence, departure, death, retirement, or termination of an individual. It provides for…

Transition Planning Guide: From School to Adult Life.

ERIC Educational Resources Information Center

Thompson, Sandra Jespersen

The guide is intended to assist disabled students, their families, and professionals working with them to become familiar with the variety of adult services available and to create a systematic plan for transition from school to adult life. The first section considers the logistics of transition planning and includes a description of the planning…

Systematic Exploitation of Marginal Flexibility in Staff Planning.

ERIC Educational Resources Information Center

Lawaetz, Peter

1984-01-01

The Technical University of Denmark has tried to free resources in a stagnant or declining budget for development of new subject areas by planned contraction of ordinary activities, with only moderate success due to low mobility and strong specialization of the scientific staff. A more realistic planning system has been introduced, using…

Nottingham Health Science Biobank: a sustainable bioresource.

PubMed

Matharoo-Ball, Balwir; Thomson, Brian J

2014-10-01

Nottingham Health Science Biobank (NHSB) was established in 2011 by a 3-year "pump priming" grant from the United Kingdom National Institute of Health Research. Before biobanking operations began, NHSB commissioned a financial report on the full costs of biobanking and worked with key stakeholders and external consultants to develop a business plan with the aim of achieving financial and operational sustainability. The plan included: scanning published information, telephone interviews with commercial companies, Freedom of Information Requests, dialogue with prospective customers, and a market analysis of global trends in the use of human tissue samples in research. Our financial report provided a comprehensive and structured costing template for biobanking and confirmed the absolute requirement to ensure cost-efficient processes, careful staff utilization, and maximization of sample turnover. Together with our external consultants, we developed a business model responsive to global interest in healthcare founded on i) identification of key therapeutic areas that mapped to the strengths of the NHSB; ii) a systematic approach to identifying companies operating in these therapy areas; iii) engagement with noncommercial stakeholders to agree strategically aligned sample collection with the aim of ensuring the value of our tissue resource. By adopting this systematic approach to business modelling, the NHSB has achieved sustainability after less than 3 years of operation.

Measuring service line competitive position. A systematic methodology for hospitals.

PubMed

Studnicki, J

1991-01-01

To mount a broad effort aimed at improving their competitive position for some service or group of services, hospitals have begun to pursue product line management techniques. A few hospitals have even reorganized completely under the product line framework. The benefits include focusing accountability for operations and results, facilitating coordination between departments and functions, stimulating market segmentation, and promoting rigorous examination of new and existing programs. As part of its strategic planning process, a suburban Baltimore hospital developed a product line management methodology with six basic steps: (1) define the service lines (which they did by grouping all existing diagnosis-related groups into 35 service lines), (2) determine the contribution of each service line to total inpatient volume, (3) determine trends in service line volumes (by comparing data over time), (4) derive a useful comparison group (competing hospitals or groups of hospitals with comparable size, scope of services, payer mix, and financial status), (5) review multiple time frames, and (6) summarize the long- and short-term performance of the hospital's service lines to focus further analysis. This type of systematic and disciplined analysis can become part of a permanent strategic intelligence program. When hospitals have such a program in place, their market research, planning, budgeting, and operations will be tied together in a true management decision support system.

Photolithography diagnostic expert systems: a systematic approach to problem solving in a wafer fabrication facility

NASA Astrophysics Data System (ADS)

Weatherwax Scott, Caroline; Tsareff, Christopher R.

1990-06-01

One of the main goals of process engineering in the semiconductor industry is to improve wafer fabrication productivity and throughput. Engineers must work continuously toward this goal in addition to performing sustaining and development tasks. To accomplish these objectives, managers must make efficient use of engineering resources. One of the tools being used to improve efficiency is the diagnostic expert system. Expert systems are knowledge based computer programs designed to lead the user through the analysis and solution of a problem. Several photolithography diagnostic expert systems have been implemented at the Hughes Technology Center to provide a systematic approach to process problem solving. This systematic approach was achieved by documenting cause and effect analyses for a wide variety of processing problems. This knowledge was organized in the form of IF-THEN rules, a common structure for knowledge representation in expert system technology. These rules form the knowledge base of the expert system which is stored in the computer. The systems also include the problem solving methodology used by the expert when addressing a problem in his area of expertise. Operators now use the expert systems to solve many process problems without engineering assistance. The systems also facilitate the collection of appropriate data to assist engineering in solving unanticipated problems. Currently, several expert systems have been implemented to cover all aspects of the photolithography process. The systems, which have been in use for over a year, include wafer surface preparation (HMDS), photoresist coat and softbake, align and expose on a wafer stepper, and develop inspection. These systems are part of a plan to implement an expert system diagnostic environment throughout the wafer fabrication facility. In this paper, the systems' construction is described, including knowledge acquisition, rule construction, knowledge refinement, testing, and evaluation. The roles played by the process engineering expert and the knowledge engineer are discussed. The features of the systems are shown, particularly the interactive quality of the consultations and the ease of system use.

Learning to manage a complex ecosystem: adaptive management and the Northwest Forest Plan.

Treesearch

George H. Stankey; Roger N. Clark; Bernard T. Bormann

2006-01-01

The Northwest Forest Plan (the Plan) identifies adaptive management as a central strategy for effective implementation. Despite this, there has been a lack of any systematic evaluation of its performance. This study is based on an extensive literature review, 50 interviews with resource managers and scientists involved with the Plan’s implementation, and a survey of...

An organized, comprehensive, and security-enabled strategic response to the Haiti earthquake: a description of pre-deployment readiness preparation and preliminary experience from an academic anesthesiology department with no preexisting international disaster response program.

PubMed

McCunn, Maureen; Ashburn, Michael A; Floyd, Thomas F; Schwab, C William; Harrington, Paul; Hanson, C William; Sarani, Babak; Mehta, Samir; Speck, Rebecca M; Fleisher, Lee A

2010-12-01

On Tuesday, January 12, 2010 at 16:53 local time, a magnitude 7.0 M(w) earthquake struck Haiti. The global humanitarian attempt to respond was swift, but poor infrastructure and emergency preparedness limited many efforts. Rapid, successful deployment of emergency medical care teams was accomplished by organizations with experience in mass disaster casualty response. Well-intentioned, but unprepared, medical teams also responded. In this report, we describe the preparation and planning process used at an academic university department of anesthesiology with no preexisting international disaster response program, after a call from an American-based nongovernmental organization operating in Haiti requested medical support. The focus of this article is the pre-deployment readiness process, and is not a post-deployment report describing the medical care provided in Haiti. A real-time qualitative assessment and systematic review of the Hospital of the University of Pennsylvania's communications and actions relevant to the Haiti earthquake were performed. Team meetings, conference calls, and electronic mail communication pertaining to planning, decision support, equipment procurement, and actions and steps up to the day of deployment were reviewed and abstracted. Timing of key events was compiled and a response timeline for this process was developed. Interviews with returning anesthesiology members were conducted. Four days after the Haiti earthquake, Partners in Health, a nonprofit, nongovernmental organization based in Boston, Massachusetts, with >20 years of experience providing medical care in Haiti contacted the University of Pennsylvania Health System to request medical team support. The departments of anesthesiology, surgery, orthopedics, and nursing responded to this request with a volunteer selection process, vaccination program, and systematic development of equipment lists. World Health Organization and Centers for Disease Control guidelines, the American Society of Anesthesiology Committee on Trauma and Emergency Preparedness, published articles, and in-country contacts were used to guide the preparatory process. An organized strategic response to medical needs after an international natural disaster emergency can be accomplished safely and effectively within 6 to 12 days by an academic anesthesiology department, with medical system support, in a center with no previously established response system. The value and timeliness of this response will be determined with further study. Institutions with limited experience in putting an emergency medical team into the field may be able to quickly do so when such efforts are executed in a systematic manner in coordination with a health care organization that already has support infrastructure at the site of the disaster.

Consultant-led, multidisciplinary balance clinic: process evaluation of a specialist model of care in a district general hospital.

PubMed

Trinidade, A; Yung, M W

2014-04-01

A specialist balance clinic to effectively deal with dizzy patients is recommended by ENT-UK. We audit the patient pathway before and following the introduction of a consultant-led dedicated balance clinic. Process evaluation and audit. ENT outpatients department of a district general hospital. The journey of dizzy patients seen in the general ENT clinic was mapped from case notes and recorded retrospectively. A consultant-led, multidisciplinary balance clinic involving an otologist, a senior audiologist and a neurophysiotherapist was then set up, and the journey was prospectively recorded and compared with that before the change. Of the 44 dizzy patients seen in the general clinic, 41% had further follow-up consultations; 64% were given definitive or provisional diagnoses; 75% were discharged without a management plan. Oculomotor examination was not systematically performed. The mean interval between Visits 1 and 2 was 8.4 weeks and the mean number of visits was 3. In the consultant-led dedicated balance clinic, following Visit 1, only 8% of patients required follow-up; 97% received definitive diagnoses, which guided management; all patients left with definitive management plans in place. In all patients, oculomotor assessment was systematically performed and all patients received consultant and, where necessary, allied healthcare professional input. By standardising the management experience for dizzy patients, appropriate and timely treatment can be achieved, allowing for a more seamless and efficient patient journey from referral to treatment. A multidisciplinary balance clinic led by a consultant otologist is the ideal way to achieve this. © 2014 John Wiley & Sons Ltd.

Systematic Reviews of Mechanisms for Financing Family Planning: Findings, Implications, and Future Agenda.

PubMed

Lissner, Craig L; Ali, Moazzam

2016-12-01

The article describes an international collaboration that systematically reviewed the evidence on financing mechanisms for family planning/contraception, assessed the strength of and summarized the evidence, identified research gaps, and proposed a new research agenda to address the gaps. The review found that the evidence base is weak owing to the paucity of studies, diversity in findings, and variations in intervention, study design, and outcome measures. Of more than 17,000 papers reviewed only 38 met the eligibility criteria. A number of general recommendations on the directions and areas of future research can be drawn. There is a strong need for more robust study designs on the effectiveness of financial incentives in family planning. © 2016 The Population Council, Inc.

Planning collision free paths for two cooperating robots using a divide-and-conquer C-space traversal heuristic

NASA Technical Reports Server (NTRS)

Weaver, Johnathan M.

1993-01-01

A method was developed to plan feasible and obstacle-avoiding paths for two spatial robots working cooperatively in a known static environment. Cooperating spatial robots as referred to herein are robots which work in 6D task space while simultaneously grasping and manipulating a common, rigid payload. The approach is configuration space (c-space) based and performs selective rather than exhaustive c-space mapping. No expensive precomputations are required. A novel, divide-and-conquer type of heuristic is used to guide the selective mapping process. The heuristic does not involve any robot, environment, or task specific assumptions. A technique was also developed which enables solution of the cooperating redundant robot path planning problem without requiring the use of inverse kinematics for a redundant robot. The path planning strategy involves first attempting to traverse along the configuration space vector from the start point towards the goal point. If an unsafe region is encountered, an intermediate via point is identified by conducting a systematic search in the hyperplane orthogonal to and bisecting the unsafe region of the vector. This process is repeatedly applied until a solution to the global path planning problem is obtained. The basic concept behind this strategy is that better local decisions at the beginning of the trouble region may be made if a possible way around the 'center' of the trouble region is known. Thus, rather than attempting paths which look promising locally (at the beginning of a trouble region) but which may not yield overall results, the heuristic attempts local strategies that appear promising for circumventing the unsafe region.

Systematic Assessment for University Sexuality Programming.

ERIC Educational Resources Information Center

Westefeld, John S.; Winkelpleck, Judy M.

1982-01-01

Suggests systematic empirical assessment is needed to plan university sexuality programing. Proposes the traditional approach of asking about students' attitudes, knowledge, and behavior is useful for developing specific programing content. Presents an assessment model emphasizing assessment of students' desires for sexuality programing in terms…

MO-G-BRE-09: Validating FMEA Against Incident Learning Data: A Study in Stereotactic Body Radiation Therapy

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

Yang, F; Cao, N; Young, L

2014-06-15

Purpose: Though FMEA (Failure Mode and Effects Analysis) is becoming more widely adopted for risk assessment in radiation therapy, to our knowledge it has never been validated against actual incident learning data. The objective of this study was to perform an FMEA analysis of an SBRT (Stereotactic Body Radiation Therapy) treatment planning process and validate this against data recorded within an incident learning system. Methods: FMEA on the SBRT treatment planning process was carried out by a multidisciplinary group including radiation oncologists, medical physicists, and dosimetrists. Potential failure modes were identified through a systematic review of the workflow process. Failuremore » modes were rated for severity, occurrence, and detectability on a scale of 1 to 10 and RPN (Risk Priority Number) was computed. Failure modes were then compared with historical reports identified as relevant to SBRT planning within a departmental incident learning system that had been active for two years. Differences were identified. Results: FMEA identified 63 failure modes. RPN values for the top 25% of failure modes ranged from 60 to 336. Analysis of the incident learning database identified 33 reported near-miss events related to SBRT planning. FMEA failed to anticipate 13 of these events, among which 3 were registered with severity ratings of severe or critical in the incident learning system. Combining both methods yielded a total of 76 failure modes, and when scored for RPN the 13 events missed by FMEA ranked within the middle half of all failure modes. Conclusion: FMEA, though valuable, is subject to certain limitations, among them the limited ability to anticipate all potential errors for a given process. This FMEA exercise failed to identify a significant number of possible errors (17%). Integration of FMEA with retrospective incident data may be able to render an improved overview of risks within a process.« less

Systematic information processing style and perseverative worry.

PubMed

Dash, Suzanne R; Meeten, Frances; Davey, Graham C L

2013-12-01

This review examines the theoretical rationale for conceiving of systematic information processing as a proximal mechanism for perseverative worry. Systematic processing is characterised by detailed, analytical thought about issue-relevant information, and in this way, is similar to the persistent, detailed processing of information that typifies perseverative worry. We review the key features and determinants of systematic processing, and examine the application of systematic processing to perseverative worry. We argue that systematic processing is a mechanism involved in perseverative worry because (1) systematic processing is more likely to be deployed when individuals feel that they have not reached a satisfactory level of confidence in their judgement and this is similar to the worrier's striving to feel adequately prepared, to have considered every possible negative outcome/detect all potential danger, and to be sure that they will successfully cope with perceived future problems; (2) systematic processing and worry are influenced by similar psychological cognitive states and appraisals; and (3) the functional neuroanatomy underlying systematic processing is located in the same brain regions that are activated during worrying. This proposed mechanism is derived from core psychological processes and offers a number of clinical implications, including the identification of psychological states and appraisals that may benefit from therapeutic interventions for worry-based problems. © 2013.

[Relationship between water supply, sanitation, public health, and environment: elements for the formulation of a sanitary infrastructure planning model].

PubMed

Soares, Sérgio R A; Bernardes, Ricardo S; Netto, Oscar de M Cordeiro

2002-01-01

The understanding of sanitation infrastructure, public health, and environmental relations is a fundamental assumption for planning sanitation infrastructure in urban areas. This article thus suggests elements for developing a planning model for sanitation infrastructure. The authors performed a historical survey of environmental and public health issues related to the sector, an analysis of the conceptual frameworks involving public health and sanitation systems, and a systematization of the various effects that water supply and sanitation have on public health and the environment. Evaluation of these effects should guarantee the correct analysis of possible alternatives, deal with environmental and public health objectives (the main purpose of sanitation infrastructure), and provide the most reasonable indication of actions. The suggested systematization of the sanitation systems effects in each step of their implementation is an advance considering the association between the fundamental elements for formulating a planning model for sanitation infrastructure.

Renewable Energy Supply for Power Dominated, Energy Intense Production Processes - A Systematic Conversion Approach for the Anodizing Process

NASA Astrophysics Data System (ADS)

>D Stollenwerk, T Kuvarakul, I Kuperjans,

2013-06-01

European countries are highly dependent on energy imports. To lower this import dependency effectively, renewable energies will take a major role in future energy supply systems. To assist the national and inter-European efforts, extensive changes towards a renewable energy supply, especially on the company level, will be unavoidable. To conduct this conversion in the most effective way, the methodology developed in this paper can support the planning procedure. It is applied to the energy intense anodizing production process, where the electrical demand is the governing factor for the energy system layout. The differences between the classical system layout based on the current energy procurement and an approach with a detailed load-time-curve analysis, using process decomposition besides thermodynamic optimization, are discussed. The technical effects on the resulting energy systems are shown besides the resulting energy supply costs which will be determined by hourly discrete simulation.

Dengue Contingency Planning: From Research to Policy and Practice

PubMed Central

Runge-Ranzinger, Silvia; Kroeger, Axel; Olliaro, Piero; McCall, Philip J.; Sánchez Tejeda, Gustavo; Lloyd, Linda S.; Hakim, Lokman; Bowman, Leigh R.; Horstick, Olaf; Coelho, Giovanini

2016-01-01

Background Dengue is an increasingly incident disease across many parts of the world. In response, an evidence-based handbook to translate research into policy and practice was developed. This handbook facilitates contingency planning as well as the development and use of early warning and response systems for dengue fever epidemics, by identifying decision-making processes that contribute to the success or failure of dengue surveillance, as well as triggers that initiate effective responses to incipient outbreaks. Methodology/Principal findings Available evidence was evaluated using a step-wise process that included systematic literature reviews, policymaker and stakeholder interviews, a study to assess dengue contingency planning and outbreak management in 10 countries, and a retrospective logistic regression analysis to identify alarm signals for an outbreak warning system using datasets from five dengue endemic countries. Best practices for managing a dengue outbreak are provided for key elements of a dengue contingency plan including timely contingency planning, the importance of a detailed, context-specific dengue contingency plan that clearly distinguishes between routine and outbreak interventions, surveillance systems for outbreak preparedness, outbreak definitions, alert algorithms, managerial capacity, vector control capacity, and clinical management of large caseloads. Additionally, a computer-assisted early warning system, which enables countries to identify and respond to context-specific variables that predict forthcoming dengue outbreaks, has been developed. Conclusions/Significance Most countries do not have comprehensive, detailed contingency plans for dengue outbreaks. Countries tend to rely on intensified vector control as their outbreak response, with minimal focus on integrated management of clinical care, epidemiological, laboratory and vector surveillance, and risk communication. The Technical Handbook for Surveillance, Dengue Outbreak Prediction/ Detection and Outbreak Response seeks to provide countries with evidence-based best practices to justify the declaration of an outbreak and the mobilization of the resources required to implement an effective dengue contingency plan. PMID:27653786

System-level planning, coordination, and communication: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

Dichter, Jeffrey R; Kanter, Robert K; Dries, David; Luyckx, Valerie; Lim, Matthew L; Wilgis, John; Anderson, Michael R; Sarani, Babak; Hupert, Nathaniel; Mutter, Ryan; Devereaux, Asha V; Christian, Michael D; Kissoon, Niranjan

2014-10-01

System-level planning involves uniting hospitals and health systems, local/regional government agencies, emergency medical services, and other health-care entities involved in coordinating and enabling care in a major disaster. We reviewed the literature and sought expert opinions concerning system-level planning and engagement for mass critical care due to disasters or pandemics and offer suggestions for system-planning, coordination, communication, and response. The suggestions in this chapter are important for all of those involved in a pandemic or disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. The American College of Chest Physicians (CHEST) consensus statement development process was followed in developing suggestions. Task Force members met in person to develop nine key questions believed to be most relevant for system-planning, coordination, and communication. A systematic literature review was then performed for relevant articles and documents, reports, and other publications reported since 1993. No studies of sufficient quality were identified upon which to make evidence-based recommendations. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. Suggestions were developed and grouped according to the following thematic elements: (1) national government support of health-care coalitions/regional health authorities (HC/RHAs), (2) teamwork within HC/RHAs, (3) system-level communication, (4) system-level surge capacity and capability, (5) pediatric patients and special populations, (6) HC/RHAs and networks, (7) models of advanced regional care systems, and (8) the use of simulation for preparedness and planning. System-level planning is essential to provide care for large numbers of critically ill patients because of disaster or pandemic. It also entails a departure from the routine, independent system and involves all levels from health-care institutions to regional health authorities. National government support is critical, as are robust communication systems and advanced planning supported by realistic exercises.

System-Level Planning, Coordination, and Communication

PubMed Central

Kanter, Robert K.; Dries, David; Luyckx, Valerie; Lim, Matthew L.; Wilgis, John; Anderson, Michael R.; Sarani, Babak; Hupert, Nathaniel; Mutter, Ryan; Devereaux, Asha V.; Christian, Michael D.; Kissoon, Niranjan; Christian, Michael D.; Devereaux, Asha V.; Dichter, Jeffrey R.; Kissoon, Niranjan; Rubinson, Lewis; Amundson, Dennis; Anderson, Michael R.; Balk, Robert; Barfield, Wanda D.; Bartz, Martha; Benditt, Josh; Beninati, William; Berkowitz, Kenneth A.; Daugherty Biddison, Lee; Braner, Dana; Branson, Richard D; Burkle, Frederick M.; Cairns, Bruce A.; Carr, Brendan G.; Courtney, Brooke; DeDecker, Lisa D.; De Jong, Marla J.; Dominguez-Cherit, Guillermo; Dries, David; Einav, Sharon; Erstad, Brian L.; Etienne, Mill; Fagbuyi, Daniel B.; Fang, Ray; Feldman, Henry; Garzon, Hernando; Geiling, James; Gomersall, Charles D.; Grissom, Colin K.; Hanfling, Dan; Hick, John L.; Hodge, James G.; Hupert, Nathaniel; Ingbar, David; Kanter, Robert K.; King, Mary A.; Kuhnley, Robert N.; Lawler, James; Leung, Sharon; Levy, Deborah A.; Lim, Matthew L.; Livinski, Alicia; Luyckx, Valerie; Marcozzi, David; Medina, Justine; Miramontes, David A.; Mutter, Ryan; Niven, Alexander S.; Penn, Matthew S.; Pepe, Paul E.; Powell, Tia; Prezant, David; Reed, Mary Jane; Rich, Preston; Rodriquez, Dario; Roxland, Beth E.; Sarani, Babak; Shah, Umair A.; Skippen, Peter; Sprung, Charles L.; Subbarao, Italo; Talmor, Daniel; Toner, Eric S.; Tosh, Pritish K.; Upperman, Jeffrey S.; Uyeki, Timothy M.; Weireter, Leonard J.; West, T. Eoin; Wilgis, John; Ornelas, Joe; McBride, Deborah; Reid, David; Baez, Amado; Baldisseri, Marie; Blumenstock, James S.; Cooper, Art; Ellender, Tim; Helminiak, Clare; Jimenez, Edgar; Krug, Steve; Lamana, Joe; Masur, Henry; Mathivha, L. Rudo; Osterholm, Michael T.; Reynolds, H. Neal; Sandrock, Christian; Sprecher, Armand; Tillyard, Andrew; White, Douglas; Wise, Robert; Yeskey, Kevin

2014-01-01

BACKGROUND: System-level planning involves uniting hospitals and health systems, local/regional government agencies, emergency medical services, and other health-care entities involved in coordinating and enabling care in a major disaster. We reviewed the literature and sought expert opinions concerning system-level planning and engagement for mass critical care due to disasters or pandemics and offer suggestions for system-planning, coordination, communication, and response. The suggestions in this chapter are important for all of those involved in a pandemic or disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. METHODS: The American College of Chest Physicians (CHEST) consensus statement development process was followed in developing suggestions. Task Force members met in person to develop nine key questions believed to be most relevant for system-planning, coordination, and communication. A systematic literature review was then performed for relevant articles and documents, reports, and other publications reported since 1993. No studies of sufficient quality were identified upon which to make evidence-based recommendations. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. RESULTS: Suggestions were developed and grouped according to the following thematic elements: (1) national government support of health-care coalitions/regional health authorities (HC/RHAs), (2) teamwork within HC/RHAs, (3) system-level communication, (4) system-level surge capacity and capability, (5) pediatric patients and special populations, (6) HC/RHAs and networks, (7) models of advanced regional care systems, and (8) the use of simulation for preparedness and planning. CONCLUSIONS: System-level planning is essential to provide care for large numbers of critically ill patients because of disaster or pandemic. It also entails a departure from the routine, independent system and involves all levels from health-care institutions to regional health authorities. National government support is critical, as are robust communication systems and advanced planning supported by realistic exercises. PMID:25144713

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis

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

Zheng, Yuanshui, E-mail: yuanshui.zheng@okc.procure.com; Johnson, Randall; Larson, Gary

Purpose: Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. Methods: The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authorsmore » estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. Results: In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. Conclusions: The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.« less

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis.

PubMed

Zheng, Yuanshui; Johnson, Randall; Larson, Gary

2016-06-01

Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authors estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.

Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update).

PubMed

Ross, Jamie; Stevenson, Fiona; Lau, Rosa; Murray, Elizabeth

2016-10-26

There is a significant potential for e-health to deliver cost-effective, quality health care, and spending on e-health systems by governments and healthcare systems is increasing worldwide. However, there remains a tension between the use of e-health in this way and implementation. Furthermore, the large body of reviews in the e-health implementation field, often based on one particular technology, setting or health condition make it difficult to access a comprehensive and comprehensible summary of available evidence to help plan and undertake implementation. This review provides an update and re-analysis of a systematic review of the e-health implementation literature culminating in a set of accessible and usable recommendations for anyone involved or interested in the implementation of e-health. MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library were searched for studies published between 2009 and 2014. Studies were included if they were systematic reviews of the implementation of e-health. Data from included studies were synthesised using the principles of meta-ethnography, and categorisation of the data was informed by the Consolidated Framework for Implementation Research (CFIR). Forty-four reviews mainly from North America and Europe were included. A range of e-health technologies including electronic medical records and clinical decision support systems were represented. Healthcare settings included primary care, secondary care and home care. Factors important for implementation were identified at the levels of the following: the individual e-health technology, the outer setting, the inner setting and the individual health professionals as well as the process of implementation. This systematic review of reviews provides a synthesis of the literature that both acknowledges the multi-level complexity of e-health implementation and provides an accessible and useful guide for those planning implementation. New interpretations of a large amount of data across e-health systems and healthcare settings have been generated and synthesised into a set of useable recommendations for practice. This review provides a further empirical test of the CFIR and identifies areas where additional research is necessary. PROSPERO, CRD42015017661.

Quality Assessment of TPB-Based Questionnaires: A Systematic Review

PubMed Central

Oluka, Obiageli Crystal; Nie, Shaofa; Sun, Yi

2014-01-01

Objective This review is aimed at assessing the quality of questionnaires and their development process based on the theory of planned behavior (TPB) change model. Methods A systematic literature search for studies with the primary aim of TPB-based questionnaire development was conducted in relevant databases between 2002 and 2012 using selected search terms. Ten of 1,034 screened abstracts met the inclusion criteria and were assessed for methodological quality using two different appraisal tools: one for the overall methodological quality of each study and the other developed for the appraisal of the questionnaire content and development process. Both appraisal tools consisted of items regarding the likelihood of bias in each study and were eventually combined to give the overall quality score for each included study. Results 8 of the 10 included studies showed low risk of bias in the overall quality assessment of each study, while 9 of the studies were of high quality based on the quality appraisal of questionnaire content and development process. Conclusion Quality appraisal of the questionnaires in the 10 reviewed studies was successfully conducted, highlighting the top problem areas (including: sample size estimation; inclusion of direct and indirect measures; and inclusion of questions on demographics) in the development of TPB-based questionnaires and the need for researchers to provide a more detailed account of their development process. PMID:24722323

Uncovering Treatment Burden as a Key Concept for Stroke Care: A Systematic Review of Qualitative Research

PubMed Central

Gallacher, Katie; Morrison, Deborah; Jani, Bhautesh; Macdonald, Sara; May, Carl R.; Montori, Victor M.; Erwin, Patricia J.; Batty, G. David; Eton, David T.; Langhorne, Peter; Mair, Frances S.

2013-01-01

Background Patients with chronic disease may experience complicated management plans requiring significant personal investment. This has been termed ‘treatment burden’ and has been associated with unfavourable outcomes. The aim of this systematic review is to examine the qualitative literature on treatment burden in stroke from the patient perspective. Methods and Findings The search strategy centred on: stroke, treatment burden, patient experience, and qualitative methods. We searched: Scopus, CINAHL, Embase, Medline, and PsycINFO. We tracked references, footnotes, and citations. Restrictions included: English language, date of publication January 2000 until February 2013. Two reviewers independently carried out the following: paper screening, data extraction, and data analysis. Data were analysed using framework synthesis, as informed by Normalization Process Theory. Sixty-nine papers were included. Treatment burden includes: (1) making sense of stroke management and planning care, (2) interacting with others, (3) enacting management strategies, and (4) reflecting on management. Health care is fragmented, with poor communication between patient and health care providers. Patients report inadequate information provision. Inpatient care is unsatisfactory, with a perceived lack of empathy from professionals and a shortage of stimulating activities on the ward. Discharge services are poorly coordinated, and accessing health and social care in the community is difficult. The study has potential limitations because it was restricted to studies published in English only and data from low-income countries were scarce. Conclusions Stroke management is extremely demanding for patients, and treatment burden is influenced by micro and macro organisation of health services. Knowledge deficits mean patients are ill equipped to organise their care and develop coping strategies, making adherence less likely. There is a need to transform the approach to care provision so that services are configured to prioritise patient needs rather than those of health care systems. Systematic Review Registration International Prospective Register of Systematic Reviews CRD42011001123 Please see later in the article for the Editors' Summary PMID:23824703

Determination of the influence of dispersion pattern of pesticide-resistant individuals on the reliability of resistance estimates using different sampling plans.

PubMed

Shah, R; Worner, S P; Chapman, R B

2012-10-01

Pesticide resistance monitoring includes resistance detection and subsequent documentation/ measurement. Resistance detection would require at least one (≥1) resistant individual(s) to be present in a sample to initiate management strategies. Resistance documentation, on the other hand, would attempt to get an estimate of the entire population (≥90%) of the resistant individuals. A computer simulation model was used to compare the efficiency of simple random and systematic sampling plans to detect resistant individuals and to document their frequencies when the resistant individuals were randomly or patchily distributed. A patchy dispersion pattern of resistant individuals influenced the sampling efficiency of systematic sampling plans while the efficiency of random sampling was independent of such patchiness. When resistant individuals were randomly distributed, sample sizes required to detect at least one resistant individual (resistance detection) with a probability of 0.95 were 300 (1%) and 50 (10% and 20%); whereas, when resistant individuals were patchily distributed, using systematic sampling, sample sizes required for such detection were 6000 (1%), 600 (10%) and 300 (20%). Sample sizes of 900 and 400 would be required to detect ≥90% of resistant individuals (resistance documentation) with a probability of 0.95 when resistant individuals were randomly dispersed and present at a frequency of 10% and 20%, respectively; whereas, when resistant individuals were patchily distributed, using systematic sampling, a sample size of 3000 and 1500, respectively, was necessary. Small sample sizes either underestimated or overestimated the resistance frequency. A simple random sampling plan is, therefore, recommended for insecticide resistance detection and subsequent documentation.

Development of Kentucky's highway incident management strategic plan.

DOT National Transportation Integrated Search

2005-05-01

ven though Kentucky has undertaken many initiatives to improve specific aspects of incident management, there has never been a plan that establishes an overall framework for a systematic, statewide, multi-agency effort to improve the management of hi...

Maximizing species conservation in continental Ecuador: a case of systematic conservation planning for biodiverse regions

PubMed Central

Lessmann, Janeth; Muñoz, Jesús; Bonaccorso, Elisa

2014-01-01

Ecuador has the largest number of species by area worldwide, but also a low representation of species within its protected areas. Here, we applied systematic conservation planning to identify potential areas for conservation in continental Ecuador, with the aim of increasing the representation of terrestrial species diversity in the protected area network. We selected 809 terrestrial species (amphibians, birds, mammals, and plants), for which distributions were estimated via species distribution models (SDMs), using Maxent. For each species we established conservation goals based on conservation priorities, and estimated new potential protected areas using Marxan conservation planning software. For each selected area, we determined their conservation priority and feasibility of establishment, two important aspects in the decision-making processes. We found that according to our conservation goals, the current protected area network contains large conservation gaps. Potential areas for conservation almost double the surface area of currently protected areas. Most of the newly proposed areas are located in the Coast, a region with large conservation gaps and irreversible changes in land use. The most feasible areas for conservation were found in the Amazon and Andes regions, which encompass more undisturbed habitats, and already harbor most of the current reserves. Our study allows defining a viable strategy for preserving Ecuador's biodiversity, by combining SDMs, GIS-based decision-support software, and priority and feasibility assessments of the selected areas. This approach is useful for complementing protected area networks in countries with great biodiversity, insufficient biological information, and limited resources for conservation. PMID:25360277

Strengthening the links between mapping, planning and global engagement for disease elimination: lessons learnt from trachoma.

PubMed

Courtright, Paul; Rotondo, Lisa A; MacArthur, Chad; Jones, Iain; Weaver, Angela; Negash, Biruck Kebede; Olobio, Nicholas; Binnawi, Kamal; Bush, Simon; Abdala, Mariamo; Haddad, Danny; Bonfield, Astrid; Emerson, Paul; Sarah, Virginia; Solomon, Anthony W

2018-06-15

Trachoma is the leading infectious cause of blindness. Until recently, reliable data on the global extent of the disease, detailed plans for elimination, and government, donor and partner engagement were all inadequate. The trachoma community undertook a systematic, three-pronged strategy to map trachoma district by district, develop national-level trachoma elimination plans, and create a framework for governments, donors and partners to convene and coordinate in support of trachoma elimination.  RESULT: There has been a frame-shift in internal and external perceptions of the global trachoma programme, from being an effort working towards disease control in focussed geographical areas, to one in the process of achieving worldwide disease elimination. Multiple factors contributed to the successful implementation of mapping, planning, and cross-sectional engagement of governments, partners and donors. Elimination of trachoma is possible if the right combination of factors is in place. Planning for success is a critical first step. Some remaining challenges must still be addressed if the elimination targets are to be successfully attained. © 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.

Assessment of nursing care using indicators generated by software.

PubMed

Lima, Ana Paula Souza; Chianca, Tânia Couto Machado; Tannure, Meire Chucre

2015-01-01

to analyze the efficacy of the Nursing Process in an Intensive Care Unit using indicators generated by software. cross-sectional study using data collected for four months. RNs and students daily registered patients, took history (at admission), performed physical assessments, and established nursing diagnoses, nursing plans/prescriptions, and assessed care delivered to 17 patients using software. Indicators concerning the incidence and prevalence of nursing diagnoses, rate of effectiveness, risk diagnoses, and rate of effective prevention of complications were computed. the Risk for imbalanced body temperature was the most frequent diagnosis (23.53%), while the least frequent was Risk for constipation (0%). The Risk for Impaired skin integrity was prevalent in 100% of the patients, while Risk for acute confusion was the least prevalent (11.76%). Risk for constipation and Risk for impaired skin integrity obtained a rate of risk diagnostic effectiveness of 100%. The rate of effective prevention of acute confusion and falls was 100%. the efficacy of the Nursing Process using indicators was analyzed because these indicators reveal how nurses have identified patients' risks and conditions, and planned care in a systematized manner.

The practice of pre-marketing safety assessment in drug development.

PubMed

Chuang-Stein, Christy; Xia, H Amy

2013-01-01

The last 15 years have seen a substantial increase in efforts devoted to safety assessment by statisticians in the pharmaceutical industry. While some of these efforts were driven by regulations and public demand for safer products, much of the motivation came from the realization that there is a strong need for a systematic approach to safety planning, evaluation, and reporting at the program level throughout the drug development life cycle. An efficient process can help us identify safety signals early and afford us the opportunity to develop effective risk minimization plan early in the development cycle. This awareness has led many pharmaceutical sponsors to set up internal systems and structures to effectively conduct safety assessment at all levels (patient, study, and program). In addition to process, tools have emerged that are designed to enhance data review and pattern recognition. In this paper, we describe advancements in the practice of safety assessment during the premarketing phase of drug development. In particular, we share examples of safety assessment practice at our respective companies, some of which are based on recommendations from industry-initiated working groups on best practice in recent years.

Restructuring Neighborhood High Schools: The House Plan Solution.

ERIC Educational Resources Information Center

Oxley, Diana; And Others

This report concludes that the house plan should be the centerpiece of a systematic restructuring of New York City neighborhood high schools to reduce the dropout rate and improve academic achievement. The house plan is based on the subdivision of one or more grades into smaller schools within schools. Long-term monitoring of New York City dropout…

Palliative Care Processes Embedded in the ICU Workflow May Reserve Palliative Care Teams for Refractory Cases.

PubMed

Mun, Eluned; Umbarger, Lillian; Ceria-Ulep, Clementina; Nakatsuka, Craig

2018-01-01

Palliative Care Teams have been shown to be instrumental in the early identification of multiple aspects of advanced care planning. Despite an increased number of services to meet the rising consultation demand, it is conceivable that the numbers of palliative care consultations generated from an ICU alone could become overwhelming for an existing palliative care team. Improve end-of-life care in the ICU by incorporating basic palliative care processes into the daily routine ICU workflow, thereby reserving the palliative care team for refractory situations. A structured, palliative care, quality-improvement program was implemented and evaluated in the ICU at Kaiser Permanente Medical Center in Hawaii. This included selecting trigger criteria, a care model, forming guidelines, and developing evaluation criteria. These included the early identification of the multiple features of advanced care planning, numbers of proactive ICU and palliative care family meetings, and changes in code status and treatment upon completion of either meeting. Early identification of Goals-of-Care, advance directives, and code status by the ICU staff led to a proactive ICU family meeting with resultant increases in changes in code status and treatment. The numbers of palliative care consultations also rose, but not significantly. Palliative care processes could be incorporated into a daily ICU workflow allowing for integration of aspects of advanced care planning to be identified in a systematic and proactive manner. This reserved the palliative care team for situations when palliative care efforts performed by the ICU staff were ineffective.

Caregiver Integration During Discharge Planning for Older Adults to Reduce Resource Use: A Metaanalysis.

PubMed

Rodakowski, Juleen; Rocco, Philip B; Ortiz, Maqui; Folb, Barbara; Schulz, Richard; Morton, Sally C; Leathers, Sally Caine; Hu, Lu; James, A Everette

2017-08-01

To determine the effect of integrating informal caregivers into discharge planning on postdischarge cost and resource use in older adults. A systematic review and metaanalysis of randomized controlled trials that examine the effect of discharge planning with caregiver integration begun before discharge on healthcare cost and resource use outcomes. MEDLINE, EMBASE, and the Cochrane Library databases were searched for all English-language articles published between 1990 and April 2016. Hospital or skilled nursing facility. Older adults with informal caregivers discharged to a community setting. Readmission rates, length of and time to post-discharge rehospitalizations, costs of postdischarge care. Of 10,715 abstracts identified, 15 studies met the inclusion criteria. Eleven studies provided sufficient detail to calculate readmission rates for treatment and control participants. Discharge planning interventions with caregiver integration were associated with a 25% fewer readmissions at 90 days (relative risk (RR) = 0.75, 95% confidence interval (CI) = 0.62-0.91) and 24% fewer readmissions at 180 days (RR = 0.76, 95% CI = 0.64-0.90). The majority of studies reported statistically significant shorter time to readmission, shorter rehospitalization, and lower costs of postdischarge care among discharge planning interventions with caregiver integration. For older adults discharged to a community setting, the integration of caregivers into the discharge planning process reduces the risk of hospital readmission. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

5 CFR 412.202 - Systematic training and development of supervisors, managers, and executives.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Systematic training and development of supervisors, managers, and executives. 412.202 Section 412.202 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS SUPERVISORY, MANAGEMENT, AND EXECUTIVE DEVELOPMENT Succession Planning...

Clusters of genetic diseases in Brazil.

PubMed

Cardoso, Gabriela Costa; de Oliveira, Marcelo Zagonel; Paixão-Côrtes, Vanessa Rodrigues; Castilla, Eduardo Enrique; Schuler-Faccini, Lavínia

2018-06-02

The aim of this paper is to present a database of isolated communities (CENISO) with high prevalence of genetic disorders or congenital anomalies in Brazil. We used two strategies to identify such communities: (1) a systematic literature review and (2) a "rumor strategy" based on anecdotal accounts. All rumors and reports were validated in a stepwise process. The bibliographical search identified 34 rumors and 245 rumors through the rumor strategy, and 144 were confirmed. A database like this one presented here represents an important tool for the planning of health priorities for rare diseases in low- and middle-income countries with large populations.

The Science Manager's Guide to Case Studies

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

Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.

2001-09-24

This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

Writing an academic essay: a practical guide for nurses.

PubMed

Booth, Y

Writing academic essays can be a major hurdle and source of anxiety for many students. Fears and misconceptions relating to this kind of writing can be dispelled if the task is approached in a logical and systematic manner. This article outlines the key steps involved in successfully completing an essay and provides some practical tips to facilitate critical and analytical writing. These steps are: analysing the task; exploring the subject; planning the essay; writing the account; and revising the drafts. Although this process is challenging, academic writing is a means of developing both personally and professionally.

Outline of Toshiba Business Information Center

NASA Astrophysics Data System (ADS)

Nagata, Yoshihiro

Toshiba Business Information Center gathers and stores inhouse and external business information used in common within the Toshiba Corp., and provides companywide circulation, reference and other services. The Center established centralized information management system by employing decentralized computers, electronic file apparatus (30cm laser disc) and other office automation equipments. Online retrieval through LAN is available to search the stored documents and increasing copying requests are processed by electronic file. This paper describes the purpose of establishment of the Center, the facilities, management scheme, systematization of the files and the present situation and plan of each information service.

Chemical and isotopic compositions in acid residues from various meteorites

NASA Technical Reports Server (NTRS)

Kano, N.; Yamakoshi, K.; Matsuzaki, H.; Nogami, K.

1993-01-01

We are planning to carry out systematic isotopic investigations of Ru, Mg, etc., in primordial samples. The investigations will be pursued in the context of a study of the pre-history of the solar system. It is hoped that the study will yield direct evidence for processes of nucleosynthesis in the pre-solar stage and detection of extinct radioactive nuclides. In this paper, we present the results of chemical compositions of acid residues obtained from three types of meteorites: Canyon Diablo (IA), Allende (CV3), and Nuevo Mercuro (H5); and the preliminary results of Ru isotopic compositions.

Organizational change tactics: the evidence base in the literature.

PubMed

Packard, Thomas; Shih, Amber

2014-01-01

Planned organizational change processes can be used to address the many challenges facing human service organizations (HSOs) and improve organizational outcomes. There is massive literature on organizational change, ranging from popular management books to academic research on specific aspects of change. Regarding HSOs, there is a growing literature, including increasing attention to implementation science and evidence-based practices. However, research which offers generalizable, evidence-based guidelines for implementing change is not common. The purpose of the authors was to assess the evidence base in this organizational change literature to lay the groundwork for more systematic knowledge development in this important field.

System engineering for image and video systems

NASA Astrophysics Data System (ADS)

Talbot, Raymond J., Jr.

1997-02-01

The National Law Enforcement and Corrections Technology Centers (NLECTC) support public law enforcement agencies with technology development, evaluation, planning, architecture, and implementation. The NLECTC Western Region has a particular emphasis on surveillance and imaging issues. Among its activities, working with government and industry, NLECTC-WR produces 'Guides to Best Practices and Acquisition Methodologies' that facilitate government organizations in making better informed purchasing and operational decisions. This presentation includes specific examples from current activities. Through these systematic procedures, it is possible to design solutions optimally matched to the desired outcomes and provide a process for continuous improvement and greater public awareness of success.

Revisiting Organisational Learning in Integrated Care.

PubMed

Nuño-Solinís, Roberto

2017-08-11

Progress in health care integration is largely linked to changes in processes and ways of doing. These changes have knowledge management and learning implications. For this reason, the use of the concept of organisational learning is explored in the field of integrated care. There are very limited contributions that have connected the fields of organisational learning and care integration in a systematic way, both at the theoretical and empirical level. For this reason, hybridization of both perspectives still provides opportunities for understanding care integration initiatives from a research perspective as well as potential applications in health care management and planning.

Revisiting Organisational Learning in Integrated Care

PubMed Central

2017-01-01

Progress in health care integration is largely linked to changes in processes and ways of doing. These changes have knowledge management and learning implications. For this reason, the use of the concept of organisational learning is explored in the field of integrated care. There are very limited contributions that have connected the fields of organisational learning and care integration in a systematic way, both at the theoretical and empirical level. For this reason, hybridization of both perspectives still provides opportunities for understanding care integration initiatives from a research perspective as well as potential applications in health care management and planning. PMID:28970762

Web-based collaboration in individual care planning challenges the user and the provider roles – toward a power transition in caring relationships

PubMed Central

Bjerkan, Jorunn; Vatne, Solfrid; Hollingen, Anne

2014-01-01

Background and objective The Individual Care Plan (ICP) was introduced in Norway to meet new statutory requirements for user participation in health care planning, incorporating multidisciplinary and cross-sector collaboration. A web-based solution (electronic ICP [e-ICP]) was used to support the planning and documentation. The aim of this study was to investigate how web-based collaboration challenged user and professional roles. Methods Data were obtained from 15 semistructured interviews with users and eight with care professionals, and from two focus-group interviews with eight care professionals in total. The data were analyzed using systematic text condensation in a stepwise analysis model. Results Users and care professionals took either a proactive or a reluctant role in e-ICP collaboration. Where both user and care professionals were proactive, the pairing helped to ensure that the planning worked well; so did pairings of proactive care professionals and reluctant users. Proactive users paired with reluctant care professionals also made care planning work, thanks to the availability of information and the users’ own capacity or willingness to conduct the planning. Where both parties were reluctant, no planning activities occurred. Conclusion Use of the e-ICP challenged the user–professional relationship. In some cases, a power transition took place in the care process, which led to patient empowerment. This knowledge might be used to develop a new understanding of how role function can be challenged when users and care professionals have equal access to health care documentation and planning tools. PMID:25525367

Meta-analysis of the effectiveness of nursing discharge planning interventions for older inpatients discharged home.

PubMed

Mabire, Cédric; Dwyer, Andrew; Garnier, Antoine; Pellet, Joanie

2018-04-01

To determine the effectiveness of nursing discharge planning interventions on health-related outcomes for older inpatients discharged home. Inadequate discharge planning for the ageing population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing interventions for older people. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be evaluated in practice. Systematic review and meta-analysis. A systematic search was undertaken across 13 databases to retrieve published and unpublished studies in English between 2000-2015. Critical appraisal, data extraction and meta-analysis followed the methodology of the Joanna Briggs Institute. Thirteen studies were included in the review, 2 of 13 were pilot studies and one had a pre-post design. Included studies involved 3,964 participants with a median age of 77 years. Nurse discharge planning did not significantly reduce hospital readmission or quality of life, except readmission was lower across studies conducted in the USA. The overall effect score for nurse discharge planning on length of stay was statistically significant and positive. Nursing discharge planning is a complex intervention and difficult to evaluate. Findings suggest that nursing discharge planning for older inpatients discharged home increases the length of stay yet neither reduces readmission rate nor improves quality of life. © 2017 John Wiley & Sons Ltd.

Energy Engineering Analysis Program (EEAP), Badger Army Ammunition Plant, Baraboo, Wisconsin: Executive summary. Final report

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

NONE

1983-12-30

The purpose of this study and report is to develop a systematic program of energy consumption reductions in compliance with the stated goals of the Army Facilities Energy Plan (AFEP). This report will: Develop a systematic plan of energy conservation opportunities (ECO`s) that will meet the objectives of the AFEP. Develop a coordinated facility-wide energy study. Prepare DD Form 1391 and Project Development Brochure (PDB`s) and required documentation for feasible projects. Include all practical energy conservation methods and determine economic feasibility in accordance with given guidelines. List and prioritize recommended projects.

Magnetic resonance imaging in prostate cancer detection and management: a systematic review.

PubMed

Monni, Fabio; Fontanella, Paolo; Grasso, Angelica; Wiklund, Peter; Ou, Yen-Chuan; Randazzo, Marco; Rocco, Bernardo; Montanari, Emanuele; Bianchi, Giampaolo

2017-12-01

The aim of our work was to evaluate the role of multi-parametric magnetic resonance imaging (mpMRI) in detection and management of prostate cancer (PC); specifically investigating the efficacy of mpMRI-based biopsy techniques in terms of diagnostic yield of significant prostate neoplasm and the improved management of patients who choose conservative treatments or active surveillance. A systematic and critical analysis through Medline, Embase, Scopus and Web of Science databases was carried out in March 2016, following the PRISMA ("Preferred Reporting Items for Systematic Reviews and Meta-Analyses") statement. The search was conducted using the following key words: "MRI/TRUS-fusion biopsy," "PIRADS," "prostate cancer," "magnetic resonance imaging (MRI)," "multiparametric MRI (mpMRI)," "systematic prostate biopsy (SB)," "targeted prostate biopsy (TPB)." English language articles were reviewed for inclusion ability. Sixty-six studies were selected in order to evaluate the characteristics and limitations of traditional sample biopsy, the role of mpMRI in detection of PC, specifically the increased degree of diagnostic accuracy of targeted prostate biopsy compared to systematic biopsy (12 cores), and to transperineal saturation biopsies with trans-rectal ultrasound (TRUS) only. MpMRI can detect index lesions in approximately 90% of cases when compared to prostatectomy specimen. The diagnostic performance of biparametric MRI (T2w + DWI) is not inferior to mpMRI, offering valid options to diminish cost- and time-consumption. Since approximately 10% of significant lesions are still MRI-invisible, systematic cores biopsy seem to still be necessary. The analysis of the different techniques shows that in-bore MRI-guided biopsy and MRI/TRUS-fusion-guided biopsy are superior in detection of significant PC compared to visual estimation alone. MpMRI proved to be very effective in active surveillance, as it prevents underdetection of significant PC and it assesses low-risk disease accurately. In higher-risk disease, presurgical MRI may change the clinically-based surgical plan in up to a third of cases. Targeted prostate biopsy, guided by mpMRI, is able to improve diagnostic accuracy and to reduce the detection of insignificant PC. Since the negative predictive value (NPV) of mpMRI is still imperfect, systematic cores biopsy should not be omitted for optimal staging of disease. A process of a progressive and periodic evolution in the detection and radiological classification of prostate lesions (such as PIRADS), is still needed in patients in active surveillance and in radical prostatectomy planning.

A study of palm biomass processing strategy in Sarawak

NASA Astrophysics Data System (ADS)

Lee, S. J. Y.; Ng, W. P. Q.; Law, K. H.

2017-06-01

In the past decades, palm industry is booming due to its profitable nature. An environmental concern regarding on the palm industry is the enormous amount of waste produced from palm industry. The waste produced or palm biomass is one significant renewable energy source and raw material for value-added products like fiber mats, activated carbon, dried fiber, bio-fertilizer and et cetera in Malaysia. There is a need to establish the palm biomass industry for the recovery of palm biomass for efficient utilization and waste reduction. The development of the industry is strongly depending on the two reasons, the availability and supply consistency of palm biomass as well as the availability of palm biomass processing facilities. In Malaysia, the development of palm biomass industry is lagging due to the lack of mature commercial technology and difficult logistic planning as a result of scattered locality of palm oil mill, where palm biomass is generated. Two main studies have been carried out in this research work: i) industrial study of the feasibility of decentralized and centralized palm biomass processing in Sarawak and ii) development of a systematic and optimized palm biomass processing planning for the development of palm biomass industry in Sarawak, Malaysia. Mathematical optimization technique is used in this work to model the above case scenario for biomass processing to achieve maximum economic potential and resource feasibility. An industrial study of palm biomass processing strategy in Sarawak has been carried out to evaluate the optimality of centralized processing and decentralize processing of the local biomass industry. An optimal biomass processing strategy is achieved.

Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council.

PubMed

Chou, Roger; Gordon, Debra B; de Leon-Casasola, Oscar A; Rosenberg, Jack M; Bickler, Stephen; Brennan, Tim; Carter, Todd; Cassidy, Carla L; Chittenden, Eva Hall; Degenhardt, Ernest; Griffith, Scott; Manworren, Renee; McCarberg, Bill; Montgomery, Robert; Murphy, Jamie; Perkal, Melissa F; Suresh, Santhanam; Sluka, Kathleen; Strassels, Scott; Thirlby, Richard; Viscusi, Eugene; Walco, Gary A; Warner, Lisa; Weisman, Steven J; Wu, Christopher L

2016-02-01

Most patients who undergo surgical procedures experience acute postoperative pain, but evidence suggests that less than half report adequate postoperative pain relief. Many preoperative, intraoperative, and postoperative interventions and management strategies are available for reducing and managing postoperative pain. The American Pain Society, with input from the American Society of Anesthesiologists, commissioned an interdisciplinary expert panel to develop a clinical practice guideline to promote evidence-based, effective, and safer postoperative pain management in children and adults. The guideline was subsequently approved by the American Society for Regional Anesthesia. As part of the guideline development process, a systematic review was commissioned on various aspects related to various interventions and management strategies for postoperative pain. After a review of the evidence, the expert panel formulated recommendations that addressed various aspects of postoperative pain management, including preoperative education, perioperative pain management planning, use of different pharmacological and nonpharmacological modalities, organizational policies, and transition to outpatient care. The recommendations are based on the underlying premise that optimal management begins in the preoperative period with an assessment of the patient and development of a plan of care tailored to the individual and the surgical procedure involved. The panel found that evidence supports the use of multimodal regimens in many situations, although the exact components of effective multimodal care will vary depending on the patient, setting, and surgical procedure. Although these guidelines are based on a systematic review of the evidence on management of postoperative pain, the panel identified numerous research gaps. Of 32 recommendations, 4 were assessed as being supported by high-quality evidence, and 11 (in the areas of patient education and perioperative planning, patient assessment, organizational structures and policies, and transitioning to outpatient care) were made on the basis of low-quality evidence. This guideline, on the basis of a systematic review of the evidence on postoperative pain management, provides recommendations developed by a multidisciplinary expert panel. Safe and effective postoperative pain management should be on the basis of a plan of care tailored to the individual and the surgical procedure involved, and multimodal regimens are recommended in many situations. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Environmental Scanning in Educational Planning: Establishing a Strategic Trend Information System.

ERIC Educational Resources Information Center

Morrison, James L.

The systematic evaluation of the macroenvironment is sometimes referred to as a strategic trend information system. Strategic trend intelligence systems are highly developed, systematic intelligence programs that focus on trends and events in the external environment and provide institutions with knowledge to reduce areas of uncertainty and with…

Developing Preservice Literacy Teachers' Observation Skills: Two Stories, Two Technologies

ERIC Educational Resources Information Center

Baker, Elizabeth A.; Wedman, Judy M.

2007-01-01

Systematic observation is a foundational skill teachers use in order to document children's reading development and plan developmentally appropriate instruction. However, a variety of challenges make it difficult for teacher educators to help preservice teachers develop systematic observation skills. The purpose of this study is to tell two…

Do systematic reviews on pediatric topics need special methodological considerations?

PubMed

Farid-Kapadia, Mufiza; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

2017-03-06

Systematic reviews are key tools to enable decision making by healthcare providers and policymakers. Despite the availability of the evidence based Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA-2009 and PRISMA-P 2015) statements that were developed to improve the transparency and quality of reporting of systematic reviews, uncertainty on how to deal with pediatric-specific methodological challenges of systematic reviews impairs decision-making in child health. In this paper, we identify methodological challenges specific to the design, conduct and reporting of pediatric systematic reviews, and propose a process to address these challenges. One fundamental decision at the outset of a systematic review is whether to focus on a pediatric population only, or to include both adult and pediatric populations. Both from the policy and patient care point of view, the appropriateness of interventions and comparators administered to pre-defined pediatric age subgroup is critical. Decisions need to be based on the biological plausibility of differences in treatment effects across the developmental trajectory in children. Synthesis of evidence from different trials is often impaired by the use of outcomes and measurement instruments that differ between trials and are neither relevant nor validated in the pediatric population. Other issues specific to pediatric systematic reviews include lack of pediatric-sensitive search strategies and inconsistent choices of pediatric age subgroups in meta-analyses. In addition to these methodological issues generic to all pediatric systematic reviews, special considerations are required for reviews of health care interventions' safety and efficacy in neonatology, global health, comparative effectiveness interventions and individual participant data meta-analyses. To date, there is no standard approach available to overcome this problem. We propose to develop a consensus-based checklist of essential items which researchers should consider when they are planning (PRISMA-PC-Protocol for Children) or reporting (PRISMA-C-reporting for Children) a pediatric systematic review. Available guidelines including PRISMA do not cover the complexity associated with the conduct and reporting of systematic reviews in the pediatric population; they require additional and modified standards for reporting items. Such guidance will facilitate the translation of knowledge from the literature to bedside care and policy, thereby enhancing delivery of care and improving child health outcomes.

Basic priority rating model 2.0: current applications for priority setting in health promotion practice.

PubMed

Neiger, Brad L; Thackeray, Rosemary; Fagen, Michael C

2011-03-01

Priority setting is an important component of systematic planning in health promotion and also factors into the development of a comprehensive evaluation plan. The basic priority rating (BPR) model was introduced more than 50 years ago and includes criteria that should be considered in any priority setting approach (i.e., use of predetermined criteria, standardized comparisons, and a rubric that controls bias). Although the BPR model has provided basic direction in priority setting, it does not represent the broad array of data currently available to decision makers. Elements in the model also give more weight to the impact of communicable diseases compared with chronic diseases. For these reasons, several modifications are recommended to improve the BPR model and to better assist health promotion practitioners in the priority setting process. The authors also suggest a new name, BPR 2.0, to represent this revised model.

Hajj stampede disaster, 2015: Reflections from the frontlines.

PubMed

Khan, Anas A; Noji, Eric K

2016-01-01

The Hajj is an annual religious mass gathering that takes place in Makkah, Saudi Arabia. The complexity of its system is multidimensional, with religious, political, cultural, security, economic, communication, operational, and logistic unique challenges. This year, yet another stampede tragedy that caused around a 1,000 deaths and severe injuries, capturing worldwide media attention and exacerbating existing political tensions across the Gulf coasts was faced. Planning is important but the planning process is more important, requiring systematic analysis based on accurate collected and targeting root cause factors. Every year, the Hajj provides us with important knowledge and experience that will help preventing such events. This will only be possible if the initiative to extract all possible lessons learned are taken. The medical and public health community in Saudi Arabia must learn from other scientific fields where much more quantitative data-driven approach to identify problems and recommending solutions.

Design of Urban Public Spaces: Intent vs. Reality

PubMed Central

Martin, W. Mike; Stewart, Tom; Troelsen, Jens

2018-01-01

This study investigated how two public spaces for sport and recreation were utilized by different user groups, and how this aligned with the initial design objectives for these spaces. Two newly built urban spaces situated in Copenhagen, Denmark, provided the context for this investigation. The System for Observing Play and Recreation in Communities (SOPARC) was used to examine the physical activity of users in these two urban spaces. The architects responsible for designing each space were interviewed to ascertain the intended target group of each space and to unravel the reasons behind the design decisions. The SOPARC observations revealed that males were more vigorously active than females when using the recreation facilities, and the observed users did not align with the intended target groups. The interviews suggested that design decisions were based on minimal interdisciplinary knowledge, and that expert knowledge was chosen randomly. These findings point to a systematic lack of evidence-based practice when designing sport and recreational facilities. This article has implications for landscape architects and urban planners; a new method must be developed to embed interdisciplinary knowledge in the planning process of future sport and recreation projects. This must be done in a systematic way to make the design process transparent. PMID:29690509

Language barriers and qualitative nursing research: methodological considerations.

PubMed

Squires, A

2008-09-01

This review of the literature synthesizes methodological recommendations for the use of translators and interpreters in cross-language qualitative research. Cross-language qualitative research involves the use of interpreters and translators to mediate a language barrier between researchers and participants. Qualitative nurse researchers successfully address language barriers between themselves and their participants when they systematically plan for how they will use interpreters and translators throughout the research process. Experienced qualitative researchers recognize that translators can generate qualitative data through translation processes and by participating in data analysis. Failure to address language barriers and the methodological challenges they present threatens the credibility, transferability, dependability and confirmability of cross-language qualitative nursing research. Through a synthesis of the cross-language qualitative methods literature, this article reviews the basics of language competence, translator and interpreter qualifications, and roles for each kind of qualitative research approach. Methodological and ethical considerations are also provided. By systematically addressing the methodological challenges cross-language research presents, nurse researchers can produce better evidence for nursing practice and policy making when working across different language groups. Findings from qualitative studies will also accurately represent the experiences of the participants without concern that the meaning was lost in translation.

Language barriers and qualitative nursing research: methodological considerations

PubMed Central

Squires, A.

2009-01-01

Aim This review of the literature synthesizes methodological recommendations for the use of translators and interpreters in cross-language qualitative research. Background Cross-language qualitative research involves the use of interpreters and translators to mediate a language barrier between researchers and participants. Qualitative nurse researchers successfully address language barriers between themselves and their participants when they systematically plan for how they will use interpreters and translators throughout the research process. Experienced qualitative researchers recognize that translators can generate qualitative data through translation processes and by participating in data analysis. Failure to address language barriers and the methodological challenges they present threatens the credibility, transferability, dependability and confirmability of cross-language qualitative nursing research. Through a synthesis of the cross-language qualitative methods literature, this article reviews the basics of language competence, translator and interpreter qualifications, and roles for each kind of qualitative research approach. Methodological and ethical considerations are also provided. Conclusion By systematically addressing the methodological challenges cross-language research presents, nurse researchers can produce better evidence for nursing practice and policy making when working across different language groups. Findings from qualitative studies will also accurately represent the experiences of the participants without concern that the meaning was lost in translation. PMID:19522941

Forest communities and the Northwest Forest Plan: what socioeconomic monitoring can tell us.

Treesearch

Jonathan Thompson

2007-01-01

The Northwest Forest Plan (the Plan) was designed to balance protection of older forest ecosystems with mitigation of impacts on rural communities and economies. It was implemented by using an adaptive management approach that featured an interagency monitoring program. This program included socioeconomic monitoring—the systematic observation and measurement of a set...

APPLICATION OF DATA QUALITY OBJECTIVES AND MEASUREMENT QUALITY OBJECTIVES TO RESEARCH PROJECTS

EPA Science Inventory

The paper assists systematic planning for research projects. It presents planning concepts in terms that have some utility for researchers. For example, measurement quality objectives are more familiar to researchers than data quality objectives because these quality criteria are...

A Step-by-Step Framework on Discrete Events Simulation in Emergency Department; A Systematic Review.

PubMed

Dehghani, Mahsa; Moftian, Nazila; Rezaei-Hachesu, Peyman; Samad-Soltani, Taha

2017-04-01

To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department. For the purpose of collecting the data, PubMed and ACM databases were used between the years 2003 and 2013. The inclusion criteria were to select English-written articles available in full text with the closest objectives from among a total of 54 articles retrieved from the databases. Subsequently, 11 articles were selected for further analysis. The studies focused on the reduction of waiting time and patient stay, optimization of resources allocation, creation of crisis and maximum demand scenarios, identification of overcrowding bottlenecks, investigation of the impact of other systems on the existing system, and improvement of the system operations and functions. Subsequently, 10 simulation steps were derived from the relevant studies after an expert's evaluation. The 10-steps approach proposed on the basis of the selected studies provides simulation and planning specialists with a structured method for both analyzing problems and choosing best-case scenarios. Moreover, following this framework systematically enables the development of design processes as well as software implementation of simulation problems.

Systematic review of the application of quality improvement methodologies from the manufacturing industry to surgical healthcare.

PubMed

Nicolay, C R; Purkayastha, S; Greenhalgh, A; Benn, J; Chaturvedi, S; Phillips, N; Darzi, A

2012-03-01

The demand for the highest-quality patient care coupled with pressure on funding has led to the increasing use of quality improvement (QI) methodologies from the manufacturing industry. The aim of this systematic review was to identify and evaluate the application and effectiveness of these QI methodologies to the field of surgery. MEDLINE, the Cochrane Database, Allied and Complementary Medicine Database, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Embase, Health Business(™) Elite, the Health Management Information Consortium and PsycINFO(®) were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Empirical studies were included that implemented a described QI methodology to surgical care and analysed a named outcome statistically. Some 34 of 1595 articles identified met the inclusion criteria after consensus from two independent investigators. Nine studies described continuous quality improvement (CQI), five Six Sigma, five total quality management (TQM), five plan-do-study-act (PDSA) or plan-do-check-act (PDCA) cycles, five statistical process control (SPC) or statistical quality control (SQC), four Lean and one Lean Six Sigma; 20 of the studies were undertaken in the USA. The most common aims were to reduce complications or improve outcomes (11), to reduce infection (7), and to reduce theatre delays (7). There was one randomized controlled trial. QI methodologies from industry can have significant effects on improving surgical care, from reducing infection rates to increasing operating room efficiency. The evidence is generally of suboptimal quality, and rigorous randomized multicentre studies are needed to bring evidence-based management into the same league as evidence-based medicine. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

What factors influence time-use of occupational therapists in the workplace? A systematic review.

PubMed

Summers, Bianca E; Laver, Kate E; Nicks, Rebecca J; Lannin, Natasha A

2018-06-01

Health-care expenditure is rapidly increasing in Australia with increasing pressure on health-care services to review processes, improve efficiency and ensure equity in service delivery. The nursing profession have improved efficiency and patient care by investigating time-use to describe current practice and support development of workforce planning models. There is, however, a lack of information to understand factors that impact on occupational therapists time-use in the clinical setting impacting the development of workforce planning models which adapt occupational therapy service delivery to match resources with demand. The objective of this review was to systematically identify known factors which impact on occupational therapists time-use in the clinical setting. A systematic review of Medline, PsycINFO and CINAHL databases and grey literature was completed in September 2016. Two authors independently screened studies for inclusion and quality was evaluated using the Downs and Black scale. Variables impacting on occupational therapists time-use were categorised and thematically analysed to synthesise key themes. Twenty studies met the inclusion criteria and were included in the review. Three key categories of factors influencing time-use were identified. These were: patient-related factors (e.g. level of function, therapy required, type, complexity of injury), therapist-related factors (e.g. experience, clinical vs non-clinical responsibility), and organisational-related factors (e.g. workplace characteristics, availability of staff, presence of students). Occupational therapist time-use in clinical settings is complex and difficult to quantify in research. How occupational therapists spend their time is impacted by a number of patient, clinician and service related factors reflecting the breadth of occupational therapy practice and client-centred nature of the profession. © 2018 Occupational Therapy Australia.

Defining conservation priorities for freshwater fishes according to taxonomic, functional, and phylogenetic diversity

USGS Publications Warehouse

Strecker, A.L.; Olden, J.D.; Whittier, Joanna B.; Paukert, C.P.

2011-01-01

To date, the predominant use of systematic conservation planning has been to evaluate and conserve areas of high terrestrial biodiversity. Although studies in freshwater ecosystems have received recent attention, research has rarely considered the potential tradeoffs between protecting different dimensions of biodiversity and the ecological processes that maintain diversity. We provide the first systematic prioritization for freshwaters (focusing on the highly threatened and globally distinct fish fauna of the Lower Colorado River Basin, USA) simultaneously considering scenarios of: taxonomic, functional, and phylogenetic diversity;contemporary threats to biodiversity (including interactions with nonnative species);and future climate change and human population growth. There was 75% congruence between areas of highest conservation priority for different aspects of biodiversity, suggesting that conservation efforts can concurrently achieve strong complementarity among all types of diversity. However, sizable fractions of the landscape were incongruent across conservation priorities for different diversity scenarios, underscoring the importance of considering multiple dimensions of biodiversity and highlighting catchments that contribute disproportionately to taxonomic, functional, and phylogenetic diversity in the region. Regions of projected human population growth were not concordant with conservation priorities;however, higher human population abundance will likely have indirect effects on native biodiversity by increasing demand for water. This will come in direct conflict with projected reductions in precipitation and warmer temperatures, which have substantial overlap with regions of high contemporary diversity. Native and endemic fishes in arid ecosystems are critically endangered by both current and future threats, but our results highlight the use of systematic conservation planning for the optimal allocation of limited resources that incorporates multiple and complementary conservation values describing taxonomic, functional, and phylogenetic diversity. ??2011 by the Ecological Society of America.

Defining conservation priorities for freshwater fishes according to taxonomic, functional, and phylogenetic diversity

USGS Publications Warehouse

Strecker, Angela L.; Olden, Julian D.; Whittier, Joanna B.; Paukert, Craig P.

2011-01-01

To date, the predominant use of systematic conservation planning has been to evaluate and conserve areas of high terrestrial biodiversity. Although studies in freshwater ecosystems have received recent attention, research has rarely considered the potential trade-offs between protecting different dimensions of biodiversity and the ecological processes that maintain diversity. We provide the first systematic prioritization for freshwaters (focusing on the highly threatened and globally distinct fish fauna of the Lower Colorado River Basin, USA) simultaneously considering scenarios of: taxonomic, functional, and phylogenetic diversity; contemporary threats to biodiversity (including interactions with nonnative species); and future climate change and human population growth. There was 75% congruence between areas of highest conservation priority for different aspects of biodiversity, suggesting that conservation efforts can concurrently achieve strong complementarity among all types of diversity. However, sizable fractions of the landscape were incongruent across conservation priorities for different diversity scenarios, underscoring the importance of considering multiple dimensions of biodiversity and highlighting catchments that contribute disproportionately to taxonomic, functional, and phylogenetic diversity in the region. Regions of projected human population growth were not concordant with conservation priorities; however, higher human population abundance will likely have indirect effects on native biodiversity by increasing demand for water. This will come in direct conflict with projected reductions in precipitation and warmer temperatures, which have substantial overlap with regions of high contemporary diversity. Native and endemic fishes in arid ecosystems are critically endangered by both current and future threats, but our results highlight the use of systematic conservation planning for the optimal allocation of limited resources that incorporates multiple and complementary conservation values describing taxonomic, functional, and phylogenetic diversity.

What works in family planning interventions: A systematic review of the evidence

PubMed Central

Mwaikambo, Lisa; Speizer, Ilene S.; Schurmann, Anna; Morgan, Gwen; Fikree, Fariyal

2013-01-01

This study presents findings from a systematic review of evaluations of family planning interventions published between 1995 and 2008. Studies that used an experimental or quasi-experimental design or had another way to attribute program exposure to observed changes in fertility or family planning outcomes at the individual or population levels were included and ranked by strength of evidence. A total of 63 studies were found that met the inclusion criteria. The findings from this review are summarized in tabular format by the type of intervention (classified as supply-side or demand-side). About two-thirds of the studies found were on demand generation type-programs. Findings from all programs revealed significant improvements in knowledge, attitudes, discussion, and intentions. Program impacts on contraceptive use and use of family planning services were less consistently found and less than half of the studies that measured fertility or pregnancy-related outcomes found an impact. Based on the review findings, we identify promising programmatic approaches and propose directions for future evaluation research of family planning interventions. PMID:21834409

Quality-assurance plan for water-resources activities of the U.S. Geological Survey in Idaho

USGS Publications Warehouse

Packard, F.A.

1996-01-01

To ensure continued confidence in its products, the Water Resources Division of the U.S. Geological Survey implemented a policy that all its scientific work be performed in accordance with a centrally managed quality-assurance program. This report establishes and documents a formal policy for current (1995) quality assurance within the Idaho District of the U.S. Geological Survey. Quality assurance is formalized by describing district organization and operational responsibilities, documenting the district quality-assurance policies, and describing district functions. The districts conducts its work through offices in Boise, Idaho Falls, Twin Falls, Sandpoint, and at the Idaho National Engineering Laboratory. Data-collection programs and interpretive studies are conducted by two operating units, and operational and technical assistance is provided by three support units: (1) Administrative Services advisors provide guidance on various personnel issues and budget functions, (2) computer and reports advisors provide guidance in their fields, and (3) discipline specialists provide technical advice and assistance to the district and to chiefs of various projects. The district's quality-assurance plan is based on an overall policy that provides a framework for defining the precision and accuracy of collected data. The plan is supported by a series of quality-assurance policy statements that describe responsibilities for specific operations in the district's program. The operations are program planning; project planning; project implementation; review and remediation; data collection; equipment calibration and maintenance; data processing and storage; data analysis, synthesis, and interpretation; report preparation and processing; and training. Activities of the district are systematically conducted under a hierarchy of supervision an management that is designed to ensure conformance with Water Resources Division goals quality assurance. The district quality-assurance plan does not describe detailed technical activities that are commonly termed "quality-control procedures." Instead, it focuses on current policies, operations, and responsibilities that are implemented at the management level. Contents of the plan will be reviewed annually and updated as programs and operations change.

Protocol for a systematic review on the effect of demand generation interventions on uptake and use of modern contraceptives in LMIC.

PubMed

Belaid, Loubna; Dumont, Alexandre; Chaillet, Nils; De Brouwere, Vincent; Zertal, Amel; Hounton, Sennen; Ridde, Valéry

2015-09-28

Despite a global increase in contraception use, its prevalence remains low in low- and middle-income countries. One strategy to improve uptake and use of contraception, as an essential complement to policies and supply-side interventions, is demand generation. Demand generation interventions have reportedly produced positive effects on uptake and use of family planning services, but the evidence base remains poorly documented. To reduce this knowledge gap, we will conduct a systematic review on the impact of demand generation interventions on the use of modern contraception. The objectives of the review will be as follows: (1) to synthesize evidence on the impacts and costs of family planning demand generation interventions and on their effectiveness in improving modern contraceptive use and (2) to identify the indicators used to assess effectiveness, cost-effectiveness, and impacts of demand generation interventions. We will systematically review the public health and health promotion literature in several databases (e.g., CINAHL, Medline, EMBASE) as well as gray literature. We will select articles from 1970 to 2015, in French and in English. The review will include studies that assess the impact of family planning programs or interventions on changes in contraception use. The studied interventions will be those with a demand generation component, even if a supply component is implemented. Two members of the team will independently search, screen, extract data, and assess the quality of the studies selected. Different tools will be used to assess the quality of the studies depending on the study design. If appropriate, a meta-analysis will be conducted. The analysis will involve comparing odd ratios (OR) DISCUSSION: The systematic review results will be disseminated to United Nations Population Fund program countries and will contribute to the development of a guidance document and programmatic tools for planning, implementing, and evaluating demand generation interventions in family planning. Improving the effectiveness of family planning programs is critical for empowering women and adolescent girls, improving human capital, reducing dependency ratios, reducing maternal and child mortality, and achieving demographic dividends in low- and middle-income countries. This protocol is registered in PROSPERO (CRD 42015017549).

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

Yu, Juan; Beltran, Chris J., E-mail: beltran.chris@mayo.edu; Herman, Michael G.

Purpose: To quantitatively and systematically assess dosimetric effects induced by spot positioning error as a function of spot spacing (SS) on intensity-modulated proton therapy (IMPT) plan quality and to facilitate evaluation of safety tolerance limits on spot position. Methods: Spot position errors (PE) ranging from 1 to 2 mm were simulated. Simple plans were created on a water phantom, and IMPT plans were calculated on two pediatric patients with a brain tumor of 28 and 3 cc, respectively, using a commercial planning system. For the phantom, a uniform dose was delivered to targets located at different depths from 10 tomore » 20 cm with various field sizes from 2{sup 2} to 15{sup 2} cm{sup 2}. Two nominal spot sizes, 4.0 and 6.6 mm of 1 σ in water at isocenter, were used for treatment planning. The SS ranged from 0.5 σ to 1.5 σ, which is 2–6 mm for the small spot size and 3.3–9.9 mm for the large spot size. Various perturbation scenarios of a single spot error and systematic and random multiple spot errors were studied. To quantify the dosimetric effects, percent dose error (PDE) depth profiles and the value of percent dose error at the maximum dose difference (PDE [ΔDmax]) were used for evaluation. Results: A pair of hot and cold spots was created per spot shift. PDE[ΔDmax] is found to be a complex function of PE, SS, spot size, depth, and global spot distribution that can be well defined in simple models. For volumetric targets, the PDE [ΔDmax] is not noticeably affected by the change of field size or target volume within the studied ranges. In general, reducing SS decreased the dose error. For the facility studied, given a single spot error with a PE of 1.2 mm and for both spot sizes, a SS of 1σ resulted in a 2% maximum dose error; a SS larger than 1.25 σ substantially increased the dose error and its sensitivity to PE. A similar trend was observed in multiple spot errors (both systematic and random errors). Systematic PE can lead to noticeable hot spots along the field edges, which may be near critical structures. However, random PE showed minimal dose error. Conclusions: Dose error dependence for PE was quantitatively and systematically characterized and an analytic tool was built to simulate systematic and random errors for patient-specific IMPT. This information facilitates the determination of facility specific spot position error thresholds.« less

A Framework for Ethical Decision Making in the Rehabilitation of Patients with Anosognosia.

PubMed

Egbert, Anna Rita

2017-01-01

Currently, the number of patients diagnosed with impaired self-awareness of their own deficits after brain injury-anosognosia-is increasing. One reason is a growing understanding of this multifaceted phenomenon. Another is the development and accessibility of alternative measurements that allow more detailed diagnoses. Anosognosia can adversely affect successful rehabilitation, as often patients lack confidence in the need for treatment. Planning such treatment can become a complex process full of ethical dilemmas. To date, there is no systematic way to deal with different aspects of anosognosia rehabilitation planning. This is the first article to present a framework for ethical decision making in establishing rehabilitation plans that are focused on increasing patients' self-awareness of their own deficits after brain injury. It concentrates especially on addressing the ethical dilemmas that may arise, and describes stepwise procedures that can be applied to distinct theoretical approaches, as well as diagnostic and rehabilitation methods. To show the flexibility of the use of this framework, alternative approaches are discussed. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

[Valid liability law in surgery. Principles of legal requirements and clinical benchmarks exemplified by visceral surgery].

PubMed

Theuer, D; Dillschneider, J; Mieth, M; Büchler, M W

2012-01-01

The spectacular increase in liability processes in the field of surgery and in particular in visceral surgery, necessitates an objectification of the conflict between surgical medical professionals and medico-legal institutions, firms of solicitors and courts. Out of court settlements assisted by expert opinion commissions of the Medical Council can avoid many legal conflicts. For improvement of the legal standpoint of a defendant medical professional an unambiguous, extensive and detailed documentation of medical examination findings, the indications for the planned operative intervention, extensive and detailed documentation on disclosure and informed consent of the patient for the planned operative intervention, an extensive, detailed careful and responsibly guided report of the operation as well as a systematic, orderly well-planned postoperative complication management are necessary to counter the accusation of an organizational failure of medical professionals and the accused hospital. The mutual building of confidence between surgical medical professionals and legal institutions is safeguarded by a comprehensive documentation and an unambiguous description and formulation of the medical discharge report on termination of inpatient treatment.

A Sampling Based Approach to Spacecraft Autonomous Maneuvering with Safety Specifications

NASA Technical Reports Server (NTRS)

Starek, Joseph A.; Barbee, Brent W.; Pavone, Marco

2015-01-01

This paper presents a methods for safe spacecraft autonomous maneuvering that leverages robotic motion-planning techniques to spacecraft control. Specifically the scenario we consider is an in-plan rendezvous of a chaser spacecraft in proximity to a target spacecraft at the origin of the Clohessy Wiltshire Hill frame. The trajectory for the chaser spacecraft is generated in a receding horizon fashion by executing a sampling based robotic motion planning algorithm name Fast Marching Trees (FMT) which efficiently grows a tree of trajectories over a set of probabillistically drawn samples in the state space. To enforce safety the tree is only grown over actively safe samples for which there exists a one-burn collision avoidance maneuver that circularizes the spacecraft orbit along a collision-free coasting arc and that can be executed under potential thrusters failures. The overall approach establishes a provably correct framework for the systematic encoding of safety specifications into the spacecraft trajectory generations process and appears amenable to real time implementation on orbit. Simulation results are presented for a two-fault tolerant spacecraft during autonomous approach to a single client in Low Earth Orbit.

Quasi-experimental study designs series-paper 12: strengthening global capacity for evidence synthesis of quasi-experimental health systems research.

PubMed

Rockers, Peter C; Tugwell, Peter; Grimshaw, Jeremy; Oliver, Sandy; Atun, Rifat; Røttingen, John-Arne; Fretheim, Atle; Ranson, M Kent; Daniels, Karen; Luiza, Vera Lucia; Bärnighausen, Till

2017-09-01

Evidence from quasi-experimental studies is often excluded from systematic reviews of health systems research despite the fact that such studies can provide strong causal evidence when well conducted. This article discusses global coordination of efforts to institutionalize the inclusion of causal evidence from quasi-experiments in systematic reviews of health systems research. In particular, we are concerned with identifying opportunities for strengthening capacity at the global and local level for implementing protocols necessary to ensure that reviews that include quasi-experiments are consistently of the highest quality. We first describe the current state of the global infrastructure that facilitates the production of systematic reviews of health systems research. We identify five important types of actors operating within this infrastructure: review authors; synthesis collaborations that facilitate the review process; synthesis interest groups that supplement the work of the larger collaborations; review funders; and end users, including policymakers. Then, we examine opportunities for intervening to build the capacity of each type of actors to support the inclusion of quasi-experiments in reviews. Finally, we suggest practical next steps for proceeding with capacity building efforts. Because of the complexity and relative nascence of the field, we recommend a carefully planned and executed approach to strengthening global capacity for the inclusion of quasi-experimental studies in systematic reviews. Copyright © 2017 Elsevier Inc. All rights reserved.

How experimental biology and ecology can support evidence-based decision-making in conservation: avoiding pitfalls and enabling application.

PubMed

Cooke, Steven J; Birnie-Gauvin, Kim; Lennox, Robert J; Taylor, Jessica J; Rytwinski, Trina; Rummer, Jodie L; Franklin, Craig E; Bennett, Joseph R; Haddaway, Neal R

2017-01-01

Policy development and management decisions should be based upon the best available evidence. In recent years, approaches to evidence synthesis, originating in the medical realm (such as systematic reviews), have been applied to conservation to promote evidence-based conservation and environmental management. Systematic reviews involve a critical appraisal of evidence, but studies that lack the necessary rigour (e.g. experimental, technical and analytical aspects) to justify their conclusions are typically excluded from systematic reviews or down-weighted in terms of their influence. One of the strengths of conservation physiology is the reliance on experimental approaches that help to more clearly establish cause-and-effect relationships. Indeed, experimental biology and ecology have much to offer in terms of building the evidence base that is needed to inform policy and management options related to pressing issues such as enacting endangered species recovery plans or evaluating the effectiveness of conservation interventions. Here, we identify a number of pitfalls that can prevent experimental findings from being relevant to conservation or would lead to their exclusion or down-weighting during critical appraisal in a systematic review. We conclude that conservation physiology is well positioned to support evidence-based conservation, provided that experimental designs are robust and that conservation physiologists understand the nuances associated with informing decision-making processes so that they can be more relevant.

How experimental biology and ecology can support evidence-based decision-making in conservation: avoiding pitfalls and enabling application

PubMed Central

Birnie-Gauvin, Kim; Lennox, Robert J.; Taylor, Jessica J.; Rytwinski, Trina; Rummer, Jodie L.; Franklin, Craig E.; Bennett, Joseph R.; Haddaway, Neal R.

2017-01-01

Abstract Policy development and management decisions should be based upon the best available evidence. In recent years, approaches to evidence synthesis, originating in the medical realm (such as systematic reviews), have been applied to conservation to promote evidence-based conservation and environmental management. Systematic reviews involve a critical appraisal of evidence, but studies that lack the necessary rigour (e.g. experimental, technical and analytical aspects) to justify their conclusions are typically excluded from systematic reviews or down-weighted in terms of their influence. One of the strengths of conservation physiology is the reliance on experimental approaches that help to more clearly establish cause-and-effect relationships. Indeed, experimental biology and ecology have much to offer in terms of building the evidence base that is needed to inform policy and management options related to pressing issues such as enacting endangered species recovery plans or evaluating the effectiveness of conservation interventions. Here, we identify a number of pitfalls that can prevent experimental findings from being relevant to conservation or would lead to their exclusion or down-weighting during critical appraisal in a systematic review. We conclude that conservation physiology is well positioned to support evidence-based conservation, provided that experimental designs are robust and that conservation physiologists understand the nuances associated with informing decision-making processes so that they can be more relevant. PMID:28835842

Saving Material with Systematic Process Designs

NASA Astrophysics Data System (ADS)

Kerausch, M.

2011-08-01

Global competition is forcing the stamping industry to further increase quality, to shorten time-to-market and to reduce total cost. Continuous balancing between these classical time-cost-quality targets throughout the product development cycle is required to ensure future economical success. In today's industrial practice, die layout standards are typically assumed to implicitly ensure the balancing of company specific time-cost-quality targets. Although die layout standards are a very successful approach, there are two methodical disadvantages. First, the capabilities for tool design have to be continuously adapted to technological innovations; e.g. to take advantage of the full forming capability of new materials. Secondly, the great variety of die design aspects have to be reduced to a generic rule or guideline; e.g. binder shape, draw-in conditions or the use of drawbeads. Therefore, it is important to not overlook cost or quality opportunities when applying die design standards. This paper describes a systematic workflow with focus on minimizing material consumption. The starting point of the investigation is a full process plan for a typical structural part. All requirements are definedaccording to a predefined set of die design standards with industrial relevance are fulfilled. In a first step binder and addendum geometry is systematically checked for material saving potentials. In a second step, blank shape and draw-in are adjusted to meet thinning, wrinkling and springback targets for a minimum blank solution. Finally the identified die layout is validated with respect to production robustness versus splits, wrinkles and springback. For all three steps the applied methodology is based on finite element simulation combined with a stochastical variation of input variables. With the proposed workflow a well-balanced (time-cost-quality) production process assuring minimal material consumption can be achieved.

Provider Perspectives on Advance Care Planning for Patients with Kidney Disease: Whose Job Is It Anyway?

PubMed Central

Szarka, Jackie; McFarland, Lynne V.; Taylor, Janelle S.; Sudore, Rebecca L.; Trivedi, Ranak; Reinke, Lynn F.; Vig, Elizabeth K.

2016-01-01

Background and objectives There is growing interest in efforts to enhance advance care planning for patients with kidney disease. Our goal was to elicit the perspectives on advance care planning of multidisciplinary providers who care for patients with advanced kidney disease. Design, setting, participants, & measurements Between April and December of 2014, we conducted semistructured interviews at the Department of Veterans Affairs Puget Sound Health Care System with 26 providers from a range of disciplines and specialties who care for patients with advanced kidney disease. Participants were asked about their perspectives and experiences related to advance care planning in this population. Interviews were audiotaped, transcribed, and analyzed inductively using grounded theory. Results The comments of providers interviewed for this study spoke to significant system–level barriers to supporting the process of advance care planning for patients with advanced kidney disease. We identified four overlapping themes: (1) medical care for this population is complex and fragmented across settings and providers and over time; (2) lack of a shared understanding and vision of advance care planning and its relationship with other aspects of care, such as dialysis decision making; (3) unclear locus of responsibility and authority for advance care planning; and (4) lack of active collaboration and communication around advance care planning among different providers caring for the same patients. Conclusions The comments of providers who care for patients with advanced kidney disease spotlight both the need for and the challenges to interdisciplinary collaboration around advance care planning for this population. Systematic efforts at a variety of organizational levels will likely be needed to support teamwork around advance care planning among the different providers who care for patients with advanced kidney disease. PMID:27084877

Provider Perspectives on Advance Care Planning for Patients with Kidney Disease: Whose Job Is It Anyway?

PubMed

O'Hare, Ann M; Szarka, Jackie; McFarland, Lynne V; Taylor, Janelle S; Sudore, Rebecca L; Trivedi, Ranak; Reinke, Lynn F; Vig, Elizabeth K

2016-05-06

There is growing interest in efforts to enhance advance care planning for patients with kidney disease. Our goal was to elicit the perspectives on advance care planning of multidisciplinary providers who care for patients with advanced kidney disease. Between April and December of 2014, we conducted semistructured interviews at the Department of Veterans Affairs Puget Sound Health Care System with 26 providers from a range of disciplines and specialties who care for patients with advanced kidney disease. Participants were asked about their perspectives and experiences related to advance care planning in this population. Interviews were audiotaped, transcribed, and analyzed inductively using grounded theory. The comments of providers interviewed for this study spoke to significant system-level barriers to supporting the process of advance care planning for patients with advanced kidney disease. We identified four overlapping themes: (1) medical care for this population is complex and fragmented across settings and providers and over time; (2) lack of a shared understanding and vision of advance care planning and its relationship with other aspects of care, such as dialysis decision making; (3) unclear locus of responsibility and authority for advance care planning; and (4) lack of active collaboration and communication around advance care planning among different providers caring for the same patients. The comments of providers who care for patients with advanced kidney disease spotlight both the need for and the challenges to interdisciplinary collaboration around advance care planning for this population. Systematic efforts at a variety of organizational levels will likely be needed to support teamwork around advance care planning among the different providers who care for patients with advanced kidney disease. Copyright © 2016 by the American Society of Nephrology.

Designing large-scale conservation corridors for pattern and process.

PubMed

Rouget, Mathieu; Cowling, Richard M; Lombard, Amanda T; Knight, Andrew T; Kerley, Graham I H

2006-04-01

A major challenge for conservation assessments is to identify priority areas that incorporate biological patterns and processes. Because large-scale processes are mostly oriented along environmental gradients, we propose to accommodate them by designing regional-scale corridors to capture these gradients. Based on systematic conservation planning principles such as representation and persistence, we identified large tracts of untransformed land (i.e., conservation corridors) for conservation that would achieve biodiversity targets for pattern and process in the Subtropical Thicket Biome of South Africa. We combined least-cost path analysis with a target-driven algorithm to identify the best option for capturing key environmental gradients while considering biodiversity targets and conservation opportunities and constraints. We identified seven conservation corridors on the basis of subtropical thicket representation, habitat transformation and degradation, wildlife suitability, irreplaceability of vegetation types, protected area networks, and future land-use pressures. These conservation corridors covered 21.1% of the planning region (ranging from 600 to 5200 km2) and successfully achieved targets for biological processes and to a lesser extent for vegetation types. The corridors we identified are intended to promote the persistence of ecological processes (gradients and fixed processes) and fulfill half of the biodiversity pattern target. We compared the conservation corridors with a simplified corridor design consisting of a fixed-width buffer along major rivers. Conservation corridors outperformed river buffers in seven out of eight criteria. Our corridor design can provide a tool for quantifying trade-offs between various criteria (biodiversity pattern and process, implementation constraints and opportunities). A land-use management model was developed to facilitate implementation of conservation actions within these corridors.

Development and evaluation of 'briefing notes' as a novel knowledge translation tool to aid the implementation of sex/gender analysis in systematic reviews: a pilot study.

PubMed

Doull, Marion; Welch, Vivian; Puil, Lorri; Runnels, Vivien; Coen, Stephanie E; Shea, Beverley; O'Neill, Jennifer; Borkhoff, Cornelia; Tudiver, Sari; Boscoe, Madeline

2014-01-01

There is increasing recognition of sex/gender differences in health and the importance of identifying differential effects of interventions for men and women. Yet, to whom the research evidence does or does not apply, with regard to sex/gender, is often insufficiently answered. This is also true for systematic reviews which synthesize results of primary studies. A lack of analysis and reporting of evidence on sex/gender raises concerns about the applicability of systematic reviews. To bridge this gap, this pilot study aimed to translate knowledge about sex/gender analysis (SGA) into a user-friendly 'briefing note' format and evaluate its potential in aiding the implementation of SGA in systematic reviews. Our Sex/Gender Methods Group used an interactive process to translate knowledge about sex/gender into briefing notes, a concise communication tool used by policy and decision makers. The briefing notes were developed in collaboration with three Cochrane Collaboration review groups (HIV/AIDS, Hypertension, and Musculoskeletal) who were also the target knowledge users of the briefing notes. Briefing note development was informed by existing systematic review checklists, literature on sex/gender, in-person and virtual meetings, and consultation with topic experts. Finally, we held a workshop for potential users to evaluate the notes. Each briefing note provides tailored guidance on considering sex/gender to reviewers who are planning or conducting systematic reviews and includes the rationale for considering sex/gender, with examples specific to each review group's focus. Review authors found that the briefing notes provided welcome guidance on implementing SGA that was clear and concise, but also identified conceptual and implementation challenges. Sex/gender briefing notes are a promising knowledge translation tool. By encouraging sex/gender analysis and equity considerations in systematic reviews, the briefing notes can assist systematic reviewers in ensuring the applicability of research evidence, with the goal of improved health outcomes for diverse populations.

Planning and Assessing To Improve Campus-Community Engagement.

ERIC Educational Resources Information Center

Bringle, Robert G.; Hatcher, Julie; Hamilton, Sharon; Young, Peter

2001-01-01

Presents two methods for assessing the scholarship of engagement at the institutional level: (1) Comprehensive Assessment of the Scholarship of Engagement (CASE), a systematic method that compiles information about service learning and community engagement, identifies campus strengths, and prioritizes planning areas; and (2) an institutional…

49 CFR 633.25 - Contents of a project management plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

...; (e) A change order procedure which includes a documented, systematic approach to the handling of... covering the project management organization, appropriate consultants, property acquisition, utility... 49 Transportation 7 2011-10-01 2011-10-01 false Contents of a project management plan. 633.25...

Integrating Risk Management and Strategic Planning

ERIC Educational Resources Information Center

Achampong, Francis K.

2010-01-01

Strategic planning is critical to ensuring that institutions of higher education thoughtfully and systematically position themselves to accomplish their mission, vision, and strategic goals, particularly when these institutions face a myriad of risks that can negatively impact their continued financial viability and compromise their ability to…

Costs of integrating economics and conservation planning.

PubMed

Arponen, Anni; Cabeza, Mar; Eklund, Johanna; Kujala, Heini; Lehtomäki, Joona

2010-10-01

Recent literature on systematic conservation planning has focused strongly on economics. It is a necessary component of efficient conservation planning because the question is about effective resource allocation. Nevertheless, there is an increasing tendency toward economic factors overriding biological considerations. Focusing too narrowly on economic cost may lead us back toward solutions resembling those obtained by opportunistic choice of areas, the avoidance of which was the motivation for development of systematic approaches. Moreover, there are many overlooked difficulties in incorporating economic considerations reliably into conservation planning because available economic data and the free market are complex. For instance, economies based on free markets tend to be shortsighted, whereas biodiversity conservation aims far into the future. Although economic data are necessary, they should not be relied on too heavily or considered separately from other sociopolitical factors. We suggest focusing on development of more-comprehensive ecological-economic modeling, while not forgetting the importance of purely biological analyses that are needed as a point of reference for evaluating conservation outcomes. © 2010 Society for Conservation Biology.

Multi-criteria decision model for retrofitting existing buildings

NASA Astrophysics Data System (ADS)

Bostenaru Dan, M. D.

2004-08-01

Decision is an element in the risk management process. In this paper the way how science can help in decision making and implementation for retrofitting buildings in earthquake prone urban areas is investigated. In such interventions actors from various spheres are involved. Their interests range among minimising the intervention for maximal preservation or increasing it for seismic safety. Research was conducted to see how to facilitate collaboration between these actors. A particular attention was given to the role of time in actors' preferences. For this reason, on decision level, both the processural and the personal dimension of risk management, the later seen as a task, were considered. A systematic approach was employed to determine the functional structure of a participative decision model. Three layers on which actors implied in this multi-criteria decision problem interact were identified: town, building and element. So-called 'retrofit elements' are characteristic bearers in the architectural survey, engineering simulations, costs estimation and define the realms perceived by the inhabitants. This way they represent an interaction basis for the interest groups considered in a deeper study. Such orientation means for actors' interaction were designed on other levels of intervention as well. Finally, an 'experiment' for the implementation of the decision model is presented: a strategic plan for an urban intervention towards reduction of earthquake hazard impact through retrofitting. A systematic approach proves thus to be a very good communication basis among the participants in the seismic risk management process. Nevertheless, it can only be applied in later phases (decision, implementation, control) only, since it serves verifying and improving solution and not developing the concept. The 'retrofit elements' are a typical example of the detailing degree reached in the retrofit design plans in these phases.

The impact of financial incentives on the implementation of asthma or diabetes self-management: A systematic review.

PubMed

Jackson, Tracy; Shields, Michael D; Heaney, Liam G; Kendall, Marilyn; Pearce, Christina J; Hui, Chi Yan; Pinnock, Hilary

2017-01-01

Financial incentives are utilised in healthcare systems in a number of countries to improve quality of care delivered to patients by rewarding practices or practitioners for achieving set targets. To systematically review the evidence investigating the impact of financial incentives for implementation of supported self-management on quality of care including: organisational process outcomes, individual behavioural outcomes, and health outcomes for individuals with asthma or diabetes; both conditions with an extensive evidence base for self-management. We followed Cochrane methodology, using a PICOS search strategy to search eight databases in November 2015 (updated May 2017) including a broad range of implementation methodologies. Studies were weighted by robustness of methodology, number of participants and the quality score. We used narrative synthesis due to heterogeneity of studies. We identified 2,541 articles; 12 met our inclusion criteria. The articles were from the US (n = 7), UK (n = 4) and Canada (n = 1). Measured outcomes were HbA1c tests undertaken and/or the level achieved (n = 10), written action plans for asthma (n = 1) and hospital/emergency department visits (n = 1). Three of the studies were part of a larger incentive scheme including many conditions; one focused on asthma; eight focussed on diabetes. In asthma, the proportion receiving 'perfect care' (including providing a written action plan) increased from 4% to 88% in one study, and there were fewer hospitalisations/emergency department visits in another study. Across the diabetes studies, quality-of-care/GP performance scores improved in three, were unchanged in six and deteriorated in one. Results for the impact of financial incentives for the implementation of self-management were mixed. The evidence in diabetes suggests no consistent impact on diabetic control. There was evidence from a single study of improved process and health outcomes in asthma. Further research is needed to confirm these findings and understand the process by which financial incentives may impact (or not) on care. Protocol registration number: CRD42016027411.

Impacts of structuring nursing records: a systematic review.

PubMed

Saranto, Kaija; Kinnunen, Ulla-Mari; Kivekäs, Eija; Lappalainen, Anna-Mari; Liljamo, Pia; Rajalahti, Elina; Hyppönen, Hannele

2014-12-01

The study aims to describe the impacts of different data structuring methods used in nursing records or care plans. This systematic review examines what kinds of structuring methods have been evaluated and the effects of data structures on healthcare input, processes and outcomes in previous studies. Retrieval from 15 databases yielded 143 papers. Based on Population (Participants), Intervention, Comparators, Outcomes elements and exclusion and inclusion criteria, the search produced 61 studies. A data extraction tool and analysis for empirical articles were used to classify the data referring to the study aim. Thirty-eight studies were included in the final analysis. The study design most often used was a single measurement without any control. The studies were conducted mostly in secondary or tertiary care in institutional care contexts. The standards used in documentation were nursing classifications or the nursing process model in clinical use. The use of standardised nursing language (SNL) increased descriptions of nursing interventions and outcomes supporting daily care, and improving patient safety and information reuse. The nursing process model and classifications are used internationally as nursing data structures in nursing records and care plans. The use of SNL revealed various positive impacts. Unexpected outcomes were most often related to lack of resources. Indexing of SNL studies has not been consistent. That might cause bias in database retrieval, and important articles may be lacking. The study design of the studies analysed varied widely. Further, the time frame of papers was quite long, causing confusion in descriptions of nursing data structures. The value of SNL is proven by its support of daily workflow, delivery of nursing care and data reuse. This facilitates continuity of care, thus contributing to patient safety. Nurses need more education and managerial support in order to be able to benefit from SNL. © 2013 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Addressing diversity and moving toward equity in hospital care.

PubMed

Cordova, Richard D; Beaudin, Christy L; Iwanabe, Kelly E

2010-01-01

Healthcare disparities are a major challenge for hospital and healthcare system leadership. Leaders must possess vision, visibility, and ability to drive organizational change toward an environment that fosters diversity and cultural competence. As challenging economic conditions force management to make difficult budgetary decisions, the integration of equity into the organization's core mission and strategic process is essential for sustainability. Building organizational capacity requires systematic actions including workforce composition, training and development, and policy advocacy. This article offers perspectives on the current state of diversity in hospitals, exemplars from pediatric hospitals, and considerations for the future. Healthcare leaders are influential in shaping the future of the organization through strategic planning and resource allocation to those efforts that enhance services, programs, and processes that support a culture of diversity and equity.

Stingray Failure Mode, Effects and Criticality Analysis: WEC Risk Registers

DOE Data Explorer

Ken Rhinefrank

2016-07-25

Analysis method to systematically identify all potential failure modes and their effects on the Stingray WEC system. This analysis is incorporated early in the development cycle such that the mitigation of the identified failure modes can be achieved cost effectively and efficiently. The FMECA can begin once there is enough detail to functions and failure modes of a given system, and its interfaces with other systems. The FMECA occurs coincidently with the design process and is an iterative process which allows for design changes to overcome deficiencies in the analysis.Risk Registers for major subsystems completed according to the methodology described in "Failure Mode Effects and Criticality Analysis Risk Reduction Program Plan.pdf" document below, in compliance with the DOE Risk Management Framework developed by NREL.

Evaluation of Graphite Fiber/Polyimide PMCs from Hot Melt vs Solution Prepreg

NASA Technical Reports Server (NTRS)

Shin, E. Eugene; Sutter, James K.; Eakin, Howard; Inghram, Linda; McCorkle, Linda; Scheiman, Dan; Papadopoulos, Demetrios; Thesken, John; Fink, Jeffrey E.

2002-01-01

Carbon fiber reinforced high temperature polymer matrix composites (PMC) have been extensively investigated as potential weight reduction replacements of various metallic components in next generation high performance propulsion rocket engines. The initial phase involves development of comprehensive composite material-process-structure-design-property-in-service performance correlations and database, especially for a high stiffness facesheet of various sandwich structures. Overview of the program plan, technical approaches and current multi-team efforts will be presented. During composite fabrication, it was found that the two large volume commercial prepregging methods (hot-melt vs. solution) resulted in considerably different composite cure behavior. Details of the process-induced physical and chemical modifications in the prepregs, their effects on composite processing, and systematic cure cycle optimization studies will be discussed. The combined effects of prepregging method and cure cycle modification on composite properties and isothermal aging performance were also evaluated.

Evaluation of Graphite Fiber/Polyimide PMCs from Hot Melt versus Solution Prepreg

NASA Technical Reports Server (NTRS)

Shin, Eugene E.; Sutter, James K.; Eakin, Howard; Inghram, Linda; McCorkle, Linda; Scheiman, Dan; Papadopoulos, Demetrios; Thesken, John; Fink, Jeffrey E.; Gray, Hugh R. (Technical Monitor)

2002-01-01

Carbon fiber reinforced high temperature polymer matrix composites (PMC) have been extensively investigated as potential weight reduction replacements of various metallic components in next generation high performance propulsion rocket engines. The initial phase involves development of comprehensive composite material-process-structure-design-property in-service performance correlations and database, especially for a high stiffness facesheet of various sandwich structures. Overview of the program plan, technical approaches and current multi-team efforts will be presented. During composite fabrication, it was found that the two large volume commercial prepregging methods (hot-melt vs. solution) resulted in considerably different composite cure behavior. Details of the process-induced physical and chemical modifications in the prepregs, their effects on composite processing, and systematic cure cycle optimization studies will be discussed. The combined effects of prepregging method and cure cycle modification on composite properties and isothermal aging performance were also evaluated.

Network planning under uncertainties

NASA Astrophysics Data System (ADS)

Ho, Kwok Shing; Cheung, Kwok Wai

2008-11-01

One of the main focuses for network planning is on the optimization of network resources required to build a network under certain traffic demand projection. Traditionally, the inputs to this type of network planning problems are treated as deterministic. In reality, the varying traffic requirements and fluctuations in network resources can cause uncertainties in the decision models. The failure to include the uncertainties in the network design process can severely affect the feasibility and economics of the network. Therefore, it is essential to find a solution that can be insensitive to the uncertain conditions during the network planning process. As early as in the 1960's, a network planning problem with varying traffic requirements over time had been studied. Up to now, this kind of network planning problems is still being active researched, especially for the VPN network design. Another kind of network planning problems under uncertainties that has been studied actively in the past decade addresses the fluctuations in network resources. One such hotly pursued research topic is survivable network planning. It considers the design of a network under uncertainties brought by the fluctuations in topology to meet the requirement that the network remains intact up to a certain number of faults occurring anywhere in the network. Recently, the authors proposed a new planning methodology called Generalized Survivable Network that tackles the network design problem under both varying traffic requirements and fluctuations of topology. Although all the above network planning problems handle various kinds of uncertainties, it is hard to find a generic framework under more general uncertainty conditions that allows a more systematic way to solve the problems. With a unified framework, the seemingly diverse models and algorithms can be intimately related and possibly more insights and improvements can be brought out for solving the problem. This motivates us to seek a generic framework for solving the network planning problem under uncertainties. In addition to reviewing the various network planning problems involving uncertainties, we also propose that a unified framework based on robust optimization can be used to solve a rather large segment of network planning problem under uncertainties. Robust optimization is first introduced in the operations research literature and is a framework that incorporates information about the uncertainty sets for the parameters in the optimization model. Even though robust optimization is originated from tackling the uncertainty in the optimization process, it can serve as a comprehensive and suitable framework for tackling generic network planning problems under uncertainties. In this paper, we begin by explaining the main ideas behind the robust optimization approach. Then we demonstrate the capabilities of the proposed framework by giving out some examples of how the robust optimization framework can be applied to the current common network planning problems under uncertain environments. Next, we list some practical considerations for solving the network planning problem under uncertainties with the proposed framework. Finally, we conclude this article with some thoughts on the future directions for applying this framework to solve other network planning problems.

Methods for medical device and equipment procurement and prioritization within low- and middle-income countries: findings of a systematic literature review.

PubMed

Diaconu, Karin; Chen, Yen-Fu; Cummins, Carole; Jimenez Moyao, Gabriela; Manaseki-Holland, Semira; Lilford, Richard

2017-08-18

Forty to 70 % of medical devices and equipment in low- and middle-income countries are broken, unused or unfit for purpose; this impairs service delivery to patients and results in lost resources. Undiscerning procurement processes are at the heart of this issue. We conducted a systematic review of the literature to August 2013 with no time or language restrictions to identify what product selection or prioritization methods are recommended or used for medical device and equipment procurement planning within low- and middle-income countries. We explore the factors/evidence-base proposed for consideration within such methods and identify prioritization criteria. We included 217 documents (corresponding to 250 texts) in the narrative synthesis. Of these 111 featured in the meta-summary. We identify experience and needs-based methods used to reach procurement decisions. Equipment costs (including maintenance) and health needs are the dominant issues considered. Extracted data suggest that procurement officials should prioritize devices with low- and middle-income country appropriate technical specifications - i.e. devices and equipment that can be used given available human resources, infrastructure and maintenance capacity. Suboptimal device use is directly linked to incomplete costing and inadequate consideration of maintenance services and user training during procurement planning. Accurate estimation of life-cycle costing and careful consideration of device servicing are of crucial importance.

Ergonomic aspects to be considered in planning public spaces destined for elderly people.

PubMed

de Oliveira Cunha, Marcella Viana Portela; Costa, Angelina Dias Leão; da Costa Ireland, Mariama

2012-01-01

As has happened in many other countries, Brazil has also witnessed an evident change in the question of accessibility over the last twenty years. In line with this theme, that of old age has only become evident in the last two decades. For a long period of time, the elderly have been systematically ignored as an object of investigation and have not been contemplated with consistent public social policies. Therefore, the main objective of this research is to verify the conditions of physical accessibility that allow the elderly to use public spaces, taking as a study case the São Gonçalo square and the Solón de Lucena Park, in the city of João Pessoa--PB, identifying the biological and functional losses suffered by elderly people due to the aging process and verifying the specific physical needs of this segment of the population. Qualitative methods were adopted, such as systematic observations with the production of behaviour maps, in addition to a review of the literature and analysis of the data. The research identified problems related to the physical accessibility of the elderly to public spaces that generate difficulties for displacement, use, information and orientation, contributing to the planning and ergonomic guidelines which aim at improving these environments, such as the use of different and contrasting colours on the urban furniture and floor, for example.

Public health terminology: Hindrance to a Health in All Policies approach?

PubMed

Synnevåg, Ellen S; Amdam, Roar; Fosse, Elisabeth

2018-02-01

National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach. A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. This paper promotes debate about the appropriateness of using the terms 'public health' and 'public health work' at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local level.

Strategic cognitive sequencing: a computational cognitive neuroscience approach.

PubMed

Herd, Seth A; Krueger, Kai A; Kriete, Trenton E; Huang, Tsung-Ren; Hazy, Thomas E; O'Reilly, Randall C

2013-01-01

We address strategic cognitive sequencing, the "outer loop" of human cognition: how the brain decides what cognitive process to apply at a given moment to solve complex, multistep cognitive tasks. We argue that this topic has been neglected relative to its importance for systematic reasons but that recent work on how individual brain systems accomplish their computations has set the stage for productively addressing how brain regions coordinate over time to accomplish our most impressive thinking. We present four preliminary neural network models. The first addresses how the prefrontal cortex (PFC) and basal ganglia (BG) cooperate to perform trial-and-error learning of short sequences; the next, how several areas of PFC learn to make predictions of likely reward, and how this contributes to the BG making decisions at the level of strategies. The third models address how PFC, BG, parietal cortex, and hippocampus can work together to memorize sequences of cognitive actions from instruction (or "self-instruction"). The last shows how a constraint satisfaction process can find useful plans. The PFC maintains current and goal states and associates from both of these to find a "bridging" state, an abstract plan. We discuss how these processes could work together to produce strategic cognitive sequencing and discuss future directions in this area.

Constructing a modern cytology laboratory: A toolkit for planning and design.

PubMed

Roberson, Janie; Wrenn, Allison; Poole, John; Jaeger, Andrew; Eltoum, Isam A

2013-01-01

Constructing or renovating a laboratory can be both challenging and rewarding. UAB Cytology (UAB CY) recently undertook a project to relocate from a building constructed in 1928 to new space. UAB CY is part of an academic center that provides service to a large set of patients, support training of one cytotechnology program and one cytopathology fellowship training program and involve actively in research and scholarly activity. Our objectives were to provide a safe, aesthetically pleasing space and gain efficiencies through lean processes. The phases of any laboratory design project are Planning, Schematic Design (SD), Design Development (DD), Construction Documents (CD) and Construction. Lab personnel are most critical in the Planning phase. During this time stakeholders, relationships, budget, square footage and equipment were identified. Equipment lists, including what would be relocated, purchased new and projected for future growth ensure that utilities were matched to expected need. A chemical inventory was prepared and adequate storage space was planned. Regulatory and safety requirements were discussed. Tours and high level process flow diagrams helped architects and engineers understand the laboratory daily work. Future needs were addressed through a questionnaire which identified potential areas of growth and technological change. Throughout the project, decisions were driven by data from the planning phase. During the SD phase, objective information from the first phase was used by architects and planners to create a general floor plan. This was the basis of a series of meetings to brainstorm and suggest modifications. DD brings more detail to the plans with engineering, casework, equipment specifics, finishes. Design changes should be completed at this phase. The next phase, CD took the project from the lab purview into purely technical mode. Construction documents were used by the contractor for the bidding process and ultimately the Construction phase. The project fitted out a total of 9,000 square feet; 4,000 laboratory and 5,000 office/support. Lab space includes areas for Prep, CT screening, sign out and Imaging. Adjacent space houses faculty offices and conferencing facilities. Transportation time was reduced (waste removal) by a Pneumatic Tube System, specimen drop window to Prep Lab and a pass thru window to the screening area. Open screening and prep areas allow visual management control. Efficiencies were gained by ergonomically placing CT Manual and Imaging microscopes and computers in close proximity, also facilitating a paperless workflow for additional savings. Logistically, closer proximity to Surgical Pathology maximized the natural synergies between the areas. Lab construction should be a systematic process based on sound principles for safety, high quality testing, and finance. Our detailed planning and design process can be a model for others undertaking similar projects.

Constructing a modern cytology laboratory: A toolkit for planning and design

PubMed Central

Roberson, Janie; Wrenn, Allison; Poole, John; Jaeger, Andrew; Eltoum, Isam A.

2013-01-01

Introduction: Constructing or renovating a laboratory can be both challenging and rewarding. UAB Cytology (UAB CY) recently undertook a project to relocate from a building constructed in 1928 to new space. UAB CY is part of an academic center that provides service to a large set of patients, support training of one cytotechnology program and one cytopathology fellowship training program and involve actively in research and scholarly activity. Our objectives were to provide a safe, aesthetically pleasing space and gain efficiencies through lean processes. Methods: The phases of any laboratory design project are Planning, Schematic Design (SD), Design Development (DD), Construction Documents (CD) and Construction. Lab personnel are most critical in the Planning phase. During this time stakeholders, relationships, budget, square footage and equipment were identified. Equipment lists, including what would be relocated, purchased new and projected for future growth ensure that utilities were matched to expected need. A chemical inventory was prepared and adequate storage space was planned. Regulatory and safety requirements were discussed. Tours and high level process flow diagrams helped architects and engineers understand the laboratory daily work. Future needs were addressed through a questionnaire which identified potential areas of growth and technological change. Throughout the project, decisions were driven by data from the planning phase. During the SD phase, objective information from the first phase was used by architects and planners to create a general floor plan. This was the basis of a series of meetings to brainstorm and suggest modifications. DD brings more detail to the plans with engineering, casework, equipment specifics, finishes. Design changes should be completed at this phase. The next phase, CD took the project from the lab purview into purely technical mode. Construction documents were used by the contractor for the bidding process and ultimately the Construction phase. Results: The project fitted out a total of 9,000 square feet; 4,000 laboratory and 5,000 office/support. Lab space includes areas for Prep, CT screening, sign out and Imaging. Adjacent space houses faculty offices and conferencing facilities. Transportation time was reduced (waste removal) by a Pneumatic Tube System, specimen drop window to Prep Lab and a pass thru window to the screening area. Open screening and prep areas allow visual management control. Efficiencies were gained by ergonomically placing CT Manual and Imaging microscopes and computers in close proximity, also facilitating a paperless workflow for additional savings. Logistically, closer proximity to Surgical Pathology maximized the natural synergies between the areas. Conclusions: Lab construction should be a systematic process based on sound principles for safety, high quality testing, and finance. Our detailed planning and design process can be a model for others undertaking similar projects PMID:23599722

Are hotspots of evolutionary potential adequately protected in southern California?

USGS Publications Warehouse

Vandergast, A.G.; Bohonak, A.J.; Hathaway, S.A.; Boys, J.; Fisher, R.N.

2008-01-01

Reserves are often designed to protect rare habitats, or "typical" exemplars of ecoregions and geomorphic provinces. This approach focuses on current patterns of organismal and ecosystem-level biodiversity, but typically ignores the evolutionary processes that control the gain and loss of biodiversity at these and other levels (e.g., genetic, ecological). In order to include evolutionary processes in conservation planning efforts, their spatial components must first be identified and mapped. We describe a GIS-based approach for explicitly mapping patterns of genetic divergence and diversity for multiple species (a "multi-species genetic landscape"). Using this approach, we analyzed mitochondrial DNA datasets from 21 vertebrate and invertebrate species in southern California to identify areas with common phylogeographic breaks and high intrapopulation diversity. The result is an evolutionary framework for southern California within which patterns of genetic diversity can be analyzed in the context of historical processes, future evolutionary potential and current reserve design. Our multi-species genetic landscapes pinpoint six hotspots where interpopulation genetic divergence is consistently high, five evolutionary hotspots within which genetic connectivity is high, and three hotspots where intrapopulation genetic diversity is high. These 14 hotspots can be grouped into eight geographic areas, of which five largely are unprotected at this time. The multi-species genetic landscape approach may provide an avenue to readily incorporate measures of evolutionary process into GIS-based systematic conservation assessment and land-use planning.

Using Intervention Mapping to Develop Health Education Components to Increase Colorectal Cancer Screening in Puerto Rico.

PubMed

Serra, Yolanda A; Colón-López, Vivian; Savas, Lara S; Vernon, Sally W; Fernández-Espada, Natalie; Vélez, Camille; Ayala, Alelí; Fernández, María E

2017-01-01

Colorectal cancer (CRC) is a leading cause of cancer-related mortality in Puerto Rico (PR). Although largely preventable through screening and treatment of precancerous polyps, CRC screening rates in PR remain low while CRC incidence and mortality continue to increase. We used intervention mapping (IM), a systematic framework using theory and evidence to plan a health promotion intervention to increase colorectal cancer screening (CRCS) among Puerto Rican adults 50 years and older who are patients of Federally Qualified Health Centers (FQHCs) in PR. To inform the development of a logic model of the problem during the needs assessment phase, we determined the CRC incidence and mortality rates in PR using recent data from the PR Cancer Registry, conducted a literature review to better understand behavioral and environmental factors influencing CRC among Hispanics in general and in Puerto Ricans, and collected new data. We conducted seven focus groups to identify community needs and resources, specific sub-behaviors related to CRCS (performance objectives) and the determinants of CRCS. We then developed matrices of change objectives that would guide the content, behavioral change method selection, and the practical applications that would be included in the program. We selected two overarching methods: entertainment education and behavioral journalism and developed practical applications, materials, and messages containing several other methods including modeling, persuasion, information, and tailoring. We developed and pretested a Tailored Interactive Multimedia Intervention, newsletter, an action plan, and supplemental print materials for patients. We also developed a patient mediated provider prompt to increase provider recommendation and improve patient provider communication. The use of IM for systematic planning produced a detailed coherent plan for the CRCS educational intervention. Guided by IM processes, steps, and tasks, we used community level information, existing literature, theory, and new data to develop health education materials that were well received by the priority population and will likely increase CRCS among FQHC patients in PR.

Using an intervention mapping framework to develop an online mental health continuing education program for pharmacy staff.

PubMed

Wheeler, Amanda; Fowler, Jane; Hattingh, Laetitia

2013-01-01

Current mental health policy in Australia recognizes that ongoing mental health workforce development is crucial to mental health care reform. Community pharmacy staff are well placed to assist people with mental illness living in the community; however, staff require the knowledge and skills to do this competently and effectively. This article presents the systematic planning and development process and content of an education and training program for community pharmacy staff, using a program planning approach called intervention mapping. The intervention mapping framework was used to guide development of an online continuing education program. Interviews with mental health consumers and carers (n = 285) and key stakeholders (n = 15), and a survey of pharmacy staff (n = 504) informed the needs assessment. Program objectives were identified specifying required attitudes, knowledge, skills, and confidence. These objectives were aligned with an education technique and delivery strategy. This was followed by development of an education program and comprehensive evaluation plan. The program was piloted face to face with 24 participants and then translated into an online program comprising eight 30-minute modules for pharmacists, 4 of which were also used for support staff. The evaluation plan provided for online participants (n ≅ 500) to be randomized into intervention (immediate access) or control groups (delayed training access). It included pre- and posttraining questionnaires and a reflective learning questionnaire for pharmacy staff and telephone interviews post pharmacy visit for consumers and carers. An online education program was developed to address mental health knowledge, attitudes, confidence, and skills required by pharmacy staff to work effectively with mental health consumers and carers. Intervention mapping provides a systematic and rigorous approach that can be used to develop a quality continuing education program for the health workforce. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Systematic Quality Development Work in a Swedish Leisure-Time Centre

ERIC Educational Resources Information Center

Lager, Karin; Sheridan, Sonja; Gustafsson, Jan

2016-01-01

There is increasing activity in the area of quality issues in education in Europe. Diverse discourses of policy for quality are encountered in daily practice. This article explores systematic quality development work in a Swedish educational setting: the leisure-time centre. By following 2 teachers' enactments of policy in planning, organising,…

Assessment selection in human-automation interaction studies: The Failure-GAM2E and review of assessment methods for highly automated driving.

PubMed

Grane, Camilla

2018-01-01

Highly automated driving will change driver's behavioural patterns. Traditional methods used for assessing manual driving will only be applicable for the parts of human-automation interaction where the driver intervenes such as in hand-over and take-over situations. Therefore, driver behaviour assessment will need to adapt to the new driving scenarios. This paper aims at simplifying the process of selecting appropriate assessment methods. Thirty-five papers were reviewed to examine potential and relevant methods. The review showed that many studies still relies on traditional driving assessment methods. A new method, the Failure-GAM 2 E model, with purpose to aid assessment selection when planning a study, is proposed and exemplified in the paper. Failure-GAM 2 E includes a systematic step-by-step procedure defining the situation, failures (Failure), goals (G), actions (A), subjective methods (M), objective methods (M) and equipment (E). The use of Failure-GAM 2 E in a study example resulted in a well-reasoned assessment plan, a new way of measuring trust through feet movements and a proposed Optimal Risk Management Model. Failure-GAM 2 E and the Optimal Risk Management Model are believed to support the planning process for research studies in the field of human-automation interaction. Copyright © 2017 Elsevier Ltd. All rights reserved.

Investigating the spatial accuracy of CBCT-guided cranial radiosurgery: A phantom end-to-end test study.

PubMed

Calvo-Ortega, Juan-Francisco; Hermida-López, Marcelino; Moragues-Femenía, Sandra; Pozo-Massó, Miquel; Casals-Farran, Joan

2017-03-01

To evaluate the spatial accuracy of a frameless cone-beam computed tomography (CBCT)-guided cranial radiosurgery (SRS) using an end-to-end (E2E) phantom test methodology. Five clinical SRS plans were mapped to an acrylic phantom containing a radiochromic film. The resulting phantom-based plans (E2E plans) were delivered four times. The phantom was setup on the treatment table with intentional misalignments, and CBCT-imaging was used to align it prior to E2E plan delivery. Comparisons (global gamma analysis) of the planned and delivered dose to the film were performed using a commercial triple-channel film dosimetry software. The necessary distance-to-agreement to achieve a 95% (DTA95) gamma passing rate for a fixed 3% dose difference provided an estimate of the spatial accuracy of CBCT-guided SRS. Systematic (∑) and random (σ) error components, as well as 95% confidence levels were derived for the DTA95 metric. The overall systematic spatial accuracy averaged over all tests was 1.4mm (SD: 0.2mm), with a corresponding 95% confidence level of 1.8mm. The systematic (Σ) and random (σ) spatial components of the accuracy derived from the E2E tests were 0.2mm and 0.8mm, respectively. The E2E methodology used in this study allowed an estimation of the spatial accuracy of our CBCT-guided SRS procedure. Subsequently, a PTV margin of 2.0mm is currently used in our department. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Curriculum planning for the development of graphicacy capability: three case studies from Europe and the USA

NASA Astrophysics Data System (ADS)

Danos, Xenia; Barr, Ronald; Górska, Renata; Norman, Eddie

2014-11-01

Curriculum planning for the development of graphicacy capability has not been systematically included in general education to coincide with the graphicacy needs of human society. In higher education, graphicacy curricula have been developed to meet the needs of certain disciplines, for example medical and teacher training and engineering, among others. A framework for graphicacy curricula, anticipating the graphicacy needs in higher education, has yet to be strategically planned for general education. This is partly a result of lack of research effort in this area, but also a result of lack of systematic curriculum planning in general. This paper discusses these issues in the context of graphicacy curricula for engineering. The paper presents three broad individual case studies spanning Europe and the USA, brought together by the common denominator, graphicacy. The case studies are based on: an analysis of graphicacy within general education curricula, an analysis of graphicacy for engineering education in Europe and an analysis of graphicacy for engineering education in the USA. These three papers were originally presented in a plenary session at the American Society for Engineering Education, Engineering Design Graphics Division at the University of Limerick in November 2012. The case studies demonstrate the potential for strategic curriculum planning in regard to the development of graphicacy in general education and an overview of a methodology to achieve that. It also offers further evidence towards the importance of the systematic classification of graphics capabilities in Engineering and how the lack of a developed theoretical framework in this area undermines the case for the importance of graphics within engineering education.

University Library Online Reference Service Program Plan, 1986/87.

ERIC Educational Resources Information Center

Koga, James S.

This program plan for online reference service--the individualized assistance provided to a library patron using an online system--at California State Polytechnic University, Pomona, covers the areas of funding, eligibility for online services, search request eligibility, database eligibility, management of online services, reference faculty…

Pre-Class Planning for Individualized Accounting

ERIC Educational Resources Information Center

Clayton, Dean; Brooke, Joyce Ann

1974-01-01

Pre-class planning of individualized accounting is involved with goals, objectives, and activities developed and selected by the teacher in providing compatibility between accounting content and teaching strategy. A systematic arrangement of activities should be developed so that students can understand and apply accounting principles at their own…

How Business Intelligence and Social Interaction Amplify Organizational Cognition

ERIC Educational Resources Information Center

Penn, Stephen Paul

2012-01-01

This systematic literature review of current scholarship on business intelligence, individual decision-making behavior, strategy as practice, and strategic planning offers a roadmap for firms seeking to increase their competitive advantage through data driven decision-making. Planning, deciding, and using information is a single phenomenon where…

Knowledge regarding advance care planning: A systematic review.

PubMed

Kermel-Schiffman, Ile; Werner, Perla

2017-11-01

Lack of knowledge is one of the main reasons for the low rates of completion of Advance Care Planning (ACP). The purpose of this study was to systematically review the existing literature on knowledge regarding Advance Care Planning. A systematic search of the literature was made in CINHAL, AgeLine, PubMed, PsyINFO and SocINDEX, from 1994 till May 2016. We identified 37 articles that satisfied the inclusion criteria: 35 were quantitative, one was qualitative and one used mixed methods. Most of the studies (n=23) were conducted in the United States and participants in most of the studies (n=22) were professionals. A variety of aspects of ACP were examined, regarding subjective and objective knowledge. Seventeen studies found that participants knew some aspects of ACP, but didn't know others. Inconsistencies were found in the types of instruments and the number of items used to assess knowledge. More effort should be invested in increasing knowledge regarding ACP among professionals and lay people. Developing validated tools to measure objective and subjective knowledge in both populations might be a first step in this direction. Copyright © 2017 Elsevier B.V. All rights reserved.

[Nursing process in advanced cardiopulmonary resuscitation].

PubMed

Lucio Peña, Gerardo; Fuentes Leonardo, Ana María

2002-01-01

The process male nurse is a systematic and organized method to offer effective and efficient cares guided to the achievement of solving real problems of health, reducing the incidence and the duration. It is organized and systematic for that consists of five sequential and interrelated steps: Valuation, diagnostic, planning, execution and evaluation, in which are carried out interrelated actions, thought to maximize the long term results. The nurse process is based on the notion that the success of the cares is measured by the degree of effectiveness and the degree of satisfaction and the patient's progress. Applying this method in the Advanced Cardiac Live Support (ACLS) the identification of a cardiovascular or cardiopulmonary urgency was achieved that implies advanced treatment of the air road, defibrillation and appropriate medications to the circumstances. The ACLS challenges the nurses in charge from the patient's attention to make decisions quick low pressure and in dramatic scenes. Reason why it develops the flowing process male nurse in the advanced cardiopulmonary reanimation due to the incidence of these events in the National Institute of Cardiology Ignacio Chávez, which should guarantee the benefit of services in basic and advanced cardiopulmonary reanimation for personal with a high formation level in all the units of intensive cares and services of hospitalization in integrated form and stratified this way to avoid that it progresses to situations that cause the death or leave irreversible sequels since in the central nervous system the time it is a factor critical for the treatment of this events.

Optimal Sensor Selection for Health Monitoring Systems

NASA Technical Reports Server (NTRS)

Santi, L. Michael; Sowers, T. Shane; Aguilar, Robert B.

2005-01-01

Sensor data are the basis for performance and health assessment of most complex systems. Careful selection and implementation of sensors is critical to enable high fidelity system health assessment. A model-based procedure that systematically selects an optimal sensor suite for overall health assessment of a designated host system is described. This procedure, termed the Systematic Sensor Selection Strategy (S4), was developed at NASA John H. Glenn Research Center in order to enhance design phase planning and preparations for in-space propulsion health management systems (HMS). Information and capabilities required to utilize the S4 approach in support of design phase development of robust health diagnostics are outlined. A merit metric that quantifies diagnostic performance and overall risk reduction potential of individual sensor suites is introduced. The conceptual foundation for this merit metric is presented and the algorithmic organization of the S4 optimization process is described. Representative results from S4 analyses of a boost stage rocket engine previously under development as part of NASA's Next Generation Launch Technology (NGLT) program are presented.

Investigation of a supplementary tool to assist in the prioritization of emphasis areas in North American strategic highway safety plans.

PubMed

Park, Peter Y; Young, Jason

2012-03-01

An important potential benefit of a jurisdiction developing an upper-level traffic safety policy statement, such as a strategic highway safety plan (SHSP) or a traffic safety action plan, is the creation of a manageable number of focus areas, known as emphasis areas. The responsible agencies in the jurisdiction can then direct their finite resources in a systematic and strategic way designed to maximize the effort to reduce the number and severity of roadway collisions. In the United States, the federal government through AASHTO has suggested 22 potential emphasis areas. In Canada, CCMTA's 10 potential emphasis areas have been listed for consideration. This study reviewed the SHSP and traffic safety action plan of 53 jurisdictions in North America, and conducted descriptive data analyses to clarify the issues that currently affect the selection and prioritization process of jurisdiction-specific emphasis areas. We found that the current process relies heavily on high-level collision data analysis and communication among the SHSP stakeholders, but may not be the most efficient and effective way of selecting and prioritizing the emphasis areas and allocating safety improvement resources. This study then formulated a formal collision diagnosis test, known as the beta-binomial test, to clarify and illuminate the selection and the prioritization of jurisdiction-specific emphasis areas. We developed numerical examples to demonstrate how engineers can apply the proposed diagnosis test to improve the selection and prioritization of individual jurisdictions' emphasis areas. Copyright © 2011 Elsevier Ltd. All rights reserved.

Beyond fighting fires and chasing tails? Chronic illness care plans in Ontario, Canada.

PubMed

Russell, Grant; Thille, Patricia; Hogg, William; Lemelin, Jacques

2008-01-01

Recent work has conceptualized new models for the primary care management of patients with chronic illness. This study investigated the experience of family physicians and patients with a chronic illness management initiative that involved the joint formulation of comprehensive individual patient care plans. A qualitative evaluation, framed by phenomenology, immediately followed a randomized controlled trial examining the effect of external facilitators in enhancing the delivery of chronic condition care planning in primary care. The study, set in Ontario family practices, used semistructured in-depth interviews with a purposive sample of 13 family physicians, 20 patients, and all 3 study facilitators. Analysis used independent transcript review and constant comparative methods. Despite the intervention being grounded in patient-centered principles, family physicians generally viewed chronic illness management from a predominantly biomedical perspective. Only a few enthusiasts viewed systematic care planning as a new approach to managing patients with chronic illness. Most family physicians found the strategy to be difficult to implement within existing organizational and financial constraints. For these participants, care planning conflicted with preexisting concepts of their role and of their patient's abilities to become partners in care. The few patients who noticed the process spoke favorably about their experience. Although the experiences of the enthusiastic family physicians were encouraging, we found important individual-level barriers to chronic illness management in primary care. These issues seemed to transcend existing organizational and resource constraints.

Tectonic and volcanic monitoring using Sentinel-1: Current status and future plans of the COMET InSAR portal

NASA Astrophysics Data System (ADS)

Spaans, Karsten; Hatton, Emma; Gonzalez, Pablo; Walters, Richard; McDougall, Alistair; Wright, Tim; Hooper, Andy

2017-04-01

The advantages of the Sentinel-1 constellation for InSAR applications over previous radar missions are numerous, and include small baselines, a planned operation time of 20 years, continuous and systematic acquisition of data over tectonic and volcanic areas, near-global coverage of the earth and free data availability. In order to take advantage of these properties, we at the Centre for the Observation and Modelling of Earthquakes, Volcanoes, and Tectonics (COMET) are developing a system that routinely processes and freely distributes interferometric products and time series over tectonic and volcanic regions. This project, and similar efforts at other institutions, will be a game changer for the monitoring and studying of tectonic and volcanic activity using InSAR. Since December 2016, the COMET-LiCS InSAR portal (http://comet.nerc.ac.uk/COMET-LiCS-portal/) has been live, delivering interferograms and coherence estimates over the entire Alpine-Himalayan belt. The portal already contains tens of thousands of products, which can be browsed in a user-friendly portal, and downloaded for free by the general public. For our processing, we use the Climate and Environmental Monitoring from Space (CEMS) facility, where we have large storage and processing facilities to our disposal and a complete duplicate of the Sentinel-1 archive is maintained. This greatly simplifies the infrastructure we have had to develop for automated processing of large areas. Here we will give an overview of the current status of the processing system, as well as discuss future plans. We will cover the infrastructure we developed to automatically produce interferograms and its challenges, and the processing strategy for time series analysis. We will outline the objectives of the system in the near and distant future, and a roadmap for its continued development. Finally, we will highlight some of the scientific results and projects linked to the system.

Dynamic interactions between visual working memory and saccade target selection

PubMed Central

Schneegans, Sebastian; Spencer, John P.; Schöner, Gregor; Hwang, Seongmin; Hollingworth, Andrew

2014-01-01

Recent psychophysical experiments have shown that working memory for visual surface features interacts with saccadic motor planning, even in tasks where the saccade target is unambiguously specified by spatial cues. Specifically, a match between a memorized color and the color of either the designated target or a distractor stimulus influences saccade target selection, saccade amplitudes, and latencies in a systematic fashion. To elucidate these effects, we present a dynamic neural field model in combination with new experimental data. The model captures the neural processes underlying visual perception, working memory, and saccade planning relevant to the psychophysical experiment. It consists of a low-level visual sensory representation that interacts with two separate pathways: a spatial pathway implementing spatial attention and saccade generation, and a surface feature pathway implementing color working memory and feature attention. Due to bidirectional coupling between visual working memory and feature attention in the model, the working memory content can indirectly exert an effect on perceptual processing in the low-level sensory representation. This in turn biases saccadic movement planning in the spatial pathway, allowing the model to quantitatively reproduce the observed interaction effects. The continuous coupling between representations in the model also implies that modulation should be bidirectional, and model simulations provide specific predictions for complementary effects of saccade target selection on visual working memory. These predictions were empirically confirmed in a new experiment: Memory for a sample color was biased toward the color of a task-irrelevant saccade target object, demonstrating the bidirectional coupling between visual working memory and perceptual processing. PMID:25228628

The CCC Institutional Development Program: Organizational Change from the Chief Executive's Perspective.

ERIC Educational Resources Information Center

Ellison, Nolen M.; Eadie, Douglas C.

Cuyahoga Community College's three-phase Institutional Development Program (IDP) was established in January, 1975, to provide systematic and uniform college-wide planning and management procedures. This report first discusses the social forces which led the college to undertake the IDP; identifies the long-range planning, governance, and…

State Special Education Laws for Functional Behavioral Assessment and Behavior Intervention Plans

ERIC Educational Resources Information Center

Zirkel, Perry A.

2011-01-01

A comprehensive search identified 31 state statutes and regulations specific to functional behavioral assessments (FBA) and behavior intervention plans (BIP) in the special education context. A systematic tabulation of the state law provisions that exceed the rather narrow foundation requirements of the Individuals with Disabilities Education Act…

Teachers' Beliefs about Using a Professional Development Plan

ERIC Educational Resources Information Center

Janssen, Sandra; Kreijns, Karel; Bastiaens, Theo J.; Stijnen, Sjef; Vermeulen, Marjan

2013-01-01

Professional development plans (PDPs) have recently been introduced in Dutch schools to support teachers' professional development. However, teachers' beliefs regarding the use of PDPs have not been systematically researched, whereas research on the use of PDPs indicates that the implementation is not always successful and depends on how use is…

Got (the Right) Milk? How a Blended Quality Improvement Approach Catalyzed Change.

PubMed

Luton, Alexandra; Bondurant, Patricia G; Campbell, Amy; Conkin, Claudia; Hernandez, Jae; Hurst, Nancy

2015-10-01

The expression, storage, preparation, fortification, and feeding of breast milk are common ongoing activities in many neonatal intensive care units (NICUs) today. Errors in breast milk administration are a serious issue that should be prevented to preserve the health and well-being of NICU babies and their families. This paper describes how a program to improve processes surrounding infant feeding was developed, implemented, and evaluated. The project team used a blended quality improvement approach that included the Model for Improvement, Lean and Six Sigma methodologies, and principles of High Reliability Organizations to identify and drive short-term, medium-term, and long-term improvement strategies. Through its blended quality improvement approach, the team strengthened the entire dispensation system for both human milk and formula and outlined a clear vision and plan for further improvements as well. The NICU reduced feeding errors by 83%. Be systematic in the quality improvement approach, and apply proven methods to improving processes surrounding infant feeding. Involve expert project managers with nonclinical perspective to guide work in a systematic way and provide unbiased feedback. Create multidisciplinary, cross-departmental teams that include a vast array of stakeholders in NICU feeding processes to ensure comprehensive examination of current state, identification of potential risks, and "outside the box" potential solutions. As in the realm of pharmacy, the processes involved in preparing feedings for critically ill infants should be carried out via predictable, reliable means including robust automated verification that integrates seamlessly into existing processes. The use of systems employed in pharmacy for medication preparation should be considered in the human milk and formula preparation setting.

Place prioritization for biodiversity content.

PubMed

Sarkar, Sahotra; Aggarwal, Anshu; Garson, Justin; Margules, Chris R; Zeidler, Juliane

2002-07-01

The prioritization of places on the basis of biodiversity content is part of any systematic biodiversity conservation planning process. The place prioritization procedure implemented in the ResNet software package is described. This procedure is primarily based on the principles of rarity and complementarity. Application of the procedure is demonstrated with two analyses, one data set consisting of the distributions of termite genera in Namibia, and the other consisting of the distributions of bird species in the Islas Malvinas/Falkland Islands. The attributes that data sets should have for the effective and reliable application of such procedures are discussed. The procedure used here is compared to some others that are also currently in use.

Cost estimation: An expert-opinion approach. [cost analysis of research projects using the Delphi method (forecasting)

NASA Technical Reports Server (NTRS)

Buffalano, C.; Fogleman, S.; Gielecki, M.

1976-01-01

A methodology is outlined which can be used to estimate the costs of research and development projects. The approach uses the Delphi technique a method developed by the Rand Corporation for systematically eliciting and evaluating group judgments in an objective manner. The use of the Delphi allows for the integration of expert opinion into the cost-estimating process in a consistent and rigorous fashion. This approach can also signal potential cost-problem areas. This result can be a useful tool in planning additional cost analysis or in estimating contingency funds. A Monte Carlo approach is also examined.

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

ERIC Educational Resources Information Center

Missouri State Dept. of Education, Jefferson City.

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

Chiropractic in North America: toward a strategic plan for professional renewal--outcomes from the 2006 Chiropractic Strategic Planning Conference.

PubMed

Triano, John J; Goertz, Christine; Weeks, John; Murphy, Donald R; Kranz, Karl C; McClelland, George C; Kopansky-Giles, Deborah; Morgan, William; Nelson, Craig F

2010-06-01

This report describes the process, participation, and recommendations of a set of consensus conferences on strategy for professional growth that emphasized elements of public trust and alignment between the chiropractic profession and its stakeholders. In February and August 2006, an invitational group of leaders in the chiropractic profession convened an ad hoc Chiropractic Strategic Planning Conference. Public notice was given and support solicited through the Foundation of Chiropractic Education and Research. A series of international and interdisciplinary speakers gave presentations on the shifting of external social dynamics and medical culture, illuminating opportunities for the profession to extend its privilege and service. A systematic round-robin discussion was followed by group breakout sessions to develop recommendations on priorities for the profession to respond to challenges and opportunities. Recommendations were reviewed by the group as a whole and voted to consensus requiring more than 70% agreement. Participants determined a series of recommendations within 5 key domains for improving health professions practice: education, research, regulation, workplace, and leadership. The action steps proposed by the Strategic Planning Committee are first steps to provide better service to the public while making use of the inherent strengths of the profession. Copyright (c) 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress

NASA Astrophysics Data System (ADS)

Anhalt-Depies, Christine M.; Knoot, Tricia Gorby; Rissman, Adena R.; Sharp, Anthony K.; Martin, Karl J.

2016-05-01

There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress.

PubMed

Anhalt-Depies, Christine M; Knoot, Tricia Gorby; Rissman, Adena R; Sharp, Anthony K; Martin, Karl J

2016-05-01

There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women.

PubMed

Highfield, Linda; Hartman, Marieke A; Mullen, Patricia Dolan; Rodriguez, Serena A; Fernandez, Maria E; Bartholomew, L Kay

2015-01-01

This paper describes and demonstrates the use of the systematic planning process, Intervention Mapping, to adapt an evidence-based public health intervention (EBI). We used a simplified version of Intervention Mapping (IM Adapt) to increase an intervention's fit with a new setting and population. IM Adapt guides researchers and practitioners in selecting an EBI, making decisions about whether and what to adapt, and executing the adaptation while guarding the EBI's essential elements (those responsible for effectiveness). We present a case study of a project in which we used IM Adapt to find, adapt, implement, and evaluate an EBI to improve mammography adherence for African American women in a new practice setting in Houston, Texas. IM Adapt includes the following (1) assess needs and organizational capacity; (2) find EBIs; (3) plan adaptations based on fit assessments; (4) make adaptations; (5) plan for implementation; and (6) plan for evaluation of the adapted EBI. The case study shows an example of how public health researchers and practitioners can use the tool to make it easier to find and use EBIs, thus encouraging greater uptake. IM Adapt adds to existing dissemination and adaptation models by providing detailed guidance on how to decide on effective adaptation, while maintaining the essential elements of the EBI.

Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women

PubMed Central

Highfield, Linda; Hartman, Marieke A.; Mullen, Patricia Dolan; Fernandez, Maria E.; Bartholomew, L. Kay

2015-01-01

This paper describes and demonstrates the use of the systematic planning process, Intervention Mapping, to adapt an evidence-based public health intervention (EBI). We used a simplified version of Intervention Mapping (IM Adapt) to increase an intervention's fit with a new setting and population. IM Adapt guides researchers and practitioners in selecting an EBI, making decisions about whether and what to adapt, and executing the adaptation while guarding the EBI's essential elements (those responsible for effectiveness). We present a case study of a project in which we used IM Adapt to find, adapt, implement, and evaluate an EBI to improve mammography adherence for African American women in a new practice setting in Houston, Texas. IM Adapt includes the following (1) assess needs and organizational capacity; (2) find EBIs; (3) plan adaptations based on fit assessments; (4) make adaptations; (5) plan for implementation; and (6) plan for evaluation of the adapted EBI. The case study shows an example of how public health researchers and practitioners can use the tool to make it easier to find and use EBIs, thus encouraging greater uptake. IM Adapt adds to existing dissemination and adaptation models by providing detailed guidance on how to decide on effective adaptation, while maintaining the essential elements of the EBI. PMID:26587531

Multi-disciplinary Care for the Elderly in Disasters: An Integrative Review.

PubMed

Johnson, Heather L; Ling, Catherine G; McBee, Elexis C

2015-02-01

Older adults are disproportionately affected by disaster. Frail elders, individuals with chronic diseases, conditions, or disabilities, and those who live in long-term care facilities are especially vulnerable. Purpose The purpose of this integrative review of the literature was to describe the system-wide knowledge and skills that multi-disciplinary health care providers need to provide appropriate care for the elderly during domestic-humanitarian and disaster-relief efforts. Data sources A systematic search protocol was developed in conjunction with a research librarian. Searches of PubMed, CINAHL, and PsycINFO were conducted using terms such as Disaster, Geological Processes, Aged, Disaster Planning, and Vulnerable Populations. Forty-six articles met criteria for inclusion in the review. Policies and guidance regarding evacuating versus sheltering in place are lacking. Tenets of elderly-focused disaster planning/preparation and clarification of legal and ethical standards of care and liability issues are needed. Functional capacity, capabilities, or impairments, rather than age, should be considered in disaster preparation. Older adults should be included in disaster planning as population-specific experts. Implications for Practice A multifaceted approach to population-specific disaster planning and curriculum development should include consideration of the biophysical and psychosocial aspects of care, ethical and legal issues, logistics, and resources.

Changing workforce demographics necessitates succession planning in health care.

PubMed

Collins, Sandra K; Collins, Kevin S

2007-01-01

Health care organizations continue to be plagued by labor shortage issues. Further complicating the already existing workforce challenges is an aging population poised to retire en masse within the next few years. With fewer cohorts in the age group of 25 to 44 years (Vital Speeches Day. 2004:71:23-27), a more mobile workforce (Grow Your Own Leaders: How to Identify, Develop, and Retain Leadership Talent, 2002), and an overall reduction in the number of individuals seeking employment in the health care field (J Healthc Manag. 2003:48:6-11), the industry could be faced with an unmanageable number of vacant positions throughout the organization. Bracing for the potential impact of these issues is crucial to the ongoing business continuity of health care organization. Many health care organizations have embraced succession planning to combat the potential labor famine. However, the health care industry as a whole seems to lag behind other industries in terms of succession planning efforts (Healthc Financ Manage. 2005;59:64-67). This article seeks to provide health care managers with a framework for improving the systematic preparation of the next generation of managers by analyzing the succession planning process. The proposition of these models is to initiate and simplify the gap reduction between theoretical concepts and future organizational application.

Modeling of laser transmission contour welding process using FEA and DoE

NASA Astrophysics Data System (ADS)

Acherjee, Bappa; Kuar, Arunanshu S.; Mitra, Souren; Misra, Dipten

2012-07-01

In this research, a systematic investigation on laser transmission contour welding process is carried out using finite element analysis (FEA) and design of experiments (DoE) techniques. First of all, a three-dimensional thermal model is developed to simulate the laser transmission contour welding process with a moving heat source. The commercial finite element code ANSYS® multi-physics is used to obtain the numerical results by implementing a volumetric Gaussian heat source, and combined convection-radiation boundary conditions. Design of experiments together with regression analysis is then employed to plan the experiments and to develop mathematical models based on simulation results. Four key process parameters, namely power, welding speed, beam diameter, and carbon black content in absorbing polymer, are considered as independent variables, while maximum temperature at weld interface, weld width, and weld depths in transparent and absorbing polymers are considered as dependent variables. Sensitivity analysis is performed to determine how different values of an independent variable affect a particular dependent variable.

Predictors of Complicated Grief: A Systematic Review of Empirical Studies

ERIC Educational Resources Information Center

Lobb, Elizabeth A.; Kristjanson, Linda J.; Aoun, Samar M.; Monterosso, Leanne; Halkett, Georgia K. B.; Davies, Anna

2010-01-01

A systematic review of the literature on predictors of complicated grief (CG) was undertaken with the aim of clarifying the current knowledge and to inform future planning and work in CG following bereavement. Predictors of CG prior to the death include previous loss, exposure to trauma, a previous psychiatric history, attachment style, and the…

Systematic Review of Cognitive Development across Childhood in Down Syndrome: Implications for Treatment Interventions

ERIC Educational Resources Information Center

Patterson, T.; Rapsey, C. M.; Glue, P.

2013-01-01

Background: There is conjecture regarding the profile of cognitive development over time in children with Down syndrome (DS). Characterising this profile would be valuable for the planning and assessment of intervention studies. Method: A systematic search of the literature from 1990 to the present was conducted to identify longitudinal data on…

Policy measures on strengthening and developing capabilities for national tobacco control in Thailand.

PubMed

Kengkarnpanich, Mondha; Termsirikulchai, Lakkhana; Benjakul, Sarunya

2012-06-01

To assess the situation and report on a national capacity plan for tobacco control under the National Strategic Plan for Tobacco Control (NSPTC) 2010-2014. Systematic documentary review and analysis were managed by the working group. The results were discussed and provided recommendations by the sub-committee on developing the NSPTC 2010-2014. Seven meetings were organized from March 2009-January 2010. Eventually, the NSPCT 2010-2014 was approved by the National Committee for Tobacco Control, chaired by the Minister of Public Health on 22 April 2010. The major result of the present study was brought to the National Capacity in Tobacco Control Plan under the NSPTC 2010-2014. The purpose of the plan is to strengthen and develop national tobacco control capacity before 2011. Seven strategic areas for National Tobacco Control Capacity have been proposed. They are, 1) tobacco control policy and leadership development, 2) developing an organizational structure and management systems, 3) developing surveillance, monitoring and evaluation systems, 4)formulate measures to support research and knowledge management, 5) capacity building and network expansion for tobacco control in various sectors, 6) capacity building and expansion of a collaborative network for tobacco control at regional levels and 7) improving and strengthening tobacco control laws. In addition, the indicators, key players and support partners were addressed. Although the strength of the strategic plan on National Capacity in Tobacco Control is participatory planning process and result in the integrated and comprehensive capacity in tobacco control plan, but some concerns should be considers. They are infrastructure, evidence and networking and leadership.

Ethical frameworks for surrogates’ end-of-life planning experiences: A qualitative systematic review

PubMed Central

Kim, Hyejin; Deatrick, Janet A; Ulrich, Connie M

2016-01-01

Despite the growing body of knowledge about surrogate decision making, we know very little about the use of ethical frameworks including ethical theories, principles, and concepts to understand surrogates’ day-to-day experiences in end-of-life care planning for incapacitated adults. This systematic review of 30 qualitative research papers was conducted to identify the types of ethical frameworks used to address surrogates’ experiences in end-of-life care planning for incapacitated adults as well as the most common themes or patterns found in surrogate decision making research.. Seven papers explicitly identified ethical theories, principles, or concepts for their studies, such as autonomy, substituted judgment, and best interests. Themes identified about surrogate decision making included: responsibilities and goals, factors affecting surrogates’ decision making, and outcomes for surrogates. In fact, an overarching theme of “wanting to do the right thing” for incapacitated adults and/or themselves was prominent. Understanding the complexity of surrogates’ experiences of end-of-life care planning is beyond the scope of conventional ethical frameworks. Ethical frameworks that address individuality and contextual variations related to decision making may more appropriately guide surrogate decision making research that explores surrogates’ end-of-life care planning experiences. PMID:27005954

Automated control of hierarchical systems using value-driven methods

NASA Technical Reports Server (NTRS)

Pugh, George E.; Burke, Thomas E.

1990-01-01

An introduction is given to the Value-driven methodology, which has been successfully applied to solve a variety of difficult decision, control, and optimization problems. Many real-world decision processes (e.g., those encountered in scheduling, allocation, and command and control) involve a hierarchy of complex planning considerations. For such problems it is virtually impossible to define a fixed set of rules that will operate satisfactorily over the full range of probable contingencies. Decision Science Applications' value-driven methodology offers a systematic way of automating the intuitive, common-sense approach used by human planners. The inherent responsiveness of value-driven systems to user-controlled priorities makes them particularly suitable for semi-automated applications in which the user must remain in command of the systems operation. Three examples of the practical application of the approach in the automation of hierarchical decision processes are discussed: the TAC Brawler air-to-air combat simulation is a four-level computerized hierarchy; the autonomous underwater vehicle mission planning system is a three-level control system; and the Space Station Freedom electrical power control and scheduling system is designed as a two-level hierarchy. The methodology is compared with rule-based systems and with other more widely-known optimization techniques.

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

Szoka de Valladares, M.R.; Mack, S.

The DOE Hydrogen Program needs to develop criteria as part of a systematic evaluation process for proposal identification, evaluation and selection. The H Scan component of this process provides a framework in which a project proposer can fully describe their candidate technology system and its components. The H Scan complements traditional methods of capturing cost and technical information. It consists of a special set of survey forms designed to elicit information so expert reviewers can assess the proposal relative to DOE specified selection criteria. The Analytic Hierarchy Process (AHP) component of the decision process assembles the management defined evaluation andmore » selection criteria into a coherent multi-level decision construct by which projects can be evaluated in pair-wise comparisons. The AHP model will reflect management`s objectives and it will assist in the ranking of individual projects based on the extent to which each contributes to management`s objectives. This paper contains a detailed description of the products and activities associated with the planning and evaluation process: The objectives or criteria; the H Scan; and The Analytic Hierarchy Process (AHP).« less

Stakeholder involvement in systematic reviews: a protocol for a systematic review of methods, outcomes and effects.

PubMed

Pollock, Alex; Campbell, Pauline; Struthers, Caroline; Synnot, Anneliese; Nunn, Jack; Hill, Sophie; Goodare, Heather; Watts, Chris; Morley, Richard

2017-01-01

Researchers are expected to actively involve stakeholders (including patients, the public, health professionals, and others) in their research. Although researchers increasingly recognise that this is good practice, there is limited practical guidance about how to involve stakeholders. Systematic reviews are a research method in which international literature is brought together, using carefully designed and rigorous methods to answer a specified question about healthcare. We want to investigate how researchers have involved stakeholders in systematic reviews, and how involvement has potentially affected the quality and impact of reviews. We plan to bring this information together by searching and reviewing the literature for reports of stakeholder involvement in systematic reviews. This paper describes in detail the methods that we plan to use to do this. After carrying out comprehensive searches for literature, we will: 1. Provide an overview of identified reports, describing key information such as types of stakeholders involved, and how. 2. Pick out reports of involvement which include detailed descriptions of how researchers involved people in a systematic review and summarise the methods they used. We will consider who was involved, how people were recruited, and how the involvement was organised and managed. 3. Bring together any reports which have explored the effect, or impact, of involving stakeholders in a systematic review. We will assess the quality of these reports, and summarise their findings. Once completed, our review will be used to produce training resources aimed at helping researchers to improve ways of involving stakeholders in systematic reviews. Background There is an expectation for stakeholders (including patients, the public, health professionals, and others) to be involved in research. Researchers are increasingly recognising that it is good practice to involve stakeholders in systematic reviews. There is currently a lack of evidence about (A) how to do this and (B) the effects, or impact, of such involvement. We aim to create a map of the evidence relating to stakeholder involvement in systematic reviews, and use this evidence to address the two points above. Methods We will complete a mixed-method synthesis of the evidence, first completing a scoping review to create a broad map of evidence relating to stakeholder involvement in systematic reviews, and secondly completing two contingent syntheses. We will use a stepwise approach to searching; the initial step will include comprehensive searches of electronic databases, including CENTRAL, AMED, Embase, Medline, Cinahl and other databases, supplemented with pre-defined hand-searching and contacting authors. Two reviewers will undertake each review task (i.e., screening, data extraction) using standard systematic review processes. For the scoping review, we will include any paper, regardless of publication status or study design, which investigates, reports or discusses involvement in a systematic review. Included papers will be summarised within structured tables. Criteria for judging the focus and comprehensiveness of the description of methods of involvement will be applied, informing which papers are included within the two contingent syntheses. Synthesis A will detail the methods that have been used to involve stakeholders in systematic reviews. Papers from the scoping review that are judged to provide an adequate description of methods or approaches will be included. Details of the methods of involvement will be extracted from included papers using pre-defined headings, presented in tables and described narratively. Synthesis B will include studies that explore the effect of stakeholder involvement on the quality, relevance or impact of a systematic review, as identified from the scoping review. Study quality will be appraised, data extracted and synthesised within tables. Discussion This review should help researchers select, improve and evaluate methods of involving stakeholders in systematic reviews. Review findings will contribute to Cochrane training resources.

Predictors of dyadic planning: Perspectives of prostate cancer survivors and their partners.

PubMed

Keller, Jan; Wiedemann, Amelie U; Hohl, Diana Hilda; Scholz, Urte; Burkert, Silke; Schrader, Mark; Knoll, Nina

2017-02-01

Extending individual planning of health behaviour change to the level of the dyad, dyadic planning refers to a target person and a planning partner jointly planning the target person's health behaviour change. To date, predictors of dyadic planning have not been systematically investigated. Integrating cognitive predictors of individual planning with four established predictor domains of social support provision, we propose a framework of predictors of dyadic planning. Including target persons' and partners' perspectives, we examine these predictor domains in the context of prostate cancer patients' rehabilitative pelvic floor exercise (PFE) following radical prostatectomy. Longitudinal data from 175 patients and their partners were analysed in a study with four post-surgery assessments across 6 months. PFE-related dyadic planning was assessed from both partners together with indicators from four predictor domains: context, target person, partner, and relationship factors. Individual planning and social support served as covariates. Findings from two-level models nesting repeated assessments in individuals showed that context (patients' incontinence), target person (i.e., positive affect and self-efficacy), and relationship factors (i.e., relationship satisfaction) were uniquely associated with dyadic planning, whereas partner factors (i.e., positive and negative affects) were not. Factors predicting patients' and partners' accounts of dyadic planning differed. Resembling prior findings on antecedents of support provision in this context, partner factors did not prevail as unique predictors of dyadic planning, whereas indicators from all other predictor domains did. To establish predictive direction, future work should use lagged predictions with shorter intermeasurement intervals. Statement of contribution What is already known on this subject? Dyadic planning has been shown to be linked to health behaviour change. However, its role in behaviour regulation frameworks is not well investigated, especially regarding factors that might be predictive of dyadic planning. What does this study add? A framework of predictors of dyadic planning in the health behaviour change process is presented. The framework is investigated accounting for both planning partners' perspectives. Context, target person, and relationship factors were related to dyadic planning. © 2016 The British Psychological Society.

An integrated process and management tools for ranking multiple emerging threats to animal health.

PubMed

Del Rio Vilas, Victor J; Voller, Fay; Montibeller, Gilberto; Franco, L Alberto; Sribhashyam, Sumitra; Watson, Eamon; Hartley, Matt; Gibbens, Jane C

2013-02-01

The UK's Department for Environment, Food and Rural Affairs supports the use of systematic tools for the prioritisation of known and well defined animal diseases to facilitate long and medium term planning of surveillance and disease control activities. The recognition that emerging events were not covered by the existing disease-specific approaches led to the establishment of the Veterinary Risk Group (VRG), constituted of government officials, and supporting structures such as the Risk Management Cycle and the Emerging Threat Highlight Report (ETHiR), to facilitate the identification, reporting and assessment of emerging threats to UK's animal health. Since its inception in November 2009 to the end of February 2011, the VRG reviewed 111 threats and vulnerabilities (T&V) reported through ETHiR. In July 2010 a decision support system (DSS) based on multi-criteria-decision-analysis (MCDA) improved ETHiR to allow the systematic prioritisation of emerging T&V. The DSS allows the regular ranking of emerging T&V by calculating a set of measurement indices related to the actual impact, possible impact on public perception and level of available capabilities associated with every T&V. The systematic characterisation of the processes leading to the assessment of T&V by the VRG has led to a consistent, auditable and transparent approach to the identification and assessment of emerging risks. The regular use of MCDA to manage a portfolio of emerging risks represents a different and novel application of MCDA in a health related context. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

Medical students as peer tutors: a systematic review

PubMed Central

2014-01-01

Background While Peer Assisted Learning (PAL) has long occurred informally in medical education, in the past ten years, there has been increasing international interest in formally organised PAL, with many benefits for both the students and institutions. We conducted a systematic review of the literature to establish why and how PAL has been implemented, focussing on the recruitment and training process for peer tutors, the benefits for peer tutors, and the competency of peer tutors. Method A literature search was conducted in three electronic databases. Selection of titles and abstracts were made based on pre-determined eligibility criteria. We utilized the ‘AMEE Peer assisted learning: a planning and implementation framework: AMEE Guide no. 30’ to assist us in establishing the review aims in a systematic review of the literature between 2002 and 2012. Six key questions were developed and used in our analysis of particular aspects of PAL programs within medical degree programs. Results We found nineteen articles that satisfied our inclusion criteria. The PAL activities fell into three broad categories of teacher training, peer teaching and peer assessment. Variability was found in the reporting of tutor recruitment and training processes, tutor outcomes, and tutor competencies. Conclusion Results from this review suggest that there are many perceived learning benefits for student tutors. However, there were mixed results regarding the accuracy of peer assessment and feedback, and no substantial evidence to conclude that participation as a peer tutor improves one’s own examination performance. Further research into PAL in medicine is required if we are to better understand the relative impact and benefits for student tutors. PMID:24912500

Advance care planning, palliative care, and end-of-life care interventions for homeless people: A systematic review.

PubMed

Sumalinog, Rafael; Harrington, Katy; Dosani, Naheed; Hwang, Stephen W

2017-02-01

Homeless individuals have a high prevalence of multiple chronic comorbidities and early mortality compared to the general population. They also experience significant barriers to access and stigmatization in the healthcare system. Providing advance care planning, palliative care, and end-of-life care for this underserved population is an important health issue. To summarize and evaluate the evidence surrounding advance care planning, palliative care, and end-of-life care interventions for homeless persons. A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Articles from MEDLINE, EMBASE, CINAHL, PsycINFO, Social Work Abstracts, Cochrane Library, Web of Science, and PubMed databases were searched through 13 June 2015. Peer-reviewed studies that implemented advance care planning, palliative care, and end-of-life care interventions for homeless populations were included. Data from studies were independently extracted by two investigators using pre-specified criteria, and quality was assessed using modified Cochrane and Critical Appraisal Skills Programme tools. Six articles met inclusion criteria. Two studies were randomized controlled trials involving advance directive completion. Two cohort studies investigated the costs of a shelter-based palliative care intervention and predictors for completing advance directives. These studies were rated low to fair quality. Two qualitative studies explored the interface between harm-reduction services and end-of-life care and the conditions for providing palliative care for homeless persons in a support home. The effectiveness of advance care planning, palliative care, and end-of-life care interventions for homeless individuals is uncertain. High-quality studies of interventions that reflect the unique and complex circumstances of homeless populations and investigate patient-related outcomes, caregiver burden, and cost-effectiveness are needed.