Full Text Available Abstract Aims: Cardiovascular disease risk factors occur more frequently in children with obesity. Project PANK is a multidisciplinary school-based intervention lasting 6 months to improve BMI z-score, waist circumference (WC, waist-to-height ratio (WHtR, blood pressure (BP, nutrition, physical activity (PA, sedentary behaviour (SB, cardiorespiratory fitness (CRF, glucose, cholesterol, and triglycerides (TG. Methods/DesignA total of 77 children (7-10 years were recruited from an urban school. The protocol includes PA and SB individual meetings for children/parents; increasing school exercise; PA and SB lessons for children; A goal in the number of steps/day to accomplish in and after school. In nutrition, the protocol includes three individual meetings for children/parents and six lessons for children. ResultsPositive associations were found between the BMI Z-score, WC, and WHtR with TG; the BMI Z-score and WHtR with glucose; the light PA time and HDL-C; the vigorous and moderate-to-vigorous PA with CRF; the caloric intake and lipids with LDL-C, BMI z-score, WC, and WHtR. A negative association was found between CRF and TG. ConclusionBaseline results stress the importance of multidisciplinary school-based interventions. We hypothesized that PANK will improve blood variables, anthropometric measures, and BP, by changing food intake, enhancing PA and CRF, and decreasing SB.
Kakekagumick, Kara E.; Naqshbandi Hayward, Mariam; Harris, Stewart B.; Saksvig, Brit; Gittelsohn, Joel; Manokeesic, Gary; Goodman, Starsky; Hanley, Anthony J.
The Sandy Lake Health and Diabetes Project (SLHDP) was initiated in 1991 as a partnership between Sandy Lake First Nation and researchers interested in addressing the high rates of type 2 diabetes mellitus (T2DM) in the community. Following the expressed wishes of the community, the SLHDP has encompassed a variety of community-wide interventions and activities including: community surveys to document T2DM prevalence and risk factors, the Northern Store program aimed at increasing the availability and knowledge of healthy food options, a home visit program for the prevention and management of T2DM, a local diabetes radio show, a school diabetes curriculum for grades 3 and 4, a community-wide walking trail to encourage increased physical activity, youth diabetes summer camps, and a variety of community events focusing on nutrition and physical activity. Over the 22 year existence of the SLHDP, the community has taken ownership of the program and activities have evolved in alignment with community needs and priorities. This paper discusses the history, implementation, evaluation, and outcomes of the SLHDP and describes its sustainability. The SLHDP is a model of culturally appropriate participatory research that is iterative, with reciprocal capacity building for both key community stakeholders and academic partners. PMID:24302919
Kara Elizabeth Kakekagumick
Full Text Available The Sandy Lake Health and Diabetes Project (SLHDP was initiated in 1991 as a partnership between Sandy Lake First Nation and researchers interested in addressing the high rates of type 2 diabetes mellitus (T2DM in the community. Following the expressed wishes of the community, the SLHDP has encompassed a variety of community-wide interventions and activities including: community surveys to document T2DM prevalence and risk factors, the Northern Store program aimed at increasing the availability and knowledge of healthy food options, a home visit program for the prevention and management of T2DM, a local diabetes radio show, a school diabetes curriculum for grades 3 and 4, a community-wide walking trail to encourage increased physical activity, youth diabetes summer camps, and a variety of community events focusing on nutrition and physical activity. Over the twenty-two year existence of the SLHDP, the community has taken ownership of the program and activities have evolved in alignment with community needs and priorities. This paper discusses the history, implementation, evaluation and outcomes of the SLHDP and describes its sustainability. The SLHDP is a model of culturally appropriate participatory research that is iterative, with reciprocal capacity building for both key community stakeholders and academic partners.
Hedemann Jensen, P. [Risoe National Lab., Roskilde (Denmark); Demin, V.F. [Russian Reserch Centre `Kurchatov Inst.`, Moscow (Russian Federation); Konstantinov, Y.O. [Research Inst. of Radiation Hygiene, St. Petersburg (Russian Federation); Likhtarev, I.A. [Ukrainian Scientific Centre for Radiation Medicine, Kiev (Ukraine); Rolevich, I.V. [Chernobyl State Commiettee, Minsk (Belarus); Schneider, T. [Centre d`etudes sur l`Evaluation de la Protection dans le domaine Nucleaire, CEPN, Paris (France)
An extensive radiation risk estimation methodology has recently been developed in Russia and used for estimates of risk in exposed populations in the republics of Russia, Belarus and Ukraine. Results based on demographic data for the three republics are presented and compared with risk estimates from the EU risk model ASQRAD. The intervention criteria in the CIS republics have been evolving since the Chernobyl accident. The development of criteria in each of the three republics has been analysed and the CIS-Criteria have been compared to international guidance on intervention. After a nuclear or radiological emergency both radiological and non-radiological protection factors will influence the level of protective actions being introduced. The role of non-radiological protection factors in the overall optimization of health protection is addressed. It is argued that optimization of the overall health protection is not a question of developing radiation radiation protection philosophy to fully include socio-psychological factors. It is rather a question of including these factors - in parallel with the radiological protection factors - in cooperation between radiation protection experts and psychological specialists under the responsibility of the decision maker. (au) 19 tabs., 10 ills., 45 refs.
Hedemann Jensen, P.; Demin, V.F.; Konstantinov, Y.O.; Likhtarev, I.A.; Rolevich, I.V.; Schneider, T.
An extensive radiation risk estimation methodology has recently been developed in Russia and used for estimates of risk in exposed populations in the republics of Russia, Belarus and Ukraine. Results based on demographic data for the three republics are presented and compared with risk estimates from the EU risk model ASQRAD. The intervention criteria in the CIS republics have been evolving since the Chernobyl accident. The development of criteria in each of the three republics has been analysed and the CIS-Criteria have been compared to international guidance on intervention. After a nuclear or radiological emergency both radiological and non-radiological protection factors will influence the level of protective actions being introduced. The role of non-radiological protection factors in the overall optimization of health protection is addressed. It is argued that optimization of the overall health protection is not a question of developing radiation radiation protection philosophy to fully include socio-psychological factors. It is rather a question of including these factors - in parallel with the radiological protection factors - in cooperation between radiation protection experts and psychological specialists under the responsibility of the decision maker. (au) 19 tabs., 10 ills., 45 refs
Successful up-scaled population interventions to reduce risk factors for non-communicable disease in adults: results from the International Community Interventions for Health (CIH) Project in China, India and Mexico.
Dyson, Pamela A; Anthony, Denis; Fenton, Brenda; Stevens, Denise E; Champagne, Beatriz; Li, Li-Ming; Lv, Jun; Ramírez Hernández, Jorge; Thankappan, K R; Matthews, David R
Non-communicable disease (NCD) is increasing rapidly in low and middle-income countries (LMIC), and is associated with tobacco use, unhealthy diet and physical inactivity. There is little evidence for up-scaled interventions at the population level to reduce risk in LMIC. The Community Interventions for Health (CIH) program was a population-scale community intervention study with comparator population group undertaken in communities in China, India, and Mexico, each with populations between 150,000-250,000. Culturally appropriate interventions were delivered over 18-24 months. Two independent cross-sectional surveys of a stratified sample of adults aged 18-64 years were conducted at baseline and follow-up. A total of 6,194 adults completed surveys at baseline, and 6,022 at follow-up. The proportion meeting physical activity recommendations decreased significantly in the control group (C) (44.1 to 30.2%), but not in the intervention group (I) (38.0 to 36.1%), p<0.001. Those eating ≥ 5 portions of fruit and vegetables daily decreased significantly in C (19.2 to 17.2%), but did not change in I (20.0 to 19.6%,), p=0.013. The proportion adding salt to food was unchanged in C (24.9 to 25.3%) and decreased in I (25.9 to 19.6%), p<0.001. Prevalence of obesity increased in C (8.3 to 11.2%), with no change in I (8.6 to 9.7%,) p=0.092. Concerning tobacco, for men the difference-in-difference analysis showed that the reduction in use was significantly greater in I compared to C (p=0.014). Up-scaling known health promoting interventions designed to reduce the incidence of NCD in whole communities in LMIC is feasible, and has measurable beneficial outcomes on risk factors for NCD, namely tobacco use, diet, and physical inactivity.
Successful up-scaled population interventions to reduce risk factors for non-communicable disease in adults: results from the International Community Interventions for Health (CIH Project in China, India and Mexico.
Pamela A Dyson
Full Text Available Non-communicable disease (NCD is increasing rapidly in low and middle-income countries (LMIC, and is associated with tobacco use, unhealthy diet and physical inactivity. There is little evidence for up-scaled interventions at the population level to reduce risk in LMIC.The Community Interventions for Health (CIH program was a population-scale community intervention study with comparator population group undertaken in communities in China, India, and Mexico, each with populations between 150,000-250,000. Culturally appropriate interventions were delivered over 18-24 months. Two independent cross-sectional surveys of a stratified sample of adults aged 18-64 years were conducted at baseline and follow-up.A total of 6,194 adults completed surveys at baseline, and 6,022 at follow-up. The proportion meeting physical activity recommendations decreased significantly in the control group (C (44.1 to 30.2%, but not in the intervention group (I (38.0 to 36.1%, p<0.001. Those eating ≥ 5 portions of fruit and vegetables daily decreased significantly in C (19.2 to 17.2%, but did not change in I (20.0 to 19.6%,, p=0.013. The proportion adding salt to food was unchanged in C (24.9 to 25.3% and decreased in I (25.9 to 19.6%, p<0.001. Prevalence of obesity increased in C (8.3 to 11.2%, with no change in I (8.6 to 9.7%, p=0.092. Concerning tobacco, for men the difference-in-difference analysis showed that the reduction in use was significantly greater in I compared to C (p=0.014.Up-scaling known health promoting interventions designed to reduce the incidence of NCD in whole communities in LMIC is feasible, and has measurable beneficial outcomes on risk factors for NCD, namely tobacco use, diet, and physical inactivity.
factors as a significant system that constrains project management success of public and ... finance for the project and prompt payment for work executed; clients .... consideration of the loading patterns of these variables, the major factor is ...
Pel, M.; Heres, M. H.; Hart, A. A.; van der Veen, F.; Treffers, P. E.
OBJECTIVE: To assess which factors influence provider-associated differences in obstetric interventions. STUDY DESIGN: A survey of obstetricians and co-workers in a sample consisting of 38 Dutch hospitals was taken, using a questionnaire that contained questions about personal and hospital-policy
Views of policy makers and health promotion professionals on factors facilitating implementation and maintenance of interventions and policies promoting physical activity and healthy eating: results of the DEDIPAC project.
Muellmann, Saskia; Steenbock, Berit; De Cocker, Katrien; De Craemer, Marieke; Hayes, Catherine; O'Shea, Miriam P; Horodyska, Karolina; Bell, Justyna; Luszczynska, Aleksandra; Roos, Gun; Langøien, Lars Jørun; Rugseth, Gro; Terragni, Laura; De Bourdeaudhuij, Ilse; Brug, Johannes; Pischke, Claudia R
The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. We aimed to gain a better understanding of what health promotion professionals and policy makers think are important factors facilitating adoption, implementation, and maintenance of multi-level interventions and policies promoting healthy eating and PA in Belgium, Germany, Ireland, Norway, and Poland. Six interventions and six policies were identified based on pre-defined criteria. Forty semi-structured interviews were conducted with stakeholders from various sectors to elicit information on factors impacting adoption, implementation, and maintenance of these interventions and policies. All interview transcripts were coded in NVivo, using a common categorization matrix. Coding in the respective countries was done by one researcher and validated by a second researcher. Active involvement of relevant stakeholders and good communication between coordinating organizations were described as important factors contributing to successful adoption and implementation of both interventions and policies. Additional facilitating factors included sufficient training of staff and tailoring of materials to match needs of various target groups. The respondents indicated that maintenance of implemented interventions/policies depended on whether they were embedded in existing or newly created organizational structures in different settings and whether continued funding was secured. Despite considerable heterogeneity of interventions and health policies in the five countries, stakeholders across these countries identify similar factors facilitating adoption, implementation, and maintenance of these interventions and policies.
Noversa, Silvana; Abreu, Cátia; Varela, Paulo; Costa, Manuel F. M.
This communication results from a pedagogical intervention project, carried out at a primary school in the district of Braga - Portugal. The intervention took place in a class of the 3rd year, composed of 16 students, and it incorporated the practice of inquiry-based science teaching addressing the theme "Light Experiments", which is part of the "Environmental Studies" curricular area. Various class activities were planned and implemented concerning some of the factors that influence the shadow of an object, in order to find answers to the following three questions: a) will 3rd year students, aged 7/8 years, be able to construct and execute an investigation strategy that involves manipulating and controlling variables? b) what are the main difficulties experienced by students in the designing and execution of such a strategy? c) how will students, in interaction with the teacher and with their peers, gradually design and execute their investigation strategy in order to respond to the problem formulated? The project adopted an action research methodology. A careful record was kept of the events most relevant to the questions under study in each class. This data was used to prepare the class diaries - descriptive and reflective narratives prepared based on recorded audio and field notes made during participant observation in the context of the classroom. A content analysis of the diaries has identified a few elements that provide answers to the research questions raised. In order to plan and implement a research project with children in the 7/8 years old range require a high level of scaffolding to allow students to gradually build a coherent strategy to tackle the research problem. Teacher's role is crucial. The teacher, by questioning and inducing reasoning and discussion, promotes encourages and regulates the cognitive activity of students. Some level of autonomy should be given to the students in large group collaborative work.
What Works Clearinghouse, 2012
"Project SEED" is a supplemental mathematics program for low-achieving students in grades 3 through 8 and is intended to prepare students to be successful in high school and college math. Based on the Socratic method, instruction is delivered through a series of questions to the class. In addition to individual responses, the instructor…
This study analyzed client's related factors that constrain project management success of public and private sector construction in Nigeria. Issues that concern clients in any project can not be undermined as they are the owners and the initiators of project proposals. It is assumed that success, failure or abandonment of ...
Full Text Available The purpose of this study is to determine the critical success factors (CSF of IT projects in Pa-kistan. The identified factors cannot only be functional to exact type IT projects but also to all types of IT projects, their success directly affects the achievement of whole organization. The proposed study of this paper has determined 15 factors influencing the most on the success of IT projects through multiple regression analysis. The survey has disclosed that many CSFs were found related to IT projects but these 15 factors are also the backbone of IT projects. The re-search results obtained clearly indicated that the Leadership Qualities played a significant role in obtaining Top Management support in order to access to resources however, the Leadership Qualities did not play any role on the trained and capable Project Team Members. Besides, it is undoubtedly defined effective communication of the project was established to be influential on the conclusion and contributing factor towards the Success of IT projects in Pakistan. Top Man-agement Support as a whole was not found to play a key role in the IT Project Success.
Zakaria, Siti Fairus; Zin, Rosli Mohamad; Mohamad, Ismail; Balubaid, Saeed; Mydin, Shaik Hussein; Mohd Rahim, E. M. Roodienyanto
Construction of infrastructure project is different from buildings. The main difference is term of project site where infrastructure project need to command a long stretch while building mostly confine to a limited area. As such factors that are critical to infrastructure project may not be that significant to building project and vice versa. Flood mitigation can be classified under infrastructure projects under which their developments are planned by the government with the specific objective to reduce or avoid the negative effects of flood to the environment and livelihood. One of the indicators in project success is delay. The impact of project delay in construction industry is significant that it decelerates the projects implementation, specifically the government projects. This study attempted to identify and compare the success factors between infrastructure and building projects, as such comparison rarely found in the current literature. A model of flood mitigation projects' success factors was developed by merging the experts' views and reports from the existing literature. The experts' views were obtained from the responses to open-ended questions on the required fundamentals to achieve successful completion of flood mitigation projects. An affinity analysis was applied to these responses to develop the model. The developed model was then compared to the established success factors found in building project, extracted from the previous studies to identify the similarities and differences between the two models. This study would assist the government and construction players to become more effective in constructing successful flood mitigation projects for the future practice in a flood-prone country like Malaysia.
Myrowitz, Elliott H
The development and progression of early onset myopia is actively being investigated. While myopia is often considered a benign condition it should be considered a public health problem for its visual, quality of life, and economic consequences. Nearly half of the visually impaired population in the world has uncorrected refractive errors, with myopia a high percent of that group. Uncorrected visual acuity should be screened for and treated in order to improve academic performance, career opportunities and socio-economic status. Genetic and environmental factors contribute to the onset and progression of myopia. Twin studies have supported genetic factors and research continues to identify myopia genetic loci. While multiple myopia genetic loci have been identified establishing myopia as a common complex disorder, there is not yet a genetic model explaining myopia progression in populations. Environmental factors include near work, education levels, urban compared to rural location, and time spent outdoors. In this field of study where there continues to be etiology controversies, there is recent agreement that children who spend more time outdoors are less likely to become myopic. Worldwide population studies, some completed and some in progress, with a common protocol are gathering both genetic and environmental cohort data of great value. There have been rapid population changes in prevalence rates supporting an environmental influence. Interventions to prevent juvenile myopia progression include pharmacologic agents, glasses and contact lenses. Pharmacological interventions over 1-2 year trials have shown benefits. Peripheral vision defocus has been found to affect the emmetropization process and may be affected by wearing glasses or contacts. Accommodation accuracy also has been implicated in myopia progression. Further research will aim to assess both the role and interaction of environmental influences and genetic factors.
This work consists of two essays on law and finance in international trade. It addresses the means of raising funds for investment through receivables financing and project finance. The first essay discusses the role of receivables financing and in particular factoring in international trade. It examines the nature of factoring transactions and presents the efforts at regulation on an international level aimed at overcoming the difficulties in enforcement. The second essay discusses project f...
Van Lippevelde, Wendy; Bere, Elling; Verloigne, Maïté; van Stralen, Maartje M; De Bourdeaudhuij, Ilse; Lien, Nanna; Vik, Frøydis Nordgård; Manios, Yannis; Grillenberger, Monika; Kovács, Eva; ChinAPaw, Mai J M; Brug, Johannes; Maes, Lea
Screen-related behaviours are highly prevalent in schoolchildren. Considering the adverse health effects and the relation of obesity and screen time in childhood, efforts to affect screen use in children are warranted. Parents have been identified as an important influence on children's screen time and therefore should be involved in prevention programmes. The aim was to examine the mediating role of family-related factors on the effects of the school-based family-focused UP4FUN intervention aimed at screen time in 10- to 12-year-old European children (n child-parent dyads = 1940). A randomised controlled trial was conducted to test the six-week UP4FUN intervention in 10- to 12-year-old children and one of their parents in five European countries in 2011 (n child-parent dyads = 1940). Self-reported data of children were used to assess their TV and computer/game console time per day, and parents reported their physical activity, screen time and family-related factors associated with screen behaviours (availability, permissiveness, monitoring, negotiation, rules, avoiding negative role modeling, and frequency of physically active family excursions). Mediation analyses were performed using multi-level regression analyses (child-school-country). Almost all TV-specific and half of the computer-specific family-related factors were associated with children's screen time. However, the measured family-related factors did not mediate intervention effects on children's TV and computer/game console use, because the intervention was not successful in changing these family-related factors. Future screen-related interventions should aim to effectively target the home environment and parents' practices related to children's use of TV and computers to decrease children's screen time. The study is registered in the International Standard Randomised Controlled Trial Number Register (registration number: ISRCTN34562078).
Reis, Stephen P; White, Benjamin; Sutphin, Patrick D; Pillai, Anil K; Kalva, Sanjeeva P; Toomay, Seth M
An important component of maintenance of certification and quality improvement in radiology is the practice quality improvement (PQI) project. In this article, the authors describe several methodologies for initiating and completing PQI projects. Furthermore, the authors illustrate several tools that are vital in compiling, analyzing, and presenting data in an easily understandable and reproducible manner. Last, they describe two PQI projects performed in an interventional radiology division that have successfully improved the quality of care for patients. Using the DMAIC (define, measure, analyze, improve, control) quality improvement framework, interventional radiology throughput has been increased, to lessen mediport wait times from 43 to 8 days, and mediport infection rates have decreased from more than 2% to less than 0.4%. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
The effect of post-discharge educational intervention on patients in achieving objectives in modifiable risk factors six months after discharge following an episode of acute coronary syndrome, (CAM-2 Project: a randomized controlled trial
de Teresa-Galván ß Eduardo
Full Text Available Abstract Objectives We investigated whether an intervention mainly consisting of a signed agreement between patient and physician on the objectives to be reached, improves reaching these secondary prevention objectives in modifiable cardiovascular risk factors six-months after discharge following an acute coronary syndrome. Background There is room to improve mid-term adherence to clinical guidelines' recommendations in coronary heart disease secondary prevention, specially non-pharmacological ones, often neglected. Methods In CAM-2, patients discharged after an acute coronary syndrome were randomly assigned to the intervention or the usual care group. The primary outcome was reaching therapeutic objectives in various secondary prevention variables: smoking, obesity, blood lipids, blood pressure control, exercise and taking of medication. Results 1757 patients were recruited in 64 hospitals and 1510 (762 in the intervention and 748 in the control group attended the six-months follow-up visit. After adjustment for potentially important variables, there were, between the intervention and control group, differences in the mean reduction of body mass index (0.5 vs. 0.2; p Conclusions At least in the short term, lifestyle changes among coronary heart disease patients are achievable by intensifying the responsibility of the patient himself by means of a simple and feasible intervention.
Verbestel, Vera; De Henauw, Stefaan; Maes, Lea; Haerens, Leen; Mårild, Staffan; Eiben, Gabriele; Lissner, Lauren; Moreno, Luis A; Frauca, Natalia Lascorz; Barba, Gianvincenzo; Kovács, Eva; Konstabel, Kenn; Tornaritis, Michael; Gallois, Katharina; Hassel, Holger; De Bourdeaudhuij, Ilse
The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory- and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The
This project highlighted best practice in the planning and assessment of proposals with the aim of: encouraging more successful renewable energy projects and proposals; lowering financial and other barriers; and stimulating a climate for success. Based on the analysis of a number of case studies, data was collected through a series of extensive interviews to identify why certain schemes were considered successful, what might have been done differently and which factors were considered important when entering a market. The Critical Success Factors can be broken down into five groups: Universal CSFs; CSFs for funding bodies; CSFs for managing agencies; CSFs for niche markets; CSFs for individual technologies. (author)
Shoebox sized and smaller, small-form-factor PCs can pack as much computing muscle as a full-sized desktop computer. They consumer less power, have few or no moving parts, and are very quiet. Whether you plan to use one as a standalone PC or want to embed it in your next hacking project, a small-form-factor PC can be a lot of fun to build. Make Projects: Small Form Factor PCs is the only book available that shows you how to build small-form-factor PCs -- from kits and from scratch -- that are more interesting and more personalized than what a full-sized PC can give you. Included in the book
Husaini Salleh; Mohd Khalid Matori; Muhammad Jamal Mat Isa; Zainal Jamaluddin; Mohd Firdaus Abdul Rahman; Mohd Khairusalih Mohd Zin
Interventional Radiology (IR) is subspecialty of diagnostic radiology where minimally invasive procedures are performed using an x-ray as a guidance. This procedure can deliver high radiation doses to patient and medical staff compared with other radiological method due to long screening time. The use of proper shielding, shorten the exposure time and keep the distance are the practices to reduce scattered radiation risks to staff involve in this procedure. This project is to study the distance factor on reducing the scattered radiation effect to the medical staff. It also may provide the useful information which can be use to establish the scattered radiation profile during the IR for the sake of radiation protection and safety to the medical staff involved. (author)
Cabal, H.; Varela, M.; Lago, C.; Saez, R. M.
The Spanish wind energy market has experienced an average annual increase over 60% in recent years. With more than 4.1 GW of power at the end of 2002, this market has became the second in Europe and the third in the world. With the objective of obtaining the origin of this success, an analysis of technical and economic features of selected wind projects has been undertaken to draw the outstanding factors that any new independent promoter/developer should take into account within this market. (Author) 16 refs
Roxana Ioana Banciu
Full Text Available The paper seeks to develop an analysis of the South Stream project in view of the Ukrainian crisis. We cannot put aside the internal factor as Ukraine is facing serious internal issues such as corruption and instability, therefore Russia’s invasion of Ukraine can not be simply ignored in this pipeline project. The article uses mostly facts that happened throughout last years, as well as for and against declarations in the case of the South Stream project and its mother Russia. When we hear about South Stream, we think of Russia and since 2007, this pipeline has encouraged Putin’s faith in energy superpower. A good point to start with was to gather all declarations since then and cover all actions that regard the South Stream game. In Russian foreign policy for the South Stream race, Soft Power was used more than enough and it has recently made room for Hard Power, which is the Ukraine never ending episode. Insights of the South Stream story have been lately related both softly and hardly, this is the reason why I have chosen to analyse both sides in order to complete the energy landscape.
Rojatz, Daniela; Merchant, Almas; Nitsch, Martina
Although workplace health promotion (WHP) has evolved over the last 40 years, systematically collected knowledge on factors influencing the functioning of WHP is scarce. Therefore, a qualitative systematic literature review was carried out to systematically identify and synthesize factors influencing the phases of WHP interventions: needs assessment, planning, implementation and evaluation. Research evidence was identified by searching electronic databases (Scopus, PubMed, Social Sciences Citation Index, ASSIA, ERIC, IBBS and PsycINFO) from 1998 to 2013, as well as by cross-checking reference lists of included peer-reviewed articles. The inclusion criteria were: original empirical research, description of WHP, description of barriers to and/or facilitators of the planning, implementation and/or evaluation of WHP. Finally, 54 full texts were included. From these, influencing factors were extracted and summarized using thematic analysis. The majority of influencing factors referred to the implementation phase, few dealt with planning and/or evaluation and none with needs assessment. The influencing factors were condensed into topics with respect to factors at contextual level (e.g. economic crisis); factors at organizational level (e.g. management support); factors at intervention level (e.g. quality of intervention concept); factors at implementer level (e.g. resources); factors at participant level (e.g. commitment to intervention) and factors referring to methodological and data aspects (e.g. data-collection issues). Factors regarding contextual issues and organizational aspects were identified across three phases. Therefore, future research and practice should consider not only the influencing factors at different levels, but also at different phases of WHP interventions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Metaphors are pervasive in human thought and action, but have been an overlooked X-factor in projects and project management. This essay presents deliberate uses of metaphors classified into specific projects and frameworks for projects in order to stimulate explicit uses of metaphors in project...
Full Text Available Intervention programs aimed at promoting study and work opportunities in the Information and Communications Technology (ICT field to schoolgirls have been encouraged to combat a decline in the interest among girls to study ICT at school. The goal of our study is to investigate the influence of such interventions on schoolgirls’ intentions to choose a career in the ICT field by analysing comprehensive survey data (n = 3577, collected during four interventions in Australia, using the Partial Least Squares method. Our study is also aimed at identifying other factors influencing ICT career intentions. We found that the attitude towards interventions has an indirect influence on ICT career intentions by affecting interest in ICT. Our results also challenge several existing theoretical studies by showing that factors that had previously been suggested as influencers were found to have little or no impact in this study, these being same-sex education and computer usage.
Freedman, Darcy A; Bell, Bethany A; Collins, Leslie V
This case study provides an in-depth examination of process and feasibility factors associated with the development of a multi-component environmental intervention designed to increase access to fresh fruits and vegetables in four low-income, minority, urban communities with few healthy food retail outlets. The intervention, the Veggie Project, included three components: (a) onsite farmers' markets, (b) a Super Shopper voucher program, and (c) a Youth Leader Board. We analyzed receipts from sales transactions at the farmers' markets, close-ended surveys with participants, in-depth interviews with project stakeholders, and journal entries completed by youth participants. Thirty-four farmers' markets occurred, resulting in 1,101 sales transactions. Financial vouchers were used to purchased 63% of the produce. All of the youth Super Shoppers came to the market at least once and made significantly more purchase transactions than adults. The farmers' markets were never accessed by 38% of the adult Super Shoppers. The Veggie Project increased access to healthy foods, particularly among youth. More research is warranted to examine the relationship between market use and dietary behaviors as well as other factors (i.e., besides physical and economic) influencing food access among adults.
Fredriksen, Per Morten; Hjelle, Ole Petter; Mamen, Asgeir; Meza, Trine J; Westerberg, Ane C
The prevalence of non-communicable diseases (NCDs) is increasing worldwide, also among children. Information about primary prevention of NCD's is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP) study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables. The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545) with two control schools (n = 752); all aged 6-11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA) of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL), non-HDL, micro C-reactive protein (mCRP) and long-term blood sugar (HbA1c). In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL), mental health, executive functions, diet and academic performance. HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention. The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 ) as of June 20 th - 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.
Per Morten Fredriksen
Full Text Available Abstract Background The prevalence of non-communicable diseases (NCDs is increasing worldwide, also among children. Information about primary prevention of NCD’s is increasing; however, convincing strategies among children is needed. The present paper describes the design and methods in the Health Oriented Pedagogical Project (HOPP study. The main objective is to evaluate the effects of a school-based physical activity intervention program on cardio-metabolic risk factors. Secondary objectives include assessment of physical, psychological and academic performance variables. Methods The HOPP study is a 7 years longitudinal large-scale controlled intervention in seven elementary schools (n = 1545 with two control schools (n = 752; all aged 6–11 years at baseline. The school-based physical activity intervention program includes an increase in physical activity (PA of 225 min/week as an integrated part of theoretical learning, in addition to the curriculum based 90 min/week of ordinary PA. Primary outcomes include cardio-metabolic risk factors measured as PA level, BMI status, waist circumference, muscle mass, percent fat, endurance test performance, total serum cholesterol, high-density lipoprotein (HDL, non-HDL, micro C-reactive protein (mCRP and long-term blood sugar (HbA1c. In addition, secondary outcomes include anthropometric growth measures, physical fitness, quality of life (QoL, mental health, executive functions, diet and academic performance. Discussion HOPP will provide evidence of effects on cardio-metabolic risk factors after a long-term PA intervention program in elementary schoolchildren. School-based PA intervention programs may be an effective arena for health promotion and disease prevention. Trial registration The study is registered in Clinical trials (ClinicalTrials.gov Identifier: NCT02495714 as of June 20th – 2015, retrospectively registered. The collection of baseline values was initiated in mid-January 2015.
labour productivity in Bayelsa State of Nigeria from the perspectives of building craftsmen and project supervisors/engineers. ..... Technology in. Environmental Sanitation, 1(2), 163-170. ... Benchmarking of Construction Productivity. Journal of ...
Full Text Available Cerebrovascular diseases are important causes of clinical death and disability because of high prevalence and morbidity and easy to recurrence. A number of risk factors have involved in the progress of cerebrovascular diseases, which include uncontrolled and controlled risk factors. The former refers to old age, gender, low birth weight, race/ethnicity, genetic factors, etc. The latter includes hypertension, diabetes mellitus, atrial fibrillation and other cardiac diseases, dyslipidemia, asymptomatic carotid stenosis, obesity, smoking, unhealthy lifestyle, alcoholism, metabolic syndrome, hyperhomocysteinemia, etc. Meanwhile, hypertension is the most important one in the above-mentioned risk factors. It would effectively reduce or postpone the onset of cerebrovascular diseases through proper intervention and management on those risk factors. DOI: 10.3969/j.issn.1672-6731.2015.01.006
Alagba, Tonye J.
Oil and gas drilling projects are the primary means by which oil companies recover large volumes of commercially available hydrocarbons from deep reservoirs. These types of projects are complex in nature, involving management of multiple stakeholder interfaces, multidisciplinary personnel, complex contractor relationships, and turbulent environmental and market conditions, necessitating the application of proven project management best practices and critical success factors (CSFs) to achieve success. Although there is some practitioner oriented literature on project management CSFs for drilling projects, none of these is based on empirical evidence, from research. In addition, the literature has reported alarming rates of oil and gas drilling project failure, which is attributable not to technical factors, but to failure of project management. The aim of this quantitative correlational study therefore, was to discover an empirically verified list of project management CSFs, which consistent application leads to successful implementation of oil and gas drilling projects. The study collected survey data online, from a random sample of 127 oil and gas drilling personnel who were members of LinkedIn's online community "Drilling Supervisors, Managers, and Engineers". The results of the study indicated that 10 project management factors are individually related to project success of oil and gas drilling projects. These 10 CSFs are namely; Project mission, Top management support, Project schedule/plan, Client consultation, Personnel, Technical tasks, Client acceptance, Monitoring and feedback, Communication, and Troubleshooting. In addition, the study found that the relationships between the 10 CSFs and drilling project success is unaffected by participant and project demographics---role of project personnel, and project location. The significance of these findings are both practical, and theoretical. Practically, application of an empirically verified CSFs list to oil
Lai, Siew-Tim; Lim, Kheng-Seang; Tang, Venus; Low, Wah-Yun
Positive psychological interventions (PPI) are increasingly employed as a coping strategy with physical and mental conditions, including neurological diseases. Its effectiveness on improving wellbeing in people with epilepsy (PWE) has been shown in a few studies. This study aimed to explore factors related to participants' willingness to engage in psychological interventions from the perspective of patients with epilepsy. Participants answered a needs assessment questionnaire eliciting information about their illness perception (Brief Illness Perception Questionnaire (Brief-IPQ)), emotions (Hospital Anxiety and Depression Scale (HADS)), willingness to participate in psychological interventions, preferences in types of PPI and intervention designs, as well as barriers in seeking mental health services. A total of 154 patients with epilepsy participated, with a mean age of 37.3years (range 16-86years). Most patients had focal epilepsy (68.2%), and drug-resistant (59.1%). Majority (71.4%) of them indicated a strong willingness to participate in PPI. Out of nine types of PPI, character strengths, mindfulness-based and expressive-based interventions were highly preferred. Those with negative illness perception (p=0.001), anxiety (p=0.004), and being unemployed (p=0.048) were more willing to participate in PPI. Most participants preferred group rather than individual session, and a shorter duration (30min) was favored by most. This study captured the self-report willingness to participate in psychological interventions. Findings suggested that psychological interventions delivered in short-group session were highly preferred. Future study is required to determine the feasibility of such design for patients with epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available This paper present review and analysis of risk factors, which could affect successful implementation of ERP system, for project performed in project oriented organizations. Presented risk breakdown structure and the list of common risk factors, are well-suited for ERP implementation projects. Considered risk categories allow for complex risk analysis. Additionally, mapping of risk importance for particular implementation phases is presented. Making presented model an important input for project risk management process, especially for the beginning phases which require identification of risk factors.
Swapnil P Wanjari
Cost overrun in India; ANOVA; factor analysis; construction projects. 1. Introduction ... gramme Implementation in India , projects of public .... case if a respondent never came across of such factor. ..... The co-relation matrix for variables of cost overruns was ..... There are various problems observed due to communication.
Amer, Tahani R.
NASA is a good investment of federal funds and strives to provide the best value to the nation. NASA has consistently budgeted to unrealistic cost estimates, which are evident in the cost growth in many of its programs. In this investigation, NASA has been using available uncertainty factors from the Aerospace Corporation, Air Force, and Booz Allen Hamilton to develop projects risk posture. NASA has no insight into the developmental of these factors and, as demonstrated here, this can lead to unrealistic risks in many NASA Programs and projects (P/p). The primary contribution of this project is the development of NASA missions uncertainty factors, from actual historical NASA projects, to aid cost-estimating as well as for independent reviews which provide NASA senior management with information and analysis to determine the appropriate decision regarding P/p. In general terms, this research project advances programmatic analysis for NASA projects.
Feraru Galina Sergeevna
Full Text Available The article addresses issues characterizing features of project management contributing to their competitive advantage; shows the factors and criteria of success of projects and the main reasons for their failures, making the failed efforts of developers to create projects.
S. Verweij (Stefan); I.F. van Meerkerk (Ingmar); J.F.M. Koppenjan (Joop); H. Geerlings (Harry)
markdownabstract__Abstract__ Urban planning projects are planned and organized through arrangements between actors. These arrangements are institutional interventions: they intervene in the institutional landscape as existing organizational boundaries are (temporarily) redrawn. Such boundary
Full Text Available BACKGROUND: The purpose of this study is to evaluate the possible difference of the impact of Women Healthy Heart Project on lifestyle, as well as physical/biochemical parameters of working women and housewives. METHODS: This was a community-based intervention study conducted over 5 years (2002-2007 in the counties of Isfahan and Najafabad (intervention areas and Arak (control. Pre-study situation analysis of women was followed by 5 years of wide-ranging interventions (educational/environmental conducted by various organizations using different methodologies. The interventions were aimed at modifying/improving lifestyle by increasing physical activity, encouraging healthy eating, and tobacco use cessation. The organizations involved in performing the interventions included the local radio and television authority, health/treatment centers, the Red Crescent Society, Municipalities, the Relief Committee, the Center for Retirees’ Welfare, and the Literacy Campaign Organization. After 5 years, final phase same as first phase was planed. The subjects studied in all phases` the pre- and post-intervention phases consisted of 10586 women aged above 18 years. Demographic data, obesity index, smoking, physical activity and eating habit were assessed before and after the study. Data were analyzed using SPSS-15 using Student’s t-test, chi-square test, the general linear model of ANOVA, and logistic regression. RESULTS: We studied 10586 women (6105 and 4481 women, pre- and post-intervention, respectively. Mean age of working women was 34.14 ± 10.09 and 34.08 ± 9.35 years before and after the study, respectively. Mean age of housewives before and after the study was 40.05 ± 14.61 and 40.36 ± 15.32 years, respectively. Interventions conducted during 5 years improved eating habits and decreased tobacco use in working women and housewives. In every phase of the study, there was a significant age difference between housewives and working women
Karunakaran, P.; Abdullah, A. H.; Nagapan, S.; Sohu, S.; Kasvar, K. K.
Cost overrun has been severely hit down the economy and reputations for many construction industry around the world. Many project management tools developed to control the budget of a project. However, the cost management is still considered poor as there are many cost overrun issues occurred in the construction industry. Thus, this paper aims to identify and cluster the potential construction project cost overrun factors according to their originating groups using the thematic approach. Basically, through literature review, all the potential factors that may cause cost overrun were screened thoroughly before they were clustered into seven (7) groups of the originating factors, namely project, contract, client, contractor, consultant, labour and external. Each potential factor was explained clearly with some examples based on the Malaysian case studies to illustrate the cost overrun scenario. These findings may aid in the future to highlight on how to mitigate the critical potential factors of cost overrun to reduce or overcome its impact on all the stakeholders involved.
Yao Weiguang; Leszczynski, Konrad
Weighting factors, which define the contributions of individual voxels of a 3D object to individual projection elements (pixels) on the detector, are the basic elements required in iterative tomographic reconstructions from transmission projections. Exact or as accurate as possible values for weighting factors are required in high-resolution reconstructions. Geometric complexity of the problem, however, makes it difficult to obtain exact weighting factor values. In this work, we derive an analytical expression for the weighting factors in cone beam projection geometry. The resulting formula is validated and applied to reconstruction from mega and kilovoltage x-ray cone beam projections. The reconstruction speed and accuracy are significantly improved by using the weighting factor values.
Karmaliani, Rozina; Pasha, Aneeta; Hirani, Saima; Somani, Rozina; Hirani, Shela; Asad, Nargis; Cassum, Laila; McFarlane, Judith
Pakistan ranks 125th out of 169 countries on the Gender Development Index and has high prevalence rates of Violence against Women (VAW). Contributing factors toward gender based violence at the micro, meso and macro levels include the acceptability of violence amongst both men and women, internalization of deservability, economic disempowerment, lack of formal education, joint family systems, entrenched patriarchal norms and values, and a lack of awareness of legal and other support systems. These factors have a long-lasting impact on the health of women and children. The gender disparities in the experience of women seeking health care in Pakistan are well-recognized and documented. In the past, common government policy responses to these disparities have included developing the role of community health workers (CHWs) and lady health visitors (LHVs). Despite being commendable initiatives, these too have been unsuccessful in addressing these multi-faceted disparities. Within this complex scenario, new interventions to address VAW and its impact on health in Pakistan include Group Counselling, Economic Skills Building, Health-Based Microfinance, and Family-Based models that increase male involvement, especially at the primary health care level. The purpose of this article is to outline key contributing factors to VAW, explore tested and new interventions, and highlight the opportunities that exist in implementing them.
Macy, Daniel J.; And Others
Project DEBT (Developmental Education Birth through Two), an early identification and intervention program for handicapped and at risk children and their parents, is described. The Koontz Child Developmental Program, the core curriculum for instructional planning and intervention in DEBT, is reviewed, and new data are presented. It is explained…
Zusevics, Kaija L.; Johnson, Sheri
Hope is positively correlated with educational attainment and health. Interventions based on project-based learning (PBL) may increase youth hope. This study examined how a PBL intervention affected hope among urban students of color. Students in health classes were invited to participate. A PBL health class was implemented in four classrooms. The…
Liew, H B; Rosli, M A; Wan Azman, W A; Robaayah, Z; Sim, K H
The National Cardiovascular Database for Percutaneous Coronary Intervention (NCVD PCI) Registry is the first multicentre interventional cardiology project, involving the main cardiac centres in the country. The ultimate goal of NCVD PCI is to provide a contemporary appraisal of PCI in Malaysia. This article introduces the foundation, the aims, methodology, database collection and preliminary results of the first six-month database.
Vanhavere, F.; Carinou, E.; Domienik, J.; Donadille, L.; Ginjaume, M.; Gualdrini, G.; Koukorava, C.; Krim, S.; Nikodemova, D.; Ruiz-Lopez, N.; Sans-Merce, M.; Struelens, L.
Within the ORAMED project (Optimization of Radiation Protection of Medical Staff) a coordinated measurement program for occupationally exposed medical staff was performed in different hospitals in Europe ( (www.oramed-fp7.eu)). The main objective was to obtain a set of standardized data on extremity and eye lens doses for staff involved in interventional radiology and cardiology and to optimize radiation protection. Special attention was given to the measurement of the doses to the eye lenses. In this paper an overview will be given of the measured eye lens doses and the main influence factors for these doses. The measured eye lens doses are extrapolated to annual doses. The extrapolations showed that monitoring of the eye lens should be performed on routine basis.
Wesam Salah Alaloul
Full Text Available Construction projects performance requires improvement to fulfil the complexity of the stakeholders’ needs and expectations. Coordination process is proposed as an efficient solution for weak performance of construction projects. Therefore, coordination factors are vital in ensuring a successful implementation of all project phases. This study aimed to identify and prioritise coordination factors that influence the performance of building projects in Malaysian context. A vast body of literature on coordination process was reviewed and resulted in 53 coordination factor. Three rounds of Delphi technique were conducted. The most effective coordination factors were ranked based on the Relative Importance Index (RII such as Scheduling (RII = 0.97, Quality assurance plan (RII = 0.93, and all parties’ participation in plans (RII = 0.89. These coordination factors have fulfilled the research gap and provided better management and higher performance for project parties. The results offer insightful perspectives to define the most effective coordination factors, for addressing the dependency between project tasks and the parties to enhance project performance.
Jusoh Zairra Mat
Full Text Available Construction projects are more often than not plagued by poor performances such as delays, cost overrun, low productivity, construction wastes and compromised quality. Amongst the critical contributory factors of poor project performances, is the ineffectiveness of materials management occurring in the construction sites. Indeed, materials management is a very important component for construction projects. However, there are only limited numbers of research available regarding this topic. Thus, this research focuses its study on materials management, specifically in identifying the influential factors that affect materials management in the construction project activities. Literatures from books, journal articles and conference papers related to poor project performances and materials management have been reviewed. Consequently, this study sorted the salient influential factors and categorized them based on their specific group. Out of 47 factors identified, they are classified into 8 groups. They are (1 site condition; (2 planning and handling on site; (3 management; (4 materials; (5 supplier and manufacturer default; (6 transportation; (7 contractual; and (8 governmental interferences. In conclusion, this study contends that by identifying the influential factors affecting materials management, it will help construction players to avoid the occurrence of those factors and will minimize the negative impacts on the overall performance of construction projects. Hence, the handling-over of project will be according to schedule and not delayed by materials mismanagement.
What Works Clearinghouse, 2010
"Project Read"[R] is a multisensory language arts curriculum designed for use in a classroom or group setting. Two main objectives of the program are to use language in all its forms, and to use responsive instruction rather than preplanned textbook lessons. The program emphasizes direct instruction, and lessons move from letter-sounds…
Escamilla, Kathy; And Others
During the 1989-90 school year, Descubriendo la Lectura, a Spanish-language adaptation of the English Reading Recovery project was implemented in a large urban school district in Arizona. The program is designed to identify first-grade students at risk of becoming poor readers and to provide a series of intense short-term learning experiences that…
Full Text Available Abstract This research project dealt with the factors affecting governance of Food security and livelihood projects a case study of the Food security and livelihood project that was implemented by AAIDRO in Monduli district and included 60 respondents all together. The specific objectives of this study intended to access the Leadership styles that are being used in project governance. The findings of the study indicated that 91.7 of the respondents were in favor of their leaders project governance styles it was portrayed that participative leadership style was being used by the leaders for project governance. Based on a sample of 60 project members this study had confirmed that a project leaders leadership roles like mentor facilitator innovator and coordinator are important in influencing project governance effectiveness which includes team mission goal achievement and empowerment open and honest communication
Determining critical success factor of it project management and its influence towards the ... Journal of Fundamental and Applied Sciences ... respondents who have background in IT management in both public and private sector to gain ...
Several Literatures in construction management support the view that procurements have impacts on project performance. Aim of this study is to investigate the effects of procurement related factors of procurement selection criteria, tendering methods and variation orders on project performance. Purpose of the study is to ...
This study was carried out with a view to showing the contribution of delay factors in the overall consideration of failed construction projects in south western Nigeria. This is considered necessary because the traditional view of construction project failure as consisting mainly of structural or functional failures tends to excuse ...
The study evaluated factors affecting sustainability of land reform projects in Mpumalanga Province in Bushbuckridge Local Municipality (BLM) of Ehlanzeni District. The study was conducted between July and September 2014. A random sampling technique was used in selecting 31 key informants from the projects.
Bosch-Sijtsema, Petra M.; Postma, Theo J. B. M.
In this study we examine governance factors affecting knowledge transfer in interorganisational development projects. There is a gap in the literature indicating a need for more insights into processes of knowledge sharing and governance of interorganisational development projects. By using cases
Crous-Bou, Marta; Minguillón, Carolina; Gramunt, Nina; Molinuevo, José Luis
Due to the progressive aging of the population, Alzheimer's disease (AD) is becoming a healthcare burden of epidemic proportions for which there is currently no cure. Disappointing results from clinical trials performed in mild-moderate AD dementia combined with clear epidemiological evidence on AD risk factors are contributing to the development of primary prevention initiatives. In addition, the characterization of the long asymptomatic stage of AD is allowing the development of intervention studies and secondary prevention programmes on asymptomatic at-risk individuals, before substantial irreversible neuronal dysfunction and loss have occurred, an approach that emerges as highly relevant.In this manuscript, we review current strategies for AD prevention, from primary prevention strategies based on identifying risk factors and risk reduction, to secondary prevention initiatives based on the early detection of the pathophysiological hallmarks and intervention at the preclinical stage of the disease. Firstly, we summarize the evidence on several AD risk factors, which are the rationale for the establishment of primary prevention programmes as well as revising current primary prevention strategies. Secondly, we review the development of public-private partnerships for disease prevention that aim to characterize the AD continuum as well as serving as platforms for secondary prevention trials. Finally, we summarize currently ongoing clinical trials recruiting participants with preclinical AD or a higher risk for the onset of AD-related cognitive impairment.The growing body of research on the risk factors for AD and its preclinical stage is favouring the development of AD prevention programmes that, by delaying the onset of Alzheimer's dementia for only a few years, would have a huge impact on public health.
Oorschot, van K.E.; Langerak, F.; Sengupta, K.
At the start of any project, new product development (NPD) teams must make accurate decisions about development time, development costs, and product performance. Such profit-maximizing decision making becomes particularly difficult when the project runs behind schedule and requires intervention
Wu Dangshi; Sheng Jufang
'THE PRACTICAL GUIDE FOR APPLICATION OF HUMAN FACTORS ENGINEERING TO NUCLEAR POWER PROJECT (First Draft, in Chinese)', which was developed under a research program sponsored by National Nuclear Safety Administration (NNSA) is described briefly. It is hoped that more conscious, more systematical and more comprehensive application of Human Factors Engineering to the nuclear power projects from the preliminary feasibility studies up to the commercial operation will benefit the safe, efficient and economical operations of nuclear power plants in China
Emma J Adams
Full Text Available Promoting walking for the journey to and from work (commuter walking is a potential strategy for increasing physical activity. Understanding the factors influencing commuter walking is important for identifying target groups and designing effective interventions. This study aimed to examine individual, employment-related and psychosocial factors associated with commuter walking and to discuss the implications for targeting and future design of interventions.1,544 employees completed a baseline survey as part of the 'Walking Works' intervention project (33.4% male; 36.3% aged <30 years. Multivariate logistic regression was used to examine the associations of individual (age, ethnic group, educational qualifications, number of children <16 and car ownership, employment-related (distance lived from work, free car parking at work, working hours, working pattern and occupation and psychosocial factors (perceived behavioural control, intention, social norms and social support from work colleagues with commuter walking.Almost half of respondents (n = 587, 49% were classified as commuter walkers. Those who were aged <30 years, did not have a car, had no free car parking at work, were confident of including some walking or intended to walk to or from work on a regular basis, and had support from colleagues for walking were more likely to be commuter walkers. Those who perceived they lived too far away from work to walk, thought walking was less convenient than using a car for commuting, did not have time to walk, needed a car for work or had always travelled the same way were less likely to be commuter walkers.A number of individual, employment-related and psychosocial factors were associated with commuter walking. Target groups for interventions to promote walking to and from work may include those in older age groups and those who own or have access to a car. Multi-level interventions targeting individual level behaviour change, social support within
Adams, Emma J; Esliger, Dale W; Taylor, Ian M; Sherar, Lauren B
Promoting walking for the journey to and from work (commuter walking) is a potential strategy for increasing physical activity. Understanding the factors influencing commuter walking is important for identifying target groups and designing effective interventions. This study aimed to examine individual, employment-related and psychosocial factors associated with commuter walking and to discuss the implications for targeting and future design of interventions. 1,544 employees completed a baseline survey as part of the 'Walking Works' intervention project (33.4% male; 36.3% aged employment-related (distance lived from work, free car parking at work, working hours, working pattern and occupation) and psychosocial factors (perceived behavioural control, intention, social norms and social support from work colleagues) with commuter walking. Almost half of respondents (n = 587, 49%) were classified as commuter walkers. Those who were aged work, were confident of including some walking or intended to walk to or from work on a regular basis, and had support from colleagues for walking were more likely to be commuter walkers. Those who perceived they lived too far away from work to walk, thought walking was less convenient than using a car for commuting, did not have time to walk, needed a car for work or had always travelled the same way were less likely to be commuter walkers. A number of individual, employment-related and psychosocial factors were associated with commuter walking. Target groups for interventions to promote walking to and from work may include those in older age groups and those who own or have access to a car. Multi-level interventions targeting individual level behaviour change, social support within the workplace and organisational level travel policies may be required in order to promote commuter walking.
Mewes, A; Saalfeld, P; Riabikin, O; Skalej, M; Hansen, C
The interaction with interventional imaging systems within a sterile environment is a challenging task for physicians. Direct physician-machine interaction during an intervention is rather limited because of sterility and workspace restrictions. We present a gesture-controlled projection display that enables a direct and natural physician-machine interaction during computed tomography (CT)-based interventions. Therefore, a graphical user interface is projected on a radiation shield located in front of the physician. Hand gestures in front of this display are captured and classified using a leap motion controller. We propose a gesture set to control basic functions of intervention software such as gestures for 2D image exploration, 3D object manipulation and selection. Our methods were evaluated in a clinically oriented user study with 12 participants. The results of the performed user study confirm that the display and the underlying interaction concept are accepted by clinical users. The recognition of the gestures is robust, although there is potential for improvements. The gesture training times are less than 10 min, but vary heavily between the participants of the study. The developed gestures are connected logically to the intervention software and intuitive to use. The proposed gesture-controlled projection display counters current thinking, namely it gives the radiologist complete control of the intervention software. It opens new possibilities for direct physician-machine interaction during CT-based interventions and is well suited to become an integral part of future interventional suites.
Rahman, Syed Moshfiqur; Ali, Nabeel Ashraf; Jennings, Larissa; Seraji, M Habibur R; Mannan, Ishtiaq; Shah, Rasheduzzaman; Al-Mahmud, Arif Billah; Bari, Sanwarul; Hossain, Daniel; Das, Milan Krishna; Baqui, Abdullah H; El Arifeen, Shams; Winch, Peter J
Well-trained and highly motivated community health workers (CHWs) are critical for delivery of many community-based newborn care interventions. High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale. We investigated reasons for high rates of CHW attrition in Sylhet District in north-eastern Bangladesh. Sixty-nine semi-structured questionnaires were administered to CHWs currently working with the project, as well as to those who had left. Process documentation was also carried out to identify project strengths and weaknesses, which included in-depth interviews, focus group discussions, review of project records (i.e. recruitment and resignation), and informal discussion with key project personnel. Motivation for becoming a CHW appeared to stem primarily from the desire for self-development, to improve community health, and for utilization of free time. The most common factors cited for continuing as a CHW were financial incentive, feeling needed by the community, and the value of the CHW position in securing future career advancement. Factors contributing to attrition included heavy workload, night visits, working outside of one's home area, familial opposition and dissatisfaction with pay. The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW. Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.
Full Text Available Abstract Background Well-trained and highly motivated community health workers (CHWs are critical for delivery of many community-based newborn care interventions. High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale. We investigated reasons for high rates of CHW attrition in Sylhet District in north-eastern Bangladesh. Methods Sixty-nine semi-structured questionnaires were administered to CHWs currently working with the project, as well as to those who had left. Process documentation was also carried out to identify project strengths and weaknesses, which included in-depth interviews, focus group discussions, review of project records (i.e. recruitment and resignation, and informal discussion with key project personnel. Results Motivation for becoming a CHW appeared to stem primarily from the desire for self-development, to improve community health, and for utilization of free time. The most common factors cited for continuing as a CHW were financial incentive, feeling needed by the community, and the value of the CHW position in securing future career advancement. Factors contributing to attrition included heavy workload, night visits, working outside of one's home area, familial opposition and dissatisfaction with pay. Conclusions The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW. Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.
Ishak, Nurfadzillah; Aswad Ibrahim, Fazdliel; Azizi Azizan, Muhammad
Presently, the refurbishment approach becomes favourable as it creates opportunities to incorporate sustainable value with other building improvement. In this regard, this approach needs to be implemented due to the issues on overwhelming ratio of existing building to new construction, which also can contribute to the environmental problem. Refurbishment principles imply to minimize the environmental impact and upgrading the performance of an existing building to meet new requirements. In theoretically, building project's performance has a direct bearing on related to its potential for project success. However, in refurbishment building projects, the criteria for measure are become wider because the projects are a complex and multi-dimensional which encompassing many factors which reflect to the nature of works. Therefore, this impetus could be achieve by examine the direct empirical relationship between critical success factors (CSFs) and complexity factors (CFs) during managing the project in relation to delivering success on project performance. The research findings will be expected as the basis of future research in establish appropriate framework that provides information on managing refurbishment building projects and enhancing the project management competency for a better-built environment.
Aneesha, K.; Haridharan, M. K.
In Today’s construction industry, to achieve a greater advantage over the firms, success of each project and efficiency is required. Effective Project Management overcomes these types of challenges. This study identifies the success factors which are important for project management in construction project success. From the literature review, 26 factors were found to be critical. Project managers, construction managers, civil engineers, contractors and site engineers were the respondents. After analyzing the data in SPSS software, the dominant factors from the regression analysis are top management support, competent project team, abilities to solve problems, realistic cost and time estimates, information/communication, competency of the project manager are the 6 factors out of 12 in 26 factors. Effective communication between stakeholders got highest priority and client involvement, good leadership, clarity of project goals got second priority. Informal communication gives better results compared to formal communications like written formats. To remove communication barrier with the stakeholders, informal communication like speaking face-to-face with the language this fits for the stakeholders.
Herrera-López, Mauricio; Casas, José A; Romera, Eva M; Ortega-Ruiz, Rosario; Del Rey, Rosario
Cyberbullying is the act of using unjustified aggression to harm or harass via digital devices. Currently regarded as a widespread problem, the phenomenon has attracted growing research interest in different measures of cyberbullying and the similarities and differences across countries and cultures. This article presents the Colombian validation of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) involving 3,830 high school students (M = 13.9 years old, standard deviation = 1.61; 48.9 percent male), of which 1,931 were Colombian and 1,899 Spanish. Confirmatory factor analysis (CFA), content validation, and multigroup analysis were performed with each of the sample subgroups. The optimal fits and psychometric properties obtained confirm the robustness and suitability of the assessment instrument to jointly measure cyber-aggression and cyber-victimization. The results corroborated the theoretical construct and the two-dimensional and universal nature of cyberbullying. The multigroup analysis showed that cyberbullying dynamics are similar in both countries. The comparative analyses of prevalence revealed that Colombian students are less involved in cyberbullying. The results indicate the suitability of the instrument and the advantages of using such a tool to evaluate and guide psychoeducational interventions aimed at preventing cyberbullying in countries where few studies have been performed.
Cindrela Devi A.
Full Text Available Construction cost is the most important criteria of project success and hence the construction project performance is generally expressed in terms of cost and its variance from the budget. In spite of having extant literature, cost estimation methods, cost indices etc., construction projects rarely meet the budgeted cost. This research study focuses on the construction cost overrun and to identify the various factors that affects the construction cost performance. Based on an extensive literature review and input from industry experts, sixty eight factors that causes cost overrun were identified for investigation. Further, a structured questionnaire survey was conducted among the industry experts and the collected data has been analysed statistically. It is concluded that the factors namely scope creep, construction delays, rework and practise of awarding the contract to the lowest bidder are most significant factors for construction cost overrun in non-infrastructural Indian projects. The relative importance of the listed factors used to guide the project team in addressing the cost related risks involved in the projects. The findings are expected to bridge the gap in the current construction cost management practices.
Remon Fayek Aziz
Full Text Available Time is one of the major considerations throughout project management life cycle and can be regarded as one of the most important parameters of a project and the driving force of project success. Time delay is a very frequent phenomenon and is almost associated with nearly all constructing projects. However, little effort has been made to curtail the phenomenon, this research work attempts to identify, investigate, and rank factors perceived to affect delays in the Egyptian construction projects with respect to their relative importance so as to proffer possible ways of coping with this phenomenon. To achieve this objective, researcher invited practitioners and experts, comprising a statistically representative sample to participate in a structured questionnaire survey. Brain storming was taken into consideration, through which a number of delay factors were identified in construction projects. Totally, ninety-nine (99 factors were short-listed to be made part of the questionnaire survey and were identified and categorized into nine (9 major categories. The survey was conducted with experts and representatives from private, public, and local general construction firms. The data were analyzed using Relative Importance Index (RII, ranking and simple percentages. Ranking of factors and categories was demonstrated according to their importance level on delay, especially after 25/1/2011 (Egyptian revolution. According to the case study results, the most contributing factors and categories (those need attention to delays were discussed, and some recommendations were made in order to minimize and control delays in construction projects. Also, this paper can serve as a guide for all construction parties with effective management in construction projects to achieve a competitive level of quality and a time effective project.
England, A.; Tam, C.L.; Thacker, D.E.; Walker, A.L.; Parkinson, A.S.; DeMello, W.; Bradley, A.J.; Tuck, J.S.; Laasch, H.-U.; Butterfield, J.S.; Ashleigh, R.J.; England, R.E.; Martin, D.F.
AIM: To evaluate prospectively the pattern, severity and predictive factors of pain after interventional radiological procedures. MATERIALS AND METHODS: All patients undergoing non-arterial radiological interventional procedures were assessed using a visual-analogue scale (VAS) for pain before and at regular intervals for 24 h after their procedure. RESULTS: One hundred and fifty patients (87 men, mean age 62 years, range 18-92 years) were entered into the study. Significant increases in VAS score occurred 8 h after percutaneous biliary procedures (+47.7 mm, SD 14.9 mm; p=0.001), 6 h after central venous access and gastrostomy insertion (+23.7 mm, SD 19.5 mm; p=0.001 and +28.4 mm, SD 9.7 mm; p=0.007, respectively) and 4 h after oesophageal stenting (+27.8 mm, SD 20.2 mm, p=0.001). Non-significant increases in VAS pain score were observed after duodenal and colonic stenting (duodenal: +5.13 mm, SD 7.47 mm; p=0.055, colonic: +23.3 mm, SD 13.10 mm, p=0.250) at a mean of 5 h (range 4-6 h). Patients reported a significant reduction in pain score for nephrostomy insertion (-28.4 mm, SD 7.11 mm, p=0.001). Post-procedural analgesia was required in 99 patients (69.2%), 40 (28.0%) requiring opiates. Maximum post-procedural VAS pain score was significantly higher in patients who had no pre-procedural analgesia (p=0.003). CONCLUSION: Post-procedural pain is common and the pattern and severity of pain between procedures is variable. Pain control after interventional procedures is often inadequate, and improvements in pain management are required
Full Text Available Absorption of European funds is on top of Romania’s public agenda for the last years although the first programming period has ended and the necessary lessons were learned so far. To have a high degree of absorption of funds provided by the EU must be of quality projects and their implementation to be successful. Through this work we aimed to investigate the success factors of infrastructure projects with European funding in Romania, Bulgaria, Moldova, Ukraine, Serbia and Kosovo, and identify critical success factors of these projects through a research surveying the teams of consultants and support personnel from the countries in an international consulting company. The research results are therefore constitute the empirical evidence of what constitutes critical success factors of infrastructure projects financed by the European Union and can be used as a starting point for scientific studies of the management of European projects or other actions that investigates measures that can be taken to improve the success rate of projects implemented in the area mentioned above.One of the contributions of this paper is to identify the critical success factors of success factors present in literature. With more so as they are critical success factors of infrastructure projects with European funding still required field studies and analysis performed in the present context. In addition, the critical factors were operationalized in a conceptual framework. Moreover, this framework includes leadership style of project manager as critical success factor has been identified in the research as the most important in the context in which it was conducted. As such, this paper demonstrates, with the necessary limitations, the importance of management style of project managers in the context of specific European funded infrastructure projects. And this is happening even though there are sophisticated project management tools availabe and relevant knowledge exists
Hatem Khaleefah Al-Ageeli; Abdul Salam J. Ali Alzobaee
The importance of the construction sector and its Great role in the provision of services and infrastructure, reduce poverty, improve living conditions and improve the economic situation in the country, impose attention to the way in which the projects implemented for its improvement and to get successful projects. The objective of this research was to determine the criteria for success as well as critical success and failure factors that have a significant impact on project success. A select...
Full Text Available Presently, the refurbishment approach becomes favourable as it creates opportunities to incorporate sustainable value with other building improvement. In this regard, this approach needs to be implemented due to the issues on overwhelming ratio of existing building to new construction, which also can contribute to the environmental problem. Refurbishment principles imply to minimize the environmental impact and upgrading the performance of an existing building to meet new requirements. In theoretically, building project’s performance has a direct bearing on related to its potential for project success. However, in refurbishment building projects, the criteria for measure are become wider because the projects are a complex and multi-dimensional which encompassing many factors which reflect to the nature of works. Therefore, this impetus could be achieve by examine the direct empirical relationship between critical success factors (CSFs and complexity factors (CFs during managing the project in relation to delivering success on project performance. The research findings will be expected as the basis of future research in establish appropriate framework that provides information on managing refurbishment building projects and enhancing the project management competency for a better-built environment.
Keyonzo, Nelson; Nyachae, Paul; Kagwe, Peter; Kilonzo, Margaret; Mumba, Feddis; Owino, Kenneth; Kichamu, George; Kigen, Bartilol; Fajans, Peter; Ghiron, Laura; Simmons, Ruth
This paper describes how the Urban Reproductive Health Initiative in Kenya, the Tupange Project (2010-2015), successfully applied the ExpandNet approach to sustainably scale up family planning interventions, first in Machakos and Kakamega, and subsequently also in its three core cities, Nairobi, Kisumu and Mombasa. This new focus meant shifting from a "project" to a "program" approach, which required paying attention to government leadership and ownership, limiting external inputs, institutionalizing interventions in existing structures and emphasizing sustainability. The paper also highlights the project's efforts to prepare for the future scale up of Tupange's interventions in other counties to support continuing and improved access to family planning services in the new context of devolution (decentralization) in Kenya. Copyright © 2015. Published by Elsevier Ltd.
Yee Cheong Yong
Full Text Available Construction projects play an important role in the advancement of a nation through infrastructure development that leads to economic growth. They are planned carefully to accomplish certain goals. However, not all the projects achieved the goals as per planned. Many factors contribute to the successes and failures, and it becomes an interesting arena for research. The primary objective of this paper is to outline the development trend of project success measurement globally and locally. The research method employed was to make selected reviews on critical success factors' (CSFs literature and to compare international standards and progress in incorporating human behavioural aspects of project management to the situation in Malaysia. A somewhat similar pattern can be observed in Malaysia where the studies have departed from the usual criteria of time, cost and quality, to define project success in a more holistic way. However, the domestic industry has failed to respond to the emerging trend globally as there has yet been any widely published research on the importance of human-related factors towards project success. A consolidated framework of CSFs has therefore, been proposed in responding to the findings. This paper fulfils an identified need as there has been a dearth of research on the subject matter locally.
Remon Fayek Aziz
Full Text Available Cost is one of the major considerations throughout the project management life cycle and can be regarded as one of the most important parameters of a project and the driving force of project success. Despite its proven importance, it is common to see a construction project failing to achieve its objectives within the specific cost. Cost variation is a very frequent phenomenon and is almost associated with nearly constructing all wastewater projects. Maintaining steady cost projection on wastewater projects had been recently an issue of serious concern, both to the client and project contractors. Cost deviation from initial cost plan had been prevalent on construction sites. However, little or no effort has been made to curtail the phenomenon, this research work attempts to identify, investigate and rank factors perceived to affect cost variation in the Egyptian wastewater projects with respect to their relative importance so as to proffer possible ways of coping with this phenomenon. To achieve this objective, author invited practitioners and experts, comprising a statistically representative sample, to participate in a structured questionnaire survey. Brain storming was taken into consideration, through which a number of cost variation factors were identified for constructing wastewater projects. Totally 52 factors were short-listed to be made part of the questionnaire survey and the survey was conducted with experts and representatives from private, public and local general construction firms. The data were analyzed using Relative Importance Index, ranking and simple percentages. It was analytically discovered that factors such as: (1 Lowest bidding procurement method; (2 Additional work; (3 Bureaucracy in bidding/tendering method; (4 Wrong method of cost estimation; and (5 Funding problems were critical for causing cost variation, while (1 Inaccurate cost estimation; (2 Mode of financing and payment for completed work; (3 Unexpected ground
Stewart Sunita M
Full Text Available Abstract Background This paper describes the development of culturally-appropriate family-based interventions and their relevant measures, to promote family health, happiness and harmony in Hong Kong. Programs were developed in the community, using a collaborative approach with community partners. The development process, challenges, and the lessons learned are described. This experience may be of interest to the scientific community as there is little information currently available about community-based development of brief interventions with local validity in cultures outside the West. Methods The academic-community collaborative team each brought strengths to the development process and determined the targets for intervention (parent-child relationships. Information from expert advisors and stakeholder discussion groups was collected and utilized to define the sources of stress in parent-child relationships. Results Themes emerged from the literature and discussion groups that guided the content of the intervention. Projects emphasized features that were appropriate for this cultural group and promoted potential for sustainability, so that the programs might eventually be implemented at a population-wide level. Challenges included ensuring local direction, relevance and acceptability for the intervention content, engaging participants and enhancing motivation to make behavior changes after a brief program, measurement of behavior changes, and developing an equal partner relationship between academic and community staff. Conclusions This work has public health significance because of the global importance of parent-child relationships as a risk-factor for many outcomes in adulthood, the need to develop interventions with strong evidence of effectiveness to populations outside the West, the potential application of our interventions to universal populations, and characteristics of the interventions that promote dissemination, including minimal
Stewart, Sunita M; Fabrizio, Cecilia S; Hirschmann, Malia R; Lam, Tai Hing
This paper describes the development of culturally-appropriate family-based interventions and their relevant measures, to promote family health, happiness and harmony in Hong Kong. Programs were developed in the community, using a collaborative approach with community partners. The development process, challenges, and the lessons learned are described. This experience may be of interest to the scientific community as there is little information currently available about community-based development of brief interventions with local validity in cultures outside the West. The academic-community collaborative team each brought strengths to the development process and determined the targets for intervention (parent-child relationships). Information from expert advisors and stakeholder discussion groups was collected and utilized to define the sources of stress in parent-child relationships. Themes emerged from the literature and discussion groups that guided the content of the intervention. Projects emphasized features that were appropriate for this cultural group and promoted potential for sustainability, so that the programs might eventually be implemented at a population-wide level. Challenges included ensuring local direction, relevance and acceptability for the intervention content, engaging participants and enhancing motivation to make behavior changes after a brief program, measurement of behavior changes, and developing an equal partner relationship between academic and community staff. This work has public health significance because of the global importance of parent-child relationships as a risk-factor for many outcomes in adulthood, the need to develop interventions with strong evidence of effectiveness to populations outside the West, the potential application of our interventions to universal populations, and characteristics of the interventions that promote dissemination, including minimal additional costs for delivery by community agencies, and high
Hatem Khaleefah Al-Ageeli
Full Text Available The importance of the construction sector and its Great role in the provision of services and infrastructure, reduce poverty, improve living conditions and improve the economic situation in the country, impose attention to the way in which the projects implemented for its improvement and to get successful projects. The objective of this research was to determine the criteria for success as well as critical success and failure factors that have a significant impact on project success. A selected 75 engineer (department managers, project managers and engineers are asked to fill the questionnaire form, Sixty-seven valid questionnaire forms were analyzed statistically to get search results, which were as follows : Twelve critical success factors, the most important factors of it were ("contractor financial efficiency ", " security ,political , economic stability ", "the project manager competence" and " Integration and clarity of contract documents " , thirteen critical failure factors, the most important factors of it were ("corruption " , " external circumstances ", "Financial difficulties of owner", and ten success criteria , the most important criteria of it were ("within allocated budget" , " within time period" , "Quality" .
Sánchez-Martínez, Francesca; Juárez, Olga; Serral, Gemma; Valmayor, Sara; Puigpinós, Rosa; Pasarín, María Isabel; Díez, Élia; Ariza, Carles
Background Childhood obesity preventive interventions should promote a healthy diet and physical activity at home and school. This study aims to describe a school-based childhood obesity preventive programme (POIBA Project) targeting 8-to-12- year-olds. Design and methods Evaluation study of a school-based intervention with a pre-post quasi-experimental design and a comparison group. Schools from disadvantaged neighbourhoods are oversampled. The intervention consists of 9 sessions, including 58 activities of a total duration between 9 and 13 hours, and the booster intervention of 2 sessions with 8 activities lasting 3 or 4 hours. They are multilevel (individual, family and school) and multicomponent (classroom, physical activity and family). Data are collected through anthropometric measurements, physical fitness tests and lifestyle surveys before and after the intervention and the booster intervention. In the intervention group, families complete two questionnaires about their children’s eating habits and physical activity. The outcome variable is the cumulative incidence rate of obesity, obtained from body mass index values and body fat assessed by triceps skinfold thickness. The independent variables are socio-demographic, contextual, eating habits, food frequency, intensity of physical activity and use of new technologies. Expected impact for public health It is essential to implement preventive interventions at early ages and to follow its effects over time. Interventions involving diet and physical activity are the most common, being the most effective setting the school. The POIBA Project intervenes in both the school and family setting and focuses on the most disadvantaged groups, in which obesity is most pronounced and difficult to prevent. Significance for public health Overweight and obesity are a major public health concern that predispose affected individuals to the development of chronic diseases. Of importance, obesity is more common among
Aga, Deribe Assefa
This dissertation sought to examine behavioral-related critical success factors in the context of Non-Governmental Organization (NGO) sector development projects in Ethiopia. The dissertation applied both a cross-sectional survey design and an experimental design in separate settings, and it is
Carvalho, Claudia Pato
This article discusses how biographical materials may be used in youth arts education projects to develop new methodologies and approaches that can stimulate artistic and social intervention in contemporary urban communities, thus changing the field of arts education policy at the community level. Through their creation of Artistic Society…
Garcia, Carolyn; Hermann, Denise; Bartels, Anna; Matamoros, Pablo; Dick-Olson, Linda; Guerra de Patino, Janeth
As the Latino population in the United States experiences rapid growth, the well-being of Latino adolescents is a growing concern because of their high rates of mental health problems. Latino adolescents have higher rates of mental health problems than their peers, including depressive symptoms, suicide attempts, and violence. Sophisticated, realistic health promotion efforts are needed to reduce these risk behaviors and enhance protective factors. Parents and schools can be key protective factors, or assets, in adolescents' lives. This article details the steps undertaken to develop Project Wings Home Visits, a collaborative school-based, community-linked mental health promotion intervention for Latino adolescents and their families. Core to the intervention is the use of a community health worker model to provide home-based outreach and education to parents of Latino adolescents. The intervention was developed using a community-based participatory research approach that involved the cooperation of a community health care system, a public high school, and a university. Our process demonstrates the benefits, strengths, and challenges of using community-based participatory research in creating and implementing health promotion interventions.
Mohamed Sayed Bassiony Ahmed Abd El-Karim
Unexpected increase in cost and delays in construction projects are caused by owner, contractor, environments, etc. in which several types of risk factors may occur concurrently. The effect of cost overrun and schedule overrun do not only influence the construction industry but the overall economy as well. Even though construction project increasing in cost and schedule has received extensive attention of researchers, but because of continuous changes and development in the field, the study considered of added value to the construction industry in Egypt, in addition to risk strategy and plan analysis. In order to meet the deadline of a project and due to the complex nature of construction projects, cost and scheduling should be flexible enough to accommodate changes without negatively affecting the overall project cost and duration. As such, the objectives of the presented research in this paper are to identify, study, and assess the effect of the factors that affect cost and time contingency. Data are collected from sixteen construction companies in Egypt. The collected data, output charts and analyses spreadsheets will be used for the development of computerized model built by the authors with identification abbreviation RIAM.
Nelson, Gary R; Filloux, Francis M; Kerr, Lynne M
In 2011, the American Academy of Neurology (AAN) released guidelines for return seizure visits detailing 8 points that should be addressed during such visits. These guidelines are designed to improve routine follow-up care for epilepsy patients. The authors performed a quality improvement project aimed at increasing compliance with these guidelines after educating providers about them. The authors performed a chart review before and after an intervention which included: education regarding the guidelines, providing materials to remind providers of the guidelines, and templates to facilitate compliance. The authors reviewed charts at 2 and 6 months after the intervention. Significant improvement in documentation of 4 of the 8 measures was observed after this educational intervention. This suggests that simple educational interventions may help providers change practice and can improve compliance with new guidelines while requiring minimal time and resources to implement. © The Author(s) 2016.
Shen, Chen; Wan, Alice; Kwok, Lit Tung; Pang, Sally; Wang, Xin; Stewart, Sunita M; Lam, Tai Hing; Chan, Sophia S
Neighborhood cohesion, which refers to the extent of the connectedness and solidarity among residents in a community or neighborhood, is an important determinant of human health. To enhance neighborhood cohesion, the "Learning Families Project" was developed with a series of intervention programs in Kwun Tong in Hong Kong, a district with low neighborhood cohesion. This project, based on the social ecological model, provided a platform for neighbors to learn, communicate and interact with each other. This quasi-experimental study included two nearby government subsidized low rent housing estates separated by busy main roads. One served as the intervention (Tsui Ping (South) Estate) and one as the control (Shun Tin Estate) estate. The intervention included promotion, resident training and learning programs, embodied by a series of community activities such as talks, day camp, thematic activities and horticulture class. Baseline (before the programs) and follow-up (one year after the programs) surveys were conducted both in the intervention and control estate to assess the impact of the programs on neighborhood cohesion. The number of residents who completed both the baseline and follow-up surveys was 502 in the intervention estate and 476 in the control estate. Neighborhood cohesion significantly improved in the intervention group after the programs (Cohen effect size d: 0.15). Compared with the control group, the improvements in closeness of the neighborhood and trust in neighbors were significantly greater in the intervention group (Cohen effect size d: 0.13 and 0.14, respectively). This brief intervention program using a quasi-experimental study design increased neighborhood cohesion in a low rent housing estate. ClinicalTrials.gov NCT02851667.
Graf, C; Dordel, S
Child and juvenile obesity is increasing worldwide; therefore, effective preventive strategies are warranted. The stepwise project CHILT (Children's Health Interventional Trial) was initiated in 2000 and combines in its multicomponent school-based arm CHILT I health education and physical activity for primary school children to prevent physical inactivity and overweight. The effect on obesity and physical performance was studied in 12 primary schools (intervention schools, IS) compared with 5 control schools (CS). Anthropometric data were recorded. Physical performance was measured by a coordination test for children (the "Körperkoordinationstest für Kinder", KTK) and the 6-minute run. Anthropometric and motoric data of 436 children in IS (55.0% of the population) and 179 children in CS (62.8%) were available at baseline and at follow-up. No difference in the incidence of overweight was found between the IS and CS after 4 years of intervention. Remission of overweight was higher in IS (23.2% versus 19.2%), but not significant. The increase in BMI was significantly lower in IS, in which the program was regularly performed. There was an improvement in selected items of the KTK in IS. In particular, endurance performance tended to be higher at final examination. School-based preventive intervention seems to have a positive influence on physical motor skills and the remission of overweight. To optimize the effects, a consistent and quality assured implementation and the integration of the children's whole environment are warranted.
Bakker, Chris J G; Peters, Nicky H G M; Vincken, Koen L; Bom, Martijn van der; Seppenwoolde, Jan-Henry
Projection dephasers are often used for background suppression and dynamic range improvement in thick-slab 2D imaging in order to promote the visibility of subslice structures, e.g., blood vessels and interventional devices. In this study, we explored the factors that govern the effectiveness of a projection dephaser by simulations and phantom experiments. This was done for the ideal case of a single subslice hyper- or hypointensity against a uniform background in the absence of susceptibility effects. Simulations and experiments revealed a pronounced influence of the slice profile, the nominal flip angle and the TE and TR of the acquisition, the size, intraslice position and MR properties of the subslice structure, and T 1 of the background. The complexity of the ideal case points to the necessity of additional explorations when considering the use of projection dephasers under less ideal conditions, e.g., in the presence of tissue heterogeneities and susceptibility gradients
Huijg, J.M.; Dusseldorp, E.; Gebhardt, W.A.; Verheijden, M.W.; Zouwe, N. van der; Middelkoop, B.J.C.; Duijzer, G.; Crone, M.R.
Background. Physical therapists play an important role in the promotion of physical activity (PA) and the effectiveness of PA interventions. However, little is known about the extent to which they implement PA interventions following the intervention protocol and about the factors influencing their
Overbeek, M.M.; de Schipper, J.C.; Lamers-Winkelman, F.; Schuengel, C.
High family risk was tested as an impediment to recovery in children exposed to interparental violence (IPV) participating in community-based intervention. Characteristics of IPV were also explored as moderators for the effect of an IPV-focused intervention over a common factors intervention.
Bacci, Jennifer L; McGrath, Stephanie Harriman; Pringle, Janice L; Maguire, Michelle A; McGivney, Melissa Somma
To identify facilitators and barriers to implementing targeted medication adherence interventions in community chain pharmacies, and describe adaptations of the targeted intervention and organizational structure within each individual pharmacy practice. Qualitative study. Central and western Pennsylvania from February to April 2012. Rite Aid pharmacists staffed at the 118 Pennsylvania Project intervention sites. Qualitative analysis of pharmacists' perceptions of facilitators and barriers experienced, targeted intervention and organizational structure adaptations implemented, and training and preparation prior to implementation. A total of 15 key informant interviews were conducted from February to April 2012. Ten pharmacists from "early adopter" practices and five pharmacists from "traditionalist" practices were interviewed. Five themes emerged regarding the implementation of targeted interventions, including all pharmacists' need to understand the relationship of patient care programs to their corporation's vision; providing individualized, continual support and mentoring to pharmacists; anticipating barriers before implementation of patient care programs; encouraging active patient engagement; and establishing best practices regarding implementation of patient care services. This qualitative analysis revealed that there are a series of key steps that can be taken before the execution of targeted interventions that may promote successful implementation of medication therapy management in community chain pharmacies.
Masters, Kevin S; Ross, Kaile M; Hooker, Stephanie A; Wooldridge, Jennalee L
There has been a notable disconnect between theories of behavior change and behavior change interventions. Because few interventions are both explicitly and adequately theory-based, investigators cannot assess the impact of theory on intervention effectiveness. Theory-based interventions, designed to deliberately engage the theory's proposed mechanisms of change, are needed to adequately test theories. Thus, systematic approaches to theory-based intervention development are needed. This article will introduce and discuss the psychometric method of developing theory-based interventions. The psychometric approach to intervention development utilizes basic psychometric principles at each step of the intervention development process in order to build a theoretically driven intervention to, subsequently, be tested in process (mechanism) and outcome studies. Five stages of intervention development are presented as follows: (i) Choice of theory; (ii) Identification and characterization of key concepts and expected relations; (iii) Intervention construction; (iv) Initial testing and revision; and (v) Empirical testing of the intervention. Examples of this approach from the Colorado Meaning-Activity Project (COMAP) are presented. Based on self-determination theory integrated with meaning or purpose, and utilizing a motivational interviewing approach, the COMAP intervention is individually based with an initial interview followed by smart phone-delivered interventions for increasing daily activity. The psychometric approach to intervention development is one method to ensure careful consideration of theory in all steps of intervention development. This structured approach supports developing a research culture that endorses deliberate and systematic operationalization of theory into behavior change intervention from the outset of intervention development.
van Beuzekom Martie
Full Text Available Abstract Background Patient safety is one of the greatest challenges in healthcare. In the operating room errors are frequent and often consequential. This article describes an approach to a successful implementation of a patient safety program in the operating room, focussing on latent risk factors that influence patient safety. We performed an intervention to improve these latent risk factors (LRFs and increase awareness of patient safety issues amongst OR staff. Methods Latent risk factors were studied using a validated questionnaire applied to the OR staff before and after an intervention. A pre-test/post-test control group design with repeated measures was used to evaluate the effects of the interventions. The staff from one operating room of an university hospital acted as the intervention group. Controls consisted of the staff of the operating room in another university hospital. The outcomes were the changes in LRF scores, perceived incident rate, and changes in incident reports between pre- and post-intervention. Results Based on pre-test scores and participants’ key concerns about organizational factors affecting patient safety in their department the intervention focused on the following LRFs: Material Resources, Training and Staffing Recourses. After the intervention, the intervention operating room - compared to the control operating room - reported significantly fewer problems on Material Resources and Staffing Resources and a significantly lower score on perceived incident rate. The contribution of technical factors to incident causation decreased significantly in the intervention group after the intervention. Conclusion The change of state of latent risk factors can be measured using a patient safety questionnaire aimed at these factors. The change of the relevant risk factors (Material and Staffing resources concurred with a decrease in perceived and reported incident rates in the relevant categories. We conclude that
Lee, Young Me; Cintron, Adanisse; Kocher, Surinder
The purpose of this integrative literature review study was to investigate factors related to risky sexual behaviors among African American adolescents, to evaluate which of the factors are common across successful and effective STI/HIV and pregnancy intervention programs, and finally, to propose suggestions for future intervention programs for African American adolescents in West Englewood, Chicago. An integrative literature review was conducted. Using CINAHL, PubMed, and ProQuest database, the following terms were searched: African American, Black, adolescents, teenagers, sexual behavior, cultural factors, pregnancy, STIs/HIV/AIDS, and intervention programs. A total of 18 articles were reviewed, findings indicated there were five major contributing factors related to risky sexual behaviors: substance use, gender roles, peer influences, parental involvement, and level of knowledge and information on sex and STIs. Six successful STI/HIV and pregnancy programs that incorporated those factors to effectively reduce risky sexual behaviors were identified. After analyzing six national intervention programs proven to be effective, the findings suggest that future prevention programs should be designed with more emphasis on avoidance or limited substance use, increased parental involvement, integration of cultural teaching components such as storytelling and history as suggested from the Aban Aya Youth Project. This study also concluded that future prevention programs should consider the length of programs be longer than 1 year, as it has been shown to be more effective than shorter programs. © 2014 Wiley Periodicals, Inc.
Alberto, P.; Coimbra Univ.; Bochum Univ.; Ruiz Arriola, E.; Fiolhais, M.; Urbano, J.N.; Coimbra Univ.; Goeke, K.; Gruemmer, F.; Bochum Univ.
Several nucleon form factors are computed within the framework of the linear chiral soliton model. To this end variational means and projection techniques applied to generalized hedgehog quark-boson Fock states are used. In this procedure the Goldberger-Treiman relation and a virial theorem for the pion-nucleon form factor are well fulfilled demonstrating the consistency of the treatment. Both proton and neutron charge form factors are correctly reproduced, as well as the proton magnetic one. The shapes of the neutron magnetic and of the axial form factors are good but their absolute values at the origin are too large. The slopes of all the form factors at zero momentum transfer are in good agreement with the experimental data. The pion-nucleon form factor exhibits to great extent a monopole shape with a cut-off mass of Λ=690 MeV. Electromagnetic form factors for the vertex γNΔ and the nucleon spin distribution are also evaluated and discussed. (orig.)
Burdon, William M; St De Lore, Jef; Prendergast, Michael L
Within prison settings, the reliance on punishment for controlling inappropriate or noncompliant behavior is self-evident. What is not so evident is the similarity between this reliance on punishment and the use of positive reinforcements to increase desired behaviors. However, seldom do inmates receive positive reinforcement for engaging in prosocial behaviors or, for inmates receiving drug treatment, behaviors that are consistent with or support their recovery. This study provides an overview of the development and implementation of a positive behavioral reinforcement intervention in male and female prison-based drug treatment programs. The active involvement of institutional staff, treatment staff, and inmates enrolled in the treatment programs in the development of the intervention along with the successful branding of the intervention were effective at promoting support and participation. However, these factors may also have ultimately impacted the ability of the randomized design to reliably demonstrate the effectiveness of the intervention.
Becker, Carolyn Black; Perez, Marisol; Kilpela, Lisa Smith; Diedrichs, Phillippa C; Trujillo, Eva; Stice, Eric
Despite recent advances in developing evidence-based psychological interventions, substantial changes are needed in the current system of intervention delivery to impact mental health on a global scale (Kazdin & Blase, 2011). Prevention offers one avenue for reaching large populations because prevention interventions often are amenable to scaling-up strategies, such as task-shifting to lay providers, which further facilitate community stakeholder partnerships. This paper discusses the dissemination and implementation of the Body Project, an evidence-based body image prevention program, across 6 diverse stakeholder partnerships that span academic, non-profit and business sectors at national and international levels. The paper details key elements of the Body Project that facilitated partnership development, dissemination and implementation, including use of community-based participatory research methods and a blended train-the-trainer and task-shifting approach. We observed consistent themes across partnerships, including: sharing decision making with community partners, engaging of community leaders as gatekeepers, emphasizing strengths of community partners, working within the community's structure, optimizing non-traditional and/or private financial resources, placing value on cost-effectiveness and sustainability, marketing the program, and supporting flexibility and creativity in developing strategies for evolution within the community and in research. Ideally, lessons learned with the Body Project can be generalized to implementation of other body image and eating disorder prevention programs. Copyright © 2015 Elsevier Ltd. All rights reserved.
Curran, Janet A; Murphy, Andrea L; Sinclair, Douglas; McGrath, Patrick
Rural emergency departments (EDs) generally have limited access to continuing education and are typically staffed by clinicians without pediatric emergency specialty training. Emergency care of children is complex and the majority of children receive emergency care in non-pediatric tertiary care centers. In recent decades, there has been a call to action to improve quality and safety in the emergency care of children. Of the one million ED visits by children in Ontario in 2005-2006, one in three visited more than once in a year and one in 15 returned to the ED within 72 hours of the index visit. This study explored factors influencing rural and urban ED clinicians' participation in a Web-based knowledge exchange intervention that focused on best practice knowledge about pediatric emergency care. The following questions guided the study: (i) What are the individual, context of practice or knowledge factors which impact a clinician's decision to participate in a Web-based knowledge exchange intervention?; (ii) What are clinicians' perceptions of organizational expectations regarding knowledge and information sources to be used in practice?; and (iii) What are the preferred knowledge sources of rural and urban emergency clinicians? A Web-based knowledge exchange intervention, the Pediatric Emergency Care Web Based Knowledge Exchange Project, for rural and urban ED clinicians was developed. The website contained 12 pediatric emergency practice learning modules with linked asynchronous discussion forums. The topics for the modules were determined through a needs assessment and the module content was developed by known experts in the field. A follow-up survey was sent to a convenience sample of 187 clinicians from nine rural and two urban Canadian EDs participating in the pediatric emergency Web-based knowledge exchange intervention study. The survey response rate was 56% (105/187). Participation in the knowledge exchange intervention was related to individual
Planas, E.; Pastor, E.; Presutto, F.; Tixier, J.
The objective of the MITRA (monitoring and intervention for the transportation of dangerous goods) project was to prototype a new operational system for monitoring the transportation of dangerous goods in Europe based on regional responsibilities. This concept, based on systems used in air traffic control, aims to provide civil security centres with real-time knowledge of the position and contents of dangerous vehicles circulating in their area of responsibility, and, in the event of a dangerous situation, to issue warnings, alerts and crisis management information, thereby allowing intervention teams to react immediately with maximum safety. The project was funded by the European Commission under the 6th Framework Programme (STREP - specific targeted research project - under the Information Society Technologies priority). It started on 1 September 2004 and ended on 31 October 2006. This paper presents the results of this project and the conclusions derived from the field tests carried out in Germany and in the French/Spanish border region in order to test the proposed operational system
Espada, José P; Gonzálvez, María T; Orgilés, Mireia; Sussman, Steve
Adolescent smoking is a major public health problem, which has led to the development of cessation programs such as Project EX. However, there is no evidence for the long-term efficacy of cessation among Spanish adolescents. This study provides a 1-year follow-up evaluation of the Project EX tobacco use cessation program among 211 smokers. The intent-to-treat 30-day smoking quit rate for the program group was 7.81 percent ( p = .04), whereas no smokers quit in the control group ( p = .02). The intervention had a significant influence on future smoking expectation, intention, motivation to quit, and overall level of 30-day smoking. Long-term outcomes of the Project EX clinic-based program are promising for adolescent smokers in Spain.
Full Text Available Nasrin Sharifi,1 Reza Amani2 1Department of Nutrition, 2Health Research Institute, Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Abstract: Cardiovascular disease (CVD is the leading cause of death not only in industrialized and developed countries but also in developing societies. Changes in lifestyle of the population living in developing countries, which is due to the socioeconomic and cultural transition, are important reasons for increase in the rate of CVD. This observation has led to extensive body of researches on CVD prevention. In Iran, as a developing country in the Middle East, the increasing incidence of CVD has prompted the health policy-makers to emphasize on nutritional interventions as a part of the main strategies to alleviate the condition. Hence, in this article, we aimed to review the nutritional interventions on preventing CVDs from the perspectives of Iranian lifestyles and dietary patterns using data search sources such as Medline, Google scholar, and Iran doc. Keywords: nutrition, intervention, cardiovascular disease, Iran
Schensul, Stephen L; Saggurti, Niranjan; Singh, Rajendra; Verma, Ravi K; Nastasi, Bonnie K; Mazumder, Papiya Guha
This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.
Huijg, Johanna M; van der Zouwe, Nicolette; Crone, Mathilde R; Verheijden, Marieke W; Middelkoop, Barend J C; Gebhardt, Winifred A
The introduction of efficacious physical activity (PA) interventions in routine primary health care (PHC) is a complex process. Understanding factors influencing the process can enhance the development of successful introduction strategies. The aim of this qualitative study was to explore stakeholders' perceptions on factors influencing the introduction, i.e., adoption, implementation, and continuation, of PA interventions in PHC. Twenty-eight semistructured interviews were held with intervention managers, PHC advisors, intervention providers, and referring general practitioners of five PA interventions delivered in PHC. A theoretical framework on the introduction of innovations in health care was used to guide the data collection. Influencing factors were identified using thematic analysis. Stakeholders reported preconditions for the introduction of PA interventions in PHC (e.g., support, resources, and networks and collaborations), in addition to characteristics of PA interventions (e.g., compatibility, flexibility, and intervention materials) and characteristics of PHC professionals (e.g., knowledge, positive attitudes, and beliefs about capabilities) perceived to enhance the introduction process. Furthermore, they proposed strategies for the development of PA interventions (e.g., involvement of future stakeholders, full development, and refinement) and strategies to introduce PA interventions in PHC (e.g., training, assistance, and reinforcement). The majority of the influencing factors were discussed specifically in relation to one or two stages. This study presents an overview of factors that are perceived to influence the introduction of PA interventions in PHC. It underscores the importance of taking these factors into account when designing introduction strategies and of giving special attention to the distinct stages of the process.
Full Text Available Background & Objective: Identifying the research barriers and assess the ability of students to use the university services and facilities is crucial to promote research activities. Present study was carried out to determine the inhibiting factors influencing the student's research projects from the view point of Yasuj University of Medical Sciences students in 2008. Materials & Methods: In this cross sectional study 96 students of Yasuj Medical University were selected by stratified random sampling. The data were collected by validate & reliable questionnaire, containing demographic information, inhibiting factors related to students (personal and organization. The data were analyzed by SPSS software. Results: The mean scores against the personal barriers and the organizational barriers questions were 43.23±12.96 and 62.58±12.08 respectively. There was a significant difference between personal and organizational barriers (P<0.001 and personal barriers were more important. According to the results, the student's inadequate skills & knowledge of research methodology and lack of awareness of research topics were the most prevalent personal barriers. The most prevalent organizational barriers were unavailability of research consulters, inadequate research skills of consulter, insufficient facilities & equipment and lack of motivating staff & faculties. Other variables such as gender, subject of study and research experience are mentioned in the full text. Conclusion: This study showed that the personal barriers were more important than organizational barriers which interfere with the student's research projects. This can be corrected and controlled by teachers, faculty members, university officials and students, themselves.
Full Text Available The Risk Drinking Project was a national implementation endeavour in Sweden, carried out from 2004 to 2010, based on a government initiative to give alcohol issues a more prominent place in routine primary, child, maternity and occupational health care. The article describes and analyses the project. Critical factors that were important for the results are identified. The magnitude of the project contributed to its reach and impact in terms of providers’ awareness of the project goals and key messages. The timing of the project was appropriate. The increase in alcohol consumption in Sweden and diminished opportunities for primary prevention strategies since entry to the European Union in 1995 have led to increased expectations for health care providers to become more actively involved in alcohol prevention. This awareness provided favourable conditions for this project. A multifaceted approach was used in the project. Most educational courses were held in workshops and seminars to encourage learning-by-doing. Motivational interviewing was an integral aspect. The concept of risk drinking was promoted in all the activities. Subprojects were tailored to the specific conditions of each respective setting, building on the skills the providers already had to modify existing work practices. Nurses were afforded a key role in the project.
Full Text Available Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety, human, and ecosystem health (1. In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.
Eaton, Lisa A.; Kalichman, Seth C.; Kenny, David A.; Harel, Ofer
Background Project EXPLORE -- a large-scale, behavioral intervention tested among men who have sex with men (MSM) at-risk for HIV infection --was generally deemed as ineffective in reducing HIV incidence. Using novel and more precise data analytic techniques we reanalyzed Project EXPLORE by including both direct and indirect paths of intervention effects. Methods Data from 4,296 HIV negative MSM who participated in Project EXPLORE, which included ten sessions of behavioral risk reduction counseling completed from 1999-2005, were included in the analysis. We reanalyzed the data to include parameters that estimate the overtime effects of the intervention on unprotected anal sex and the over-time effects of the intervention on HIV status mediated by unprotected anal sex simultaneously in a single model. Results We found the indirect effect of intervention on HIV infection through unprotected anal sex to be statistically significant up through 12 months post-intervention, OR=.83, 95% CI=.72-.95. Furthermore, the intervention significantly reduced unprotected anal sex up through 18 months post-intervention, OR=.79, 95% CI=.63-.99. Discussion Our results reveal effects not tested in the original model that offer new insight into the effectiveness of a behavioral intervention for reducing HIV incidence. Project EXPLORE demonstrated that when tested against an evidence-based, effective control condition can result in reductions in rates of HIV acquisition at one year follow-up. Findings highlight the critical role of addressing behavioral risk reduction counseling in HIV prevention. PMID:23245226
Alfonso, Sarah V; Alfonso, Lauren A; Llabre, Maria M; Fernandez, M Isabel
Although there is evidence supporting the use of equine-assisted activities to treat mental disorders, its efficacy in reducing signs and symptoms of social anxiety in young women has not been examined. We developed and pilot tested Project Stride, a brief, six-session intervention combining equine-assisted activities and cognitive-behavioral strategies to reduce symptoms of social anxiety. A total of 12 women, 18-29 years of age, were randomly assigned to Project Stride or a no-treatment control. Participants completed the Liebowitz Social Anxiety Scale at baseline, immediate-post, and 6 weeks after treatment. Project Stride was highly acceptable and feasible. Compared to control participants, those in Project Stride had significantly greater reductions in social anxiety scores from baseline to immediate-post [decrease of 24.8 points; t (9) = 3.40, P = .008)] and from baseline to follow-up [decrease of 31.8 points; t (9) = 4.12, P = .003)]. These findings support conducting a full-scale efficacy trial of Project Stride. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available (1 Background: Musculoskeletal disorders have a multifactorial etiology that is not only associated with physical risk factors, but also psychosocial risk factors; (2 Objective: This study evaluated the effects of an ergonomic intervention on musculoskeletal disorders and psychosocial risk factors; (3 Material and Methods: This study took a participatory ergonomic (PE approach with a randomized controlled trial (RCT conducted at tertiary care hospitals during July to December 2014. A group of hospital orderlies in Thailand were randomly selected for examination. Fifty orderlies were placed in a case group and another 50 orderlies were placed in the control group. The Nordic Musculoskeletal Disorders Questionnaire (NMQ and the Copenhagen Psychosocial Questionnaire (COPSOQ were used for data collection before and after the intervention program; (4 Results: The most commonly reported problem among hospital orderlies was found to be lower back symptoms (82%. The study found significant differences in prevalence rates of reported musculoskeletal conditions in the arm, upper back, and lower back regions before and after intervention. Findings showed that psychosocial risk factors were affected by the intervention. COPSOQ psychosocial risk factors were significantly different pre/post intervention. These variables included: work pace, influence at work, meaning of work, predictability, rewards, role conflicts, and social support from supervisors. No other psychosocial risk factors were found to be significant; (5 Conclusions: Positive results were observed following the intervention in the work environment, particularly in terms of reducing physical work environment risk factors for musculoskeletal disorders and increasing promotion factors of the psychosocial work environment.
Chanchai, Withaya; Songkham, Wanpen; Ketsomporn, Pranom; Sappakitchanchai, Punnarat; Siriwong, Wattasit; Robson, Mark Gregory
(1) BACKGROUND: Musculoskeletal disorders have a multifactorial etiology that is not only associated with physical risk factors, but also psychosocial risk factors; (2) OBJECTIVE: This study evaluated the effects of an ergonomic intervention on musculoskeletal disorders and psychosocial risk factors; (3) MATERIAL AND METHODS: This study took a participatory ergonomic (PE) approach with a randomized controlled trial (RCT) conducted at tertiary care hospitals during July to December 2014. A group of hospital orderlies in Thailand were randomly selected for examination. Fifty orderlies were placed in a case group and another 50 orderlies were placed in the control group. The Nordic Musculoskeletal Disorders Questionnaire (NMQ) and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used for data collection before and after the intervention program; (4) RESULTS: The most commonly reported problem among hospital orderlies was found to be lower back symptoms (82%). The study found significant differences in prevalence rates of reported musculoskeletal conditions in the arm, upper back, and lower back regions before and after intervention. Findings showed that psychosocial risk factors were affected by the intervention. COPSOQ psychosocial risk factors were significantly different pre/post intervention. These variables included: work pace, influence at work, meaning of work, predictability, rewards, role conflicts, and social support from supervisors. No other psychosocial risk factors were found to be significant; (5) CONCLUSIONS: Positive results were observed following the intervention in the work environment, particularly in terms of reducing physical work environment risk factors for musculoskeletal disorders and increasing promotion factors of the psychosocial work environment.
Wilson, Deleise S; Montie, Mary; Conlon, Paul; Reynolds, Margaret; Ripley, Robert; Titler, Marita G
Evidence-based (EB) fall prevention interventions to mitigate patient-specific fall risk factors are readily available but not routinely used in practice. Few studies have examined nurses' perceptions about both the use of these EB interventions and implementation strategies designed to promote their adoption. This article reports qualitative findings of nurses' perceptions about use of EB fall prevention interventions to mitigate patient-specific fall risks, and implementation strategies to promote use of these interventions. The findings revealed five major themes: before-study fall prevention practices, use of EB fall prevention interventions tailored to patient-specific fall risk factors, beneficial implementation strategies, overall impact on approach to fall prevention, and challenges These findings are useful to guide nurses' engagement and use of EB fall prevention practices tailored to patient-specific fall risk factors. © The Author(s) 2016.
Owusu, Emmanuel Kingsford; Chan, Albert P C; Shan, Ming
The development of efficient and strategic anti-corruption measures can be better achieved if a deeper understanding and identification of the causes of corruption are established. Over the past years, many studies have been devoted to the research of corruption in construction management (CM). This has resulted in a significant increase in the body of knowledge on the subject matter, including the causative factors triggering these corrupt practices. However, an apropos systematic assessment of both past and current studies on the subject matter which is needful for the future endeavor is lacking. Moreover, there is an absence of unified view of the causative factors of corruption identified in construction project management (CPM). This paper, therefore, presents a comprehensive review of the causes of corruption from selected articles in recognized construction management journals to address the mentioned gaps. A total number of 44 causes of corruption were identified from 37 publications and analyzed in terms of existing causal factors of corruption, annual trend of publications and the thematic categorization of the identified variables. The most identifiable causes were over close relationships, poor professional ethical standards, negative industrial and working conditions, negative role models and inadequate sanctions. A conceptual framework of causes of corruption was established, after categorizing the 44 variables into five unique categories. In descending order, the five constructs are Psychosocial-Specific Causes, Organizational-Specific Causes, Regulatory-Specific Causes, Project-Specific Causes and Statutory-Specific Causes. This study extends the current literature of corruption research in construction management and contributes to a deepened understanding of the causal instigators of corruption identified in CPM. The findings from this study provide valuable information and extended knowledge to industry practitioners and policymakers as well as
Greaney, Mary L.; Puleo, Elaine; Bennett, Gary G.; Haines, Jess; Viswanath, K.; Gillman, Matthew W.; Sprunck-Harrild, Kim; Coeling, Molly; Rusinak, Donna; Emmons, Karen M.
Background: Many U.S. adults have multiple behavioral risk factors, and effective, scalable interventions are needed to promote population-level health. In the health care setting, interventions are often provided in print, although accessible to nearly everyone, are brief (e.g., pamphlets), are not interactive, and can require some logistics…
Heikkinen, Anna Maria; Broms, Ulla; Pitkaniemi, Janne; Koskenvuo, Markku; Meurman, Jukka
The authors aimed to investigate factors associated with smoking cessation among adolescents after tobacco intervention. They examined smokers (n = 127) from one birth cohort (n = 545) in the city of Kotka in Finland. These smokers were randomized in 3 intervention groups the dentist (n = 44) and the school nurse (n = 42 groups), and a control…
Grotberg, Edith H.
This article discusses the nature of resilience in children, means to measure and verify it, and attempts to promote it through education; it also describes a study of parental, teacher and caregiver efforts to promote resilience in children. The International Resilience Project examined resilience factors children and their parents use in…
Bodewes, Thomas C F; Soden, Peter A.; Ultee, Klaas H J; Zettervall, Sara L.; Pothof, Alexander B.; Deery, Sarah E.; Moll, Frans L.; Schermerhorn, Marc L.
Objective Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular
Martinková, Patrícia; Freeman, J.; Drabinová, Adéla; Erosheva, E.; Cattaneo, D.; Jonsdottir, J.; Baert, I.; Smedal, T.; Romberg, A.; Feys, P.; Alves-Guerreiro, J.; Habek, M.; Henze, T.; Santoyo Medina, C.; Beiske, A.; Van Asch, P.; Bakalidou, D.; Salci, Y.; Dimitrova, E.N.; Pavlíková, M.; Řasová, K.
Roč. 22, May (2018), s. 59-67 ISSN 2211-0348 Institutional support: RVO:67985807 Keywords : Multiple Sclerosis * Physical Therapy * Physiotherapeutic interventions * Europe * Questionnaire Survey * Cluster Analysis Impact factor: 2.349, year: 2016
Mullen, Roseland McG; Carroll, Marguerite R.
Discusses factors that deter counselors in responding to wife abuse. Characteristics of the abused wife are outlined. Strategies used in helping abused women are discussed, including support groups, feminist-oriented counseling, and exploring the possibility of ending the relationship. (Author/JAC)
Baker, Ross A.
The author investigated the existence of critical success factors for computer technology projects. Current research literature and a survey of experienced project managers indicate that there are 23 critical success factors (CSFs) that correlate with project success. The survey gathered an assessment of project success and the degree to which…
Full Text Available BACKGROUND. “Project Protect” aims to find highly infectious individuals through screening for acute/recent infection cases and prevent HIV transmission in the risk networks of these cases through contact tracing of these networks` participants, distributing community alerts about risk of acute infection among them and accurate post-test counseling.METHODS. An ongoing pilot phase of the intervention began in Kriviy Rig and Lviv, Ukraine in November, 2011. Participants are recruited through: 1 screening for cases of acute/recent infection at voluntary counseling and testing (VCT sites and in partner organizations (including AIDS-Centers which conduct VCT; 2 visits to drug use venues, chain-referral and contact tracing. Genscreen ultra HIV Ag-Ab “special-tests” are used to detect cases of acute infection. Recent infection is defined as positive test result and preceding negative result within 6 months and/or age younger than 21 years old.RESULTS. In the two cities 173 respondents were recruited to the project, 118 special tests were done. No cases of acute infection and eleven cases of recent infection were found (8 injection drug users (IDUs with preceding negative result within 6 months, 2 IDUs younger than 21 recruited by project team; one non-IDU with preceding negative result within 6 months referred from AIDS-Center. Six recent cases were recruited through screening at VCT sites, 5 others through contact tracing. Psychologists conducted 41 interviews with recent infection cases and their risk networks` members; 176 community alert flyers were distributed to members of risk networks during the interview by psychologist, at the venue by social worker and by participants themselves; 3 drug use venues were visited by project team with concomitant HIV-testing of people present at the venue. CONCLUSIONS. Network tracing seems to be feasible and to help find recently infected people. Further research is needed to tell whether this
Low, Sui Pheng
The book presents the development of the Construction Quality Assessment System (CONQUAS), Singapore’s de facto quality performance measurement system, explains the application of the Quality Management System (QMS) to manage CONQUAS and identifies 33 critical success factors (CSFs) for achieving high CONQUAS scores. Through CONQUAS, the reader benefits from understanding how the Singapore government developed and implemented the first objective system for measuring what many building professionals have perceived to be elusive quality standards in the construction industry. The book presents both the theoretical concepts as well as the practical aspects to achieving strategic Project Quality Management that is anchored on the CSFs to building best practices. To realistically reflect the practical aspects and challenging issues faced by stakeholders in the construction industry, questionnaire surveys were conducted with building professionals to distinguish the importance level and extent of adoption of the ...
Leerlooijer, Joanne N; Bos, Arjan E R; Ruiter, Robert A C; van Reeuwijk, Miranda A J; Rijsdijk, Liesbeth E; Nshakira, Nathan; Kok, Gerjo
A large proportion of unmarried teenage mothers in Uganda face physical, psychological, and social problems after pregnancy and childbirth, such as obstetric complications, lack of education, and stigmatisation in their communities. The Teenage Mothers Project (TMP) in Eastern Uganda empowers unmarried teenage mothers to cope with the consequences of early pregnancy and motherhood. Since 2000, 1036 unmarried teenage mothers, their parents, and community leaders participated in economic and social empowerment interventions. The present study explored the changes resulting from the TMP as well as factors that either enabled or inhibited these changes. Semi-structured interviews (N = 23) were conducted with former teenage mothers , community leaders, and project implementers, and lifeline histories were obtained from former teenage mothers (N = 9). Quantitative monitoring data regarding demographic and social characteristics of teenage mother participants (N = 1036) were analysed. The findings suggest that, overall, the TMP seems to have contributed to the well-being of unmarried teenage mothers and to a supportive social environment. It appears that the project contributed to supportive community norms towards teenage mothers' position and future opportunities, increased agency, improved coping with early motherhood and stigma, continued education, and increased income generation by teenage mothers. The study findings also suggest limited change in disapproving community norms regarding out-of-wedlock sex and pregnancy, late active enrolment of teenage mothers in the project (i.e., ten months after delivery of the child), and differences in the extent to which parents provided support. It is concluded that strengths of the community-based TMP seem to be its socio-ecological approach, the participatory planning with community leaders and other stakeholders, counselling of parents and unmarried teenage mothers, and the emphasis on education and income
Silva, Fabiana Brito
Obesity is one of the most pressing global population health issues, and importantly one that affects racial/ethnic minorities and those of low socioeconomic status disproportionately. Obesity tracks from childhood into adulthood and is related to serious medical and economic consequences throughout the life course. Childhood obesity is well recognized as a complex and multifaceted problem influenced by broader social, geographic and environmental factors. A social ecological framework that i...
Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne
Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers' ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. EMS: Emergency medical services; SIRI: Suicide intervention response inventory.
Gilson, Nicholas; Brown, Wendy J; Faulkner, Guy; McKenna, Jim; Murphy, Marie; Pringle, Andy; Proper, Karin; Puig-Ribera, Anna; Stathi, Aphroditi
This paper aimed to use the Delphi technique to develop a consensus framework for a multinational, workplace walking intervention. Ideas were gathered and ranked from eight recognized and emerging experts in the fields of physical activity and health, from universities in Australia, Canada, England, The Netherlands, Northern Ireland, and Spain. Members of the panel were asked to consider the key characteristics of a successful campus walking intervention. Consensus was reached by an inductive, content analytic approach, conducted through an anonymous, three-round, e-mail process. The resulting framework consisted of three interlinking themes defined as "design, implementation, and evaluation." Top-ranked subitems in these themes included the need to generate research capacity (design), to respond to group needs through different walking approaches (implementation), and to undertake physical activity assessment (evaluation). Themes were set within an underpinning domain, referred to as the "institution" and sites are currently engaging with subitems in this domain, to provide sustainable interventions that reflect the practicalities of local contexts and needs. Findings provide a unique framework for designing, implementing, and evaluating walking projects in universities and highlight the value of adopting the Delphi technique for planning international, multisite health initiatives.
Nikodemova, Denisa; Fueloep, Marko; Cabanekova, Helena
The results of the recently published doses obtained by medical staff working in pulsed radiation fields, and performing interventional radiology (IR) or interventional cardiology (IC) procedures, as well as applications of radionuclides in nuclear medicine (NM), have shown significantly high levels of exposure, mainly to the hands and other parts of their bodies uncovered by protective equipment. The coordinated project ORAMED (Optimization of Radiation Protection of Medical Staff) was set-up by participation of 12 European countries and 34 IR/IC and NM departments, with the 5 main tasks: (i) optimization of radiation protection in IR and IC,with the aim to standardize a unified method of extremities and eye lens doses estimation, for 3 cardiac and 5 interventional diagnostic and therapeutic examinations; (ii) verification of the possibilities to use active personal dosemeters for typical pulsed radiation fields used in IR and IC; (iii) contribution to the extremities and eye lens dose reduction in nuclear medicine; (iv) development and application of a suitable eye lens dosemeter; and (v) elaboration of training materials and guidelines for radiation protection issues at IR, IC and NM workplaces. The present study presents some important results and recommendations for dose reduction and avoidance of some typical failures during work near ionizing radiation sources. (P.A.)
Xu, Xibao; Tan, Yan; Yang, Guishan
The paper takes China's authoritative Environmental Impact Statement for the Yangzi (Yangtze) Three Gorges Project (TGP) in 1992 as a benchmark against which to evaluate emerging major environmental outcomes since the initial impoundment of the Three Gorges reservoir in 2003. The paper particularly examines five crucial environmental aspects and associated causal factors. The five domains include human resettlement and the carrying capacity of local environments (especially land), water quality, reservoir sedimentation and downstream riverbed erosion, soil erosion, and seismic activity and geological hazards. Lessons from the environmental impact assessments of the TGP are: (1) hydro project planning needs to take place at a broader scale, and a strategic environmental assessment at a broader scale is necessary in advance of individual environmental impact assessments; (2) national policy and planning adjustments need to react quickly to the impact changes of large projects; (3) long-term environmental monitoring systems and joint operations with other large projects in the upstream areas of a river basin should be established, and the cross-impacts of climate change on projects and possible impacts of projects on regional or local climate considered.
Barkoukis, Vassilis; Lazuras, Lambros; Ourda, Despoina; Tsorbatzoudis, Haralambos
Cyberbullying is an emerging form of bullying that takes place through contemporary information and communication technologies. Building on past research on the psychosocial risk factors for cyberbullying in this age group, the present study assessed a theory-driven, school-based preventive intervention that targeted moral disengagement, empathy and social cognitive predictors of cyberbullying. Adolescents (N = 355) aged between 16 and 18 years were randomly assigned into the intervention and the control group. Both groups completed anonymous structured questionnaires about demographics, empathy, moral disengagement and cyberbullying-related social cognitive variables (attitudes, actor prototypes, social norms, and behavioral expectations) before the intervention, post-intervention and 6 months after the intervention. The intervention included awareness-raising and interactive discussions about cyberbullying with intervention group students. Analysis of covariance (ANCOVA) showed that, after controlling for baseline measurements, there were significant differences at post-intervention measures in moral disengagement scores, and in favorability of actor prototypes. Further analysis on the specific mechanisms of moral disengagement showed that significant differences were observed in distortion of consequences and attribution of blame. The implications of the intervention are discussed, and guidelines for future school-based interventions against cyberbullying are provided. © 2015 Wiley Periodicals, Inc.
Jones, Eleri; Lattof, Samantha R; Coast, Ernestina
The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their
Hudon, Catherine; Chouinard, Maud-Christine; Lambert, Mireille; Diadiou, Fatoumata; Bouliane, Danielle; Beaudin, Jérémie
The aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness. Thematic analysis review of CM studies. We built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004-December 2015 period, then updated to July 2017, with the keywords 'CM' and 'frequent use'. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir's implementation of health innovations framework was used to organise results into four broad levels of factors: (1) ,environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level. Access to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration. CM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted
Osuna, Diego; Barrera, Manuel; Strycker, Lisa A; Toobert, Deborah J; Glasgow, Russell E; Geno, Cristy R; Almeida, Fabio; Perdomo, Malena; King, Diane; Doty, Alyssa Tinley
Because Latinas experience a high prevalence of type 2 diabetes and its complications, there is an urgent need to reach them with interventions that promote healthful lifestyles. This article illustrates a sequential approach that took an effective multiple-risk-factor behavior-change program and adapted it for Latinas with type 2 diabetes. Adaptation stages include (a) information gathering from literature and focus groups, (b) preliminary adaptation design, and (c) preliminary adaptation test. In this third stage, a pilot study finds that participants were highly satisfied with the intervention and showed improvement across diverse outcomes. Key implications for applications include the importance of a model for guiding cultural adaptations, and the value of procedures for obtaining continuous feedback from staff and participants during the preliminary adaptation test.
Azlan Shah Ali
Full Text Available Delay in construction projects is a situation where the project cannot be completed under the planned time. It is a common issue faced in the construction industry all over the world especially in developing countries. In the Malaysian construction industry, 17.3% of construction projects experience more than 3 months delay and some of them are abandoned. Hence, the study of factors contributing to delay is very important in order to reduce the number of projects that experience delay in project delivery. Three objectives of the research have been formulated, namely (1 to identify factors that contribute to delay in construction projects; (2 to analyse and rank the causes of delay rated by contractors; and (3 to study the effects of delay in construction projects. One hundred questionnaires were distributed during data collection stage and only 36 responses received. The respondents only consist of contractors and sub-contractors because the scope of the research focuses on contractors' perception. The data collected was analysed using SPSS software. Seven factors that contribute to delay were identified through literature review, namely contractors' financial difficulties, construction mistakes and defective work, labour shortage, coordination problems, shortage of tools and equipment, material shortage and poor site management. Of those factors, the three most important factors were found to be labour shortage, contractors' financial difficulties and construction mistakes and defective works. Besides project delay, the research shows that cost overrun and extension of time (EOT are the most common effects of delay in construction projects.
Full Text Available It is widely accepted that project leaders should adapt their behaviour to meet the unique leadership demands of a variety of situations. Recently, vertical, shared, and horizontal styles of leadership have gained prominence, especially in the project management literature. Several factors are believed to play a role in determining an appropriate balance between these leadership styles. This theoretical study explores the influence of project types, the stage in the project life cycle, organisational project management maturity, and the level of trust and collaboration between project team members on the appropriate balance of leadership styles in projects. This paper presents a conceptual framework of these factors, while empirical results will be reported on in the sequel to this paper.
Goudet, Sophie; Griffiths, Paula; Bogin, Barry; Madise, Nyovani
Children living in slums are at high risk of being malnourished. There are no published reviews on existing interventions promoting better nutrition for children living in slums and the risk factors for children's malnutrition. Improved understanding of the risk factors for malnutrition in slums communities and the impact of interventions on children's health can provide guidance to practitioners and decision-makers. The present review is designed to provide this information. The search included 30 electronic bibliographic databases and relevant eligible studies published up to December 2013. The search located 1512 citations. Full text relevance screening was conducted on 226 studies and on abstracts for 16 studies. The final 58 unique studies included 22 on interventions and 38 on risk. All of the interventions were nutrition-specific, with nutritional intervention being the most dominant type. Seventy-three per cent of the interventions were assessed effective. The findings stressed the gaps in knowledge in terms of quality assessment and programmatic recommendations to identify children who are the most at risk of malnutrition to appropriately target interventions. Finally, the review helped to inform a systematic review (Cochrane Systematic review protocol 2015) that will examine the impact of interventions on outcome measures.
Zivković, M; Bjegović, V; Vuković, D; Marinković, J
Contemporary health-education intervention programs are increasingly used as a tool for improving health of school children [1-4]. Since 1992 a Network of 13 elementary Health Promoting Schools established in Yugoslavia (though not yet admitted to the European Network) has been operational. The Project was approved by the Ministries of Health, Education and Ecology from the very beginning, and financially supported by the Government of Serbia since 1995. The team of up to 40 health professionals, school principals and school project managers worked together for four years to change the working conditions in schools knowledge, attitudes and behaviour of school children and staff in order to improve their health . The goal of this paper is to present results of health education intervention in changing of hygienic conditions in schools, as well as some of the attitudes, behaviour and knowledge of pupils and their parents. The study took place before and after the intervention--at two points in time--during 1993 and 1996. The tri-angular approach including (1) pupils, (2) schools (teachers, school environment), and (3) parents, was used. A random pretest and post-test study design with control group (12 experimental and two control schools) has been implemented. The multiphase cluster sample was employed in order to represent all of the country typical regions. Six types of especially designed questionnaires were used to provide comparable variables in the sample of pupils, their parents and teachers. Exception were 1st-graders and 4th-graders for whom information were gathered by means of a "draw-and-write" investigation technique . The response rate was 88.70% before and 98.28% after intervention. Data were analyzed by descriptive and inferential statistics using SPSS/PC software. Schools are somewhat less overcrowded, much cleaner and better maintained after the four-year intervention. Toilets are in a better condition, but there is still much more to be done
Van der Houwen, H.K.
In this dissertation some of the major facets associated with the psychological effects of bereavement were the subject of investigation: risk factors, mediating processes and intervention. Previous research on risk factors is limited because of a number of methodological shortcomings: a focus on
Sustainability remains an important issue for the construction industry. Yet, sustainable real estate developments are still considered as highly ambitious projects. To find out how and why sustainable renovation projects actually became sustainable we systematically evaluated 21 leading Dutch real
Hossen, Muhammed Mufazzal; Kang, Sunkoo; Kim, Jonghyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)
It is crucial for the nuclear power plant project decision makers and management personnel to identify the actual factors of construction delay and their ranking in order to take preventive actions. NPP project is complex in nature and the construction phase is one of the most key phase which is subject to many factors result from many sources. From experience, nuclear projects have faced challenges similar to other complex mega projects with additional nuclear specific issues and life time cost of nuclear reactor is concentrated upfront as capital cost, and therefore delays in construction may become intolerable in terms of both lost revenues and interest on the capital. Budget over-runs and delays on next generation new build nuclear projects in recent years clearly demonstrate that the nuclear industry continues to repeat its failed management and project control processes of the past. Similar to major infra-structure projects, actual completion times can vary substantially from initial estimates but this uncertainty is too crucial to the nuclear industry due to high levels of capital at risk, for every year a project is delayed the levelized cost of electricity increases by approximately 8-10%. causes of delay, to develop a generalized AHP model for delay factors, and to prioritize the risk in different factors in various levels of construction phase in international turnkey NPP project. This paper describes and prioritizes Nuclear Power Plant (NPP) construction schedule delay factor for turnkey international project. This study also determines the different party's importance in percentage behind the construction schedule delay of NPP which constitutes main contractor (28.4%), regulatory authority (27.3%), financial and country factor (23.5%), and utility (20.8%). Decision makers of nuclear industry can understand the significance of different factors on NPP construction phase and they can apply risk informed decision making to avoid unexpected
Hossen, Muhammed Mufazzal; Kang, Sunkoo; Kim, Jonghyun
It is crucial for the nuclear power plant project decision makers and management personnel to identify the actual factors of construction delay and their ranking in order to take preventive actions. NPP project is complex in nature and the construction phase is one of the most key phase which is subject to many factors result from many sources. From experience, nuclear projects have faced challenges similar to other complex mega projects with additional nuclear specific issues and life time cost of nuclear reactor is concentrated upfront as capital cost, and therefore delays in construction may become intolerable in terms of both lost revenues and interest on the capital. Budget over-runs and delays on next generation new build nuclear projects in recent years clearly demonstrate that the nuclear industry continues to repeat its failed management and project control processes of the past. Similar to major infra-structure projects, actual completion times can vary substantially from initial estimates but this uncertainty is too crucial to the nuclear industry due to high levels of capital at risk, for every year a project is delayed the levelized cost of electricity increases by approximately 8-10%. causes of delay, to develop a generalized AHP model for delay factors, and to prioritize the risk in different factors in various levels of construction phase in international turnkey NPP project. This paper describes and prioritizes Nuclear Power Plant (NPP) construction schedule delay factor for turnkey international project. This study also determines the different party's importance in percentage behind the construction schedule delay of NPP which constitutes main contractor (28.4%), regulatory authority (27.3%), financial and country factor (23.5%), and utility (20.8%). Decision makers of nuclear industry can understand the significance of different factors on NPP construction phase and they can apply risk informed decision making to avoid unexpected
Isoda, Hachiro; Yasutake, J.Y.
This paper describes work in progress to develop interventions to reduce human errors and increase maintenance productivity in nuclear power plants. The effort is part of a two-phased Human Factors research program being conducted jointly by the Central Research Institute of Electric Power Industry (CRIEPI) in Japan and the Electric Power Research Institute (EPRI) in the United States. The overall objective of this joint research program is to identify critical maintenance tasks and to develop, implement and evaluate interventions which have high potential for reducing human errors or increasing maintenance productivity. As a result of the Phase 1 effort, ten critical maintenance tasks were identified. For these tasks, over 25 candidate interventions were identified for potential development. After careful analysis, seven interventions were selected for development during Phase 2. This paper describes the methodology used to analyze and identify the most critical tasks, the process of identifying and developing selected interventions and some of the initial results. (author)
Full Text Available In the built environment (BE sector, the co-creation process of design demands understanding of requirements (as viewed by parties involved, mobilisation of tacit knowledge, negotiation, and complex exchange of information. The need to collaborate over distance has further exacerbated the complexity of the process, and, in itself, represents a significant challenge for BE professionals who are increasingly expected to undertake this process within globally distributed virtual teams. The research aims to identify key success factors and develop guidance for international collaborative design projects, via the implementation of collaborative design courses in UK and Canadian universities over three academic years. Questionnaire surveys, focus groups, observation of online meetings, personal reflections provided data for the analysis. The findings reveal the significance of the perceived risk of collaboration and a difference in preferred communication mode between architects and civil/structural engineers. These findings suggest the impact of training in the subject discipline, and that the opportunity for co-located working has helped the development of trust. The guidance is aimed at BE educators who wish to implement this activity in their courses.
Waqa, Gade; Moodie, Marj; Schultz, Jimaima; Swinburn, Boyd
Nearly one-half of the adult population in Fiji between the ages of 15-64 years is either overweight or obese; and rates amongst school children have, on average, doubled during the last decade. There is an urgent need to scale up the promotion of healthy behaviors and environments using a multi-sectoral approach. The Healthy Youth Healthy Community (HYHC) project in Fiji used a settings approach in secondary schools and faith-based organizations to increase the capacity of the whole community, including churches, mosques and temples, to promote healthy eating and regular physical activity, and to prevent unhealthy weight gain in adolescents aged 13-18 years. The team consisted of a study manager, project coordinator and four research assistants (RAs) committed to planning, designing and facilitating the implementation of intervention programs in collaboration with other stakeholders, such as the wider school communities, government and non-governmental organizations and business partners. Process data were collected on all intervention activities and analyzed by dose, frequency and reach for each specific strategy. The Fiji Action Plan included nine objectives for the school settings; four were based on nutrition and two on physical activity in schools, plus three general objectives, namely capacity building, social marketing and evaluation. Long-term change in nutritional behavior was difficult to achieve; a key contributor to this was the unhealthy food served in the school canteens. Whilst capacity-building proved to be one of the best mechanisms for intervening, it is important to consider the cultural and social factors influencing health behaviors and affecting specific groups.
Richmond, R; Kehoe, L; Heather, N; Wodak, A
The workplace provides a useful setting for early identification and intervention with individuals who have unhealthy lifestyles. The objective was to evaluate the effects of a workplace-based lifestyle intervention (Workscreen) to reduce excessive drinking. There were eight Australia Post networks randomly allocated to experimental and control conditions, comprising 67 worksites and 1206 employees. The experimental condition involved a broad spectrum lifestyle campaign, incorporating support from management, employee awareness of health, and brief interventions for high-risk behaviors, including excessive alcohol use. Focus groups identified relevant cultural factors. Changes in workplace culture and employee behavior were assessed 10 months after baseline. Males and females were analyzed separately. Over half of APOST employees participated at each screening point. In the experimental condition 61% of employees overall and 58% of those identified as excessive drinkers in Phase 1 responded to the lifestyle campaign by attending health assessments. Analyses focusing on the organization as a whole did not reveal significant reductions in excessive alcohol consumption among men or women. However, a significant reduction in number of drinks was observed in the experimental condition among women for whom completion of baseline and follow-up could be confirmed (P workplace-based lifestyle campaign can assist self-selected employees in reducing their alcohol consumption. There was a moderately high level of participation among those identified as drinking excessively, which supports our approach of embedding a low-intensity alcohol program within the context of a broader health promotion campaign. Copyright 2000 American Health Foundation and Academic Press.
Leitlein, Lisa; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska
This article is a report of a study that aimed to identify factors influencing practice nurses' and nurse practitioners' intention to adopt a new smoking cessation intervention. Although effective smoking cessation interventions exist and practice nurses can offer a considerable resource in advertising patients to quit smoking, due to several reasons the majority of practice nurses do not implement these interventions. A cross-sectional study was undertaken among Dutch practice nurses and nurse practitioners working in general practices (n = 139) using electronic questionnaires. Data were collected from January until March in 2009. T-tests were used to compare adopters with non-adopters about their predisposing and motivational factors. Logistic regression analyses were conducted to assess the variation in intention explained by these factors. The majority of practice nurses did not intend to adopt the new intervention (n = 85; 61.2%). More practice nurses than nurse practitioners intended to adopt the intervention. Attitude and perceived social norms were found to be positively correlated with the intention to adopt the intervention whereas satisfaction with current smoking cessation activities was found to be negatively correlated. Important associations were found between profession, attitude, social norms and satisfaction, and the intention to adopt the new smoking cessation intervention. Practice nurses who do not intend to adopt need to be persuaded of the advantages of adopting. Perceived social norms need to be restructured and before presenting the intervention to a general practice current smoking cessation activities should be determined to increase the intervention's compatibility with these current practices. © 2011 Blackwell Publishing Ltd.
Kothe, Emily J; Mullan, Barbara A
Fresh Facts is a 30-day email-delivered intervention designed to increase the fruit and vegetable consumption of Australian young adults. This study investigated the extent to which the program was acceptable to members of the target audience and examined the relationships between participant and intervention characteristics, attrition, effectiveness, and acceptability ratings. Young adults were randomised to two levels of message frequency: high-frequency (n = 102), low-frequency (n = 173). Individuals in the high-frequency group received daily emails while individuals in the low-frequency group received an email every 3 days. Individuals in the high-frequency group were more likely to indicate that they received too many emails than individuals in the low-frequency group. No other differences in acceptability were observed. Baseline beliefs about fruit and vegetables were an important predictor of intervention acceptability. In turn, acceptability was associated with a number of indicators of intervention success, including change in fruit and vegetable consumption. The findings highlight the importance of considering the relationship between these intervention and participant factors and acceptability in intervention design and evaluation. Results support the ongoing use of email-based interventions to target fruit and vegetable consumption within young adults. However, the relationships between beliefs about fruit and vegetable consumption and acceptability suggest that this intervention may be differentially effective depending on individual's existing beliefs about fruit and vegetable consumption. As such, there is a pressing need to consider these factors in future research in order to minimize attrition and maximize intervention effectiveness when interventions are implemented outside of a research context.
Lygnugaryte-Griksiene, Aidana; Leskauskas, Darius; Jasinskas, Nedas; Masiukiene, Agne
ABSTRACT Background: Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. Aims: To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). Method: Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey asses...
Jones, Rhys G; Trivedi, Amal N; Ayanian, John Z
Reducing racial and ethnic disparities in health care has become an important policy goal in the United States and other countries, but evidence to inform interventions to address disparities is limited. The objective of this study was to identify important dimensions of interventions to reduce health care disparities. We used qualitative research methods to examine interventions aimed at improving diabetes and/or cardiovascular care for patients from racial and ethnic minority groups within five health care organizations. We interviewed 36 key informants and conducted a thematic analysis to identify important features of these interventions. Key elements of interventions included two contextual factors (external accountability and alignment of incentives to reduce disparities) and four factors related to the organization or intervention itself (organizational commitment, population health focus, use of data to inform solutions, and a comprehensive approach to quality). Consideration of these elements could improve the design, implementation, and evaluation of future interventions to address racial and ethnic disparities in health care. Copyright 2009 Elsevier Ltd. All rights reserved.
Sharpe, Emma Elizabeth; Karasouli, Eleni; Meyer, Caroline
Digital interventions for weight management provide a unique opportunity to target daily lifestyle choices and eating behaviors over a sustained period of time. However, recent evidence has demonstrated a lack of user engagement with digital health interventions, impacting on the levels of intervention effectiveness. Thus, it is critical to identify the factors that may facilitate user engagement with digital health interventions to encourage behavior change and weight management. The aim of this study was to identify and synthesize the available evidence to gain insights about users' perspectives on factors that affect engagement with digital interventions for weight management. A rapid review methodology was adopted. The search strategy was executed in the following databases: Web of Science, PsycINFO, and PubMed. Studies were eligible for inclusion if they investigated users' engagement with a digital weight management intervention and were published from 2000 onwards. A narrative synthesis of data was performed on all included studies. A total of 11 studies were included in the review. The studies were qualitative, mixed-methods, or randomized controlled trials. Some of the studies explored features influencing engagement when using a Web-based digital intervention, others specifically explored engagement when accessing a mobile phone app, and some looked at engagement after text message (short message service, SMS) reminders. Factors influencing engagement with digital weight management interventions were found to be both user-related (eg, perceived health benefits) and digital intervention-related (eg, ease of use and the provision of personalized information). The findings highlight the importance of incorporating user perspectives during the digital intervention development process to encourage engagement. The review contributes to our understanding of what facilitates user engagement and points toward a coproduction approach for developing digital
Ramo, Danielle E; Thrul, Johannes; Delucchi, Kevin L; Hall, Sharon; Ling, Pamela M; Belohlavek, Alina; Prochaska, Judith J
To test the efficacy of the Tobacco Status Project (TSP) Facebook smoking cessation intervention for young adults relative to referral to an on-line program on biochemically verified 7-day abstinence from smoking. Two-group parallel randomized controlled trial, comparing TSP (n = 251) to on-line control (n = 249) with follow-up to 12 months. On-line, throughout the United States. Young adult cigarette smokers (mean age 21 years; 73% white, 55% female, 87% daily smokers). TSP provided private Facebook groups tailored to stage of change to quit smoking, daily contacts, weekly live counseling sessions, and for those ready to quit, six cognitive behavioral therapy counseling sessions. Some TSP groups were assigned randomly to receive a monetary incentive for engagement. Control provided referral to the National Cancer Institute Smokefree.gov website. PRIMARY OUTCOME: Biochemically verified 7-day abstinence over 12 months. Post-treatment (3-month) abstinence; reported abstinence, quit attempt, reduction in smoking, readiness to quit smoking over 12 months. Verified 7-day abstinence was not significantly different for intervention compared with control over 1 year: month 3 (8.3 versus 3.2%), 6 (6.2 versus 6.0%), and 12 (5.9 versus 10.0%); odds ratio (OR) = 1.07; 95% confidence interval (CI) = 0.23, 4.97; retention = 71%. There was an effect at 3 months (OR = 2.52; CI = 1.56, 4.04; P Facebook smoking cessation intervention did not improve abstinence from smoking over 1 year, but increased abstinence at the end of treatment and was engaging to participants. © 2018 Society for the Study of Addiction.
Van der Houwen, H.K.
In this dissertation some of the major facets associated with the psychological effects of bereavement were the subject of investigation: risk factors, mediating processes and intervention. Previous research on risk factors is limited because of a number of methodological shortcomings: a focus on only one or a few factors (which increases the chances of reporting spurious results) and reliance on use of a single measure of bereavement outcome. We avoided these pitfalls by simultaneously exami...
Full Text Available The present work attempts to identify critical success factors (CSFs influencing the performance of development projects based on their key performance indicators (KPIs. It has considered the case of Constituency Development Fund (CDF projects constructed between 2003 and 2011 in Kenya and secured the perceptions of 175 respondents comprising clients, consultants and contractors involved in the implementation of CDF projects on 30 success variables. Findings reveal that individual items constituting these six factors represent six CSFs namely project-related, client-related, consultant-related, contractor-related, supply chain-related, and external environment-related factor. The findings are also relevant to development projects undertaken in other developing countries.
Huijg, Johanna M; Dusseldorp, Elise; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; Middelkoop, Barend J C; Duijzer, Geerke; Crone, Mathilde R
Physical therapists play an important role in the promotion of physical activity (PA) and the effectiveness of PA interventions. However, little is known about the extent to which they implement PA interventions following the intervention protocol and about the factors influencing their implementation behaviors. The study objective was to investigate physical therapists' implementation fidelity regarding PA interventions, including completeness and quality of delivery, and influencing factors with a Theoretical Domains Framework-based questionnaire. The study was based on a cross-sectional design. A total of 268 physical therapists completed the Determinants of Implementation Behavior Questionnaire. Questions about completeness and quality of delivery were based on components and tasks of PA interventions as described by the Royal Dutch Society for Physical Therapy. Multilevel regression analyses were used to identify factors associated with completeness and quality of delivery. High implementation fidelity was found for the physical therapists, with higher scores for completeness of delivery than for quality of delivery. Physical therapists' knowledge, skills, beliefs about capabilities and consequences, positive emotions, behavioral regulation, and the automaticity of PA intervention delivery were the most important predictors of implementation fidelity. Together, the Theoretical Domains Framework accounted for 23% of the variance in both total completeness and total quality scores. The cross-sectional design precluded the determination of causal relationships. Also, the use of a self-report measure to assess implementation fidelity could have led to socially desirable responses, possibly resulting in more favorable ratings for completeness and quality. This study enhances the understanding of how physical therapists implement PA interventions and which factors influence their behaviors. Knowledge about these factors may assist in the development of strategies to
Cabal Cuesta, H; Varela Conde, M; Lago Rodriguez, C; Saez Angulo, R M
The Spanish wind energy market has experienced an average annual increase over 60% in recent years. With more than 4.1 GW of power at the end of 2002, this market has became the second in Europe and the third the world. With the objective of obtaining the origin of this success,an analysis of technical and economic features of selected wind projects has been undertaken to draw the outstanding factors that any new independent promoter/developer should take into account within this market. (Author) 16 refs.
Debadyuti Das; Christopher Ngacho
The present work attempts to identify critical success factors (CSFs) influencing the performance of development projects based on their key performance indicators (KPIs). It has considered the case of Constituency Development Fund (CDF) projects constructed between 2003 and 2011 in Kenya and secured the perceptions of 175 respondents comprising clients, consultants and contractors involved in the implementation of CDF projects on 30 success variables. Findings reveal that individual items co...
Full Text Available Abstract Background The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. Methods A total of 300 children (grade 3; 8-9 years of age from six schools in Granada (Spain will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school or a control group (no intervention school; 50 children. Outcomes will include physical activity (measured by accelerometry, physical fitness (assessed using the ALPHA fitness battery, and anthropometry (height, weight and waist circumference. Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires, academic achievement (grades from the official school’s records, and health-related quality of life (child and parental questionnaires. To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. Discussion The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.
Tercedor, Pablo; Villa-González, Emilio; Ávila-García, Manuel; Díaz-Piedra, Carolina; Martínez-Baena, Alejandro; Soriano-Maldonado, Alberto; Pérez-López, Isaac José; García-Rodríguez, Inmaculada; Mandic, Sandra; Palomares-Cuadros, Juan; Segura-Jiménez, Víctor; Huertas-Delgado, Francisco Javier
The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions) to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. A total of 300 children (grade 3; 8-9 years of age) from six schools in Granada (Spain) will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school) or a control group (no intervention school; 50 children). Outcomes will include physical activity (measured by accelerometry), physical fitness (assessed using the ALPHA fitness battery), and anthropometry (height, weight and waist circumference). Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires), academic achievement (grades from the official school's records), and health-related quality of life (child and parental questionnaires). To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.
Tak, Young-Ran; An, Ji-Yeon; Kim, Young-A; Woo, Hae-Young
The purpose of this study was to identify the effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children. Thirty-two participants (BMI>or=85 percentile or relative obesity>or=10) were allocated to the PABM-intervention group and behavior modification only intervention group. The PABM-intervention was composed of exercise intervention consisting of 50 minutes of physical activity(Hip-hop dance & gym-based exercises) twice a week and the behavior modification intervention consisted of 50 minutes of instruction for modifying lifestyle habits(diet & exercise) once a week. Effectiveness of intervention was based on waist circumference, BP, HDL-cholesterol, TG, and fasting glucose before and after the intervention. The proportion of subjects with 1, 2, 3 or more metabolic risk factors were 28.1, 43.8, and 15.6%, respectively. After the 8-week intervention, waist circumference, systolic BP, diastolic BP, and HDL-cholesterol changed significantly(p<.01) in the PABM group. This provides evidence that a PABM-intervention is effective in changing metabolic risk factors such as waist circumference, systolic BP, diastolic BP, and HDL-cholesterol in overweight and obese elementary school children.
Olsson, Nils E O; Hansen, Geir K
This paper analyzes the dynamics relating to flexibility in a hospital project context. Three research questions are addressed: (1) When is flexibility used in the life cycle of a project? (2) What are the stakeholders' perspectives on project flexibility? And (3) What is the nature of the interaction between flexibility in the process of a project and flexibility in terms of the characteristics of a building? Flexibility is discussed from both a project management point of view and from a hospital architecture perspective. Flexibility in project life cycle and from a stakeholder perspective is examined, and the interaction between flexibility in scope lock-in and building flexibility is investigated. The results are based on case studies of four Norwegian hospital projects. Information relating to the projects has been obtained from evaluation reports, other relevant documents, and interviews. Observations were codified and analyzed based on selected parameters that represent different aspects of flexibility. One of the cases illustrates how late changes can have a significant negative impact on the project itself, contributing to delays and cost overruns. Another case illustrates that late scope lock-in on a limited part of the project, in this case related to medical equipment, can be done in a controlled manner. Project owners and users appear to have given flexibility high priority. Project management teams are less likely to embrace changes and late scope lock-in. Architects and consultants are important for translating program requirements into physical design. A highly flexible building did not stop some stakeholders from pushing for significant changes and extensions during construction.
M.Comm. (Business Management) Project failures worldwide are still significantly high, despite the availability of project management frameworks, standards, techniques and methodologies. A project’s success is, in part, contingent on effectively managing the constraints of time, costs and performance, and in order to achieve this, it is essential for the project manager to possess and display appropriate competencies. The problem addressed in this study is to gain understanding of the proj...
Haukka, Eija; Pehkonen, Irmeli; Leino-Arjas, Päivi; Viikari-Juntura, Eira; Takala, Esa-Pekka; Malmivaara, Antti; Hopsu, Leila; Mutanen, Pertti; Ketola, Ritva; Virtanen, Tuija; Holtari-Leino, Merja; Nykänen, Jaana; Stenholm, Sari; Ojajärvi, Anneli; Riihimäki, Hilkka
To study the effect of a participatory ergonomics intervention on psychosocial factors among kitchen workers. A cluster randomised controlled trial. Four cities in Finland, 2002-2005. 504 workers in 119 municipal kitchens. Kitchens were randomised to intervention (n=59) and control (n=60) groups. The intervention lasted 11-14 months and was based on the workers' active participation in work analysis, planning and implementing the ergonomic changes aimed at decreasing the physical and mental workload. Mental stress, mental strenuousness of work, hurry, job satisfaction, job control, skill discretion, co-worker relationships and supervisor support. Data were collected by questionnaire at baseline, at the end of the intervention, and at a 12-month follow-up (PI(12)). At the end of the intervention, the OR of job dissatisfaction for the intervention group as compared with the control group was 3.0 (95% CI 1.1 to 8.5), of mental stress 2.3 (1.2 to 4.7) and of poor co-worker relationships 2.3 (1.0 to 5.2). At the PI(12), the OR of job dissatisfaction was 3.0 (1.2 to 7.8). Analysis of the independent and joint effects of the intervention and unconnected organisational reforms showed that adverse changes were accentuated among those with exposure to both. No favourable effects on psychosocial factors at work were found. The adverse changes were due to a joint effect of the intervention and the unconnected organisational reforms. The findings do not support the usefulness of this kind of intervention in changing unsatisfactory psychosocial working conditions.
Harper, Gary W.; Lemos, Diana; Hosek, Sybil G.
This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma—personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV—as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of...
Kelley, A. J.; Murphy, D. C.
This paper presents initial findings of a study designed to detail the relationships among situational, structural, and process variables as they relate to project effectiveness. In the paper, emphasis is placed on delineating those variables which tend to improve and those which tend to impede project effectiveness.
Rodrigues Jr., Jose Florencio; Lehmann, Angela Valeria Levay; Fleith, Denise De Souza
Building on previous studies centred on the interaction between adviser and advisee in masters thesis projects, in which a qualitative approach was used, the present study uses factor analysis to identify the factors that determine either a successful or unsuccessful outcome for the masters thesis project. There were five factors relating to the…
Gallenne, A.; Kervella, P.; Mérand, A.; Pietrzyński, G.; Gieren, W.; Nardetto, N.; Trahin, B.
Context. The Baade-Wesselink (BW) method, which combines linear and angular diameter variations, is the most common method to determine the distances to pulsating stars. However, the projection factor, p-factor, used to convert radial velocities into pulsation velocities, is still poorly calibrated. This parameter is critical on the use of this technique, and often leads to 5-10% uncertainties on the derived distances. Aims: We focus on empirically measuring the p-factor of a homogeneous sample of 29 LMC and 10 SMC Cepheids for which an accurate average distances were estimated from eclipsing binary systems. Methods: We used the SPIPS algorithm, which is an implementation of the BW technique. Unlike other conventional methods, SPIPS combines all observables, i.e. radial velocities, multi-band photometry and interferometry into a consistent physical modelling to estimate the parameters of the stars. The large number and their redundancy insure its robustness and improves the statistical precision. Results: We successfully estimated the p-factor of several Magellanic Cloud Cepheids. Combined with our previous Galactic results, we find the following P-p relation: -0.08± 0.04(log P-1.18) + 1.24± 0.02. We find no evidence of a metallicity dependent p-factor. We also derive a new calibration of the period-radius relation, log R = 0.684± 0.007(log P-0.517) + 1.489± 0.002, with an intrinsic dispersion of 0.020. We detect an infrared excess for all stars at 3.6 μm and 4.5 μm, which might be the signature of circumstellar dust. We measure a mean offset of Δm3.6 = 0.057 ± 0.006 mag and Δm4.5 = 0.065 ± 0.008 mag. Conclusions: We provide a new P-p relation based on a multi-wavelength fit that can be used for the distance scale calibration from the BW method. The dispersion is due to the LMC and SMC width we took into account because individual Cepheids distances are unknown. The new P-R relation has a small intrinsic dispersion: 4.5% in radius. This precision will
Full Text Available Project delivery planning is a key stage used by the project owner (or project investor for organizing design, construction, and other operations in a construction project. The main task in this stage is to select an appropriate project delivery method. In order to analyze different factors affecting the PDM selection, this paper establishes a multiagent model mainly to show how project complexity, governance strength, and market environment affect the project owner’s decision on PDM. Experiment results show that project owner usually choose Design-Build method when the project is very complex within a certain range. Besides, this paper points out that Design-Build method will be the prior choice when the potential contractors develop quickly. This paper provides the owners with methods and suggestions in terms of showing how the factors affect PDM selection, and it may improve the project performance.
Furniss, Dominic; Curzon, Paul; Blandford, Ann
Organisational competence in Human Factors and UX (user experience) has not been looked at before despite its relevance to project success. We define organisational competence as the collective competence of the individuals, bringing together their complementary abilities to deliver an outcome that is typically more than the sum of its parts. Twenty-two UX and Human Factors practitioners were interviewed about their project work in two contrasting domains: web design and safety-critical systems to explore organisational competences. Through doing a FRAM analysis, 29 functions and 6 main areas of competences were identified: the central project process; the process of learning about the problem; maintaining and developing client relations; staff development; evolving practices; and the management of documentation for audit and quality control. These dynamic and situated competences form a web of interactions. Managing competences is essential for project success. Implications for managing careers, project tactics and organisational strategy are discussed. Practitioner Summary: Organisational competences impact how routine and non-routine project work is performed, but these have received little attention in the literature. Six key areas of competences in Human Factors and UX project work were identified from practitioner interviews. Managing combinations of adaptive competences is important for developing careers, project tactics and organisational strategies.
Fernandez, A C; Wood, M D; Laforge, R; Black, J T
Matriculation from high school to college is typified by an increase in alcohol use and related harm for many students. Therefore, this transition period is an ideal time for preventive interventions to target alcohol use and related problems. The purpose of this report is to describe the design and methods used in the Transitions Project, a randomized controlled trial of two interventions designed to prevent and reduce heavy episodic drinking and alcohol-related negative consequences among incoming college students. This study used a 2 × 2 factorial design to investigate the effects of a two-session brief motivational intervention delivered to students and a handbook-based parent intervention. Interventions were administered to students and parents. Follow-up assessment took place at 10- and 22-months post-baseline. The Transitions Project successfully recruited and retained participants across a major transition period (i.e., entering college), administered and compared two distinct but complementary interventions, and collected and analyzed highly skewed data. The application of a factorial design and two-part latent growth curve modeling allowed us to examine main and interactive intervention effects in terms of both initiation and growth in heavy drinking and alcohol-related problems. While we conducted successful tests of our primary and secondary study hypotheses over a lengthy follow-up period, our study design did not permit full interpretation of null findings. We suggest that researchers carefully consider assessment timing, tests of assessment reactivity, and ensure objective tests of intervention efficacy when conducting clinical trials of motivational interventions. The lessons we learned while conducting this trial have the potential to assist other researchers designing and conducting future preventive interventions targeting parents and college students. The data analytic procedures presented can also help guide trials that plan to analyze
M. Luisa Martínez
Full Text Available Child-parent Violence (hereinafter CPV is an increasingly evident problem in the social, health, and judicial protection systems which, however, continue to show a number of major deficiencies with respect to the main characteristics of CPV, the people involved, the underlying factors, and efficacious interventions. Nevertheless, there is a consensus regarding its devastating consequences. The present bibliographical review is focused on analysing the problem of CPV with the aim of offering useful data for future research and intervention proposals. Specifically, this paper provides a definition of CPV and its types, some data on prevalence, the main characteristics of aggressive children and abused parents, and the most important individual, family, school and community risk factors highlighted in the current scientific literature. The keys areas of intervention with this group are also presented.
Full Text Available The majority of all deaths attributable to cardiovascular diseases (CVDs are in developing countries. There is now a pressing need for developing countries to define and implement preventive interventions for CVDs. We used WHO MONICA Project protocols to measure trends in coronary risk factors in Bushehr Port in the Persian Gulf Healthy Heart Project. Coronary risk factors of 2092 , aged >= 25 years men and women were evaluated in a cross-sectional study. Of the studied population, 97.7% had at least one coronary risk factor, 44.3% of men and 69% of women had at least two coronary risk factors. The high prevalence rates of diabetes mellitus (8.6%, central obesity (59.4%, obesity (26.8%, hypertension (24.5%, smoking (15.7%, physical inactivity (71.1%, hypercholesterolemia (24% and low HDL-cholesterol (61.5% showed that coronary risk factors prevail in Bushehr Port. Therefore, preventive strategies should be implemented immediately to avoid cardiovascular epidemic in the near future.
team members experience job satisfaction and are, therefore, motivated to be ... who are principal agents that were the interface between the client and the contractor. .... define roles and responsibilities of project team members. According.
, to identify their relative importance in promoting good governance. Data obtained from experienced professionals and clients in PPP projects were critically analysed using influence index value. A total of 26 constraints and 12 CSFs were ...
Lau, Erica Y.; Saunders, Ruth P.; Beets, Michael W.; Cai, Bo; Pate, Russell R.
Examining factors that influence implementation of key program components that underlie an intervention's success provides important information to inform the development of effective dissemination strategies. We examined direct and indirect effects of preschool capacity, quality of prevention support system and teacher characteristics on…
Chitiyo, Jonathan; May, Michael E.
The Schoolwide Positive Behavior Intervention Support model (SWPBIS) continues to gain widespread use across schools in the United States and abroad. Despite its widespread implementation, little research has examined factors that influence its sustainability. Informed by Rogers's diffusion theory, this study examined school personnel's…
Domitrovich, Celene E; Pas, Elise T; Bradshaw, Catherine P; Becker, Kimberly D; Keperling, Jennifer P; Embry, Dennis D; Ialongo, Nicholas
Evidence-based interventions are being disseminated broadly in schools across the USA, but the implementation levels achieved in community settings vary considerably. The current study examined the extent to which teacher and school factors were associated with implementation dosage and quality of the PAX Good Behavior Game (PAX GBG), a universal classroom-based preventive intervention designed to improve student social-emotional competence and behavior. Specifically, dosage (i.e., number of games and duration of games) across the school year and quality (i.e., how well the game is delivered) of PAX GBG implementation across four time points in a school year were examined. Hierarchical linear modeling was used to examine the association between teacher-level factors (e.g., demographics, self-reports of personal resources, attitudes toward the intervention, and workplace perceptions) and longitudinal implementation data. We also accounted for school-level factors, including demographic characteristics of the students and ratings of the schools' organizational health. Findings indicated that only a few teacher-level factors were significantly related to variation in implementation. Teacher perceptions (e.g., fit with teaching style, emotional exhaustion) were generally related to dosage, whereas demographic factors (e.g., teachers' age) were related to quality. These findings highlight the importance of school contextual and proximal teacher factors on the implementation of classroom-based programs.
Andersén, Åsa; Ståhl, Christian; Anderzén, Ingrid; Kristiansson, Per; Larsson, Kjerstin
The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individual's ability to work. The aim of this study was to investigate clients' experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.
Full Text Available Abstract Background The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy may have an impact on an individual’s ability to work. The aim of this study was to investigate clients’ experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. Methods A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. Results The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. Conclusions The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training
Lager, Kate E; Mistri, Amit K; Khunti, Kamlesh; Haunton, Victoria J; Sett, Aung K; Wilson, Andrew D
People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Evidence-based strategies for secondary stroke prevention have been established. However, the implementation of prevention strategies could be improved. To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control, including patient adherence to prescribed medications, and the occurrence of secondary cardiovascular events. We searched the Cochrane Stroke Group Trials Register (April 2013), the Cochrane Effective Practice and Organisation of Care Group Trials Register (April 2013), CENTRAL (The Cochrane Library 2013, issue 3), MEDLINE (1950 to April 2013), EMBASE (1981 to April 2013) and 10 additional databases. We located further studies by searching reference lists of articles and contacting authors of included studies. We included randomised controlled trials (RCTs) that evaluated the effects of organisational or educational and behavioural interventions (compared with usual care) on modifiable risk factor control for secondary stroke prevention. Two review authors selected studies for inclusion and independently extracted data. One review author assessed the risk of bias for the included studies. We sought missing data from trialists. This review included 26 studies involving 8021 participants. Overall the studies were of reasonable quality, but one study was considered at high risk of bias. Fifteen studies evaluated predominantly organisational interventions and 11 studies evaluated educational and behavioural interventions for patients. Results were pooled where appropriate, although some clinical and methodological heterogeneity was present. The estimated effects of organisational interventions were compatible with improvements and no differences in the modifiable risk factors mean systolic blood pressure (mean difference (MD) -2.57 mmHg; 95% confidence
Mohammad Mehdi Mozaffari
Full Text Available Complexity is one of the most important issues influencing success of any construction project and there are literally different studies devoted to detect important factors increasing complexity of projects. During the past few years, there have been growing interests in developing mass construction projects in Iran. The proposed study of this paper uses Delphi technique to find out about important factors as barriers of construction projects in Iran. The results show that among 47 project complexity factors, 19 factors are more important than others are. The study groups different factors into seven categories including environmental, organizational, objectives, tasks, stakeholders, technological, information systems and determines the relative importance of each. In each group, many other sub group activities are determined and they are carefully investigated. The study provides some detailed suggestions on each category to reduce the complexity of construction project.
McLean, Siân A; Wertheim, Eleanor H; Masters, Jennifer; Paxton, Susan J
This pilot study investigated the effectiveness of a social media literacy intervention for adolescent girls on risk factors for eating disorders. A quasi-experimental pre- to post-test design comparing intervention and control conditions was used. Participants were 101 adolescent girls (M age = 13.13, SD = 0.33) who were allocated to receive three social media literacy intervention lessons (n = 64) or to receive classes as usual (n = 37). Self-report assessments of eating disorder risk factors were completed one week prior to, and one week following the intervention. Significant group by time interaction effects revealed improvements in the intervention condition relative to the control condition for body image (body esteem-weight; d = .19), disordered eating (dietary restraint; d = .26) and media literacy (realism scepticism; d = .32). The outcomes of this pilot study suggest that social media literacy is a potentially useful approach for prevention of risk for eating disorders in adolescent girls in the current social media environment of heightened vulnerability. Replication of this research with larger, randomized controlled trials, and longer follow-up is needed. © 2017 Wiley Periodicals, Inc.
Anna E. Wise
Full Text Available Post-traumatic stress disorder (PTSD symptoms are relatively common following pediatric traumatic injury and are related to poor long-term child outcomes. However, due to concerns regarding the efficacy of early child preventive interventions, and difficulty intervening with injured and medicated children soon after the event, it is not feasible to provide early psychological interventions to children exposed to traumatic injury. Parental PTSD symptoms and reactions to the child’s traumatic injury impact child outcomes and provide potential targets for early intervention to reduce child symptom development without involving the child. The authors conducted a review of the literature using Psycinfo and Pubmed research databases (publication years = 1990–2017 and identified 65 published studies relevant to the topic of the review. The present review considers parent factors [parenting styles, parental post-traumatic pathology (PTS, adaptive and maladaptive coping strategies, and communication regarding the traumatic injury] and their impact on child PTS. We focus specifically on factors amenable to intervention. We further review moderators of these relationships (e.g., child age and gender, parent gender and conclude that it is unlikely that a one-size-fits-all approach to treatment will be successful. Rather, it is necessary to consider the age and gender of parent child dyads in designing and providing targeted interventions to families following the traumatic injury of a child.
Windsor, Jennifer; Moraru, Ana; Nelson, Charles A., III.; Fox, Nathan A.; Zeanah, Charles H.
This study reports on language outcomes at eight years from the Bucharest Early Intervention Project, a randomized controlled study of foster care. We previously have shown that children placed in foster care by age two have substantially stronger preschool language outcomes than children placed later and children remaining in institutional care.…
Full Text Available The subject matter of the article is to determine the role of leadership for building a project team as the team quality and the professionalism of the team participants play a key role in ensuring the proper work performance that is specified by the tasks of the project. The goal of the article is to reveal the significance of the capability of a leader to build a project team and to develop in it a favorable psychological climate, common values and ideals and show the place of this capability in the general system of the leader’s behavioural competences, that is to justify the importance of this skill and its application to increase the effectiveness of the impact of leadership on the project team. The objectives of the study involve - identifying a project team as a complex social organism where highly qualified people perform a specific set of functions; - emphasizing the fact that different individual features and qualities of participants greatly complicate the process of building a project team as well as coordinating the goals, aspirations and interests of team participants. Besides, the students who study Project Management should be familiarized with the methods of acquiring the knowledge and developing skills necessary for building a team. The methods of the study involve the analysis of the role of motivation in the process of team building since while building a team the leader has to solve many problems and the issues of motivation are among them. Second, the character of relations among the participants and the rational organization of their efficient teamwork should be analyzed. Third, the analysis of the leader’s capability to foster the professional and personal development of the participants in the teamwork is of great importance. Fourth, the effective method of cultivating in leaders the skills of building a team is increasing the level of teaching behavioural competences using innovative pedagogical techniques
In recent years, many surgical procedures have increasingly been replaced by interventional procedures that guide catheters into the arteries under X ray fluoroscopic guidance to perform a variety of operations such as ballooning, embolization, implantation of stents etc. The radiation exposure to patients and staff in such procedures is much higher than in simple radiographic examinations like X ray of chest or abdomen such that radiation induced skin injuries to patients and eye lens opacities among workers have been reported in the 1990's and after. Interventional procedures have grown both in frequency and importance during the last decade. This Coordinated Research Project (CRP) and TECDOC were developed within the International Atomic Energy Agency's (IAEA) framework of statutory responsibility to provide for the worldwide application of the standards for the protection of people against exposure to ionizing radiation. The CRP took place between 2003 and 2005 in six countries, with a view of optimizing the radiation protection of patients undergoing interventional procedures. The Fundamental Safety Principles and the International Basic Safety Standards for Protection against Ionizing Radiation (BSS) issued by the IAEA and co-sponsored by the Food and Agriculture Organization of the United Nations (FAO), the International Labour Organization (ILO), the World Health Organization (WHO), the Pan American Health Organization (PAHO) and the Nuclear Energy Agency (NEA), among others, require the radiation protection of patients undergoing medical exposures through justification of the procedures involved and through optimization. In keeping with its responsibility on the application of standards, the IAEA programme on Radiological Protection of Patients encourages the reduction of patient doses. To facilitate this, it has issued specific advice on the application of the BSS in the field of radiology in Safety Reports Series No. 39 and the three volumes on Radiation
Zhao, Zhen-Yu. [School of Business Administration, North China Electric Power University, Beijing 102206 (China); Zuo, Jian; Zillante, George [School of Natural and Built Environments, University of South Australia, Adelaide 5001 (Australia); Wang, Xin-Wei [Shandong Nuclear Power Equipment Manufacturing Co. Ltd, Haiyang, Shandong 265118 (China)
Chinese electric power industry has adopted Build-Operate-Transfer (BOT) approach in a number of projects to alleviate the pressure of sole state-owned investment. The Chinese government has taken enormous efforts to create an environment to facilitate the application of BOT approach in electric power projects. Moreover, the growing attention on the sustainability issues puts the traditional major source of electricity - thermal power project under more strict scrutiny. As a result, various renewable energy projects, particularly the wind power projects have involved private sector funds. Both thermal power and wind power projects via BOT approach have met with a varying degree of success. Therefore, it is imperative to understand the factors contributing towards the success of both types of BOT power projects. Using an extensive literature survey, this paper identifies 31 success factors under 5 categories for Chinese BOT electric power projects. This is followed by a questionnaire survey to exam relative significance of these factors. The results reveal the different levels of significance of success factors for BOT thermal power projects versus wind power projects. Finally, survey results were analyzed to explore the underlying construction and distributions among the identified success factors. This study provides a valuable reference for all involved parties that are interested in developing BOT electric power projects in China. (author)
Weiler, Monica R; Lavender, Steven A; Crawford, J Mac; Reichelt, Paul A; Conrad, Karen M; Browne, Michael W
This study explored factors contributing to intervention adoption decisions among Emergency Medical Service (EMS) workers. Emergency Medical Service workers (n = 190), from six different organisations, participated in a two-month longitudinal study following the introduction of a patient transfer-board (also known as slide-board) designed to ease lateral transfers of patients to and from ambulance cots. Surveys administered at baseline, after one month and after two months sampled factors potentially influencing the EMS providers' decision process. 'Ergonomics Advantage' and 'Patient Advantage' entered into a stepwise regression model predicting 'intention to use' at the end of month one (R (2 )= 0.78). After the second month, the stepwise regression indicated only two factors were predictive of intention to use: 'Ergonomics Advantage,' and 'Endorsed by Champions' (R (2 )= 0.58). Actual use was predicted by: 'Ergonomics Advantage' and 'Previous Tool Experience.' These results relate to key concepts identified in the diffusion of innovation literature and have the potential to further ergonomics intervention adoption efforts. Practitioner Summary. This study explored factors that potentially facilitate the adoption of voluntarily used ergonomics interventions. EMS workers were provided with foldable transfer-boards (slideboards) designed to reduce the physical demands when laterally transferring patients. Factors predictive of adoption measures included perceived ergonomics advantage, the endorsement by champions, and prior tool experience.
Young, Diana K.
While the productivity and quality implications of agile software development methods (SDMs) have been demonstrated, research concerning the project contexts where their use is most appropriate has yielded less definitive results. Most experts agree that agile SDMs are not suited for all project contexts. Several project and team factors have been…
Information technology (IT) projects are unsuccessful at a rate of 65% to 75% per year, in spite of employing the latest technologies and training employees. Although many studies have been conducted on project successes in U.S. companies, there is a lack of research studying the impact of various factors on software project success in offshore IT…
The purpose of this research was to investigate the causes of the dominant risk factors, affecting Enterprise System implementation projects and propose remedies for those risk factors from the perspective of implementation consultants. The study used a qualitative research strategy, based on e-mail interviews, semi-structured personal interviews with consultants and participant observation during implementation projects. The main contribution of this paper is that it offers viable indications of how to mitigate the dominant risk factors. These indications were grouped into the following categories: stable project scope, smooth communication supported by the project management, dedicated, competent and decision-making client team, competent and engaged consultant project manager, schedule and budget consistent with the project scope, use of methodology and procedures, enforced and enabled by the project managers, competent and dedicated consultants. A detailed description is provided for each category.
Scharfenberg, J; Schaper, K; Krummenauer, F
Award of the degree MD has special relevance in Germany since the underlying research project can be started during the qualification for admission to doctoral training. This leads to a large number of thesis projects with a not always sufficiently pronounced enthusiasm and thus poor chances of success. Accordingly a case control study was undertaken in the Department of Human Medicine, Witten/Herdecke University to investigate reported drop-outs of thesis projects. In autumn 2012 all students in the clinical phases of human medicine education were surveyed using a self-conceived questionnaire on previously initiated or terminated thesis projects, "terminated" is defined as the unsuccessful ending of a project after working for at least 3 months. Individually reported thesis terminations were evaluated using defined items in a 4-stage Likert scale regarding thesis plan and project, subsequently, graduate students who successfully completed a project received the same questionnaire. The items possibly corresponding to process determinants were averaged to a total of 7 dimensions prior to the analysis; the resulting scores were normalised in value ranges 0.0 to 1.0 (1.0 = optimal project situation) whereby individual items could be included in several scores. By means of 5 items a primary endpoint from the faculty's perspective on "compliance with formal procedures" was aggregated; by means of a two-sided Wilcoxon test at the 5 % level students with unsuccessful and successful courses were compared along the corresponding scores. 181 of 276 students from 7 study semesters participated in the screening; details of 17 terminations and 23 currently successful courses could be evaluated in the case control study. For significant differences (p thesis projects to the responsible committees. A weakness is the low number of evaluable self-reported drop-outs as well as the overall moderate response rate. Georg Thieme Verlag KG Stuttgart · New York.
Kubaha, K.; Fiala, D.; Toftum, Jørn
Projected area factors for individual segments of the standing and sedentary human body were modelled for both direct and diffuse solar radiation using detailed 3D geometry and radiation models. The local projected area factors with respect to direct short-wave radiation are a function of the solar...
Aug 16, 2013 ... effect of the direct cost variation factors (p-values between 0.365 and 0.930). Construction, resources, and performance factors are the most significant of the groups (MS range = 3.66 to 4.33), though no .... financial control on site ranked first and second ... order according to the consultants were, inflation.
Ranebennur, Virupax; Gaikwad, Sanjeevsingh; Ramesh, Sowmya; Bhende, Amrita
Background It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Materials and methods Data were drawn from the Behavioural Tracking Survey, a cross-sectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and “vulnerability index”, a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Results Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4–3.6; P<0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2–4.8; P<0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2–3.5; P<0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0–2.8, P<0.033) compared to those less vulnerable with similar exposure to the Aastha program. Conclusion It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented service-delivery model and community
Carvalho, Maria Carmo; de Sousa, Mariana Pinto; Frango, Paula; Dias, Pedro; Carvalho, Joana; Rodrigues, Marta; Rodrigues, Tania
Kosmicare project implements crisis intervention in situations related to the use of psychoactive substances at Boom Festival (Portugal). We present evaluation research that aims to contribute to the transformation of the project into an evidence-based intervention model. It relies on harm reduction and risk minimization principles, crisis intervention models, and Grof's psychedelic psychotherapy approach for crisis intervention in situations related to unsupervised use of psychedelics. Intervention was expected to produce knowledge about the relation between substance use and mental health impact in reducing potential risk related to the use of psychoactive substances and mental illness, as well as an impact upon target population's views of themselves, their relationship to substance use, and to life events in general. Research includes data on process and outcome indicators through a mixed methods approach, collected next to a sample of n=176 participants. Sample size varied considerably, however, among different research measures. 52% of Kosmicare visitors reported LSD use. Over 40% also presented multiple drug use. Pre-post mental state evaluation showed statistically significant difference (p<.05) confirming crisis resolution. Crisis episodes that presented no resolution were more often related with mental health outburst episodes, with psychoactive substance use or not. Visitors showed high satisfaction with intervention (n=58) and according to follow-up (n=18) this perception was stable over time. Crisis intervention was experienced as very significant. We discuss limitations and implications of evaluating natural setting based interventions, and the relation between psychoactive substance use and psychopathology. Other data on visitor's profile and vulnerability to crisis showed inconclusive.
Weech-Maldonado, Robert; Dreachslin, Janice L; Epané, Josué Patien; Gail, Judith; Gupta, Shivani; Wainio, Joyce Anne
Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels. This demonstration project employs a pre-post control group design. Two hospital systems participated in the study. Within each system, two hospitals were selected to serve as the intervention and control hospitals. Executive leadership (C-suite) and all staff at one general medical/surgical nursing unit at the intervention hospitals experienced a systematic, planned cultural competency intervention. Assessments and interventions focused on three organizational level competencies of cultural competency (diversity leadership, strategic human resource management, and patient cultural competency) and three individual level competencies (diversity attitudes, implicit bias, and racial/ethnic identity status). In addition, we evaluated the impact of the intervention on diversity climate and workforce diversity. Overall performance improvement was greater in each of the two intervention hospitals than in the control hospital within the same health care system. Both intervention hospitals experienced improvements in the organizational level competencies of diversity leadership and strategic human resource management. Similarly, improvements were observed in the individual level competencies for diversity attitudes and implicit bias for Blacks among the intervention hospitals. Furthermore, intervention hospitals outperformed their respective
Full Text Available Internationally projects exhibit time and cost overrun. It is observed that problems during design development contribute significantly to delays. In India, projects undertaken by government were largely planned and designed by departmental planners and engineers. However, after globalization, projects have increased in number resulting in design outsourcing, but with attendant challenges. The paper is aimed at identifying and analysing factors in the design development phase that can have impact on project success. 30 factors related to design development were identified through two separate brainstorming sessions. A questionnaire was then administered to determine importance ranking of these factors. Relative importance index (RII was used to prioritise these factors. Top ten factors in design development identified using RII include structural design parameters, soil investigations, design quality control, topographic survey, and architectural design parameters. The results can help firms improve their design development practices by prioritising activities that could have more impact on project performance.
Nieminen, Irja; Kaunonen, Marja
Mental health service users (MHSUs) often face difficulties in achieving successful participation in education; however, the tools that could help them succeed are rarely investigated. This study aimed to illuminate the experiences of MHSUs in an education intervention based on a European Union (EU) project. Their experiences are compared across nine EU countries. The data were collected through individual interviews with MHSUs (n = 47) at day activity centres that provide mental health services. An inductive content analysis was used as the method of analysis. Three main categories, which include seven subcategories, are revealed by the analysis. The main categories are as follows: (i) the factors related to MHSUs' educational preparedness, (ii) the dimensions of the learning environment, and (iii) the effects of training intervention. The MHSUs' experiences with the education intervention were similar across all countries. The findings showed that this education intervention is a multidimensional process. It contains social, mental, and physical dimensions linked to a learner and learning environment. These dimensions influence the MHSUs' ability to participate in the education process. At its best, the education intervention supports the personal growth of MHSUs and prepares them for social integration. An education intervention can be a usable tool in the rehabilitation of MHSUs if the multidimensional nature of education is taken into consideration. Therefore, designing and executing education interventions requires the attendance of the MHSUs in cooperation with mental health and education professionals. Our findings suggest a tentative framework that can be used in designing and executing education for MHSUs. © 2018 Australian College of Mental Health Nurses Inc.
Canavati, Sara E; Quintero, Cesia E; Lawford, Harriet L S; Yok, Sovann; Lek, Dysoley; Richards, Jack S; Whittaker, Maxine Anne
During the process of malaria elimination in the Greater Mekong Sub-region, mobile and migrant populations (MMPs) have been identified as the most at-risk demographic. An important sub-group of MMPs are seasonal workers, and this paper presents an evaluation of the reach and effectiveness of interventions tailored towards this group and was carried out as part of the Containment Project from 2009-11. A mixed-methods study was conducted in Pailin Province in Western Cambodia. Three-hundred-and-four seasonal workers were surveyed using a structured questionnaire. Qualitative data were gathered through a total of eight focus group discussions and 14 in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. High mobility and low access of the target population to the interventions, as well as lack of social and anthropological research that led to implementation oversights, resulted in under-exposure of seasonal workers to interventions. Consequently, their reach and impact were severely limited. Some services, particularly Mobile Malaria Workers, had the ability to significantly impact key factors, such as risky behaviours among those they did reach. Others, like Listening and Viewing Clubs and mass media campaigns, showed little impact. There is potential in two of the interventions assessed, but high mobility and inadequate exposure of seasonal workers to these interventions must be considered in the development and planning of future interventions to avoid investing in low-impact activities and ensure that all interventions perform according to their maximum potential. This will be critical in order for Cambodia to achieve its aim of malaria elimination. The lessons learned from this study can be extrapolated to other areas of health care in Cambodia and other countries in order to reduce the gap between healthcare provided to MMPs, especially seasonal workers, and to the general population.
Janssen, Wouter; Johansen, Monika Alise
Background eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Objective Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. Methods We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Results Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow
Granja, Conceição; Janssen, Wouter; Johansen, Monika Alise
eHealth has an enormous potential to improve healthcare cost, effectiveness, and quality of care. However, there seems to be a gap between the foreseen benefits of research and clinical reality. Our objective was to systematically review the factors influencing the outcome of eHealth interventions in terms of success and failure. We searched the PubMed database for original peer-reviewed studies on implemented eHealth tools that reported on the factors for the success or failure, or both, of the intervention. We conducted the systematic review by following the patient, intervention, comparison, and outcome framework, with 2 of the authors independently reviewing the abstract and full text of the articles. We collected data using standardized forms that reflected the categorization model used in the qualitative analysis of the outcomes reported in the included articles. Among the 903 identified articles, a total of 221 studies complied with the inclusion criteria. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The article frequency analysis did not show a significant discrepancy between the number of reports on failure (392/844, 46.5%) and on success (452/844, 53.6%). The qualitative analysis identified 27 categories that represented the factors for success or failure of eHealth interventions. A quantitative analysis of the results revealed the category quality of healthcare (n=55) as the most mentioned as contributing to the success of eHealth interventions, and the category costs (n=42) as the most mentioned as contributing to failure. For the category with the highest unique article frequency, workflow (n=51), we conducted a full-text review. The analysis of the 23 articles that met the inclusion criteria identified 6 barriers related to workflow: workload (n=12), role definition (n=7), undermining of face-to-face communication (n=6), workflow disruption (n=6), alignment with clinical
Welch, Whitney A; Spring, Bonnie; Phillips, Siobhan M; Siddique, Juned
The purpose of this study is to identify whether weather-related factors moderate the effect of a physical activity (PA) intervention. Participants (N=204, 77% female, mean age 33 [SD=11] years, mean BMI 28.2 [SD=7.1]) from the Make Better Choices 1 trial, enrolled April 2005 to April 2008, were randomized to one of two treatment conditions: (1) increase moderate to vigorous physical activity (MVPA) treatment group, or (2) decrease sedentary behavior control group. Participants wore an accelerometer for 5 weeks: a 2-week baseline assessment followed by a 3-week intervention. Accelerometer data were used to estimate minutes/day of MVPA. Average daily temperature, day length, and precipitation were obtained from the National Climatic Data Center and combined with the accelerometer data. Linear mixed effects models were used to determine whether these weather-related factors moderated the effect of the intervention on MVPA. Separate models were fit for season, daily average temperature, and day length. There was a significant moderating effect of season on MVPA such that the PA intervention, as compared with control, increased MVPA 10.4 minutes more in the summer than in the winter (95% CI=1.1, 19.6, p=0.029). There was a significant moderating effect of daily temperature such that every 10°F increase in temperature was associated with an additional 1.5 minutes/day increase in the difference in MVPA increase between the two intervention conditions (95% CI=0.1, 2.9, p=0.015). There was a significant moderating effect of day length such that every additional hour of daylight was associated with a 2.23-minute increase in the PA intervention's impact on increasing MVPA (95% CI=0.8, 3.7, p=0.002). Day length and temperature had a significant moderating effect on change in MVPA during a PA intervention such that the intervention was less effective on colder days and on shorter days, independently. These results suggest that strategies to overcome environmental barriers
Full Text Available Contrast induced nephropathy (CIN is one of important complication of contrast media administration. Its incidence and risk factors among Indonesian patients undergoing coronary intervention has not been reported yet. CIN was defined as increasing of serum creatinine by 0.5 mg/dl or more in the third day following contrast media exposure. Of 312 patients undergoing coronary intervention, 25% developed CIN. Patient-related risk factors comprised of hypertension, diabetes mellitus, NYHA class, proteinuria, serum creatinine > 1.5 mg/dl and ejection fraction ≤ 35%. Contrast-related risk factors comprised of contrast media volume > 300 ml, contrast media type. However, our final model demonstrated that only hypertension [Hazard ratio (HR = 2.89, 95% confidence intrval (CI = 1.78 to 4.71, P = 0.000], diabetes mellitus (HR = 3.09, 95% CI = 1.89 to 5.06, P = 0.000, ejection fraction (EF ≤ 35% (HR = 2.92; 95% CI = 1.72 to 4.96; P = 0.000, total contrast volume > 300 ml (HR = 7.73; 95% CI = 3.09 to 19.37; P = 0.000 and proteinuria (HR = 14.96; 95% CI = 3.45 to 64.86; P = 0.000 were independent risk factors of CIN. In conclusion, CIN developed in 25% of patients undergoing coronary intervention. The independent risk factors of CIN included hypertension, diabetes mellitus, EF ≤ 35%, contrast volume > 300 ml and proteinuria. (Med J Indones 2008; 17: 131-7Keywords: contrast induced nephropathy, coronary intervention
Larkins, Randy James
environment possible in whatever form the focus group takes place. Suggestions for future research include recruiting participants from online classes and attempting to engage more disenfranchised students in other studies. Similar to new types of focus group methods due to technological advances, academic interventions for students facing failing grades are also increasing due to the internet and new methods of service delivery. The contextual aspect of this research involved asking students to participate in an initial focus group session, four weeks of email updates, and a final focus group session in which students participated in the same group as the initial session. The purpose of the focus groups was to evaluate whether or not the universities' attempts to help students succeed in a course known in the past for high failure rates through a program known as the Early Alert Project was succeeding. Interview data were analyzed using thematic coding to evaluate available support services using a comprehensive implementation evaluation model which included effort, monitoring, process, components; and treatment specification. The primary findings were although students believed the university was trying to help them succeed, Early Alert Project efforts were adversely received. In addition, participants felt that although there were enough support services to help them succeed in the course, the components of the support system were confusing and not organized in any systematic manner. Suggestions for further research included researching delivery of this type of communication that might be more amenable to the students who received it and applying this research to other courses to examine whether the same results occur. Finally, implications of the use of traditional methods and academic support services are discussed in addition to the effect of the research itself upon its participants.
Crocker-Buque, Tim; Mindra, Godwin; Duncan, Richard; Mounier-Jack, Sandra
In 2014, over half (54%) of the world's population lived in urban areas and this proportion will increase to 66% by 2050. This urbanizing trend has been accompanied by an increasing number of people living in urban poor communities and slums. Lower immunization coverage is found in poorer urban dwellers in many contexts. This study aims to identify factors associated with immunization coverage in poor urban areas and slums, and to identify interventions to improve coverage. We conducted a systematic review, searching Medline, Embase, Global Health, CINAHL, Web of Science and The Cochrane Database with broad search terms for studies published between 2000 and 2016. Of 4872 unique articles, 327 abstracts were screened, leading to 63 included studies: 44 considering factors and 20 evaluating interventions (one in both categories) in 16 low or middle-income countries. A wide range of socio-economic characteristics were associated with coverage in different contexts. Recent rural-urban migration had a universally negative effect. Parents commonly reported lack of awareness of immunization importance and difficulty accessing services as reasons for under-immunization of their children. Physical distance to clinics and aspects of service quality also impacted uptake. We found evidence of effectiveness for interventions involving multiple components, especially if they have been designed with community involvement. Outreach programmes were effective where physical distance was identified as a barrier. Some evidence was found for the effective use of SMS (text) messaging services, community-based education programmes and financial incentives, which warrant further evaluation. No interventions were identified that provided services to migrants from rural areas. Different factors affect immunization coverage in different urban poor and slum contexts. Immunization services should be designed in collaboration with slum-dwelling communities, considering the local context
Huijg, J.M.; Crone, M.R.; Verheijden, M.W.; Zouwe, N. van der; Middelkoop, B.J.; Gebhardt, W.A.
Background: The introduction of efficacious physical activity interventions in primary health care is a complex process. Understanding factors influencing the process can enhance the development of effective introduction strategies. This Delphi study aimed to identify factors most relevant for the
van den Driessche, José J; Plat, Jogchum; Mensink, Ronald P
Functional foods can be effective in the prevention of metabolic syndrome and subsequently the onset of cardiovascular diseases and type II diabetes mellitus. More recently, however, another term was introduced to describe foods with additional health benefits: "superfoods", for which, to date, no generally accepted definition exists. Nonetheless, their consumption might contribute to the prevention of metabolic syndrome, for example due to the presence of potentially bioactive compounds. This review provides an overview of controlled human intervention studies with foods described as "superfoods" and their effects on metabolic syndrome parameters. First, an Internet search was performed to identify foods described as superfoods. For these superfoods, controlled human intervention trials were identified until April 2017 investigating the effects of superfood consumption on metabolic syndrome parameters: waist circumference or BMI, blood pressure, or concentrations of HDL cholesterol, triacylglycerol or glucose. Seventeen superfoods were identified, including a total of 113 intervention trials: blueberries (8 studies), cranberries (8), goji berries (3), strawberries (7), chili peppers (3), garlic (21), ginger (10), chia seed (5), flaxseed (22), quinoa (1), cocoa (16), maca (1), spirulina (7), wheatgrass (1), acai berries (0), hemp seed (0) and bee pollen (0). Overall, only limited evidence was found for the effects of the foods described as superfoods on metabolic syndrome parameters, since results were not consistent or the number of controlled intervention trials was limited. The inconsistencies might have been related to intervention-related factors, such as duration or dose. Furthermore, conclusions may be different if other health benefits are considered.
Leslie B. Hammer
Full Text Available The goal of this study was to test the effectiveness of a workplace intervention targeting work-life stress and safety-related psychosocial risk factors on health and safety outcomes. Data were collected over time using a randomized control trial design with 264 construction workers employed in an urban municipal department. The intervention involved family- and safety-supportive supervisor behavior training (computer-based, followed by two weeks of behavior tracking and a four-hour, facilitated team effectiveness session including supervisors and employees. A significant positive intervention effect was found for an objective measure of blood pressure at the 12-month follow-up. However, no significant intervention results were found for self-reported general health, safety participation, or safety compliance. These findings suggest that an intervention focused on supervisor support training and a team effectiveness process for planning and problem solving should be further refined and utilized in order to improve employee health with additional research on the beneficial effects on worker safety.
Hammer, Leslie B.; Truxillo, Donald M.; Bodner, Todd; Rineer, Jennifer; Pytlovany, Amy C.; Richman, Amy
The goal of this study was to test the effectiveness of a workplace intervention targeting work-life stress and safety-related psychosocial risk factors on health and safety outcomes. Data were collected over time using a randomized control trial design with 264 construction workers employed in an urban municipal department. The intervention involved family- and safety-supportive supervisor behavior training (computer-based), followed by two weeks of behavior tracking and a four-hour, facilitated team effectiveness session including supervisors and employees. A significant positive intervention effect was found for an objective measure of blood pressure at the 12-month follow-up. However, no significant intervention results were found for self-reported general health, safety participation, or safety compliance. These findings suggest that an intervention focused on supervisor support training and a team effectiveness process for planning and problem solving should be further refined and utilized in order to improve employee health with additional research on the beneficial effects on worker safety. PMID:26557703
Mamidala, Madhu Poornima; Polinedi, Anupama; Kumar, P T V Praveen; Rajesh, N; Vallamkonda, Omsai Ramesh; Udani, Vrajesh; Singhal, Nidhi; Rajesh, Vidya
Globalization and women empowerment have led to stressful life among Indian women. This stress impairs women's hormonal makeup and menstrual cycle, leading to infertility. National Family Health Survey-3 (NFHS-3) reports a decline in fertility status in India, indicating a rise in various infertility treatments involving hormonal interventions. No studies are available from India on the risk association link between maternal hormonal treatments and ASD. Hence, this study explores the association of maternal hormonal interventions with risk for ASD. Parents of 942 children (471 ASD and 471 controls) across 9 cities in India participated in the questionnaire-based study. The questionnaire was pilot tested and validated for its content and reliability as a psychometric instrument. Data collection was done at 70 centres through direct interaction with parents and with the help of trained staff. Statistical analysis of data was carried out using SAS 9.1.3. Out of the 471 ASD cases analysed, 58 mothers had undergone hormonal interventions (12.3 percent) while there were only 22 mothers among controls who underwent hormonal interventions (4.6 percent). According to logistic regression analysis maternal hormonal intervention (OR=2.24) was a significant risk factor for ASD.
Xu Peng; Zhang Gaofeng; Wu Xusheng; Qiao Qi; Yu Liqun
Objective: To study the prognostic risk factors of male patients with coronary heart disease in stent placement era. Methods: One hundred and four patients were enrolled in this study (aged 64.9 ± 9.6 years) including 61 diagnosed as acute myocardial infarction, and 43 as unstable angina with followed up 11.9 ± 8.7 months. All factors including demographic factors, non-interventional work-up, associated clinical complications and results of coronary artery angiography reached a model of Logistic regression analysis. Results: Based on MACE (major adverse cardiac events), as quantitative factors, diseased proximal middle left anterior descending artery was a significant independent variable (P<0.05), and its coefficient was 22.00. Conclusions: Diseased proximal middle left anterior descending coronary artery is the prognostic factor of MACE in male patients with acute coronary syndrome. (authors)
Khelassi-Toutaoui, Nadia; Merad, Ahmed; Toutaoui, A.E.K.; Bairi, Souad
Full text: Purpose: To evaluate patient doses in Interventional Radiology (IR) and Cardiology (IC) procedures in Algeria, within the framework of an International Atomic Energy Agency (IAEA) regional project on radiation protection of patients and medical exposure control (RAF 9033). Materials and Methods: Three public hospitals (CHU Bab el Oued, CHU Parnet and CHU Mustapha) and one specialised Cardiology Service (Clinique Maouche) were chosen for the study. For Maximum Skin Dose (MSD) evaluation, gafchromic films XR type R were used, placed on patient's back before the procedure. The Dose Area Product (DAP) and MSD were measured in 57 IR and IC procedures, either diagnostic or therapeutic. Results: The results revealed large variations in MSD (0.06-3.3 Gy) and DAP (5.5-332 mGycm 2 ). Mean MSD was 0.227 Gy in cerebral angiography, 0.202 Gy in coronary angiography, 1.162 Gy in Percutaneus Transluminal Coronary Angioplasty (PTCA) and 0.128 in abdominal angiography. The correlation of DAP and MSD was significant (r = 0.7). The correlation was DAP and fluoroscopy time was also significant (r = 0.8). Conclusion: The highest MSD values were found in PTCA which is a therapeutic procedure. Two PTCAs out of the 57 procedures measured in total had MSD over the threshold of 2 Gy for deterministic effects (MSD 1 = 3.0 Gy and MSD 2 3.3 Gy). The large variations in MSD reveal the need to continuously monitor patient doses in IR and IC procedures with special emphasis in PTCA procedure. (author)
Hill, Karl G; Bailey, Jennifer A; Hawkins, J David; Catalano, Richard F; Kosterman, Rick; Oesterle, Sabrina; Abbott, Robert D
The objectives of this study were to examine (1) whether the onset of sexually transmitted infections (STI) through age 30 differed for youths who received a social developmental intervention during elementary grades compared to those in the control condition; (2) potential social-developmental mediators of this intervention; and (3) the extent to which these results differed by ethnicity. A nonrandomized controlled trial followed participants to age 30, 18 years after the intervention ended. Three intervention conditions were compared: a full-intervention group, assigned to intervention in grades 1 through 6; a late intervention group, assigned to intervention in grades 5 and 6 only; and a no-treatment control group. Eighteen public elementary schools serving diverse neighborhoods including high-crime neighborhoods of Seattle are the setting of the study. Six hundred eight participants in three intervention conditions were interviewed from age 10 through 30. Interventions include teacher training in classroom instruction and management, child social and emotional skill development, and parent workshops. Outcome is the cumulative onset of participant report of STI diagnosis. Adolescent family environment, bonding to school, antisocial peer affiliation, early sex initiation, alcohol use, cigarette use, and marijuana use were tested as potential intervention mechanisms. Complementary log-log survival analysis found significantly lower odds of STI onset for the full-intervention compared to the control condition. The lowering of STI onset risk was significantly greater for African Americans and Asian Americans compared to European Americans. Family environment, school bonding, and delayed initiation of sexual behavior mediated the relationship between treatment and STI hazard. A universal intervention for urban elementary school children, focused on classroom management and instruction, children's social competence, and parenting practices may reduce the onset of STI
Hill, Karl G.; Bailey, Jennifer A.; Hawkins, J. David; Catalano, Richard F.; Kosterman, Rick; Oesterle, Sabrina; Abbott, Robert D.
Objectives To examine (1) whether onset of sexually transmitted infections (STI) through age 30 differed for youths who received a social developmental intervention during elementary grades compared to those in the control condition; (2) potential social-developmental mediators of this intervention; and (3) the extent to which these results differed by ethnicity. Design A nonrandomized controlled trial followed participants to age 30, 18 years after the intervention ended. Three intervention conditions were compared: a full intervention group, assigned to intervention in grades 1 through 6; a late intervention group, assigned to intervention in grades 5 and 6 only; and a no-treatment control group. Setting Eighteen public elementary schools serving diverse neighborhoods including high-crime neighborhoods of Seattle. Analysis Sample 608 participants in three intervention conditions interviewed from age 10 through 30. Interventions Teacher training in classroom instruction and management, child social and emotional skill development, and parent workshops. Outcome Cumulative onset of participant report of STI diagnosis. Intervention Mechanisms Adolescent family environment, bonding to school, antisocial peer affiliation, early sex initiation, alcohol use, cigarette use, and marijuana use were tested. Analysis and Results Complementary log-log survival analysis found significantly lower odds of STI onset for the full intervention compared to the control condition. The lowering of STI onset risk was significantly greater for African Americans and Asian Americans compared to European Americans. Family environment, school bonding and delayed initiation of sexual behavior mediated the relationship between treatment and STI hazard. Conclusions A universal intervention for urban elementary school children, focused on classroom management and instruction, children’s social competence, and parenting practices may reduce the onset of STI through age 30, especially for African
Bechara, Glaucia Margonari; Castelo Branco, Fernanda; Rodrigues, Avelino Luiz; Chinnici, Daniela; Chaney, David; Calliari, Luis Eduardo P; Franco, Denise Reis
Although it is known that school care is a major challenge in diabetes treatment, there is still no published international initiative. The aims of this study were to introduce an international educational intervention tool, the International Diabetes Federation (IDF) KiDS and Diabetes in Schools project (KiDS project), and to describe its impact on diabetes knowledge and behavior of caregivers and school professionals. The KiDS project was developed with the support of IDF and the International Society for Pediatric and Adolescent Diabetes and provides online free material in 10 languages, directed to caregivers and school personnel. A pilot evaluation of the KiDS intervention was performed in Brazil. An educational intervention was conducted in 5 primary schools, with 42 parents and school staff, followed by 2 individual interviews after 1 and 3 months. The results were evaluated in a qualitative study with a descriptive design based on content analysis. School staff acquired new knowledge on diabetes and its treatment. They felt more confident when helping students with diabetes and said the educational intervention promoted a positive impact on the teacher-student relationship, on the caring for health, and on school infrastructure. Family members of children with diabetes stated that the educational intervention gave them an opportunity to strengthen and update information on treatment and improve their knowledge. The KiDS project is the first international tool directed to foster a safe and supportive environment and a better understanding of diabetes in schools. In this pilot evaluation, it achieved the goal of informing and changing the behavior of parents and school staff, thus improving the care provided to children with diabetes in schools. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Aveling, Emma-Louise; Stone, Juliana; Sundt, Thoralf; Wright, Cameron; Gino, Francesca; Singer, Sara
Surgical excellence demands teamwork. Poor team behaviors negatively affect team performance and are associated with adverse events and worse outcomes. Interventions to improve surgical teamwork focusing on frontline team members' nontechnical skills have proliferated but shown mixed results. Literature on teamwork in organizations suggests that team behaviors are also contingent on psycho-social, cultural and organizational factors. This study examines factors influencing surgical team behaviors in order to inform more contextually sensitive and effective approaches to optimizing surgical teamwork. Qualitative study of cardiac surgical teams in a large US teaching hospital included 34 semi-structured interviews. Thematic network analysis was used to examine perceptions of ideal teamwork and factors influencing team behaviors in the OR. Perceptions of ideal teamwork were largely shared, but team members held discrepant views of which team and leadership behaviors enhanced or undermined teamwork. Other factors impacting team behaviors related to: local organizational culture, including management of staff behavior; variable case demands and team members' technical competence; fitness of organizational structures and processes to support teamwork. These factors affected perceptions of what constituted optimal interpersonal and team behaviors in the OR. Team behaviors are contextually contingent and organizationally determined, and beliefs about optimal behaviors are not necessarily shared. Interventions to optimize surgical teamwork requires establishing consensus regarding best practice, ability to adapt as circumstances require, and organizational commitment to addressing contextual factors that impact teams. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Kobra Salehi; Shahnaz Kohan; Fariba Taleghani
Introduction: Parents' attachment to the child is an intimate,warm and continuous relationship which is the basis of the natural development of the child. Attachment starts long before birth, and is affected by a variety of factors that are not definitively recognized. Also, several interventions have been proposed for improving it that their effectiveness has not yet been determined. Given the evidence about the role of cultural and national differences, it is necessary to review existing st...
Ali Mohammed Alashwal
Full Text Available The success of international construction projects is fraught with various challenges such as competitiveness, lack of resources, versatile global economy, and specific conditions in the host country. Malaysian contractors have been venturing into global construction market since early 1980s. However, their venturing was not successful all the time. The number of international projects awarded to Malaysian contractors has reduced drastically during the past decade. Taking advantage of this experience, this paper aims to identify the success criteria and success factors of international construction projects. The data was collected from 120 respondents using a questionnaire survey and analysed using principal component analysis and regression analysis. The results revealed three principal criteria of project success namely, Management Success, Functional Success, and Organisation Success. The main components of success factors include Team Power and Skills, Resource Availability, External Environment, Organisation Capability, Project Support, and Project Organisation. Further analysis emphasized the importance of strong financing capacity of contractors, project social environment, and competence of the project manager in achieving project success. The results of this paper can serve as a guideline for contractors and project managers to achieve success in this context. Future studies may provide in-depth analysis of success criteria and success factors specific for construction project type and host-country location.
Rahmati Najarkolaei, Fatemeh; Ghaffarpasand, Eiman; Gholami Fesharaki, Mohammad; Jonaidi Jafari, Nematollah
Fast growing epidemic of chronic diseases causes many health challenges over the world. Regarding reported pros and cons, the aim of the current study is to review the effect of nutrition and physical educational intervention in decreasing cardiovascular risk factors. In this review study, searching has done through the English and Persian databases. Articles with other languages, lack of important information, and score 3 or less in the JADAD standard checklist were exluded from the study. In the primary search, 194 articles have been found.Through four stages of secondary search and further evaluation, 43 articles were selected. These articles were published between 1989 to 2013. According to these findings, the majority of articles showed a positive effect of nutrition and physical activity educational interventions on cardiovascular risk factors- blood cholesterol, systolic and diastolic blood pressure, as well as smoking cigarette in high risk patients. These results, suggest the necessity of continiuting nutrition and physical educational intervention for individuals with cardiovascular risk factors.
Hammoudeh, Ayman J; Alhaddad, Imad A; Khader, Yousef; Tabbalat, Ramzi; Al-Mousa, Eyas; Saleh, Akram; Jarrah, Mohamad; Nammas, Assem; Izraiq, Mahmoud
Background and aims: Cardiovascular disease (CVD) is the leading cause of death in the Middle East. We sought to study the prevalence and coexistence of 6 cardiovascular risk factors (RFs) among patients who underwent percutaneous coronary intervention (PCI), and to evaluate the impact of age and gender on the presence of multiple RFs. In this prospective, multicenter study, 2426 consecutive patients were enrolled. Mean age was 59.0 ± 10.1 years and 500 (20.6%) were women. Acute coronary syndrome and stable coronary disease were the indications for PCI in 77.1% and 22.9%, respectively. Hypertension was present in 62.3%, diabetes in 53.8%, hypercholesterolemia in 48.8%, smoking in 43.5%, family history of premature CVD 39.4% and obesity in 28.8%. Only 3.8% did not have any of these RFs. Presence of ⩾3 and ⩾4 RFS was observed in 57.4% and 29.5% of patients, respectively. Presence of ⩾3 RFs was more common in women than men (69.0% vs. 54.5%, p Eastern population undergoing PCI. More than half and more than one-fourth of the patients had at least 3 or 4 RFs; respectively. More women than men and more middle aged patients than older or younger patients had significantly higher rates of presence of multiple RFs.
Wang, Zhiyun; Wang, Jianping; Maercker, Andreas
Insight into user adherence to Web-based intervention programs and into its relationship to intervention effect is needed. The objective of this study was to examine use of a Web-based self-help intervention program, the Chinese version of My Trauma Recovery (CMTR), among Chinese traumatized individuals, and to investigate the relationship between program use and user characteristics before the intervention and change in outcomes after the intervention and at 3-months' follow-up. The sample consisted of 56 urban survivors of different trauma types and 90 rural survivors of the 2008 Sichuan earthquake, who used the CMTR in 1 month on their own or guided by volunteers in a counseling center. Predictors were demographics (sex, age, highest education, marital status, and annual family income), health problems (trauma duration, posttraumatic symptoms, and depression), psychological factors (coping self-efficacy), and social factors (social functioning impairment and social support). Program use was assessed by general program usage (eg, number of visiting days) and program adherence (eg, webpages completed in modules). Outcome measures were the Posttraumatic Diagnostic Scale (PDS), Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy scale (CSE), Crisis Support Scale (CSS), and Social Functioning Impairment questionnaire (SFI) adopted from the CMTR. (1) Program use: rural participants had a larger total number of visiting days (F1,144=40.50, Psocial factors at pretest. (3) Program use and outcomes change: in general, use of the triggers and self-talk modules showed a consistent positive association with improvement in PDS, SCL-D, SFI, and CSE. The relaxation module was associated with positive change in PDS, but with negative change in CSS and SFI. The professional help module was associated with positive change in SCL-D, but its use on the first day was associated with negative change in CSS and CSE. The unhelpful coping module was associated with
Jardi Besa, X.; Munoz Cervantes, A.
At the onset of nuclear projects in Spain, there was an import of nuclear technology. In a second phase, there was a transfer of technology. Subsequently, there was an adaptation of the technology. In this evolution, comparable to that of other countries, were involved several countries, overcoming the difficulties of human factors involved. The current nuclear projects multinationals have a new difficulty: the different industrial technological environments. This paper will address the organizational challenges of multinational engineering projects, in the type of project and the human factors of the participating companies.
Zhang, Xin-Yi; Shuai, Jian; Li, Li-Ping
Our study objective was to determine the effect of vision intervention and combinations of different intervention components on preventing falls and fall-related injuries among older people. Six electronic databases were searched to identify seven articles published before May, 2014. We conducted a systematic review of data from seven randomized controlled trails and identified eight regimens: vision intervention alone (V), vision plus exercise (referred to as physical exercise) interventions (V + E), vision plus home hazard interventions (V + HH), vision plus exercise plus home hazard interventions (V + E + HH), vision plus exercise plus sensation interventions (V + E + S), vision plus hearing interventions (V + H), vision plus various risk factor assessment and interventions (V + VRF), and the control group (C, no intervention group). The main outcome was the incidence of falls during the follow-up period. Seven papers included 2723 participants. Network meta-analysis of seven trials, using pairwise comparisons between each intervention, indicated there was no significant difference. However, there was a trend in which intervention incorporating V + VRF had more advantages than any other combination of interventions. In conclusion, V + VRF proves to be more effective than other V combination interventions in preventing falls in older people (≥65 years of age). V alone appears less effective in our network meta-analysis.
Johnston, Maximilian J; Arora, Sonal; King, Dominic; Darzi, Ara
This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety. A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards. Twenty-seven junior and senior surgeons completed validated questionnaires assessing supervision, escalation of care, and safety culture pre and post-intervention along with interviews to further explore the impact of the intervention. Patient outcomes pre and postintervention were also analyzed. Questionnaires revealed significant improvements in supervision postintervention (senior median pre 5 vs post 7, P = 0.002 and junior 4 vs 6, P = 0.039) and senior surgeon approachability (junior 5 vs 6, P = 0.047). Both groups agreed that they would feel safer as a patient in their hospital postintervention (senior 3 vs 4.5, P = 0.021 and junior 3 vs 4, P = 0.034). The interviews confirmed that the safety culture of the department had improved. There were no differences in inpatient mortality, cardiac arrest, reoperation, or readmission rates pre and postintervention. Improving supervision and introducing clear protocols can improve safety culture on the surgical ward. Future work should evaluate the effect these measures have on patient outcomes in multiple institutions.
Sady Darcy Silva Junior
Full Text Available Project Management (PM and Strategic Management (SM are two subjects of growing importance in the corporate environment which are normally considered in isolation. One way of integrating these two concepts might be via the concept of project management maturity (Westphal et al., 2008. Rabechini and Pessoa (2005 state that to obtain project management maturity, it is necessary to achieve success in a number of critical factors which include organizational culture and structure, as well as sponsorship at both tactical and strategic levels (Silva et al., 2008. Another way of achieving this connection is by using Balanced Scorecard (BSC as an auxiliary tool to integrate between projects and organizational strategy (Brock et al., 2003. The original developers of the BSC, Kaplan e Norton, subsequently developed the concept of strategy mapping, which they affirm "represents the missing link between the formulation and the execution of the strategy" (Kaplan e Norton, 2004. This paper proposes a strategy map identifying critical factors for attaining project management maturity. To formulate the map, we used a qualitative, exploratory approach oriented by Project Management theory and strategy mapping. We first identified 13 critical factors, then developed a strategy map, which was evaluated by six specialists (three in SM area and three in PM area.The results suggest links between strategic mapping nad critical factors in project management. It also contributes to both areas independently. Specifically, the study identifies critical factors for project management maturity while demonstrating the applicability of strategic mapping techniques to Balanced Scorecard concepts.
Schall, Carol M; Wehman, Paul; Brooke, Valerie; Graham, Carolyn; McDonough, Jennifer; Brooke, Alissa; Ham, Whitney; Rounds, Rachael; Lau, Stephanie; Allen, Jaclyn
This paper presents findings from a retrospective observational records review study that compares the outcomes associated with implementation of supported employment (SE) with and without prior Project SEARCH with ASD Supports (PS-ASD) on wages earned, time spent in intervention, and job retention. Results suggest that SE resulted in competitive employment for 45 adults with ASD. Twenty-five individuals received prior intervention through PS-ASD while the other 20 individuals received SE only. Individuals in this sample who received PS-ASD required fewer hours of intervention. Additionally, individuals in the PS-ASD group achieved a mean higher wage and had higher retention rates than their peers who received SE only. Further research with a larger sample is needed to confirm these findings.
Romeo B. Batacan
Full Text Available The effects of light intensity physical activity (LIPA on cardiovascular disease (CVD risk factors remain to be established. This review summarizes the effects of LIPA on CVD risk factors and CVD-related markers in adults. A systematic search of four electronic databases (PubMed, Academic Search Complete, SPORTDiscus, and CINAHL examining LIPA and CVD risk factors (body composition, blood pressure, glucose, insulin, glycosylated hemoglobin, and lipid profile and CVD-related markers (maximal oxygen uptake, heart rate, C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and tumor necrosis factor receptors 1 and 2 published between 1970 and 2015 was performed on 15 March 2015. A total of 33 intervention studies examining the effect of LIPA on CVD risk factors and markers were included in this review. Results indicated that LIPA did not improve CVD risk factors and CVD-related markers in healthy individuals. LIPA was found to improve systolic and diastolic blood pressure in physically inactive populations with a medical condition. Reviewed studies show little support for the role of LIPA to reduce CVD risk factors. Many of the included studies were of low to fair study quality and used low doses of LIPA. Further studies are needed to establish the value of LIPA in reducing CVD risk.
Zacarías, Andrea; Narváez, Javier; Rodríguez Moreno, Jesús; Jordana, Montserrat; Nolla, Joan M; Gómez Vaquero, Carmen
To evaluate the effectiveness of an intervention on cardiovascular risk factors (CVRF) in patients with rheumatoid arthritis. After determining their CVRF and cardiovascular risk (CVR) by modified SCORE, we gave the patients a letter for their general practitioners in which they were requested for their cooperation in controlling CVRF and where the therapeutic goal for LDL cholesterol was specified. Three months later, any therapeutic intervention was recorded as well as the results. We included 211 patients, 29% with a high CVR. There were new diagnoses of CVRF in 100 patients (47%). The general practitioner changed the treatment in 2/12 diabetes, 30/84 HBP, 74/167 with elevation of LDL cholesterol and 21/51 with hypertriglyceridemia. The percentage of patients with good control over CVRF was: a) in HBP, 25 to 73%; b) elevation of LDL cholesterol from 10 to 17%; and c) in hypertriglyceridemia, 25 to 38%. Through this intervention, a new CVRF was diagnosed in nearly half of the patients. The effectiveness of the intervention on CVRF was low. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
Chipo Mellania Maseko
Full Text Available Controlling project risks has become a daunting task in construction and this can be attributed to issues such as the nature of modern projects. The challenge is that risk appears unannounced at any project phase for various reasons and thereby affecting the performance and the success of unprepared projects. The current studies that explored risk matters include Pehlivan and Öztemir (2015, Katre, and Ghaitidak (2016 amongst others. However, there is absence of unanimity from these studies on risk factors in construction. Thus, this article was instigated in order to identify and classify risk factors that affect the chances of project success. The research methodology selected for this article comprised of peer-reviewed articles between the periods of 2007 to 2017. This approach involved a comprehensive scrutiny into scholarly articles to comprehend risks in construction projects. Following a conceptual analysis, eighty factors were identified and classified under the following; technical, construction, financial, socio-political, physical, organisational, and environmental and other risks. From these categories, political instability was, found to be the most influential risk factor in construction projects and this factor was classified within the socio-political category and this category has total of 11 factors. Finding suggests the need for further empirical study.
Dour, Colleen A; Horacek, Tanya M; Schembre, Susan M; Lohse, Barbara; Hoerr, Sharon; Kattelmann, Kendra; White, Adrienne A; Shoff, Suzanne; Phillips, Beatrice; Greene, Geoffrey
To evaluate the motivational effect of the Project WebHealth study procedures and intervention components on weight-related health behavior changes in male and female college students. Process evaluation. Eight universities in the United States. Project WebHealth participants (n = 653; 29% men). Participants rated motivational effects of study procedures and intervention components. Participants were grouped into outcome-based health behavior categories based on achievement of desired targets for fruit and vegetable intake, physical activity, and/or body weight. Differences in motivation from each procedure and component were analyzed by gender- and outcome-based health behavior category. Women were generally more motivated than men. Compared to those who did not meet any target health behaviors, men with improved health outcomes (68%) were significantly more motivated by the skills to fuel the body lesson, goal setting, and research snippets. Their female counterparts (63%) were significantly more motivated by the lessons on body size and eating enjoyment, and by the suggested weekly activities. Specific study procedures and components of Project WebHealth motivated study participants to improve their weight-related health behaviors, and they differed by gender. Findings support the need for gender-tailored interventions in this population. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
MacLean, Sarah; Berends, Lynda; Hunter, Barbara; Roberts, Bridget; Mugavin, Janette
Few studies systematically explore elements of successful project implementation across a range of alcohol and other drug (AOD) activities. This paper provides an evidence base to inform project implementation in the AOD field. We accessed records for 127 completed projects funded by the Alcohol, Education and Rehabilitation Foundation from 2002 to 2008. An adapted realist synthesis methodology enabled us to develop categories of enablers and barriers to successful project implementation, and to identify factors statistically associated with successful project implementation, defined as meeting all funding objectives. Thematic analysis of eight case study projects allowed detailed exploration of findings. Nine enabler and 10 barrier categories were identified. Those most frequently reported as both barriers and enablers concerned partnerships with external agencies and communities, staffing and project design. Achieving supportive relationships with partner agencies and communities, employing skilled staff and implementing consumer or participant input mechanisms were statistically associated with successful project implementation. The framework described here will support development of evidence-based project funding guidelines and project performance indicators. The study provides evidence that investing project hours and resources to develop robust relationships with project partners and communities, implementing mechanisms for consumer or participant input and attracting skilled staff are legitimate and important activities, not just in themselves but because they potentially influence achievement of project funding objectives. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.
Annie Maddison Warren
Full Text Available Since the beginning of modern project management in the 1960s, academic researchers have sought to identify a definitive list of Critical Success Factors (CSFs, the key things that project managers must get right in order to deliver a successful product. With the advent of Information Technology (IT projects and, more recently, projects to deliver Enterprise Resource Planning (ERP systems, attention has turned to identifying definitive lists of CSFs for these more specific project types. The purpose of this paper is to take stock of this research effort by examining how thinking about each type of project has evolved over time, before producing a consolidated list of CSFs for each as a basis for comparison. This process reveals a high degree of similarity, leading to the conclusion that the goal of identifying a generic list of CSFs for project management has been achieved. Therefore, rather than continuing to describe lists of CSFs, researchers could increase the value of their contribution by taking a step forward and focusing on why, despite this apparent knowledge of how to ensure their success, ERP projects continue to fail.
Dattilo, Anne M
Worldwide, the prevalence of childhood obesity has increased, amounting to 42 million overweight or obese children, and there is increasing evidence that the origins are within the first 1,000 days: the period of conception through 2 years. Antecedents of early childhood obesity are multifactorial, and associations of varying strength have been documented for genetic/epigenetic, biologic, dietary, environmental, social, and behavioral influences. Modifiable factors in pregnancy and early infancy associated with childhood obesity include maternal overweight/obesity, maternal smoking, gestational weight gain, infant and young child feeding, caregiver responsive feeding practices, as well as sleep duration, and physical activity. Promising obesity prevention interventions include those beginning during the first 1,000 days, using a multicomponent approach, with roots in nutrition education theories or behavior change communication that can continue over time. However, the limited number of completed interventions to date (within pediatric clinics or in home-based or community settings) may not be scalable to the magnitude needed for sustainable obesity prevention. Scale-up interventions that can be maintained for the durations needed, addressing infant and young child feeding and other modifiable risk factors associated with childhood obesity are needed. © 2017 Nestec Ltd., Vevey/S. Karger AG, Basel.
Many factors influence the perception of economic performance for developing projects. Some of these factors can be controlled by the developer, while some are outside the developer's sphere of influence. Technology selection, management systems, stakeholder involvement, environmental responsiveness and risk management are areas that may be influenced, however interest rates, product prices and currency exchange all have a measurable effect on project economics and are beyond a developer's control. Economic considerations for evaluating mineable oil sand development projects are outlined, focussing on the key factors unique to such developments in general and to the OSLO project in particular. The OSLO project is a proposed $5 billion energy development that entails constructing an open pit oil sands mine and a bitumen extraction facility north of Fort McMurray, Alberta, coupled with a bitumen upgrader in the Redwater area. 7 figs
Resaland, G K; Anderssen, S A; Holme, I M
at the I-school carried out 60 min of PA daily. The PA lessons were planned, organized and led by expert physical education (PE) teachers. In the C-school, children were offered the normal 45 min of PE twice weekly. The intervention resulted in a greater beneficial development in systolic (P=0......The aim of this study was to investigate the effect of a 2-year school-based physical activity (PA) intervention in 9-year-old children on cardiovascular disease (CVD) risk factors. One intervention school (I-school) (n=125) and one control school (C-school) (n=131) were included. The children...
Full Text Available Purpose: In developing countries such as South Africa, many organisations are reliant on information and communication technology (ICT to provide accurate, relevant and timely information. For organisations to obtain and sustain a competitive advantage, ICT systems are constantly implemented, upgraded, modified or replaced. These initiatives are often managed as projects. While there is an increasing amount of both financial resources and effort being spent on ICT, these projects are not always delivered within the predetermined project constraints. This implies additional time to complete, as well as additional costs, as resources are not released in time to participate in other projects. It is therefore important to understand the factors that influence the outcome of South African ICT projects relative to their original constraints. Problem Investigated: The goal of this article is to determine the factors that influence South African ICT projects, taking into consideration the fact that most current published research on this topic was done within the context of a developed country such as the USA and Europe. Design and/or methodology: The outcomes of ICT projects in South Africa as well as the factors that influence them were determined through an extensive survey. An analysis was done on the factors together with a correlation between the main factors contributing to project outcomes. The purpose of this was to establish if a factor's presence or absence influenced the eventual outcome. Findings: The factors that contribute to a successful outcome are often outside the direct control of the project manager and tend to be complex in nature. One factor that does stand out is that the alignment of projects with business objectives influences their perceived success. Originality/Value: The benefits of this article are that it firstly provides a South African perspective of current ICT project management practices, and secondly, it highlights
Full Text Available Introduction: Parents' attachment to the child is an intimate,warm and continuous relationship which is the basis of the natural development of the child. Attachment starts long before birth, and is affected by a variety of factors that are not definitively recognized. Also, several interventions have been proposed for improving it that their effectiveness has not yet been determined. Given the evidence about the role of cultural and national differences, it is necessary to review existing studies in order to identify these factors and interventions in Iran.Methods and Materials: In this review, Web of Science, Scopous, Proquest,Psycinfo, CINAHL and Pubmed databases and SID, Magiran, Irondoc, Barakat Knowledge Network System as Iranian databases were searched using English and Persian keywords such as prenatal attachment, relationship, maternal attachment between 2000 and 2017, to find articles related to prenatal attachment. The full text of the articles was studied by two reviewer and their main findings were extracted and categorized.Results: Factors and interventions associated with parental attachment summarized into 12 themes: parent education, culture, anxiety, family, planning for pregnancy, history of fetal loss, substance abuse, postpartum attachment, fetal anomaly, paternal attachment, attachment measurement tools, and effectiveness of education on prenatal attachment .Conclusion: the effect of education and counseling on prenatal attachment in Iranian parents suggests the use of these methods in prenatal care. Parent’s education, social support and marital satisfaction were significant associated factors with increasing maternal attachment. History of fetal loss, anxiety and smoking was associated with the poor prenatal attachment
Lock, Catherine A; Kaner, Eileen F S
In the UK, GPs and practice nurses selectively provide brief alcohol interventions to risk drinkers. GPs' provision of a brief alcohol intervention can be predicted by patient characteristics, practitioner characteristics and structural factors such as the features of the practice and how it is organized. However, much less is known about possible modifiers of nurse practice. Our aim was to investigate if patient characteristics, nurse characteristics and practice factors influence provision of a brief alcohol intervention by practice nurses in primary health care. One hundred and twenty-eight practice nurses who had implemented a brief alcohol intervention programme in a previous trial based in the North of England were requested to screen adults presenting to their surgery and follow a structured protocol to give a brief intervention (5 min of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of 5541 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires were collected after a 3-month implementation period and analysed by logistic regression analysis. Although AUDIT identified 1500 'risk' drinkers, only 926 (62%) received a brief intervention. Logistic regression modelling showed that patients' risk status as measured by AUDIT score was the most influential predictor of a brief intervention by practice nurses. However, risk drinkers who were most likely to receive a brief intervention were male. Patients' age or social class did not independently predict a brief intervention. The multilevel model was unable to identify any independent nurse characteristics that could predict a brief intervention, but indicated significant variation between nurses in their tendency to offer the intervention to patients. No structural factors were found to be positively associated with selective provision. Patient and nurse factors contributed to the selective provision of a brief intervention in primary care. If
Soto-Rodríguez, Anxela; García-Soidán, José Luís; de Toro-Santos, Manuel; Rodríguez-González, Manuel; Arias-Gómez, M Jesús; Pérez-Fernández, María Reyes
To assess whether an educational intervention in women in perimenopausal age with diabetes mellitus, hypertension and/or dyslipidemia could improve aspects of quality of life and exercise. A randomized clinical trial. physical activity, quality of life and weight in women aged 45-60 years (n = 320) at time 0 and 12 months after surgery. intervention group (IG): 3 interactive workshops on cardiovascular disease prevention and control group (CG): information by mail. The IG obtained better scores on the mental component of quality of life one year later (p cardiovascular risk factor improves aspects of quality of life and of healthy habits such as physical activity. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Nyberg, E; Stieglitz, R-D; Flury, M; Riecher-Rössler, A
BACKGROUND AND HYPOTHESES: Domestic violence is common and can lead to severe physical and psychological problems. Thus, we have investigated the frequency of occurrence, forms and risk factors of domestic violence against female patients on a crisis intervention ward. 115 women were screened with the "screening spouse violence" (SPG) and the "index of spouse abuse" (ISA). The life time prevalence concerning spouse violence was 70 %. Out of 74 women who were currently living in a relationship 28 (38 % )were victims of violence in the last 12 months prior to their admission. Women who experienced violence had a significantly lower level of education. Screening for domestic violence in female patients in the field of crisis intervention and psychiatry should become a standard of "good clinical practice". © Georg Thieme Verlag KG Stuttgart · New York.
Hulme, Katrin; Hudson, Joanna L; Rojczyk, Philine; Little, Paul; Moss-Morris, Rona
Fatigue is a prevalent and debilitating symptom, preceded by an acute infectious episode in some patients. This systematic review aimed to identify risk factors for the development of persistent fatigue after an acute infection, to develop an evidence-based working model of post-infectious fatigue. Electronic databases (Medline, PsycINFO and EMBASE) were searched, from inception to March 2016, for studies which investigated biopsychosocial risk factors of on-going fatigue after an acute infection. Inclusion criteria were: prospective design; biological, psychological or social risk factors; standardised measure of post-infectious fatigue (self-report scales or clinical diagnosis). Studies were excluded if the sample had a pre-existing medical condition, infection was conceptualised as 'vaccination' or they were intervention trials. A narrative synthesis was performed. Eighty-one full texts were screened, of which seventeen were included in the review. Over half included glandular fever populations. Other infections included dengue fever, 'general'/'viral' and Q-fever. Risk factors were summarised under biological, social, behavioural, cognitive and emotional subthemes. Patients' cognitive and behavioural responses to the acute illness, and pre-infection or baseline distress and fatigue were the most consistent risk factors for post-infectious fatigue. An empirical summary model is provided, highlighting the risk factors most consistently associated with persistent fatigue. The components of the model, the possible interaction of risk factors and implications for understanding the fatigue trajectory and informing preventative treatments are discussed. Copyright © 2017. Published by Elsevier Inc.
Choi, Youngsoo; Ro, Heejung
The development of positive attitudes in team-based work is important in management education. This study investigates hospitality students' attitudes toward group projects by examining instructional factors and team problems. Specifically, we examine how the students' perceptions of project appropriateness, instructors' support, and evaluation…
Sohu, Samiullah; Abdullah, Abd Halid; Nagapan, Sasitharan; Fattah, Abdul; Ullah, Kaleem; Kumar, Kanesh
Construction industry of Pakistan is creating a number of opportunities in employment as well as plays a role model for economy development of the country. This construction industry has a serious issue of cost overrun in all construction projects especially in construction of highway projects. Cost overrun is a serious and critical issue in construction of highway projects which gives negative impact to construction practitioners because it is not only cross the approved budget but also approved time of the project. The main objective of this study is to find out critical factors causing cost overrun in highway projects of Sindh according to contractors' perspectives. Deep literature review was carried out and a total of 64 factors of cost overrun were identified. To achieve the objective, a questionnaire was designed and distributed among 16 selected respondents who have more than 20 years of experience in construction of highway projects. The results from analysis found that most critical factors of cost overrun in the order of importance include financial and cash flow difficulties faced by contractor, frequent changes in design, changes in price of materials, poor planning by client, change in scope of project, change in specification of materials and delay in taking decisions. This study will assist contractors to narrow down some of the critical factors that would lead to cost overrun, and therefore be prepared with the ways to mitigate these problems in construction of highway projects of Sindh province.
Hasan, Bassam; Ali, Jafar
Although group project concepts and skills have become a major component in most information systems (IS) academic programs, very little research has attempted to examine factors that may improve or undermine effectiveness of IS group projects. Accordingly, based on relevant literatures, this study develops and empirically tests a model of factors…
Sohu, S.; Halid, A.; Nagapan, S.; Fattah, A.; Latif, I.; Ullah, K.
Cost overrun is an increase of cost of project from approved budget which was signed by parties at the time of tender. Cost overrun in construction of highway projects is a common problem worldwide and construction industry of Pakistan is also facing this crucial problem of cost overrun in highway projects of Pakistan. The main objective of this research is to identify the causative factors of cost overrun in highway projects of Sindh province of Pakistan. A well designed questionnaire was developed based on 64 common factors of cost overrun from literature review. Developed questionnaire was distributed among selected 30 experts from owner/client, designer/consultant and contractor who have experience more than 20 years’ experience in highway projects. The collected data was statistical analyzed. After analysis results showed that delay process in payment by client, inadequate planning, client interference, poor contract management, delay of decision making, change of scope of project and financial problems faced by client were most causative factors of cost overrun in highway projects. This research will provide alertness to stakeholders of highway projects of Sindh province to avoid cost overrun in projects.
Afeez Olalekan Sanni
Full Text Available The implementation of public private partnership (PPP procurement method is expected to help governments in the development of infrastructures and provides an opportunity for the reduction in the governments’ debt profiles. This method has been adopted in Nigeria for more than a decade and with these years of implementation, few infrastructural projects have been developed using this method while some have been unsuccessful. This study aims to examine the PPP projects implementation in Nigeria and identify the most critical factors that could determine the success of such projects. A total of 184 questionnaires were received from public and private sectors’ participants in the implementation of PPP projects. An exploratory factor analysis identified seven critical success factors as projects feedback, leadership focus, risk allocation and economic policy, good governance and political support, short construction period, favourable socio-economic factors, and delivering publicly needed service. This study shows that more developmental projects could be delivered through PPP if the government could focus on these main factors in the implementation process. The result will influence policy development towards PPP and guide the partners in the development of PPP projects.
Lemos, Diana; Hosek, Sybil G.
Abstract This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma—personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV—as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women. PMID:25216106
Harper, Gary W; Lemos, Diana; Hosek, Sybil G
This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma-personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV-as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women.
Ashman, Amy M; Brown, Leanne J; Collins, Clare E; Rollo, Megan E; Rae, Kym M
Indigenous people continue to experience health disparities relative to non-Indigenous populations. Interventions to improve nutrition during pregnancy in these groups may improve health outcomes for mothers and their infants. The effectiveness of existing nutrition intervention programs has not been reviewed previously. The objective was to identify interventions targeting improving nutrition-related outcomes for pregnant Indigenous women residing in Organisation for Economic Co-operation and Development countries, and to identify positive factors contributing to successful programs. Thirteen electronic databases were searched up until October 2015. Key words identified studies intervening to improve nutrition-related outcomes for pregnant Indigenous women. Two reviewers assessed articles for inclusion and study quality and extracted data. Only studies published in English were included. Data were summarized narratively. Abstracts and titles were screened (n=2,566) and 315 full texts were reviewed for eligibility. This review included 27 articles from 20 intervention programs from Australia, Canada, and the United States. The most prevalent measurable outcomes were birth weight (n=9) and breastfeeding initiation/duration (n=11). Programs with statistically significant results for these outcomes employed the following nutrition activities: individual counseling/education (n=8); delivery by senior Indigenous woman (n=2), peer counselor (n=3), or other Indigenous health worker (n=4); community-wide interventions (n=2); media campaigns (n=2); delivery by non-Indigenous health professional (n=3); and home visits (n=3). Heterogeneity of included studies made it challenging to make firm recommendations regarding program success. Authors of included studies recommended community consultation be included when designing studies and working with communities at all stages of the research process. Individualized counseling/education can contribute to successful program
Bass, Frederic; Naish, Brigham; Buwembo, Isaac
To learn whether front-line personnel in primary care practices can increase delivery of clinical tobacco interventions and also help smokers address physical inactivity, at-risk alcohol use, and depression. Uncontrolled before-and-after design. Vancouver, BC, area (4 practices); northern British Columbia (2 practices). Six practices, with 1 staff person per practice serving as a "health coordinator" who tracked and, after the baseline period, delivered preventive interventions to all patients who smoked. To assess delivery of preventive interventions, each practice was to sample 300 consecutive patient records, both at baseline and at follow-up 15 months later. Front-office staff were recruited, trained, paid, and given ongoing support to provide preventive care. Clinicians supplemented this care with advice and guided the use of medication. Effectiveness of the intervention was based on comparison, at baseline and at follow-up, of the proportion of patients with any of the following 6 proven intervention components documented in their medical records: chart reminder, advice received, self-management plan, target quit date, referral, and follow-up date (as they applied to tobacco, physical inactivity, at-risk alcohol use, and depression). A Tobacco Intervention Flow Sheet cued preventive care, and its data were entered into a spreadsheet (which served as a smokers' registry). Qualitative appraisal data were noted. For tobacco, substantial increases occurred after the intervention period in the proportion of patients with each of the intervention components noted in their charts: chart reminder (20% vs 94%); provision of advice (34% vs 79%); self-management plan (14% vs 57%); target quit date (5% vs 11%); referral (6% vs 11%); and follow-up date (7% vs 42%). Interventions for physical inactivity and depression showed some gains, but there were no gains for at-risk alcohol use. Front-line staff, patients, and clinicians were enthusiastic about the services offered
Aviñó, Dory; Paredes-Carbonell, Joan J; Peiró-Pérez, Rosana; La Parra Casado, Daniel; Álvarez-Dardet, Carlos
To describe how health agents and professionals working in a community project perceive the changes related to the population health status and their use of health-care services after the RIU intervention in an urban area of socioeconomic disadvantage. A qualitative descriptive study based on individual and group interviews and participant observation conducted between October 2008-July 2009. Raval (Algemesí-Valencia) We selected by purposive sample 7 women health agents, all persons who completed the intervention, and 10 professionals for their involvement in the intervention. We conducted a group interview with the women at 6 months and a group and 7 individuals interviews both at 9 months of intervention. We realized a thematic descriptive analysis from health promotion framework. We used participant observation in a meeting with professionals at 9 months and analyzed field notes as: appraisal project, detected changes, challenges and recommendations. Women acquired information about health, contraception, pregnancy and heath services; they noted changes in self-care and social skills and leadership; they internalized the role of health worker disseminating what they learned and showed improvement in self-esteem and social recognition. They caused changes in the people related on health care and access to services. Professionals didn't incorporate at their work the community perspective; they valued positively the project; professionals and women agreed on improving access and use of services and closeness population-professionals. RIU increases the capabilities of the participants, their social recognition and improves access and use of health services. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.
Juan J. Carrique-Mas
Full Text Available Antimicrobial usage and antimicrobial resistance (AMR in animal production is now recognized to be an important contributor to the global problem of AMR. Initiatives to curb indiscriminate antimicrobial use in animal production are currently being discussed in many low- and middle-income countries. Well-designed, scientifically sound interventions aimed to tackle excessive antimicrobial usage should provide scientists and policy makers with evidence of the highest quality to guide changes in policy and to formulate better targeted research initiatives. However, since large-scale interventions are costly, they require careful planning in order not to waste valuable resources. Here, we describe the components of the ViParc project (www.viparc.org, one of the first large-scale interventions of its kind to tackle excessive antimicrobial usage in Southeast Asian animal production systems. The project has been formulated as a “randomized before-and-after controlled study” targeting small-scale poultry farms in the Mekong Delta region of Vietnam. It aims to provide farmers with a locally-adapted veterinary support service to help them reduce their reliance on antimicrobials. ViParc has been developed in the backdrop of efforts by the Government of Vietnam to develop a National Action Plan to reduce Antimicrobials in Livestock and Aquaculture. Crucially, the project integrates socio-economic analyses that will provide insights into the drivers of antimicrobial usage, as well as an assessment of the cost-effectiveness of the proposed intervention. Information generated from ViParc should help the Government of Vietnam refine its policies to curb excessive antimicrobial usage in poultry production, while lessons from ViParc will help tackle excessive antimicrobial usage in other productions systems in Vietnam and in the broader Southeast Asian region.
Carrique-Mas, Juan J; Rushton, Jonathan
Antimicrobial usage and antimicrobial resistance (AMR) in animal production is now recognized to be an important contributor to the global problem of AMR. Initiatives to curb indiscriminate antimicrobial use in animal production are currently being discussed in many low- and middle-income countries. Well-designed, scientifically sound interventions aimed to tackle excessive antimicrobial usage should provide scientists and policy makers with evidence of the highest quality to guide changes in policy and to formulate better targeted research initiatives. However, since large-scale interventions are costly, they require careful planning in order not to waste valuable resources. Here, we describe the components of the ViParc project (www.viparc.org), one of the first large-scale interventions of its kind to tackle excessive antimicrobial usage in Southeast Asian animal production systems. The project has been formulated as a "randomized before-and-after controlled study" targeting small-scale poultry farms in the Mekong Delta region of Vietnam. It aims to provide farmers with a locally-adapted veterinary support service to help them reduce their reliance on antimicrobials. ViParc has been developed in the backdrop of efforts by the Government of Vietnam to develop a National Action Plan to reduce Antimicrobials in Livestock and Aquaculture. Crucially, the project integrates socio-economic analyses that will provide insights into the drivers of antimicrobial usage, as well as an assessment of the cost-effectiveness of the proposed intervention. Information generated from ViParc should help the Government of Vietnam refine its policies to curb excessive antimicrobial usage in poultry production, while lessons from ViParc will help tackle excessive antimicrobial usage in other productions systems in Vietnam and in the broader Southeast Asian region.
Full Text Available The quality of the constructed social infrastructure project has been considered a necessary measure for the sustainability of projects. Studies on factors affecting project quality have used various techniques and methods to explain the relationships between particular variables. Unexpectedly, Structural Equation Modeling (SEM has acquired very little concern in factors affecting project quality studies. To address this limitation in the body of knowledge, the objective of this study was to apply the SEM approach and build a model that explained and identified the critical factors affecting quality in social infrastructure projects. The authors developed a quantitative approach using smart-PLS version 3.2.7. This study shed light on the views of different experts based on their experience in public construction projects in Pakistan. Particularly, the authors aimed to find out the relationships between construction, stakeholders, materials, design, and external factors, and how these relate to project quality. The findings of this study revealed that the R2 value of the model was scored at 0.749, which meant that the five exogenous latent constructs collectively explained 74.9% of the variance in project quality. The Goodness-of-Fit of the model was 0.458. The construction related factor was the most important out of the five constructs. This study determined that better planning and monitoring and evaluation should be developed to better address and control the quality defects by decision-makers, project managers as well as contractors. These findings might support practitioners and decision makers to focus on quality related problems that might occur in their current or future projects.
Kitchen, Meaghan S; Ransley, Joan K; Greenwood, Darren C; Clarke, Graham P; Conner, Mark T; Jupp, Jennifer; Cade, Janet E
The School Fruit and Vegetable Scheme (SFVS) is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3) their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group), consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET), and height and weight measurements collected, at baseline (Year 2) and 18 month follow-up (Year 4). The primary outcome will be the ability of the intervention (Project Tomato) to maintain consumption of fruit and vegetable portions compared to the control group. A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. Medical Research Council Registry code G0501297.
Kitchen, Meaghan S; Ransley, Joan K; Greenwood, Darren C; Clarke, Graham P; Conner, Mark T; Jupp, Jennifer; Cade, Janet E
Background The School Fruit and Vegetable Scheme (SFVS) is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3) their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. Method This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group), consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET), and height and weight measurements collected, at baseline (Year 2) and 18 month follow-up (Year 4). The primary outcome will be the ability of the intervention (Project Tomato) to maintain consumption of fruit and vegetable portions compared to the control group. Discussion A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. Trial registration Medical Research Council Registry code G0501297 PMID:19531246
Conner Mark T
Full Text Available Abstract Background The School Fruit and Vegetable Scheme (SFVS is an important public health intervention. The aim of this scheme is to provide a free piece of fruit and/or vegetable every day for children in Reception to Year 2. When children are no longer eligible for the scheme (from Year 3 their overall fruit and vegetable consumption decreases back to baseline levels. This proposed study aims to design a flexible multi-component intervention for schools to support the maintenance of fruit and vegetable consumption for Year 3 children who are no longer eligible for the scheme. Method This study is a cluster randomised controlled trial of Year 2 classes from 54 primary schools across England. The schools will be randomly allocated into two groups to receive either an active intervention called Project Tomato, to support maintenance of fruit intake in Year 3 children, or a less active intervention (control group, consisting of a 5 A DAY booklet. Children's diets will be analysed using the Child And Diet Evaluation Tool (CADET, and height and weight measurements collected, at baseline (Year 2 and 18 month follow-up (Year 4. The primary outcome will be the ability of the intervention (Project Tomato to maintain consumption of fruit and vegetable portions compared to the control group. Discussion A positive result will identify how fruit and vegetable consumption can be maintained in young children, and will be useful for policies supporting the SFVS. A negative result would be used to inform the research agenda and contribute to redefining future strategies for increasing children's fruit and vegetable consumption. Trial registration Medical Research Council Registry code G0501297
Al-Waleedi, Ali A; El-Nimr, Nessrin A; Hasab, Ali A; Bassiouny, Hassan K; Al-Shibani, Latifa A
Schistosomiasis is one of the most important public health problems in Yemen. The prevalence of urinary schistosomiasis varies considerably across different parts of Yemen and was estimated to be 10% among schoolchildren in Sana'a. Praziquantel (PZQ) is highly effective against all five major human species of schistosomes. The aim of the present work was to estimate the prevalence of urinary schistosomiasis, describe the risk factors associated with its endemicity, and implement and assess a chemotherapeutic intervention using PZQ in a village in Yemen. The sample included 696 schoolchildren from a village in Abyan Governorate. During the baseline school survey, personal, sociodemographic, and environmental data, and data on practices in relation to water contact were collected from each study participant using a predesigned structured questionnaire. Urine samples from each participant were examined for macrohematuria and the presence of Schistosoma haematobium eggs. The chemotherapeutic intervention was assessed 3 and 6 months after the treatment and certain indicators were calculated. The prevalence of S. haematobium was 18.1%. The main significant risk factors were male sex; proximity of houses to water ponds; and using pond water for swimming, agricultural activities, and for bathing in houses. PZQ treatment reduced the prevalence of infection and decreased the prevalence of high-intensity infection. Survival analysis showed that the probability of residual infection also dropped after the treatment intervention. Male sex and using pond water for various activities were the main significant risk factors associated with urinary schistosomiasis. PZQ is still a cornerstone drug in reducing or eliminating morbidity associated with schistosomiasis infection. Health education programs tailored for the community are required for the control and prevention of urinary schistosomiasis. To address schoolchildren, school curricula should include lessons about urinary
Research shows that there are many bottle-necks in Public Private Partnership (PPP) Projects in Dutch spatial development. Due to the specific properties of Public Private Partnerships, these bottle-necks can lead to dysfunctional conflicts which are damaging the project. Hence the question is: how
Monroe, Jessica T; Lofgren, Ingrid E; Sartini, Becky L; Greene, Geoffrey W
To investigate the effectiveness of an online, interactive intervention, referred to as the Green Eating (GE) Project, to motivate university students to adopt GE behaviours. The study was quasi-experimental and integrated into courses for credit/extra credit. Courses were randomly stratified into experimental or non-treatment control. The 5-week intervention consisted of four modules based on different GE topics. Participants completed the GE survey at baseline (experimental, n 241; control, n 367) and post (experimental, n 187; control, n 304). The GE survey has been previously validated and consists of Transtheoretical Model constructs including stage of change (SOC), decisional balance (DB: Pros and Cons) and self-efficacy (SE: School and Home) as well as behaviours for GE. Modules contained basic information regarding each topic and knowledge items to assess content learning. The GE Project took place at a public university in the north-eastern USA. Participants were full-time students between the ages of 18 and 24 years. The GE Project was effective in significantly increasing GE behaviours, DB Pros, SE School and knowledge in experimental compared with control, but did not reduce DB Cons or increase SE Home. Experimental participants were also more likely to be in later SOC for GE at post testing. The GE Project was effective in increasing GE behaviours in university students. Motivating consumers towards adopting GE could assist in potentially mitigating negative consequences of the food system on the environment. Future research could tailor the intervention to participant SOC to further increase the effects or design the modules for other participants.
Allyson L. Dir
Full Text Available Alcohol use, particularly binge drinking (BD, is a major public health concern among adolescents. Recent national data show that the gender gap in alcohol use is lessening, and BD among girls is rising. Considering the increase in BD among adolescent girls, as well as females’ increased risk of experiencing more severe biopsychosocial negative effects and consequences from BD, the current review sought to examine gender differences in risk factors for BD. The review highlights gender differences in (1 developmental-related neurobiological vulnerability to BD, (2 psychiatric comorbidity and risk phenotypes for BD, and (3 social-related risk factors for BD among adolescents, as well as considerations for BD prevention and intervention. Most of the information gleaned thus far has come from preclinical research. However, it is expected that, with recent advances in clinical imaging technology, neurobiological effects observed in lower mammals will be confirmed in humans and vice versa. A synthesis of the literature highlights that males and females experience unique neurobiological paths of development, and although there is debate regarding the specific nature of these differences, literature suggests that these differences in turn influence gender differences in psychiatric comorbidity and risk for BD. For one, girls are more susceptible to stress, depression, and other internalizing behaviors and, in turn, these symptoms contribute to their risk for BD. On the other hand, males, given gender differences across the lifespan as well as gender differences in development, are driven by an externalizing phenotype for risk of BD, in part, due to unique paths of neurobiological development that occur across adolescence. With respect to social domains, although social and peer influences are important for both adolescent males and females, there are gender differences. For example, girls may be more sensitive to pressure from peers to fit in and
Ludvigsson, M L; Peterson, G; Dedering, Å; Falla, D; Peolsson, A
Some studies support the prescription of exercise for people with whiplash-associated disorders (WAD); however, the response is highly variable. Further research is necessary to identify factors which predict response. This is a secondary analysis of a randomized, multicentre controlled clinical trial of 202 volunteers with chronic WAD (grades 2 and 3). They received either neck-specific exercise with, or without a behavioural approach, or prescription of physical activity for 12 weeks. Treatment response, defined as a clinical important reduction in pain or disability, was registered after 3 and 12 months, and factors associated with treatment response were explored using logistic regression. Participation in the neck-specific exercise group was the only significant factor associated with both neck pain and neck disability reduction both at 3 and 12 months. Patients in this group had up to 5.3 times higher odds of disability reduction and 3.9 times higher odds of pain reduction compared to those in the physical activity group. Different baseline features were identified as predictors of response depending on the time point examined and the outcome measure selected (pain vs. disability). Factors associated with treatment response after exercise interventions differ in the short and long term and differ depending on whether neck pain or disability is considered as the primary outcome. Participation in a neck-specific exercise intervention, in contrast to general physical activity, was the only factor that consistently indicated higher odds of treatment success. These results support the prescription of neck-specific exercise for individuals with chronic WAD. © 2015 European Pain Federation - EFIC®
Rogério M. Pinto
Full Text Available Worldwide, the human immunodeficiency virus (HIV continuum of care involves health promotion providers (e.g., social workers and health educators linking patients to medical personnel who provide HIV testing, primary care, and antiretroviral treatments. Regrettably, these life-saving linkages are not always made consistently and many patients are not retained in care. To design, test and implement effective interventions, we need to first identify key factors that may improve linkage-making. To help close this gap, we used in-depth interviews with 20 providers selected from a sample of 250 participants in a mixed-method longitudinal study conducted in New York City (2012–2017 in order to examine the implementation of HIV services for at-risk populations. Following a sociomedical framework, we identified provider-, interpersonal- and environmental-level factors that influence how providers engage patients in the care continuum by linking them to HIV testing, HIV care, and other support services. These factors occurred in four domains of reference: Providers’ Professional Knowledge Base; Providers’ Interprofessional Collaboration; Providers’ Work-Related Changes; and Best Practices in a Competitive Environment. Of particular importance, our findings show that a competitive environment and a fear of losing patients to other agencies may inhibit providers from engaging in linkage-making. Our results suggest relationships between factors within and across all four domains; we recommend interventions to modify factors in all domains for maximum effect toward improving care continuum linkage-making. Our findings may be applicable in different areas of the globe with high HIV prevalence.
Eziyi Offia Ibem
Full Text Available The application of Public-Private Partners (PPPs in housing provisioning is on the increase across the world. However, there is a paucity of empirical studies on the specific factors considered at the initiation, and measures taken to ensure transparency at the procurement stages, of PPP housing projects. This study examined project selection factors and transparency measures in PPP housing projects using data sourced from oral interviews with 27 experts in nine PPP housing schemes in Nigeria. Results of the content analysis revealed that the top two selection factors considered by both the public and private sector operators of PPP housing projects in Nigeria are the availability of land and viability of the funding arrangements. Whereas the public-sector partners also consider the availability of competent private sector to deliver the projects, the private developers are concerned with the location of proposed projects. It was also found that the two key measures taken to ensure transparency at the procurement stage of the projects are transparent and competitive bidding and open advertisements of tender opportunities. These imply that before embarking on PPP housing projects, operators should ensure that there is available land in good locations, sound funding arrangements, and measures for achieving transparency in the schemes.
Hamers Jan PH
Full Text Available Abstract Background Because of high demands at work, nurses are at high risk for occupational burnout and physical complaints. The presence of job resources (such as job autonomy or social support and recovery opportunities could counteract the adverse effect of high job demands. However, it is still unclear how job resources and recovery opportunities can be translated into effective workplace interventions aiming to improve employee health, well-being, and performance-related outcomes. The aim of the current research project is developing and implementing interventions to optimize job resources and recovery opportunities, which may lead to improved health, well-being and performance of nurses. Methods/design The DIRECT-project (DIsc Risk Evaluating Controlled Trial is a longitudinal, quasi-experimental field study. Nursing home staff of 4 intervention wards and 4 comparison wards will be involved. Based on the results of a base-line survey, interventions will be implemented to optimize job resources and recovery opportunities. After 12 and 24 month the effect of the interventions will be investigated with follow-up surveys. Additionally, a process evaluation will be conducted to map factors that either stimulated or hindered successful implementation as well as the effectiveness of the interventions. Discussion The DIRECT-project fulfils a strong need for intervention research in the field of work, stress, performance, and health. The results could reveal (1 how interventions can be tailored to optimize job resources and recovery opportunities, in order to counteract job demands, and (2 what the effects of these interventions will be on health, well-being, and performance of nursing staff.
Spoor, Ellen; de Jonge, Jan; Hamers, Jan P H
Because of high demands at work, nurses are at high risk for occupational burnout and physical complaints. The presence of job resources (such as job autonomy or social support) and recovery opportunities could counteract the adverse effect of high job demands. However, it is still unclear how job resources and recovery opportunities can be translated into effective workplace interventions aiming to improve employee health, well-being, and performance-related outcomes. The aim of the current research project is developing and implementing interventions to optimize job resources and recovery opportunities, which may lead to improved health, well-being and performance of nurses. The DIRECT-project (DIsc Risk Evaluating Controlled Trial) is a longitudinal, quasi-experimental field study. Nursing home staff of 4 intervention wards and 4 comparison wards will be involved. Based on the results of a base-line survey, interventions will be implemented to optimize job resources and recovery opportunities. After 12 and 24 month the effect of the interventions will be investigated with follow-up surveys. Additionally, a process evaluation will be conducted to map factors that either stimulated or hindered successful implementation as well as the effectiveness of the interventions. The DIRECT-project fulfils a strong need for intervention research in the field of work, stress, performance, and health. The results could reveal (1) how interventions can be tailored to optimize job resources and recovery opportunities, in order to counteract job demands, and (2) what the effects of these interventions will be on health, well-being, and performance of nursing staff.
Guest, Rebecca S; Baser, Ray; Li, Yuelin; Scardino, Peter T; Brown, Arthur E; Kissane, David W
We showed in a companion paper that the prevalence of burnout among surgical oncologists at a comprehensive cancer center was 42% and psychiatric morbidity 27%, and high quality of life (QOL) was absent for 54% of surgeons. Here we examine modifiable workplace factors and other stressors associated with burnout, psychiatric morbidity, and low QOL, together with interest in interventions to reduce distress and improve wellness. Study-specific questions important for morale, QOL, and stressors associated with burnout were included in an anonymous Internet-based survey distributed to the surgical faculty at Memorial Sloan-Kettering Cancer Center. Among the 72 surgeons who responded (response rate of 73%), surgeons identified high stress from medical lawsuits, pressure to succeed in research, financial worries, negative attitudes to gender, and ability to cope with patients' suffering and death. Workplace features requiring greatest change were the reimbursement system, administrative support, and schedule. Work-life balance and relationship issues with spouse or partner caused high stress. Strongest correlations with distress were a desire to change communication with patients and the tension between the time devoted to work versus time available to be with family. Surgeons' preferences for interventions favored a fitness program, nutrition consultation, and increased socialization with colleagues, with less interest in interventions conventionally used to address psychological distress. Several opportunities to intervene at the organizational level permit efforts to reduce burnout and improve QOL.
Lau, Erica Y; Saunders, Ruth P; Pate, Russell R
The Environmental Intervention in Children's Homes (ENRICH) study was the first published physical activity intervention undertaken in residential children's homes (RCHs). The study revealed differences in implementation across the homes, which may be a key factor that affects program effectiveness. The purpose of this study was to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation of the ENRICH intervention. This study analyzed the ENRICH process evaluation data collected from 24 RCHs. Bayesian Path analysis was used to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation. Level of implementation across RCHs was variable, ranging from 38 to 97 % (M = 68.3, SD = 14.45). Results revealed that organizational capacity and provider characteristics had significant direct associations with level of implementation. Neither direct nor indirect associations between quality of prevention support system and level of implementation reached statistical significance. Conducting formative assessments on organizational capacity and provider characteristics and incorporating such information in implementation planning may increase the likelihood of achieving higher levels of implementation in future studies.
Rocha, C; Montoya, R; Zevallos, K; Curatola, A; Ynga, W; Franco, J; Fernandez, F; Becerra, N; Sabaduche, M; Tovar, M A; Ramos, E; Tapley, A; Allen, N R; Onifade, D A; Acosta, C D; Maritz, M; Concha, D F; Schumacher, S G; Evans, C A
Tuberculosis (TB) affected households in impoverished shantytowns, Lima, Peru. To evaluate socio-economic interventions for strengthening TB control by improving uptake of TB care and prevention services. Barriers to TB control were characterised by interviews with TB-affected families. To reduce these barriers, a multidisciplinary team offered integrated community and household socio-economic interventions aiming to: 1) enhance uptake of TB care by education, community mobilisation and psychosocial support; and 2) reduce poverty through food and cash transfers, microcredit, microenterprise and vocational training. An interim analysis was performed after the socio-economic interventions had been provided for 2078 people in 311 households of newly diagnosed TB patients for up to 34 months. Poverty (46% earned microcredit; poverty;social determinants.
Liu, Dan; Dong, Si-Ping; Gao, Guang-Ming; Fan, Ming-Yu; Zhang, Zong-Jiu; Fang, Peng-Qian
To get scientific basis for further health education through the research of the road construction workers' KBP before and after the interventions of highway AIDS prevention project. Multi-stage random sampling method was employeed to select workers of 8 sites from 14 sites along highway to investigate their AIDS knowledge, belief and performance (KBP) before and after highway AIDS prevention project. Over 90% of the investigated workers had ever heard about AIDS, and the non-skilled workers of lower educational level improved more after intervention. The correct answer rate of the three transmitting ways of AIDS of drivers which is the focused group of highway before and after intervention had the obvious statistical significance (Proad construction workers is effective and further health education of HIV prevention should be carried out among the road construction workers to improve their knowledge and awareness of avoiding the high-risk behaviors. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.
Wang Yongli; Cui Shitao; Zhang Jiaxing; Ru Fuming; Xu Jiahua; Xu Jichong
Objective: To evaluate emergent angiography and interventional management in treating massive upper gastrointestinal (GI) arterial hemorrhage, and to discuss the factors influencing the angiographic bleeding signs and the interventional therapeutic results. Methods: The clinical data of 56 patients with massive upper GI arterial hemorrhage, who underwent diagnostic arteriography and interventional management with trans-catheter vasopressin infusion and embolization, were retrospectively analyzed. Systolic blood pressure of both pre-and post-interventional therapy was recorded and statistically analyzed. The arteriographic positive rates were separately calculated according to the catheter tip's location, being placed at the 2nd grade branch or at the 3 rd -4 th grade branch of the artery, and the relation of the positive rate with the tip's location was analyzed. A comparison of the hemostatic effect between trans-catheter vasopressin infusion and trans-catheter embolization was made. Results: The average systolic blood pressure of pre-and post-procedure was (93.14 ± 18.63) mmHg and (11.64 ± 13.61) mmHg respectively, with a significant difference (P = 0.023). The angiographic bleeding signs were demonstrated in 12 cases (21.4%) with the catheter's tip at the 2nd grade branch and in 56 cases (100%) with the catheter's tip at the 3 rd -4 th grade branch,the difference between the two was of statistically significance (P < 0.05). The technical success rate and the clinical hemostasis rate of via catheter vasopressin infusion was 80% (16 / 20) and 55% (11/20) respectively. Of nine re-bleeding cases, seven were successfully controlled with embolization therapy by using microcatheter and two had to receive surgery because of arterial rupture which was proved by angiography. The technical and the clinical rates of success for transcatheter embolization therapy were 93% (42 / 45) and 89% (40 / 45) respectively. Recurrence of bleeding was seen in two patients who got
Lee, Young-Me; Dancy, Barbara; Florez, Elizabeth; Holm, Karyn
The purpose of this integrative literature review was to explore factors that are related to sexual practices among Latino adolescents and identify which of those factors are common across successful sexually transmitted infection (STI)/HIV intervention programs for Latino adolescents. An integrative literature review was conducted. Search terms included Latino, Hispanic, education, intervention/prevention programs, sex, sexuality, reproductive health, health risk behaviors, multiple sex partners, contraception, STI/HIV/AIDS, sexually transmitted diseases, delay in initiation of sexual intercourse, consistent use of birth control, avoidance of STI/HIV infections, unintended pregnancy, cultural factors, and gender roles. Findings revealed from the review of 17 articles addressing factors related to sexual practices among Latino adolescents included familialism, religion, gender roles, level of knowledge/information, and privacy/confidentiality. Five successful STI/HIV intervention programs, that incorporated those factors to effectively reduce risky sexual behaviors were identified. STI/HIV knowledge and gender roles were recognized as common factors integrated into and across successful intervention programs for this population. Only STI/HIV knowledge and gender roles were found as common factors across the five successful STI/HIV intervention programs and should be incorporated into future intervention programs that are culturally and gender specific. Therefore, health care providers need to understand culturally related gender roles and their impact on sexual practices to provide culturally sensitive and appropriate sex education about STIs and HIV for Latino adolescents to increase the program potential for reducing STI/HIV. © 2013 Wiley Periodicals, Inc.
Syed Sulaiman Syed Azhar
Full Text Available Abstract Background There is substantial evidence to support the association between tuberculosis (TB and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. Methods An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group or conventional TB DOTS alone (comparison or DOTS group. At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. Results A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when
Awaisu, Ahmed; Nik Mohamed, Mohamad Haniki; Mohamad Noordin, Noorliza; Abd Aziz, Noorizan; Syed Sulaiman, Syed Azhar; Muttalif, Abdul Razak; Ahmad Mahayiddin, Aziah
There is substantial evidence to support the association between tuberculosis (TB) and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS) providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group) or conventional TB DOTS alone (comparison or DOTS group). At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when compared with those who received the conventional TB
Panday, Arvind; Inda, Maria Eugenia; Bagam, Prathyusha; Sahoo, Malaya K; Osorio, Diana; Batra, Sanjay
The nuclear factor (NF)-κB family of transcription factors are ubiquitous and pleiotropic molecules that regulate the expression of more than 150 genes involved in a broad range of processes including inflammation, immunity, cell proliferation, differentiation, and survival. The chronic activation or dysregulation of NF-κB signaling is the central cause of pathogenesis in many disease conditions and, therefore, NF-κB is a major focus of therapeutic intervention. Because of this, understanding the relationship between NF-κB and the induction of various downstream signaling molecules is imperative. In this review, we provide an updated synopsis of the role of NF-κB in DNA repair and in various ailments including cardiovascular diseases, HIV infection, asthma, herpes simplex virus infection, chronic obstructive pulmonary disease, and cancer. Furthermore, we also discuss the specific targets for selective inhibitors and future therapeutic strategies.
Clinton-Sherrod, A Monique; Morgan-Lopez, Antonio A; Gibbs, Deborah; Hawkins, Stephanie R; Hart, Laurie; Ball, Barbara; Irvin, Neil; Littler, Nicole
This study extends past research by examining factors associated with changes in attitudes, knowledge, and intended behaviors related to sexual assault. This study included 1,182 participants from four unique multiple-session school-based sexual violence interventions. Implementation and participant factors examined include single- versus mixed-gender groups, group setting versus classroom lecture setting, and participant gender. Participants completed self-administered, paper-and-pencil pre- and postsurveys. A significant desired overall effect was found on participants' reports of positive attitudes, beliefs, and behavior regarding sexual harassment and personal boundaries and positive dating relationship norms (from pretest to posttest). There were steeper increases over time in both measures, with larger mixed-gender/single-gender differences among boys than among girls. Differences in the impact of participating in mixed- versus single-gender groups depended on classroom versus small group settings. The implications of these findings are discussed for sexual assault prevention programs.
Korshøj, Mette; Krustrup, Peter; Jørgensen, Marie Birk
. The clusters will be balanced on the following criteria: Geographical work location, gender, age and seniority. Cleaners are randomized to either I) a reference group, receiving lectures concerning healthy living, or II) an intervention group, performing worksite aerobic exercise. Data collection......ABSTRACT: BACKGROUND: Prevalence of cardiovascular risk factors is unevenly distributed among occupational groups. The working environment, as well as lifestyle and socioeconomic status contribute to the disparity and variation in prevalence of these risk factors. High physical work demands have...... been shown to increase the risk for cardiovascular disease and mortality, contrary to leisure time physical activity. High physical work demands in combination with a low cardiorespiratory fitness infer a high relative workload and an excessive risk for cardiovascular mortality. Therefore, the aim...
Journy, N; Sinno-Tellier, S; Maccia, C; Le Tertre, A; Pirard, P; Pagès, P; Eilstein, D; Donadieu, J; Bar, O
Objective The study aimed to characterise the factors related to the X-ray dose delivered to the patient's skin during interventional cardiology procedures. Methods We studied 177 coronary angiographies (CAs) and/or percutaneous transluminal coronary angioplasties (PTCAs) carried out in a French clinic on the same radiography table. The clinical and therapeutic characteristics, and the technical parameters of the procedures, were collected. The dose area product (DAP) and the maximum skin dose (MSD) were measured by an ionisation chamber (Diamentor; Philips, Amsterdam, The Netherlands) and radiosensitive film (Gafchromic; International Specialty Products Advanced Materials Group, Wayne, NJ). Multivariate analyses were used to assess the effects of the factors of interest on dose. Results The mean MSD and DAP were respectively 389 mGy and 65 Gy cm−2 for CAs, and 916 mGy and 69 Gy cm−2 for PTCAs. For 8% of the procedures, the MSD exceeded 2 Gy. Although a linear relationship between the MSD and the DAP was observed for CAs (r=0.93), a simple extrapolation of such a model to PTCAs would lead to an inadequate assessment of the risk, especially for the highest dose values. For PTCAs, the body mass index, the therapeutic complexity, the fluoroscopy time and the number of cine frames were independent explanatory factors of the MSD, whoever the practitioner was. Moreover, the effect of technical factors such as collimation, cinematography settings and X-ray tube orientations on the DAP was shown. Conclusion Optimising the technical options for interventional procedures and training staff on radiation protection might notably reduce the dose and ultimately avoid patient skin lesions. PMID:22457404
Jakobsen, M D; Sundstrup, E; Brandt, M; Andersen, L L
The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were randomly allocated at the cluster level (18 departments) to 10 weeks of (i) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed alone during leisure-time for 5 × 10 minutes per week. Linear mixed models accounting for cluster identified factors affecting pain reduction. On average 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. The multi-adjusted analysis showed a significant effect on pain reduction of both training adherence (P=.04) and intervention group (P=.04) with participants in WORK experiencing greater reductions compared with HOME. Obesity at baseline was associated with better outcome. Leisure-time exercise, daily patient transfer, age, and chronic pain did not affect the changes in pain. In conclusion, even when adjusted for training adherence, performing physical exercise at the workplace is more effective than home-based exercise in reducing musculo-skeletal pain in healthcare workers. Noteworthy, obese individuals may especially benefit from physical exercise interventions targeting musculo-skeletal pain. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available This study aims at ascertaining the social factor causing the shifting of Bahasa Jawa Ngoko into Bahasa Indonesia among the elementary school students and confirming whether this phenomenon also occurs in all grades. The data were collected through observation and interview. Those data were analyzed using interactive analysis model (Milles & Huberman, 1994. There are two triangulations used in this research: source and method triangulations. Finally, the research found that peer-oriented intervention (Mrug et al,. 2001 functions as a social factor of language shift. However, this Javanese shift did not occur in the fifth grade students since they are from the same speech community. Penelitian ini bertujuan untuk mengetahui faktor sosial yang menyebabkan pergeseran Bahasa Jawa Ngoko dalam Bahasa Indonesia di kalangan siswa sekolah dasar dan memastikan apakah fenomena ini juga terjadi di semua kelas. Data dikumpulkan melalui pengamatan dan wawancara. Selanjutnya, data tersebut dianalisis dengan menerapkan model analisis interaktif (Milles &Huberman, 1994. Selain itu, penelitian ini menggunakan triangulasi sumber dan metode. Penelitian ini menemukan bahwa peer-oriented intervention berfungsi sebagai faktor sosial pergeseran bahasa. Namun, pergeseran Bahasa Jawa Ngoko ke Bahasa Indonesia ini tidak terjadi pada siswa kelas lima karena mereka berasal dari komunitas bahasa yang sama.
Evagorou, Olympia; Arvaniti, Aikaterini; Samakouri, Maria
It is a well known fact that postpartum depression (PPD) is a global phenomenon that women may experience, regardless of cultural identity and beliefs. This literature review presents the cultural beliefs and postnatal practices around the world, in each continent and people's origins, looking through the extent to which they contribute positively or negatively to the onset of the disease. 106 articles were used in this research, through a systematic electronic search of Pubmed (Medline) and Scopus. Comparison is also made between the prevalence, the risk factors and the different ways of appearance of the disease around the world and among immigrants. Finally, the initiatives and interventions made so far by the governments and institutions with a view to prevent and address this global problem are presented. The results showed (a) that different cultures share the same risk factors towards the disease (b) significant differences in the prevalence of the disease among both Western and non Western cultures and between the cultures themselves (c) more tendencies for somatization of depressive symptoms in non-Western cultures, (d) different postnatal practices between cultures, which are not always effective (e) the more non-West a culture is, the less interventions concern on mental health; the same phenomenon is observed on populations burdened by immigration. The beliefs held by culture should be taken seriously in detecting of PPD, as well as the assessment of the needs of women who have recently given birth.
Randomized controlled trials are the gold standard in research but may not fully explain or predict outcome variations in community-based interventions. Demonstrating efficacy of externally driven programs in well-controlled environments may not translate to community-based implementation where resources and priorities vary. A bottom-up evaluation…
Williams, Geoffrey C; Patrick, Heather; Niemiec, Christopher P; Ryan, Richard M; Deci, Edward L; Lavigne, Holly McGregor
A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence, which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of the three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6 month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6 month SDT-based intervention to 12 months and trains an important other to provide support for smokers' basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30 days but who are willing to reduce their cigarette use by half. The primary outcome is 12 month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30 day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others. Copyright © 2011 Elsevier Inc. All rights reserved.
Wahl, Hans-Werner; Kammerer, Annette; Holz, Frank; Miller, Daniel; Becker, Stefanie; Kaspar, Roman; Himmelsbach, Ines
This study evaluated an emotion-focused and a problem-focused intervention designed for patients with age-related macular degeneration. It found a limited decrease in depression in the emotion-focused group and an increase in active problem orientation and in adaptation to vision loss in the problem-focused group.
This study is about rural agricultural development and social processes of change in rural Zimbabwe. It is aimed at understanding how irrigation intervention in a remote rural context changed the cultural, social, political and farming lives of people. It is a study of people coping with
Full Text Available at the start of the epidemic, contributed to the spread of HIV in Carletonville, the largest gold-mining complex in the world. We first consider the political and economic context within which earlier attempts to develop HIV intervention programmes were made...
Guegan, Eleanor Woodford; Cook, Andrew
Evaluation is essential for the management of international projects or networks in health technology assessment (HTA). It extends beyond the normal process of project management by incorporating qualitative dimensions and provides information about a project's effectiveness and achievements. This article aimed to identify the factors that are important for the success of international HTA projects. The European network for Health Technology Assessment Joint Action (EUnetHTA JA) is presented as an exemplar. METHODS for the evaluation of international HTA projects include interviews, focus groups, questionnaires, observations and documentary review, and the key points of these approaches have been summarized. The impact and effectiveness of the EUnetHTA JA was evaluated by questionnaires of project participants and external stakeholders, and by documentary review. The response rate for the three annual questionnaires sent to project participants ranged from 86 percent to 88 percent and for external stakeholders ranged from 65 percent to 88 percent. Key factors for project success included production of deliverables according to the workplan, achievement of objectives, added value generated, effective communication, involvement of external stakeholders, workstream management and progress from the preceding EUnetHTA 2006-2008 project. The experience of this project can inform the evaluation of future international HTA collaborations, such as the EUnetHTA 2nd Joint Action and HTAsiaLink. A high response rate was achieved to the self-completion questionnaires and the strategy followed is recommended for evaluation of international HTA projects. Future assessments of international HTA projects should strive to measure outcomes and impact, not just outputs and process.
Tzeng, Huey-Ming; Yin, Chang-Yi
There is an urgent need to prioritize the risk factors for injurious falls and effective interventions in nursing practice. Registered nurses perceived that the most frequently observed risk factors were confusion, gait problems, Alzheimer disease, disorientation, and inability to follow safety instructions. The most effective interventions were keeping hospital bed brakes locked, keeping floor surfaces clean/dry, using appropriate footwear for patients, maintaining a call light within reach, and reducing tripping hazards.
The main aim of this thesis was to evaluate the added benefit of applying specific factors in community-based intervention for child witnesses of interparental violence (IPV) and their parents, by means of a randomized controlled trial (RCT). The results of this RCT showed no additional benefits of
Kure-Biegel, Nanna; Schnohr, Christina Warrer; Hindhede, Anette Lykke
BACKGROUND: Individual-based interventions aim to improve patient self-management of chronic disease and to improve lifestyle among people at high risk, to reduce the prevalence of diseases contributing to health inequality. The present study investigates risk factors for uncompleted health...... interventions, via a combination of quantitative and qualitative methods. METHODS: From a health centre in Copenhagen, questionnaire data on educational level, gender, age, and cohabitation status from 104 participants in health interventions were used to examine risks for dropout. Qualitative telephone...... with low socioeconomic status will most likely have reduced opportunities for making healthy choices, in this case, completing the intervention, and this may increase health inequality....
Jones, Norma Gray
The purpose of this study was to examine the relationship between protective factors and the responses of African American males in traditional batterers' interventions. African American male batterers have been viewed as responding poorly to batterers' interventions and were reported in the literature as at risk for dropout and treatment failure. This research proposed that there were culturally related protective factors that enhanced traditional interventions for African American males, increasing their potential for changing abusive behaviors. This within-group study used secondary data to examine the influence of protective factors on the responses of 268 active duty Navy African American males. They were a sub-sample of 861 males randomly assigned to one of four different interventions for batterers. The interventions included a cognitive behavioral men's group, couple's group, safety and stabilization group, and a control group. Each of their cases had been officially substantiated by the Navy for assault of their spouses. The measures for the protective factors of religion, self-esteem, and family support were drawn from the original study's self-report measurement tool. The results of the statistical analyses were found to be significant. The protective factors performed as social controls for reducing certain types of abusive behaviors. Little research has been conducted on the influence of cultural factors on batterers intervention outcome for African Americans. This study established a strong support for further research.
Pestka, Elizabeth; Nash, Virginia; Evans, Michele; Cronin, Joan; Bee, Susan; King, Susan; Osborn, Kristine; Gehin, Jessica; Weis, Karen; Loukianova, Larissa
This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5-10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health-care cost savings. © 2015 John Wiley & Sons Australia, Ltd.
Szoeke, Cassandra; Lehert, Philippe; Henderson, Victor W; Dennerstein, Lorraine; Desmond, Patricia; Campbell, Stephen
Abnormalities in brain structure and function can occur several decades prior to the onset of cognitive decline. It is in the preceding decades that an intervention is most likely to be effective, when informed by an understanding of factors contributing to the disease prodrome. Few studies, however, have sufficient longitudinal data on relevant risks to determine the optimum targets for interventions to improve cognition in aging. In this article we examine the timing and exposure of factors contributing to verbal memory performance in later life. 387 participants from the population-based Women's Healthy Ageing Project, mean age at baseline of 49.6 years (range: 45-55 years), had complete neuropsychiatric assessments, clinical information, physical measures, and biomarkers collected at baseline, with at least three follow-up visits that included at least one cognitive reassessment. Mixed linear models were conducted to assess the significance of risk factors on later-life verbal memory. We explored the influence of early, contemporaneous, and cumulative exposures. Younger age and better education were associated with baseline memory test performance (CERAD). Over the 20 years of study follow-up, cumulative mid- to late-life physical activity had the strongest effect on better later life verbal memory (0.136 [0.058, 0.214]). The next most likely contributors to verbal memory in late life were the negative effect of cumulative hypertension (-0.033 [-0.047, -0.0.18] and the beneficial effect of HDL cholesterol (0.818 [0.042, 1.593]). Findings suggest that midlife interventions focused on physical activity, hypertension control, and achieving optimal levels of HDL cholesterol will help maintain later-life verbal memory skills. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
Swinburn, B; Malakellis, M; Moodie, M; Waters, E; Gibbs, L; Millar, L; Herbert, J; Virgo-Milton, M; Mavoa, H; Kremer, P; de Silva-Sanigorski, A
Childhood obesity has been increasing over decades and scalable, population-wide solutions are urgently needed to reverse this trend. Evidence is emerging that community-based approaches can reduce unhealthy weight gain in children. In some countries, such as Australia, the prevalence of childhood obesity appears to be flattening, suggesting that some population-wide changes may be underway. A community-based intervention project for obesity prevention in a rural town appears to have increasing effects 3 years after the end of the project, substantially reducing overweight and obesity by 6% points in new cohorts of children, 6 years after the original baseline. An apparent and unanticipated 'spillover' of effects into the surrounding region appeared to have occurred with 10%-point reductions in childhood overweight and obesity over the same time period. A 'viral-like' spread of obesity prevention efforts may be becoming possible and an increase in endogenous community activities appears to be surprisingly successful in reducing childhood obesity prevalence. The long-term evaluations of community-based childhood obesity prevention interventions are needed to determine their sustainability and scalability. To measure the impacts of the successful Be Active Eat Well (BAEW) programme in Victoria, Australia (2003-2006), 3 years after the programme finished (2009). A serial cross-sectional study of children in six intervention and 10 comparison primary schools in 2003 (n = 1674, response rate 47%) and 2009 (n = 1281, response rate 37%). Height, weight, lunch box audits, self-reported behaviours and economic investment in obesity prevention were measured. Compared with 2003, the 2009 prevalence of overweight/obesity (World Health Organization criteria) was significantly lower (P investment in obesity prevention in intervention schools was about 30 000 Australian dollars (AUD) per school per year, less than half the amount during BAEW. By contrast, the
Bodewes, Thomas C.F.; Soden, Peter A.; Ultee, Klaas H.J.; Zettervall, Sara L.; Pothof, Alexander B.; Deery, Sarah E.; Moll, Frans L.; Schermerhorn, Marc L.
Objective Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing healthcare costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aims to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. Methods We identified all patients undergoing an infrainguinal endovascular intervention in the Targeted Vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014. Perioperative outcomes were stratified by symptom status (chronic limb-threatening ischemia [CLI] vs. claudication). Patients who died during index admission, and those who remained in the hospital after 30 days, were excluded. Indications for unplanned readmission related to the index procedure were evaluated. Multivariable logistic regression was used to identify preoperative and in-hospital (during index admission) risk factors of 30-day unplanned readmission. Results 4449 patients underwent infrainguinal endovascular intervention, of which 2802 (63%) had CLI (66% tissue loss) and 1647 (37%) had claudication. The unplanned readmission rates for CLI and claudication patients were 16% (N=447) and 6.5% (N=107), respectively. Mortality after index admission was higher for readmitted patients compared to those not readmitted (CLI: 3.4% vs. 0.7%, P readmissions were related to the index procedure. Among CLI patients, the most common indication for readmission related to the index procedure was wound- or infection-related (42%), while patients with claudication were mainly readmitted for recurrent symptoms of peripheral vascular disease (28%). In patients with CLI, predictors of unplanned readmission included diabetes (OR: 1.3, 95% CI: 1.01–1.6), congestive heart failure (1.6, 1.1–2.5), renal insufficiency
Tang, Mariann; Fenger-Eriksen, Christian; Wierup, Per; Greisen, Jacob; Ingerslev, Jørgen; Hjortdal, Vibeke; Sørensen, Benny
Cardiac surgery may cause a serious coagulopathy leading to increased risk of bleeding and transfusion demands. Blood bank products are commonly first line haemostatic intervention, but has been associated with hazardous side effect. Coagulation factor concentrates may be a more efficient, predictable, and potentially a safer treatment, although prospective clinical trials are needed to further explore these hypotheses. This study investigated the haemostatic potential of ex vivo supplementation of coagulation factor concentrates versus blood bank products on blood samples drawn from patients undergoing cardiac surgery. 30 adults were prospectively enrolled (mean age=63.9, females=27%). Ex vivo haemostatic interventions (monotherapy or combinations) were performed in whole blood taken immediately after surgery and two hours postoperatively. Fresh-frozen plasma, platelets, cryoprecipitate, fibrinogen concentrate, prothrombin complex concentrate (PCC), and recombinant FVIIa (rFVIIa) were investigated. The haemostatic effect was evaluated using whole blood thromboelastometry parameters, as well as by thrombin generation. Immediately after surgery the compromised maximum clot firmness was corrected by monotherapy with fibrinogen or platelets or combination therapy with fibrinogen. At two hours postoperatively the coagulation profile was further deranged as illustrated by a prolonged clotting time, a reduced maximum velocity and further diminished maximum clot firmness. The thrombin lagtime was progressively prolonged and both peak thrombin and endogenous thrombin potential were compromised. No monotherapy effectively corrected all haemostatic abnormalities. The most effective combinations were: fibrinogen+rFVIIa or fibrinogen+PCC. Blood bank products were not as effective in the correction of the coagulopathy. Coagulation factor concentrates appear to provide a more optimal haemostasis profile following cardiac surgery compared to blood bank products. Copyright © 2017
Bammann, Karin; Peplies, Jenny; Sjöström, Michael
Obesity is a major public health problem in developed countries. We present a European project, called Identification and Prevention of Dietary and Lifestyle-induced Health Effects in Children and Infants (IDEFICS), that focuses on diet- and lifestyle-related diseases in children. This paper...... outlines methodological aspects and means of quality control in IDEFICS. IDEFICS will use a multicentre survey design of a population-based cohort of about 17,000 2- to 10-year-old children in nine European countries (Belgium, Cyprus, Estonia, Germany, Greece, Hungary, Italy, Spain and Sweden). The project...... will investigate the impact of dietary factors such as food intake and food preferences, lifestyle factors such as physical activity, psychosocial factors and genetic factors on the development of obesity and other selected diet- and lifestyle-related disorders. An intervention study will be set up in pre...
Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara
of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk......], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers......’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account...
Peloso, Paul M; Khan, Mahweesh; Gross, Anita R; Carlesso, Lisa; Santaguida, Lina; Lowcock, Janet; MacDermid, Joy C; Walton, Dave; Goldsmith, Charlie H; Langevin, Pierre; Shi, Qiyun
Objectives: To conduct an overview (review-of-reviews) on pharmacological interventions for neck pain. Search Strategy: Computerized databases and grey literature were searched from 2006 to 2012. Selection Criteria: Systematic reviews of randomized controlled trials (RCT) in adults with acute to chronic neck pain reporting effects of pharmacological interventions including injections on pain, function/disability, global perceived effect, quality of life and patient satisfaction. Data Collection & Analysis: Two independent authors selected articles, assessed risk of bias and extracted data The GRADE tool was used to evaluate the body of evidence and an external panel provided critical review. Main Results: We found 26 reviews reporting on 47 RCTs. Most pharmacological interventions had low to very low quality methodologic evidence with three exceptions. For chronic neck pain, there was evidence of: a small immediate benefit for eperison hydrochloride (moderate GRADE, 1 trial, 157 participants);no short-term pain relieving benefit for botulinum toxin-A compared to saline (strong GRADE; 5 trial meta-analysis, 258 participants) nor for subacute/chronic whiplash (moderate GRADE; 4 trial meta-analysis, 183 participants) including reduced pain, disability or global perceived effect; andno long-term benefit for medial branch block of facet joints with steroids (moderate GRADE; 1 trial, 120 participants) over placebo to reduce pain or disability; Reviewers' Conclusions: While in general there is a lack of evidence for most pharmacological interventions, current evidence is against botulinum toxin-A for chronic neck pain or subacute/chronic whiplash; against medial branch block with steroids for chronic facet joint pain; but in favour of the muscle relaxant eperison hydrochloride for chronic neck pain. PMID:24155805
The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew. The major areas of work, or subtasks, within this DRP are: 1) Displays, 2) Controls, 3) Electronic Procedures and Fault Management, and 4) Human Performance Modeling. This DRP is a collaborative effort between researchers atJohnson Space Center and Ames Research Center. T
De Jong, Joop T V M
Political violence, armed conflicts and human rights violations are produced by a variety of political, economic and socio-cultural factors. Conflicts can be analyzed with an interdisciplinary approach to obtain a global understanding of the relative contribution of risk and protective factors. A public health framework was designed to address these risk factors and protective factors. The framework resulted in a matrix that combined primary, secondary and tertiary interventions with their implementation on the levels of the society-at-large, the community, and the family and individual. Subsequently, the risk and protective factors were translated into multi-sectoral, multi-modal and multi-level preventive interventions involving the economy, governance, diplomacy, the military, human rights, agriculture, health, and education. Then the interventions were slotted in their appropriate place in the matrix. The interventions can be applied in an integrative form by international agencies, governments and non-governmental organizations, and molded to meet the requirements of the historic, political-economic and socio-cultural context. The framework maps the complementary fit among the different actors while engaging themselves in preventive, rehabilitative and reconstructive interventions. The framework shows how the economic, diplomatic, political, criminal justice, human rights, military, health and rural development sectors can collaborate to promote peace or prevent the aggravation or continuation of violence. A deeper understanding of the association between risk and protective factors and the developmental pathways of generic, country-specific and culture-specific factors leading to political violence is needed.
Reza Taheriattar; Morvarid Farzanehrafat
Sustainable construction is a comprehensive concept which requires long-term planning. Moreover, construction managers play a key role in leading, planning and scheduling of a construction project. As a result, sustainability of construction projects can be affected by construction managers’ decisions. In addition, for greater development of sustainable construction, affecting factors should firstly be notified. Therefore, it seems necessary to investigate construction managers’ perception of...
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ENGLISH ABSTRACT: Manufacturing companies operate in a business environment where incremental growth may be achieved through expansion and renewal of existing plant and facilities. Effective management of the critical success factors of such capital development projects may also provide competitive advantage. These projects tend to be of a brown-field nature, characterised by a significant level of risk arising from the interaction between the project implementation and concurrent operation of the existing physical asset base. So it is vital to understand the factors that influence the success of capital expansion and renewal projects in the brown-field context. Although each project has unique features, there are critical success factors that can be customised for successful outcomes in the brown-field environment. This study identifies five critical success factors applicable to brown-field capital expansion and renewal projects. Managerial focus on the critical factors, and the prospects for successful brown-field projects, are discussed in the paper.
AFRIKAANSE OPSOMMING: Vervaardigers funksioneer in ‘n sakeomgewing waar voortgesette groei bereik word via uitbreiding en hernuwing van bestaande fasiliteite. Die doeltreffende bestuur van kritiese suksesfaktore van sodanige kapitaalprojekte bied geleentheid vir mededingende voordeel. Projekte van hierdie aard neig om geklassifiseer te word as van herontwikkelingsaard, met betekenisvolle gepaardgaande risiko wat voortspruit uit die interaksie tussen projekimplementering en gelyktydige bedryf van bestaande fisiese bates. Derhalwe is dit belangrik om in die konteks van herontwikkeling aandag te gee aan die kritiese faktore wat ‘n rol speel in die bereiking van sukses. Die navorsing identifiseer vyf kritiese suksesfaktore van belang vir uitbreidings- en vernuwingsprojekte.
Kamphuis, M.E.; Korfker, D.G.; Detmar, S.B.; Hindori, M.P.; Boere-Boonekamp, M.M.; Vondeling, H.; Hindori-Mohangoo, A.D.
Background: Every year approximately 10,000 babies are born in Suriname of which an estimated 400 die in the perinatal period. The main purpose of the Perisur project is to improve perinatal outcomes and improve under-five and maternal health. This study focused on introducing preconception care in
What Works Clearinghouse, 2011
The "University of Chicago School Mathematics Project ("UCSMP") 6-12 Curriculum" is a series of yearlong courses--(1) Transition Mathematics; (2) Algebra; (3) Geometry; (4) Advanced Algebra; (5) Functions, Statistics, and Trigonometry; and (6) Precalculus and Discrete Mathematics--emphasizing problem solving, real-world applications, and the use…
What Works Clearinghouse, 2009
University of Chicago School Mathematics Project (UCSMP) Algebra is a one-year course covering three primary topics: (1) linear and quadratic expressions, sentences, and functions; (2) exponential expressions and functions; and (3) linear systems. Topics from geometry, probability, and statistics are integrated with the appropriate algebra.…
Arriola, Kimberly; Robinson, Dana H.; Thompson, Nancy J.; Perryman, Jennie P.
This study sought to evaluate the effectiveness of "Project ACTS: About Choices in Transplantation and Sharing," which was developed to increase readiness for organ and tissue donation among African American adults. Nine churches (N = 425 participants) were randomly assigned to receive donation education materials currently available to consumers…
Human patient simulation is an innovative teaching strategy that can facilitate practice development and preparation for entry into today's healthcare environment for nursing students. Unfortunately, the use of human patient simulation has been limited due to the perceptions of nursing faculty members. This project sought to explore those…
Ramo, Danielle E; Thrul, Johannes; Chavez, Kathryn; Delucchi, Kevin L; Prochaska, Judith J
Young adult smokers are a challenging group to engage in smoking cessation interventions. With wide reach and engagement among users, Facebook offers opportunity to engage young people in socially supportive communities for quitting smoking and sustaining abstinence. We developed and tested initial efficacy, engagement, and acceptability of the Tobacco Status Project, a smoking cessation intervention for young adults delivered within Facebook. The intervention was based on the US Public Health Service Clinical Practice Guidelines and the Transtheoretical Model and enrolled participants into study-run 3-month secret Facebook groups matched on readiness to quit smoking. Cigarette smokers (N=79) aged 18-25, who used Facebook on most days, were recruited via Facebook. All participants received the intervention and were randomized to one of three monetary incentive groups tied to engagement (commenting in groups). Assessments were completed at baseline, 3-, 6-, and 12-months follow-up. Analyses examined retention, smoking outcomes over 12 months (7-day point prevalence abstinence, ≥50% reduction in cigarettes smoked, quit attempts and strategies used, readiness to quit), engagement, and satisfaction with the intervention. Retention was 82% (65/79) at 6 months and 72% (57/79) at 12 months. From baseline to 12-months follow-up, there was a significant increase in the proportion prepared to quit (10/79, 13%; 36/79, 46%, Pused a nicotine replacement therapy approved by the Food and Drug Administration, while 18% (14/79) used an electronic nicotine delivery system to quit (eg, electronic cigarette). A majority (48/79, 61%) commented on at least one Facebook post, with more commenting among those with biochemically verified abstinence at 3 months (P=.036) and those randomized to receive a personal monetary incentive (P=.015). Over a third of participants (28/79, 35%) reported reading most or all of the Facebook posts. Highest acceptability ratings of the intervention were
Jackson Estomih Muro
Full Text Available ABSTRACT The purpose of this study was to have a fresh look at the local governance status through exploring governance factors affecting community participation in public development projects. The study also has investigated the actors and factors shaping participation as well as causes for non-participation. For the purpose of the study six wards within two divisions of Poli and Mbuguni and Meru district headquarters were selected. In the wards a total of 80 respondents from among the community members were interviewed through a structured questionnaire. Others were Village chairman Village Executive Officers Ward Executive Officers and Councilors were also interviewed and involved in the FGD. Data were analyzed using SPSS. Simple descriptive statistics and cross tabulation and figures were used in the analysis. The analysis showed that the communities were participated in the public development projects and people were participating through financial material and labor contribution to the public development projects. The analysis also showed that the government supported the ongoing public development projects including through provision of fund and expertise. The study showed the benefit of community participation in the development projects or programs like ownership of the projects and enjoying the benefits accrued from the projects. The study also indicated that there is significant change in terms of governance as influencers of community participation in public development projects. Despite the fortunes study showed some challenges found in wards and villages being the incidence of corruptions and misuse of public resources which were mentioned to slow community participation in public development projects. It was therefore concluded that adhering to the good governance principles contribute positively towards community participation in public development projects.
Full Text Available This paper is an exploratory study on renewable energy implementation in the rural areas of Indonesia. The study aim was to investigate the factors contributing to the sustainability of renewable energy projects in the rural areas. It mostly uses a qualitative approach. Primary data was mainly obtained from in-depth interviews conducted in site areas with the project owners, project managers, a key person in each local government, industry representatives, and the local community, including local leaders and users of renewable energy. Secondary data in the form of various official project reports was also used. The results indicated that the success of energy project implementation lay not only in good technology performance and long-term maintenance, but was also highly dependent on six key factors, namely: (1 project planning and development; (2 community participation; (3 active communication and beneficiaries; (4 availability of maintenance program, workshop and technician; (5 project management and institutionalization; (6 local government support and networks. The findings from this study provide useful insights to all stakeholders involved in the implementation of renewable energy technology for the rural areas in Indonesia.
Suhonen, Marjo; Paasivaara, Leena
To explore factors of human capital related to project success that employees expect from nurse managers. Human capital refers to those resources that managers working with projects possess, such as abilities, knowledge and qualities of character. The data were collected by open interviews (n=14) with nurses, public health nurses and nurse managers working in primary health care and a hospital. Data analysis was carried out using qualitative content analysis. The main factors of human capital related to project success proved to be as follows: (1) management of enthusiastic project culture, (2) management of regeneration and (3) management of emotional intelligence. Future research is needed on the kind of means nurse managers use in human capital management in projects and how they see their possibilities in managing human capital. Human capital management skills should be underlined as an important competence area when recruiting a nurse manager. The success of health care projects cannot be improved only through education or by training of nurse managers; in addition, projects need nurse managers who understand workplace spirituality and have high emotional intelligence. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
Tone, J M
Background and aims: Eighteen months after the completion of a vascular risk intervention study, the authors aimed to ascertain whether participants who attended the intensive, nurse-led group had better retention of knowledge of diabetes and heart disease compared with those who had undergone standard diabetes care. Method: A knowledge-based questionnaire was sent to participants who completed the vascular risk intervention study, 94 from the intensive, nurse-led group and 94 from the standard care group. Results: A response rate of 75% was achieved. Although more participants in the intensive group achieved recommended vascular risk targets, there was no increase in retained knowledge of vascular risks. A high proportion of the total cohort could not quantify targets for blood pressure (67.2%), cholesterol (65.1%) or HbA1c (68.1%). Conclusion: In this cohort of people with type 2 diabetes, knowledge retention regarding treatment targets was poor. Education programmes should stress awareness of vascular risk factors and diabetes.
Dittman, Cassandra K; Farruggia, Susan P; Palmer, Melanie L; Sanders, Matthew R; Keown, Louise J
The present study involved an examination of the extent to which a wide range of child, parent, family, and program-related factors predicted child behavior and parenting outcomes after participation in an 8-session online version of the Triple P-Positive Parenting Program. Participants were mothers and fathers of 97 children aged between 3 and 8 years displaying elevated levels of disruptive behavior problems. For both mothers and fathers, poorer child behavior outcomes at postintervention were predicted by the number of sessions of the intervention completed by the family. For mothers, postintervention child behavior was also predicted by the quality of the mother-child relationship at baseline; for fathers, baseline child behavior severity was an additional predictor. Mothers' postintervention ineffective parenting was predicted by session completion and preintervention levels of ineffective parenting, whereas the only predictor of fathers' ineffective parenting at postintervention was preintervention levels of ineffective parenting. Socioeconomic risk, parental adjustment, and father participation in the intervention were not significant predictors of mother- or father-reported treatment outcomes. The implications of the findings for the provision of online parenting support are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Ajslev, Jeppe; Brandt, Mikkel; Møller, Jeppe Lykke
, video documentation of working tasks, and a 3-phased workshop program. METHODS: The evaluation is designed in an adapted process evaluation framework, addressing recruitment, reach, fidelity, satisfaction, intervention delivery, intervention received, and context of the intervention companies......: Intervention studies are challenging to conduct and evaluate in the construction industry, often because of narrow time frames and ever-changing contexts. The mixed-methods design presents opportunities for obtaining detailed knowledge of the practices intra-acting with the intervention, while offering...
Rehani, Madan M.; Ciraj-Bjelac, Olivera; Al-Naemi, Huda M.; Al-Suwaidi, Jamila Salem; El-Nachef, Leila; Khosravi, Hamid Reza; Kharita, Mohammad Hassan; Muthuvelu, Pirunthavany; Pallewatte, Aruna S.; Juan, Bayani Cruz San; Shaaban, Mohamed; Zaman, Areesha
Recognizing the lack of information on image quality and patient doses in most countries in Asia, the International Atomic Energy Agency (IAEA) initiated a project to assess the status of imaging technology, practice in conventional radiography, mammography, computed tomography (CT) and interventional procedures, and to implement optimisation actions. A total of 20 countries participated. Obsolete practices of use of fluoroscopy for positioning, photofluorography, chest fluoroscopy and conventional tomography were reported by 4 out of 7 countries that provided this information. Low-kV technique for chest radiography is in use in participating countries for 20–85% of cases, and manual processing is in 5–85% of facilities in 5 countries. Instances of the use of adult CT protocol for children in three participating countries were observed in 10–40% of hospitals surveyed. After implementation of a Quality Control programme, the image quality in conventional radiography improved by zero to 13 percentage points in certain countries and dose reduction was from 10% to 85%. In mammography, poor quality, ranging from 10 to 29% of images in different countries was observed. The project increased attention to dose quantities and dose levels in computed tomography, although doses in most cases were not higher than reference levels. In this study 16–19% of patients in interventional cardiology received doses that have potential for either stochastic risk or tissue reaction. This multi-national study is the first of its kind in the Asia, and it provided insight into the situation and opportunities for improvement
Rehani, Madan M., E-mail: Madan.email@example.com [International Atomic Energy Agency (IAEA), Vienna International Centre, P.O. Box 100, Vienna (Austria); Ciraj-Bjelac, Olivera, E-mail: firstname.lastname@example.org [University of Belgrade, Vinca Institute of Nuclear Sciences, Radiation Protection Department, Mike Petrovica Alasa 12-14, P.O. Box 522, 11001 Belgrade (Serbia); Al-Naemi, Huda M., E-mail: Halnaomi@hmc.org.qa [Hamad Medical Corp, Occupational Health and Safety, P.O. Box 1725, Doha (Qatar); Al-Suwaidi, Jamila Salem, E-mail: email@example.com [Dubai Hospital, Dubai (United Arab Emirates); El-Nachef, Leila, E-mail: firstname.lastname@example.org [Lebanon Atomic Energy Commission (Lebanon); Khosravi, Hamid Reza, E-mail: email@example.com [National Radiation Protection Department, Iranian Nuclear Regulatory Authority, Tehran (Iran, Islamic Republic of); Kharita, Mohammad Hassan, E-mail: firstname.lastname@example.org [Atomic Energy Commission of Syria, Damascus (Syrian Arab Republic); Muthuvelu, Pirunthavany, E-mail: email@example.com [Ministry of Health Malaysia, Putrajaya Wilayah Persekutuan (Malaysia); Pallewatte, Aruna S., E-mail: firstname.lastname@example.org [Lady Ridgeway Hospital for Children, Dr Danister de Silva Mawatha, Colombo (Sri Lanka); Juan, Bayani Cruz San, E-mail: email@example.com [Center for Device Regulation, Radiation Health, and Research Department of Health, Manila (Philippines); Shaaban, Mohamed, E-mail: firstname.lastname@example.org [Al-Sabah Hospital (Kuwait); Zaman, Areesha, E-mail: email@example.com [Institute of Nuclear Medicine and Oncology, PAEC, Lahore (Pakistan)
Recognizing the lack of information on image quality and patient doses in most countries in Asia, the International Atomic Energy Agency (IAEA) initiated a project to assess the status of imaging technology, practice in conventional radiography, mammography, computed tomography (CT) and interventional procedures, and to implement optimisation actions. A total of 20 countries participated. Obsolete practices of use of fluoroscopy for positioning, photofluorography, chest fluoroscopy and conventional tomography were reported by 4 out of 7 countries that provided this information. Low-kV technique for chest radiography is in use in participating countries for 20–85% of cases, and manual processing is in 5–85% of facilities in 5 countries. Instances of the use of adult CT protocol for children in three participating countries were observed in 10–40% of hospitals surveyed. After implementation of a Quality Control programme, the image quality in conventional radiography improved by zero to 13 percentage points in certain countries and dose reduction was from 10% to 85%. In mammography, poor quality, ranging from 10 to 29% of images in different countries was observed. The project increased attention to dose quantities and dose levels in computed tomography, although doses in most cases were not higher than reference levels. In this study 16–19% of patients in interventional cardiology received doses that have potential for either stochastic risk or tissue reaction. This multi-national study is the first of its kind in the Asia, and it provided insight into the situation and opportunities for improvement.
Dinglas, Victor D; Parker, Ann M; Reddy, Dereddi Raja S; Colantuoni, Elizabeth; Zanni, Jennifer M; Turnbull, Alison E; Nelliot, Archana; Ciesla, Nancy; Needham, Dale M
Rehabilitation started early during an intensive care unit (ICU) stay is associated with improved outcomes and is the basis for many quality improvement (QI) projects showing important changes in practice. However, little evidence exists regarding whether such changes are sustainable in real-world practice. To evaluate the sustained effect of a quality improvement project on the timing of initiation of active physical therapy intervention in patients with acute lung injury (ALI). This was a pre-post evaluation using prospectively collected data involving consecutive patients with ALI admitted pre-quality improvement (October 2004-April 2007, n = 120) versus post-quality improvement (July 2009-July 2012, n = 123) from a single medical ICU. The primary outcome was time to first active physical therapy intervention, defined as strengthening, mobility, or cycle ergometry exercises. Among ICU survivors, more patients in the post-quality improvement versus pre-quality improvement group received physical therapy in the ICU (89% vs. 24%, P quality improvement versus pre-quality improvement group, there was a shorter median (interquartile range) time to first physical therapy (4 [2, 6] vs. 11 d [6, 29], P quality improvement period was associated with shorter time to physical therapy (adjusted hazard ratio [95% confidence interval], 8.38 [4.98, 14.11], P quality improvement period. The following variables were independently associated with a longer time to physical therapy: higher Sequential Organ Failure Assessment score (0.93 [0.89, 0.97]), higher FiO2 (0.86 [0.75, 0.99] for each 10% increase), use of an opioid infusion (0.47 [0.25, 0.89]), and deep sedation (0.24 [0.12, 0.46]). In this single-site, pre-post analysis of patients with ALI, an early rehabilitation quality improvement project was independently associated with a substantial decrease in the time to initiation of active physical therapy intervention that was sustained over 5 years. Over the entire pre
Rush, E.C.; Cumin, M.B.; Migriauli, L.; Ferguson, L.R.; Plank, L.D.
We examined the effect of a 9-week diet and physical activity intervention provided in the workplace by a group education session where personal dietary and physical activity goals were proposed. Measurements of anthropometry, fasting blood lipids, glucose and insulin, assays for antioxidant activity (AOA) and questionnaires were completed at 0, 3, 6, 9, and 12 weeks in 50 healthy workers (50% male, mean age 46y). Followup measurements in 39 (56% male) were possible at 52 weeks. At week 3 a group dietary and physical activity motivational seminar was held. At week 6, half the group were supplied daily kiwifruit for 3 weeks with cross over at week 9 until week 12. Compared to baseline, lipid, glucose, insulin and AOA measurements were improved at 12 and 52 weeks. Body measurements did not change. Group diet and physical activity advice reinforced over 9 weeks is associated with a sustained improvement in cardiovascular risk factors at 52 weeks.
Rush, Elaine C.; Cumin, Michelle B.; Migriauli, Lela; Ferguson, Lynnette R.; Plank, Lindsay D.
We examined the effect of a 9-week diet and physical activity intervention provided in the workplace by a group education session where personal dietary and physical activity goals were proposed. Measurements of anthropometry, fasting blood lipids, glucose and insulin, assays for antioxidant activity (AOA) and questionnaires were completed at 0, 3, 6, 9, and 12 weeks in 50 healthy workers (50% male, mean age 46y). Followup measurements in 39 (56% male) were possible at 52 weeks. At week 3 a group dietary and physical activity “motivational seminar” was held. At week 6, half the group were supplied daily kiwifruit for 3 weeks with cross over at week 9 until week 12. Compared to baseline, lipid, glucose, insulin and AOA measurements were improved at 12 and 52 weeks. Body measurements did not change. Group diet and physical activity advice reinforced over 9 weeks is associated with a sustained improvement in cardiovascular risk factors at 52 weeks. PMID:20169118
Elaine C. Rush
Full Text Available We examined the effect of a 9-week diet and physical activity intervention provided in the workplace by a group education session where personal dietary and physical activity goals were proposed. Measurements of anthropometry, fasting blood lipids, glucose and insulin, assays for antioxidant activity (AOA and questionnaires were completed at 0, 3, 6, 9, and 12 weeks in 50 healthy workers (50% male, mean age 46y. Followup measurements in 39 (56% male were possible at 52 weeks. At week 3 a group dietary and physical activity “motivational seminar” was held. At week 6, half the group were supplied daily kiwifruit for 3 weeks with cross over at week 9 until week 12. Compared to baseline, lipid, glucose, insulin and AOA measurements were improved at 12 and 52 weeks. Body measurements did not change. Group diet and physical activity advice reinforced over 9 weeks is associated with a sustained improvement in cardiovascular risk factors at 52 weeks.
Hack, Samantha M; DeForge, Bruce R; Lucksted, Alicia
The sociocultural identities that people self-assign or accept influence their interpersonal interactions and decision making. Identity-based interventions attempt to influence individuals by associating healthy behaviors with in-group membership. Outreach and educational efforts aimed at veterans may rely on "typical" veteran identity stereotypes. However, as discussed in this Open Forum, there is evidence that veteran identity is not monolithic but rather fluctuates on the basis of personal characteristics and individual military service experiences. Overall, the impact of veteran identity on veterans' health behaviors and use of health care is not known and has been understudied. A major limiting factor is the lack of a standardized measure of veteran identity that can assess variations in salience, prominence, and emotional valence.
Allroggen, M; Rau, T; Fegert, J M
Sexual harassment among adolescents has long been neglected in Germany though it is frequent and leads to significant strain for the victims. In international studies, the prevalence of sexual harassment ranges from 10 to 80 % among students. For the development of sexual harassment individual as well as school based factors play a role. Different pathways lead to this problematic behaviour. The effect of new media in the development of sexual harassment cannot be estimated so far. Frequent consequences of sexual harassment in addition to school associated difficulties are unspecific somatic complaints. General practitioners and pediatricians are frequently consulted tn the first place. Recommendations for consultation and interventions are presented. © Georg Thieme Verlag KG Stuttgart · New York.
Ghosh, Dibakar; Banerjee, Santo
Highlights: • Projective synchronization in coupled delayed neural chaotic systems with modulated delay time is introduced. • An adaptive rule for the scaling factors is introduced. • This scheme is highly applicable in secure communication. -- Abstract: In this work, the projective synchronization between two continuous time delayed neural systems with time varying delay is investigated. A sufficient condition for synchronization for the coupled systems with modulated delay is presented analytically with the help of the Krasovskii–Lyapunov approach. The effect of adaptive scaling factors on synchronization are also studied in details. Numerical simulations verify the effectiveness of the analytic results
Vadstrup, Eva S; Frølich, Anne; Perrild, Hans
BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non-pharmacological t......BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non...... and physical fitness will be examined after 6, 12 and 24 months. DISCUSSION: The Copenhagen Type 2 Diabetes Rehabilitation Project evaluates a multi-disciplinary non-pharmacological intervention programme in a primary care setting and provides important information about how to organize non...... programme consists of empowerment-based education, supervised exercise and dietary intervention. The effectiveness of this multi-disciplinary intervention is compared with conventional individual counselling in a Diabetes Outpatient Clinic and evaluated in a prospective and randomized controlled trial...
The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the project of Particular intervention plan for the Belleville-sur-Loire Nuclear Power Plant (Cher, France)
Full Text Available OBJECTIVE: Percutaneous transluminal angioplasty and stenting (PTA + stent has gained acceptance as a primary treatment modality for the superficial femoral artery (SFA diseases. Popliteal artery embolization (PAE is a severe complication in SFA interventions. The purpose of this study was to evaluate the incidence, risk factors, treatment and prognosis of PAE in primary SFA PTA + stent. METHODS: Chronic SFA arteriosclerosis cases that underwent primary PTA + stent were reviewed from a retrospectively maintained database. Runoff vessels were evaluated in all cases before and after the interventions for PAE detection. The primary patency, secondary patency and limb salvage rates were calculated using Kaplan-Meier analysis and compared using log-rank analysis. Cox multivariate regression was performed to evaluate predictors of patency and limb salvage rates. RESULTS: There were 436 lesions treated in 388 patients with 10 PAE events (2.3% in total. PAE rate was significantly higher in Transatlantic Inter-Society Consensus (TASC C/D group compared with TASC A/B group (OR = 8.91, P = .002, in chronic total occlusion (CTO lesions compared with stenotic lesions (P<.0001, and in group with history of cerebral ischemic stroke (OR = 6.11, P = .007. PAE rates were not significantly affected by age, sex, smoking, hypertension, diabetes, hyperlipidemia and runoff status. The binary logistic regression showed that only the TASC C/D was an independent predictor of PAE (P = .031. The 12-month and 24-month primary patency, secondary patency and limb salvage rates in PAE group showed no significant differences comparing with non-PAE group. CONCLUSIONS: PAE is a rare event in primary SFA PTA + stent. TASC C/D lesion, CTO and cerebral ischemic stroke history are risk factors for PAE. PAE is typically reversible by comprehensive techniques. If the popliteal flow is restored in time, PAE has no significant effect on long-term patency and limb
Full Text Available Various factors identified from the literature that caninfluence quality of building projects in Nigeria have beenstudied by means of questionnaire survey sent to architects,engineers and quantity surveyors in the industry. From atotal response of 107 consultants, the importance of eachfactor was obtained via severity and frequency responsesof the factors. Data analysis includes comparisons ofranking among consultants using severity, frequency andimportance indexes, correlation analysis, and percentagerank agreement factor (PRAF to measure the agreement inthe importance ranking among the consultants.Correlation results between the professionals are architects/quantity surveyors (0.75, architects/engineers (0.21 ,and engineers/quantity surveyors (0.24. The percentagerank agreement factor (PRAF shows that the five mostimportant factors affecting quality are 'design changes'(78.9%; 'inadequate involvement of other professionalsduring the design stage' (78.9%; 'insufficient andunrealistic constraints of project cost' (71.1 %; 'poor levelof commitment to quality improvement among designprofessionals' (63.2%; and 'making design decisions oncost and not value of work' (55.3%. The results of this studywould provide feedback for the clients, project and qualitymangers and all the consultants in the industry, so thateffective management of quality can be ensured from theconceptual-design stage of the project.
Fu, Christine; Leoutsakos, Jeannie-Marie; Underwood, Carol
This study is an evaluation of a psychosocial intervention involving child and adolescent survivors of the 2008 Sichuan China earthquake. Sociodemographics, earthquake-related risk exposure, resilience using the Connor-Davidson Resilience Scale, and posttraumatic stress disorder (PTSD) using the UCLA-PTSD Index were collected from 1,988 intervention participants and 2,132 controls. Mean resilience scores and the odds of PTSD did not vary between groups. The independent factors for risk and resilience and the dependent variable, PTSD, in the measurement models between control and intervention groups were equivalent. The structural model of risk and 2 resilience factors on PTSD was examined and found to be unequivalent between groups. In contrast to controls, risk exposure (B = −0.32, p Rational thinking (B = −0.48, p < .001), a resilience factor, was more negatively associated with PTSD in the intervention group. The second resilience factor explored, self-awareness, was positively associated with PTSD in both groups (B = 0.46 for controls, p < .001, and B = 0.69 for intervention, p < .001). Results highlight the need for more cross-cultural research in resilience theory to develop culturally appropriate interventions and evaluation measures.
Nurbasirah Mohamed Alias
Full Text Available It should be pointed out that the dilemma of interruption and stoppage in the construction industry is a large-scale trend. Construction interruption and stoppage is considered one of the most recurring problems in the construction industry. Construction Interruption and stoppage is always measured as costly to all parties concerned in the projects and very often it will result in clash, claims, total desertion and much difficult for the feasibility and it slows the growth of construction sector. The objective of the research work that underpins this paper was to investigate the Factors and Consequences of construction projects on local contractors. A construction project is commonly acknowledged as successful when the aim of the project is achieved in terms of predetermined objectives that are mainly completed the project on time, within budget and specified quality in accordance with the specifications and to stakeholders’ satisfaction. One of the most important problems that may arise in the construction project is delays and the magnitude of these delays varies considerably from project to project. According to delay categories that were contractor related, client related, consultant related, labour related and external related, the study revealed the six major effects of delay that were time overrun, cost overrun, dispute, arbitration, total abandonment, and litigation.
Full Text Available Examining the interrelationships among critical success factors (CSFs for public private partnership (PPP projects is of importance for improving PPP project performance and maintaining the sustainability of PPP project implementation. Previous studies mostly focused on the identification of the CSFs for PPP projects; limited studies investigated the interrelationships among CSFs. Hence, the research objectives are (a to determine the interrelationships among CSFs of PPP projects taking into account the public and (b to identify influence paths contributing to take advantage of CSFs in the process of PPP implementation. A literature review and expert interviews were adopted to construct the CSFs framework; nine hypotheses were constructed and tested by the structural equation modelling (SEM based on the data collected from a questionnaire survey. This research reveals that the relationship between public and private partners is the leader-follower relationship, not the partnership relationship, in PPP projects, indicating that the responsibilities, power or resources existing among partners are very unequal. It also highlights that public involvement has a negative effect on the process of service provisions, and costs and risks exist in the process of public involvement in PPP projects. The determined interrelationships among CSFs will contribute to the sustainability and success of a PPP project.
Background Implementing new initiatives and physical activity interventions in schools represents a myriad of challenges that if overcome can potentially facilitate a range of behavioural changes. The aim of this paper is to describe the process evaluation of specific design constructs used in the GLAMA (Girls! Lead! Achieve! Mentor! Activate!) peer leadership and physical activity pilot project. Conducted in a state secondary school in Australia, the intervention was designed to provide students with opportunities to develop leadership skills, school and social connectedness in addition to a range of physical activity experiences. Methods This process evaluation used the RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) health promotion evaluation framework to assess three design constructs of the intervention: the effectiveness of leadership training and leader preparedness, activity suitability and participation, and the barriers to implementation of the intervention and potential solutions to overcome these barriers. As it was not the specific aim of this pilot, no behavioural change data were collected from students. Data were collected using a mixed methods approach including student questionnaires, teachers and researchers reporting on their own observations and feedback from students. Results There were three main considerations evident across more than one RE-AIM dimension that need to be addressed to assist with future GLAMA dissemination. Firstly, the development of teacher, school and student participation. This needs to be through a variety of professional development opportunities for teachers, integration of the program within timetabled classes within the school and promoting the program to students as an opportunity to develop a range of skills to apply to future learning and workplace environments. Secondly, the successful translation of leadership training to practice is necessary to ensure that leaders are effectively able to
MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Bruzzese, Jean-Marie; Wang, Bo; Brody, Aaron
complete a series of computer-delivered asthma education modules matched for length, location, and method of delivery of the intervention session. Control participants will also receive text messages between intervention sessions. Message content will be the same for all control participants and contain general facts about asthma (not tailored). It is hypothesized that youth randomized to multicomponent technology-based intervention will show improvements in medication adherence (primary outcome) and asthma control (secondary outcome) compared with comparison condition at all postintervention follow-ups (3, 6, 9, and 12 months). The proposed study was funded by NHLBI from September 1, 2016 through August 31, 2021. This project will test a brief, technology-based intervention specifically targeting adherence to asthma controller medications in an under-researched population, African American emerging adults. If successful, our multicomponent technology-based intervention aimed at improving adherence to asthma medications has the potential to improve quality of life of minority emerging adults with asthma at relatively low cost. It could eventually be integrated into clinical settings and practice to reach a large number of emerging adults with asthma. ClinicalTrials.gov NCT03121157; https://clinicaltrials.gov/ct2/show/NCT03121157 (Archived by WebCite at http://www.webcitation.org/6wq4yWHPv). ©Karen MacDonell, Sylvie Naar, Wanda Gibson-Scipio, Jean-Marie Bruzzese, Bo Wang, Aaron Brody. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 07.05.2018.
Full Text Available This study seeks to identify the critical success factors of teams in the application-development project. To achieve this goal, a qualitative approach and content analysis was utilized. Semi-structured interviews with 14 developers and experts was performed for data collection. A systematic review of previous research shows that after 9 critical success factors. With the analysis interviews, the CSf's raised to 12; including user experience, strategy and project management, support and promotion, business models, planning and goal setting, financial and budgeting, marketing and customer needs, infrastructure, technical issues and design, contextual factors, teamwork and staffing. The results show that the customer experience, teamwork and contextual factors are core categories in the research paradigm model.
Tawanda B. Chiyangwa
Full Text Available Background: The continued in failure of agile and traditional software development projects have led to the consideration, attention and dispute to critical success factors that are the aspects which are most vital to make a software engineering methodology fruitful. Although there is an increasing variety of critical success factors and methodologies, the conceptual frameworks which have causal relationship are limited. Objective: The objective of this study was to identify and provide insights into the critical success factors that influence the success of software development projects using agile methodologies in South Africa. Method: Quantitative method of collecting data was used. Data were collected in South Africa through a Web-based survey using structured questionnaires. Results: These results show that organisational factors have a great influence on performance expectancy characteristics. Conclusion: The results of this study discovered a comprehensive model that could provide guidelines to the agile community and to the agile professionals.
Sidebottom, Abbey C; Sillah, Arthur; Vock, David M; Miedema, Michael D; Pereira, Raquel; Benson, Gretchen; Lindberg, Rebecca; Boucher, Jackie L; Knickelbine, Thomas; VanWormer, Jeffrey J
The Heart of New Ulm Project (HONU), is a population-based project designed to reduce modifiable cardiovascular disease (CVD) risk factors in the rural community of New Ulm, MN. HONU interventions address multiple levels of the social-ecological model. The community is served by one health system, enabling the use of electronic health record (EHR) data for surveillance. The purpose of this study was to assess if trends in CVD risk factors and healthcare utilization differed between a cohort of New Ulm residents age 40-79 and matched controls selected from a similar community, using EHR data from baseline (2008-2009) through three follow up time periods (2010-2011, 2012-2013, 2014-2015). Matching, using covariate balance sparse technique, yielded a sample of 4077 New Ulm residents and 4077 controls. We used mixed effects longitudinal models to examine trends over time between the two groups. Blood pressure, total cholesterol, low-density lipoprotein-cholesterol, and triglycerides showed better management in New Ulm over time compared to the controls. The proportion of residents in New Ulm with controlled blood pressure increased by 6.2 percentage points compared to an increase of 2 points in controls (p risk scores increased less in New Ulm (5.1) than the comparison community (5.9). The intervention and control community did not differ with regard to inpatient stays, smoking, or glucose. Findings suggest efficacy for the HONU project interventions for some outcomes. Copyright © 2017. Published by Elsevier Inc.
Harris, Lauren N; Cleary, Elizabeth H; Stanton, Annette L
This study's purpose was to characterize the experience of patients with breast cancer randomly assigned to the intervention arm of Project Connect Online (PCO), a randomized controlled trial of an Internet-based intervention, and to examine relationships between website use variables and psychosocial outcomes. In the larger PCO trial, patients with breast cancer (n = 88) were randomly assigned to an intervention or a waiting-list control. This report pertains to the 46 women in the intervention arm, a 3-h workshop for creation of personal websites with a blog function to communicate with their interpersonal network and chronicle their breast cancer experience. Participants completed assessments at 1 and 6 months. Visitors to the websites (n = 66) completed an online questionnaire. Reactions to website use were positive, although lack of time was a barrier for some. Women with advanced cancer were more likely to use their websites. Women found the websites useful for telling the story of their experience and expressing emotions. Positive word use was associated with heightened positive mood at 6 months; negative word use was associated with improved depressive symptoms. Visitors were most commonly female friends of participants who valued the websites as a way to connect emotionally with participants and receive information about their health. Specific aspects of patients' blogs predicted improvements in psychosocial functioning. Personal websites can help women with breast cancer construct a narrative of their experience, express emotions, and receive the social support they need, particularly from friends and extended family. Copyright © 2014 John Wiley & Sons, Ltd.
Susan I Woodruff
Full Text Available Introduction: Visits to settings such as emergency departments (EDs may present a “teachable moment” in that a patient may be more open to feedback and suggestions regarding their risky alcohol and illicit drug-use behaviors. Screening, Brief Intervention, and Referral to Treatment (SBIRT is an ’opportunistic’ public health approach that targets low-risk users, in addition to those already dependent on alcohol and/or drugs. SBIRT programs provide patients with comprehensive screening and assessments, and deliver interventions of appropriate intensity to reduce risks related to alcohol and drug use. Methods: This study used a single group pre-post test design to assess the effect of the California SBIRT service program (i.e., CASBIRT on 6 substance-use outcomes (past-month prevalence and number of days of binge drinking, illegal drug use, and marijuana use. Trained bilingual/bicultural Health Educators attempted to screen all adult patients in 12 EDs/trauma centers (regardless of the reason for the patient’s visit using a short instrument, and then delivered a brief motivational intervention matched to the patient’s risk level. A total of 2,436 randomly selected patients who screened positive for alcohol and/or drug use consented to be in a 6-month telephone follow-up interview. Because of the high loss to follow-up rate, we used an intention-to-treat approach for the data analysis. Results: Results of generalized linear mixed models showed modest reductions in all 6 drug- and alcohol-use outcomes. Men (versus women, those at relatively higher risk status (versus lower risk, and those with only one substance of misuse (versus both alcohol and illicit drug misuse tended to show more positive change. Conclusion: These results suggest that SBIRT services provided in acute care settings are associated with modest changes in self-reported recent alcohol and illicit drug use. [West J Emerg Med. 2013;14(3:263–270.
El-Bassel, Nabila; Gilbert, Louisa; Goddard-Eckrich, Dawn; Chang, Mingway; Wu, Elwin; Hunt, Tim; Epperson, Matt; Shaw, Stacey A; Rowe, Jessica; Almonte, Maria; Witte, Susan
This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision. We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision. We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH. Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners. Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02-0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57-0.90). The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may be scaled up to redress the concentrated epidemics of HIV/STIs among drug-involved women in the criminal justice system. Clinical
ABDELNASER OMRAN; SITI NORHYDAYATON BINTI MAMAT
This study investigates the factors affecting cost performance of construction projects in Kelantan State located in the east-coast part of Malaysia. It draws on relevant previous research in the theory of work on cost performance. Thirty-three contractors companies with different working grades in the state of Kelantan were participated in the study. Data were collected from the contractors using a questionnaire survey. The results indicated that the success factors affecting the cost perfor...
Bhiri, Sana; Maatoug, Jihene; Zammit, Nawel; Msakni, Zineb; Harrabi, Imed; Amimi, Souad; Mrizek, Nejib; Ghannem, Hassen
To assess the effectiveness of a 3-year workplace-based intervention program on the control of the main noncommunicable disease risk factors (poor nutrition, physical inactivity, and tobacco use) among the employees of Sousse, Tunisia. We conducted a quasi-experimental study (pre- and postassessments with intervention and control groups) in six companies of the governorate of Sousse in Tunisia.The intervention program consisted of health education programs (eg, workshops, films and open sensitization days). We also scheduled free physical activity sessions and free smoking cessation consultations. Our intervention program showed meaningful improvement among the employees toward dietary and physical activity behaviors but not for tobacco use. Workplace is a crucial setting for health promotion, and future programs should consider a multisectoral approach to control the main noncommunicable disease risk factors.
Full Text Available The paper proposes a systematization of the key success factors of projects, through the theoretical review of family-owned companies operating in the EU market. It is the small and medium companies that in their own way contribute to the overall success of the national economy in terms of economic activity, increased employment, development activities and defining better business environment. The theoretical review observed numerous studies of family businesses, and the contribution of this work is in the systematization of the results of previous research – over three horizons, i.e., over the role of managers in the creation of successful projects (or owner if it is a family enterprise, institutional support for companies in Serbia and the EU, specific industries and the parent (regional markets where a family company operates. Project management, as a general representation of the concept of implementation of strategic and operational endeavors, contains many specifics in terms of critical success factors of projects depending on the environment in which they are implemented. The goal of the paper is reflected in the identification and presentation of critical success factors of projects implemented in family companies. The paper concludes with a discussion of the research results in relation to the existing, similar research studies, as well as with the announcement of future research, which will examine the conclusions drawn on a real sample.
Tai, Shuangliang; Sun, Chengshuang; Zhang, Shoujian
It has been found that a low level of trust among members of a construction project team leads to poor performance in China. Many researchers have described the challenges, consequently advocating partnering as an attractive approach for more valuable cooperation. Because substantial investments have been poured into construction projects since the year 2000, trust research will improve the performance of construction projects and will be meaningful to the Chinese construction industry. The purpose of this paper is to investigate the attributes affecting owners' trust of contractors, to understand the potential properties of these factors, and to rank the factors in order of importance. Twenty-four attributes are identified from a literature review. Supported by qualitative reviews, a questionnaire is conducted to obtain relevant data, and 168 valid responses are obtained for data analysis. Principal component analysis (PCA) is employed to find the factor structure of the identified trust attributes. By the method of PCA, the attributes are extracted into eight factors, including interaction history, information sharing and communication, contract and institution, relation-specific investment, reputation, integrity, competence, and opportunistic behaviour. The value and originality of this paper are embodied in using PCA to understand the various attribute groupings and to illuminate trust impact factors in the Chinese context. When they understand the critical factors affecting trust better, owners and contractors can devise more appropriate strategies to improve performance.
Naomi Burn; Lynda Heather Norton; Claire Drummond; Kevin Ian Norton
Background: Declining physical activity (PA) and associated health risk factors are well established. Workplace strategies to increase PA may be beneficial to ameliorate extensive sedentary behavior. This study assessed the effectiveness of two PA interventions in workplace settings. Methods: Interventions were conducted over 40 days targeting insufficiently active (<150 min/wk PA) and/or obese (BMI ≥ 30 kg/m2) adults; participants were randomly allocated to instructor-led exercise session...
Kassam-Adams, Nancy; Marsac, Meghan L; Hildenbrand, Aimee; Winston, Flaura
After pediatric injury, transient traumatic stress reactions are common, and about 1 in 6 children and their parents develop persistent posttraumatic stress (PTS) symptoms that are linked to poorer physical and functional recovery. Meta-analytic studies identify risk factors for persistent PTS, including preinjury psychological problems, peritrauma fear and perceived life threat, and posttrauma factors such as low social support, maladaptive coping strategies, and parent PTS symptoms. There is growing prospective data indicating that children's subjective appraisals of the injury and its aftermath influence PTS development. Secondary prevention of injury-related PTS often involves parents and focuses on promoting adaptive child appraisals and coping strategies. Web-based psychoeducation and targeted brief early intervention for injured children and their parents have shown a modest effect, but additional research is needed to refine preventive approaches. There is a strong evidence base for effective psychological treatment of severe and persistent PTS via trauma-focused cognitive behavioral therapy; evidence is lacking for psychopharmacological treatment. Pediatric clinicians play a key role in preventing injury-related PTS by providing "trauma-informed" pediatric care (ie, recognizing preexisting trauma, addressing acute traumatic stress reactions associated with the injury event, minimizing potentially traumatic aspects of treatment, and identifying children who need additional monitoring or referral).
Evans, R W; Shaten, B J; Hempel, J D; Cutler, J A; Kuller, L H
A nested case-control study was undertaken involving men participating in the Multiple Risk Factor Intervention Trial (MRFIT). Serum samples from 712 men, stored for upto 20 years, were analysed for homocyst(e)ine. Cases involved non-fatal myocardial infractions, identified through the active phase of the study, which ended on February 28, 1982, and deaths due to coronary heart disease, monitored through 1990. The non-fatal myocardial infarction occurred within 7 years of sample collection, whereas the majority of coronary heart disease deaths occurred more than 11 years after sample collection. Mean homocyst(e)ine concentrations were in the expected range and did not differ significantly between case patients and control subjects: myocardial infarction cases, 12.6 micromol/L; myocardial infarction controls, 13.1 micromol/L; coronary heart disease death cases, 12.8 micromol/L; and coronary heart disease controls, 12.7 micromol/L. Odds ratios versus quartile 1 for coronary heart disease deaths and myocardial infarctions combined were as follows: quartile 2, 1.03; quartile 3, 0.84; and quartile 4, 0.92. Thus, in this prospective study, no association of homocyst(e)ine concentration with heart disease was detected. Homocyst(e)ine levels were weakly associated with the acute-phase (C-reactive) protein. These results are discussed with respect to the suggestion that homocyst(e)ine is an independent risk factor for heart disease.
Lippman, Sheri A; Donini, Angela; Díaz, Juan; Chinaglia, Magda; Reingold, Arthur; Kerrigan, Deanna
We sought to determine the association of social-environmental factors with condom use and sexually transmitted infections (STIs) among 420 sex workers participating in an STI/HIV prevention study in Corumbá, Brazil, to inform future intervention efforts. Participants provided urine samples for polymerase chain reaction testing of chlamydia and gonorrhea and responded to multi-item scales addressing perceived social cohesion, participation in networks, and access to and management of resources. We conducted multivariate log-linear and negative binomial regression analyses of these data. Increased social cohesion was inversely associated with number of unprotected sex acts in the preceding week among women (adjusted incidence rate ratio [IRR] = 0.80; P < .01), and there was a marginal association among men (adjusted IRR = 0.41; P = .08). Women's increased participation in social networks was associated with a decrease in frequency of unprotected sex acts (adjusted IRR = 0.83; P = .04), as was men's access to and management of social and material resources (IRR = 0.15; P = .01). Social-environmental factors were not associated with STIs. The social context within which populations negotiate sexual behaviors is associated with condom use. Future efforts to prevent STI/HIV should incorporate strategies to modify the social environment.
Savikko, Niina; Routasalo, Pirkko; Tilvis, Reijo; Pitkälä, Kaisu
Loneliness among community-dwelling older people is a common problem, with serious health consequences. The favourable processes and mediating factors of a psychosocial group rehabilitation intervention in alleviating older people's loneliness were evaluated. Altogether, 117 lonely, home-dwelling individuals (aged ≥75 years) participated in a psychosocial group rehabilitation intervention. The content comprised (i) art and inspiring activities, (ii) group exercise and discussions or (iii) therapeutic writing and group therapy. The psychosocial group rehabilitation intervention was evaluated from the group leaders' diaries and by observing the groups. Experiences of loneliness and social participation were collected by postintervention questionnaires from the participants. Data were analysed using methodological triangulation. Doing things together and sharing experiences with their peers inspired lively discussions, created a feeling of togetherness and led to participants' empowerment and increased self-esteem. The intervention socially activated the participants, and their feelings of loneliness had been alleviated during the intervention. Several common favourable processes and mediating factors were identified in the psychosocial group rehabilitation intervention that led to alleviation of loneliness among older people. Relevance to clinical practice. The psychosocial group rehabilitation intervention gives nurses an effective tool to support older people's psychosocial resources by activating them and alleviating their loneliness. © 2009 Blackwell Publishing Ltd.
Gobel, Peter; Kano, Makimi
Digital storytelling projects provide a variety of opportunities for learning in the language classroom, but along with these opportunities come a number of challenges for both pedagogy and technology. This presentation describes an ongoing multi-method study into factors involved in task-based learning using digital storytelling. Using intact…
Purpose The conceptual and modularization of project management maturity models is based on the principle of process control. This research was designed to challenge these boundaries to reveal non-process factors. The paper aims to discuss these issues. Design/methodology/approach A multimethod
Stoyanoff, Dawn Galadriel Pfeiffer
This study examined the enterprise resource planning (ERP) implementations that utilized a shared services model in higher education. The purpose of this research was to examine the critical success factors which were perceived to contribute to project success. This research employed a quantitative non-experimental correlational design and the…
Chung, Chee Yeun; Licznerski, Pawel; Alavian, Kambiz N.; Simeone, Antonio; Lin, Zhicheng; Martin, Eden; Vance, Jeffery; Isacson, Ole
Two adjacent groups of midbrain dopaminergic neurons, A9 (substantia nigra pars compacta) and A10 (ventral tegmental area), have distinct projections and exhibit differential vulnerability in Parkinson's disease. Little is known about transcription factors that influence midbrain dopaminergic subgroup phenotypes or their potential role in disease.…
Sidhu, Anupreet Kaur; Sussman, Steve; Tewari, Abha; Bassi, Shalini; Arora, Monika
Tobacco use experimentation is most frequent between the ages of 15–24 in India. Therefore, programming to counteract tobacco use among adolescents is needed. There is a lack of evidence-based teen tobacco use prevention and cessation programs. The current study provides an outcome evaluation of the Project EX tobacco use prevention and cessation program among Indian adolescents (16–18 years). An eight-session classroom-based curriculum was adapted to the Indian context and translated from English to Hindi (local language). Next, it was tested using a quasi-experimental design with 624 Indian students at baseline, involving two program and two control schools, with a three-month post-program follow-up. Project EX involves motivation enhancement (e.g., talk shows and games) and coping skills (e.g., complementary and alternative medicine) components. Program participants rated complementary and alternative medicine (CAM) activities like meditation, yoga and healthy breathing higher than talk shows and games. Compared to the standard care control condition, the program condition revealed a prevention effect, but not a cessation effect. Implications for prevention/cessation programming among Indian teens are discussed. This study was approved by the Independent Ethics Committee, Mumbai.
McLaren Loring, Joyce
Land-use planning poses a significant barrier to the further development of on-shore wind energy in many countries. There has been increasing discussion regarding the use of public participation in the planning process in order to address concerns of local residents and ease conflicts. This research explores the dynamics of the planning process for wind energy in England, Wales and Denmark in order to better understand the factors influencing project success. Through 18 in-depth case studies, it investigates the degree of local community participation in the planning process and the stability of the network of individuals and organisations involved in the project to determine their relationship to the public's acceptance of the project and the planning outcome. The study draws on the frameworks of public participation in planning and actor-network theories in order to develop indicators of the level of community involvement and network formation for each case. The analysis discusses predictions made by the theoretical approaches as to the importance of these variables to the success of new projects. The results indicate that projects with high levels of participatory planning are more likely to be publicly accepted and successful. In addition, stable supporting networks are more likely to form. The presence of a stable network of supporters is not found to be related to project acceptance and success; however, the absence of a stable network of opponents is found to be necessary for project acceptance and success in receiving planning permission
Pelletier, Jean-François; Pouliot-Morneau, Denis; Houle, Janie; Bordeleau, Julie; Laroche, Sébastien; Rowe, Michael
Objectives The Global Model of Public Mental Health is "global" not only in the sense of having an international perspective, but in regarding service users as actors at all levels of public mental health exerting collective and organized influence on the social determinants of health, in addition to being recipients of care. Having access to appropriate health and mental health care when needed is a fundamental human right. Having a say over the manner in which care is provided, including partnership in decision making in care planning and ongoing care, has gained increasing support among recipients and providers of care. Over the past few decades in the Canadian province of Quebec, patient participation and partnership in decision-making has been promoted through successive Mental Health Action Plans (MHAP) and other policies. In these documents, participation and partnership are associated with the exercise of citizenship and the promotion of service users' rights, including the rights to participate in one's own care. In this article, using the case example of a citizenship-oriented intervention, namely the Projet citoyen, we discuss the results to a new measure of citizenship, which was developed from a service users' perspective.Methods Employing a mixed methods approach, two types of data were collected from users of mental health care. Quantitative data were generated from administration of a 23-item measure of citizenship with service users in the province of Quebec (N=802), and qualitative data were collected from four focus groups with another sample of 18 service users. They were presented with results from the administration of the measure, and asked to comment on them in regard to their own experience of citizenship.Results Among the five dimensions of the measure of citizenship, participants scored lowest on the 'involvement in the community' dimension, and higher on the other dimensions of 'basic needs,' 'respect by others,' 'self
To investigate the association of pre-intervention and post-intervention patient and eye characteristics with failure of argon laser trabeculoplasty (ALT) and trabeculectomy. Cohort study of participants in the Advanced Glaucoma Intervention Study. This multicenter study took place between 1988 and 2001. Between 1988 and 1992, 789 eyes of 591 patients aged 35 to 80 years with advanced glaucoma were randomized into one of two surgical treatment sequences: argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy or trabeculectomy-ALT-trabeculectomy. Upon study-defined failure (based on maximum medications, sustained intraocular pressure (IOP) elevation, visual field defect, and disk rim deterioration) of each intervention, patients were offered the subsequent intervention. Potential follow-up was 8 to 13 years. This report is based on data from 779 eyes that had at least 3 months of follow-up. The main outcome measures are failure of ALT and trabeculectomy, whether as first or second interventions. Effect size is measured by the hazard ratio (HR) and its corresponding 95% confidence interval (CI) obtained from Cox multiple regression analysis, where HR corresponds to the coefficient of change in risk associated with a unit increase in a factor. For binary factors, this corresponds to the change in risk in eyes with the factor relative to the risk in eyes without the factor. Pre-intervention factors associated with failure of ALT are younger age (HR = 0.98, CI = 0.96-0.99, P =.009) and higher IOP (1.11, 1.08-1.15, P <.001). Pre-intervention factors associated with failure of trabeculectomy are younger age (HR = 0.97, CI = 0.95-0.99, P =.005) and higher IOP (1.04, 1.01-1.06, P =.002), as well as diabetes (2.86, 1.88-4.36, P <.001) and any postoperative complication (1.99, 1.35-2.93, P <.001). Individual postoperative complications significantly associated with increased risk of failure of trabeculectomy are elevated IOP (3.4, 1.9-6.1, P <.001) and marked
Esteves, José; Pastor Collado, Juan Antonio; Casanovas Garcia, Josep
This technical research report proposes the usage of a statistical approach named Partial Least squares (PLS) to define the relationships between critical success factors for ERP implementation projects. In previous research work, we developed a unified model of critical success factors for ERP implementation projects. Some researchers have evidenced the relationships between these critical success factors, however no one has defined in a form...
Full Text Available Aim: to determine factors associated with In-Stent Restenosis (ISR in patients following Percutaneous Coronary Intervention (PCI. Methods: a retrospective cross-sectional study was conducted using secondary information from medical records of post-PCI patients who underwent follow-up of angiography PCI between January 2009 and March 2014 at The Integrated Cardiovascular Service Unit, Cipto Mangunkusumo Hospital, Jakarta. Angiographic ISR was defined when the diameter of stenosis ≥50% at follow-up angiography including the diameter inside the stent and diameter with five-mm protrusion out of the proximal and distal ends of the stent. Results: there were 289 subjects including 133 subjects with and 156 subjects without ISR. The incidence of ISR in patients using of bare-metal stent (BMS and drug-eluting stent (DES were 61.3% and 40.7%, respectively. Factors associated with ISR are stent-type (OR=4.83, 95% CI 2.51-9.30, stent length (OR=3.71, 95% CI 1.99-6.90, bifurcation lesions (OR=2.43, 95% CI 1.16-5.10, smoking (OR=2.30, 95% CI 1.33-3.99, vascular diameter (OR=2.18, 95% CI 1.2-3.73, hypertension (OR=2.16, 95% CI 1.16-4.04 and diabetes mellitus (OR=2.14, 95% CI 1.23-3.70. Conclusion: stent type, stent length, bifurcation lesions, smoking, vascular diameter, hypertension and DM are factors associated with ISR in patients following PCI. Key words: bare-metal stent; drug-eluting stent; in-stent restenosis.
Couser, Gregory P
To explore the literature regarding prevention of depression in the workplace. Literature review of what the author believes are seminal articles highlighting workplace factors and interventions in preventing depression in the workplace. Employees can help prevent depression by building protective factors such as better coping and stress management skills. Employees may be candidates for depression screening if they have certain risk factors such as performance concerns. Organizational interventions such as improving mental health literacy and focusing on work-life balance may help prevent depression in the workplace but deserve further study. A strategy to prevent depression in the workplace can include developing individual resilience, screening high-risk individuals and reducing that risk, improving organizational literacy, and integrating workplace and health care systems to allow access to proactive quality interventions.
Baccini, Michela; Carreras, Giulia
This paper describes the methods used to investigate variations in total alcoholic beverage consumption as related to selected control intervention policies and other socioeconomic factors (unplanned factors) within 12 European countries involved in the AMPHORA project. The analysis presented several critical points: presence of missing values, strong correlation among the unplanned factors, long-term waves or trends in both the time series of alcohol consumption and the time series of the main explanatory variables. These difficulties were addressed by implementing a multiple imputation procedure for filling in missing values, then specifying for each country a multiple regression model which accounted for time trend, policy measures and a limited set of unplanned factors, selected in advance on the basis of sociological and statistical considerations are addressed. This approach allowed estimating the "net" effect of the selected control policies on alcohol consumption, but not the association between each unplanned factor and the outcome.
Llauradó, Elisabet; Aceves-Martins, Magaly; Tarro, Lucia; Papell-Garcia, Ignasi; Puiggròs, Francesc; Arola, Lluís; Prades-Tena, Jordi; Montagut, Marta; Moragas-Fernández, Carlota M; Solà, Rosa; Giralt, Montse
The encouragement of healthy lifestyles for obesity prevention in young people is a public health priority. The European Youth Tackling Obesity (EYTO) project is a multicentric intervention project with participation from the United Kingdom, Portugal, the Czech Republic and Spain. The general aim of the EYTO project is to improve lifestyles, including nutritional habits and physical activity practice, and to prevent obesity in socioeconomically disadvantaged and vulnerable adolescents. The EYTO project works through a peer-led social marketing intervention that is designed and implemented by the adolescents of each participating country. Each country involved in the project acts independently. This paper describes the "Som la Pera" intervention Spanish study that is part of the EYTO project. In Spain, the research team performed a cluster randomised controlled intervention over 2 academic years (2013-2015) in which 2 high-schools were designated as the control group and 2 high-schools were designated as the intervention group, with a minimum of 121 schoolchildren per group. From the intervention group, 5 adolescents with leadership characteristics, called "Adolescent Challenge Creators" (ACCs), were recruited. These 5 ACCs received an initial 4 h training session about social marketing principles and healthy lifestyle theory, followed by 24 sessions (1.30 h/session) divided in two academic years to design and implement activities presented as challenges to encourage healthy lifestyles among their peers, the approximately 180-200 high-school students in the intervention group. During the design of the intervention, it was essential that the ACCs used the 8 social marketing criteria (customer orientation, behaviour, theory, insight, exchange, competition, segmentation and methods mix). The expected primary outcomes from the Spanish intervention will be as follows: increases in the consumption of fruits and vegetables and physical activity practice along with
Vidrine, Damon J; Fletcher, Faith E; Danysh, Heather E; Marani, Salma; Vidrine, Jennifer Irvin; Cantor, Scott B; Prokhorov, Alexander V
Despite a significant decrease in smoking prevalence over the past ten years, cigarette smoking still represents the leading cause of preventable morbidity and mortality in the United States. Moreover, smoking prevalence is significantly higher among those with low levels of education and those living at, or below, the poverty level. These groups tend to be confronted with significant barriers to utilizing more traditional smoking cessation intervention approaches. The purpose of the study, Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods), is to utilize a mobile clinic model, a network of community sites (i.e., community centers and churches) and an interactive mobile messaging system to reach and deliver smoking cessation treatment to underserved, low-income communities. We are using a group-randomized design, with the community site as the sampling unit, to compare the efficacy of three smoking cessation interventions: 1) Standard Care--brief advice to quit smoking, nicotine replacement therapy (NRT), and self-help materials; 2) Enhanced Care--standard care components plus a cell phone-delivered text/graphical messaging component; and 3) Intensive Care--enhanced care components plus a series of 11 cell phone-delivered proactive counseling sessions. An economic evaluation will also be performed to evaluate the relative cost effectiveness of the three treatment approaches. We will recruit 756 participants (252 participants in each of the 3 intervention groups). At the time of randomization, participants complete a baseline assessment, consisting of smoking history, socio-demographic, and psychosocial variables. Monthly cell phone assessments are conducted for 6 months-post enrollment, and a final 12-month follow-up is conducted at the original neighborhood site of enrollment. We will perform mixed-model logistic regression to compare the efficacy of the three smoking cessation intervention treatment groups. It is
Vidrine Damon J
Full Text Available Abstract Background Despite a significant decrease in smoking prevalence over the past ten years, cigarette smoking still represents the leading cause of preventable morbidity and mortality in the United States. Moreover, smoking prevalence is significantly higher among those with low levels of education and those living at, or below, the poverty level. These groups tend to be confronted with significant barriers to utilizing more traditional smoking cessation intervention approaches. The purpose of the study, Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods, is to utilize a mobile clinic model, a network of community sites (i.e., community centers and churches and an interactive mobile messaging system to reach and deliver smoking cessation treatment to underserved, low-income communities. Methods/Design We are using a group-randomized design, with the community site as the sampling unit, to compare the efficacy of three smoking cessation interventions: 1 Standard Care - brief advice to quit smoking, nicotine replacement therapy (NRT, and self-help materials; 2 Enhanced Care - standard care components plus a cell phone-delivered text/graphical messaging component; and 3 Intensive Care - enhanced care components plus a series of 11 cell phone-delivered proactive counseling sessions. An economic evaluation will also be performed to evaluate the relative cost effectiveness of the three treatment approaches. We will recruit 756 participants (252 participants in each of the 3 intervention groups. At the time of randomization, participants complete a baseline assessment, consisting of smoking history, socio-demographic, and psychosocial variables. Monthly cell phone assessments are conducted for 6 months-post enrollment, and a final 12-month follow-up is conducted at the original neighborhood site of enrollment. We will perform mixed-model logistic regression to compare the efficacy of the three smoking
Grant, Sean; Agniel, Denis; Almirall, Daniel; Burkhart, Q; Hunter, Sarah B; McCaffrey, Daniel F; Pedersen, Eric R; Ramchand, Rajeev; Griffin, Beth Ann
Over 1.6 million adolescents in the United States meet criteria for substance use disorders (SUDs). While there are promising treatments for SUDs, adolescents respond to these treatments differentially in part based on the setting in which treatments are delivered. One way to address such individualized response to treatment is through the development of adaptive interventions (AIs): sequences of decision rules for altering treatment based on an individual's needs. This protocol describes a project with the overarching goal of beginning the development of AIs that provide recommendations for altering the setting of an adolescent's substance use treatment. This project has three discrete aims: (1) explore the views of various stakeholders (parents, providers, policymakers, and researchers) on deciding the setting of substance use treatment for an adolescent based on individualized need, (2) generate hypotheses concerning candidate AIs, and (3) compare the relative effectiveness among candidate AIs and non-adaptive interventions commonly used in everyday practice. This project uses a mixed-methods approach. First, we will conduct an iterative stakeholder engagement process, using RAND's ExpertLens online system, to assess the importance of considering specific individual needs and clinical outcomes when deciding the setting for an adolescent's substance use treatment. Second, we will use results from the stakeholder engagement process to analyze an observational longitudinal data set of 15,656 adolescents in substance use treatment, supported by the Substance Abuse and Mental Health Services Administration, using the Global Appraisal of Individual Needs questionnaire. We will utilize methods based on Q-learning regression to generate hypotheses about candidate AIs. Third, we will use robust statistical methods that aim to appropriately handle casemix adjustment on a large number of covariates (marginal structural modeling and inverse probability of treatment weights
Sutliffe, Jay Thomas; Fuhrman, Joel Harvey; Carnot, Mary Jo; Beetham, Raena Marie; Peddy, Madison Sarah
conduct interventions for health promotion and disease prevention to ameliorate chronic risk factors for disease, such as for cardiovascular disease (CVD). Likewise, nutrient-dense, plant-rich (NDPR) dietary patterns have been shown to be effective at preventing and improving chronic-disease conditions, including CVD. Objective • The study's aim was to determine the feasibility and effectiveness of an NDPR dietary intervention for worksites to lower CVD risk factors. Design • The study was a 6-wk pilot intervention using a pretest and posttest design. The intervention was conducted at the Northern Arizona University (Flagstaff, AZ, USA) and sponsored by its Employee Assistance and Wellness Department. Participants • Participants were 35 employees with body mass indexes (BMIs) >25 kg/m2 who were ready and willing to make a lifestyle change, who were not currently participating in a weight loss program, and who were not taking any medications that could increase medical risk or had weight loss as a primary side effect. The average age of participants was 42.57 y; 91.4% were female, and 80% were Caucasian. Intervention • The intervention used a dietary protocol consisting of the daily consumption of greens, beans, legumes, and a variety of other vegetables, as well as fresh or frozen whole fruits, nuts, seeds, and whole grains. Participants were encouraged to minimize the consumption of refined grains, vegetable oils, processed foods, and animal products. Outcome Measures • The study measured serum lipids, height, weight, waist and hip circumference, waist-to-hip ratio, and blood pressure. Results • Based on paired-sample t tests and Wilcoxon signed-ranks test with a maximum level of P = .05, the intervention resulted in significant changes in weight, BMI, waist and hip measurements, high-density lipoproteins, low-density lipoproteins, and estimated average glucose. Conclusions • The findings favorably revealed that an NDPR dietary intervention that was
Full Text Available Schistosomiasis remains a significant health burden in many areas of the world. Morbidity control, focused on limiting infection intensity through periodic delivery of anti-schistosomal medicines, is the thrust of current World Health Organization guidelines (2006 for reduction of Schistosoma-related disease. A new appreciation of the lifetime impact of repeated Schistosoma infection has directed attention toward strategies for greater suppression of parasite infection per se, with the goal of transmission interruption. Variations in drug schedules involving increased population coverage and/or treatment frequency are now undergoing field trials. However, their relative effectiveness in long-term infection suppression is presently unknown.Our study used available field data to calibrate advanced network models of village-level Schistosoma transmission to project outcomes of six different community- or school age-based programs, as compared to the impact of current 2006 W.H.O. recommended control strategies. We then scored the number of years each of 10 typical villages would remain below 10% infection prevalence (a practicable level associated with minimal prevalence of disease. All strategies that included four annual treatments effectively reduced community prevalence to less than 10%, while programs having yearly gaps ('holidays' failed to reach this objective in half of the communities. Effective post-program suppression of infection prevalence persisted in half of the 10 villages for 7-10 years, whereas in five high-risk villages, program effects on prevalence lasted zero to four years only.At typical levels of treatment adherence (60 to 70%, current WHO recommendations will likely not achieve effective suppression of Schistosoma prevalence unless implemented for ≥6 years. Following more aggressive 4 year annual intervention, some communities may be able to continue without further intervention for 8-10 years, while in higher
Wozney, Lori M; Baxter, Pamela; Fast, Hilary; Cleghorn, Laura; Hundert, Amos S; Newton, Amanda S
Research in the fields of human performance technology and human computer interaction are challenging the traditional macro focus of usability testing arguing for methods that help test moderators assess "use in context" (ie, cognitive skills, usability understood over time) and in authentic "real world" settings. Human factors in these complex test scenarios may impact on the quality of usability results being derived yet there is a lack of research detailing moderator experiences in these test environments. Most comparative research has focused on the impact of the physical environment on results, and rarely on how the sociotechnical elements of the test environment affect moderator and test user performance. Improving our understanding of moderator roles and experiences with conducting "real world" usability testing can lead to improved techniques and strategies To understand moderator experiences of using Web-conferencing software to conduct remote usability testing of 2 eHealth interventions. An exploratory case study approach was used to study 4 moderators' experiences using Blackboard Collaborate for remote testing sessions of 2 different eHealth interventions. Data collection involved audio-recording iterative cycles of test sessions, collecting summary notes taken by moderators, and conducting 2 90-minute focus groups via teleconference. A direct content analysis with an inductive coding approach was used to explore personal accounts, assess the credibility of data interpretation, and generate consensus on the thematic structure of the results. Following the convergence of data from the various sources, 3 major themes were identified: (1) moderators experienced and adapted to unpredictable changes in cognitive load during testing; (2) moderators experienced challenges in creating and sustaining social presence and untangling dialogue; and (3) moderators experienced diverse technical demands, but were able to collaboratively troubleshoot with test users
Full Text Available Nowadays organizations compete between themselves in various categories such as faster delivery, price tags, state of art - technology and higher quality dimensio ns. A Conceptual framework with lean manufacturing and hum an factors interventions for improving business performance in terms of improved quality, reduced cost and faster de livery is presented and example s from literature are given to illustrate the desir ed situation in which ergonomics is considered as an integrated part of performance strategy . A case from an industry engaged in manufacturing shafts using lean manufacturing practices with successful ergonomic or human factors interventions is also inves tigated.
The Health and Sport Engagement (HASE) Intervention and Evaluation Project: protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity.
Mansfield, Louise; Anokye, Nana; Fox-Rushby, Julia; Kay, Tess
Sport is being promoted to raise population levels of physical activity for health. National sport participation policy focuses on complex community provision tailored to diverse local users. Few quality research studies exist that examine the role of community sport interventions in raising physical activity levels and no research to date has examined the costs and cost-effectiveness of such provision. This study is a protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity, the Health and Sport Engagement (HASE) project part of the national Get Healthy Get Active programme led by Sport England. The HASE study is a collaborative partnership between local community sport deliverers and sport and public health researchers. It involves designing, delivering and evaluating community sport interventions. The aim is to engage previously inactive people in sustained sporting activity for 1×30 min a week and to examine associated health and well-being outcomes. The study uses mixed methods. Outcomes (physical activity, health, well-being costs to individuals) will be measured by a series of self-report questionnaires and attendance data and evaluated using interrupted time series analysis controlling for a range of sociodemographic factors. Resource use will be identified and measured using diaries, interviews and records and presented alongside effectiveness data as incremental cost-effectiveness ratios and cost-effectiveness acceptability curves. A longitudinal process evaluation (focus groups, structured observations, in-depth interview methods) will examine the efficacy of the project for achieving its aim using the principles of thematic analysis. The results of this study will be disseminated through peer-reviewed publications, academic conference presentations, Sport England and national public health organisation policy conferences, and practice-based case studies
Lefebvre, B.; Berard, E.; Arpino, J.-M.
This article describes the specificities of the operating principles chosen by EDF for the EPR project as a result of an extensive Human Factor Engineering program successfully implemented in an industrial project context. The design process and its achievements benefit of the EDF experience feedback not only in term of NPP operation - including the fully computerized control room of the N4-serie - but also in term of NPP designer. The elements exposed hereafter correspond to the basic design phase of EPR HMI which has been completed and successfully validated by the end of 2003. The article aims to remind the context of the project which basically consists in designing a modern and efficient HMI taking into account the operating needs while relying on proven and reliable technologies. The Human Factor Engineering program implemented merges these both aspects by : 1) being fully integrated within the project activities and scheduling; 2) efficiently taking into account the users needs as well as the feasibility constraints by relying on a multidisciplinary design team including HF specialists, I and C specialists, Process specialists and experienced operator representatives. The resulting design process makes a wide use of experience feedback and experienced operator knowledge to complete largely the existing standards for providing a fully useable and successful design method in an industrial context. The article underlines the design process highlights that largely contribute to the successful implementation of a Human Factor Engineering program for EPR. (authors)
El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E
The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians' choice of workplace, and policy interventions for retaining physicians in the public sector. Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Nineteen articles met the inclusion criteria. Six major themes that affected physicians' choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. While factors affecting physicians' choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross-country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public sector.
El Koussa, Maria; Atun, Rifat; Bowser, Diana; Kruk, Margaret E
Objectives The movement of skilled physicians from the public to the private sector is a key constraint to achieving universal health coverage and is currently affecting health systems worldwide. This systematic review aims to assess factors influencing physicians’ choice of workplace, and policy interventions for retaining physicians in the public sector. Methods Five literature databases were searched. Studies were included in the review if they focused on at least one of the following criteria: (i) incentives or motivators for retaining physicians in the public sector, (ii) pull factors that encouraged physicians to move to the private sector, (iii) push factors that forced physicians to leave the public sector, (iv) policy interventions or case studies that addressed physician retention in the public sector, and (v) qualitative reviews of policy interventions that were implemented in different health system settings. Results Nineteen articles met the inclusion criteria. Six major themes that affected physicians’ choice of workplace were identified including: financial incentives, career development, infrastructure and staffing, professional work environment, workload and autonomy. The majority of the studies suggested that the use of financial incentives was a motivator in retaining physicians in the public sector. The review also identified policy interventions including: regulatory controls, incentives and management reforms. Regulatory controls and incentives were the two most frequently reported policy interventions. Conclusion While factors affecting physicians’ choice of workplace are country specific, financial incentives and professional development are core factors. Other factors are highly influenced by context, and thus, it would be useful for future cross–country research to use standardized data collection tools, allowing comparison of contextual factors as well as the examination of how context affects physician retention in the public
Gazder, U.; Khan, R.A.
The construction industry is viewed as the regulator of national economy globally. Its importance in Pakistan has increased greatly because of the involvement of international funding agencies in infrastructure projects. The feasibility of such projects is largely dependent upon the satisfaction of multiple stakeholders. Hence, it is important to explore the factors considered by different construction organizations in evaluating the failure of their projects. This study focuses on providing a rating of factors affecting construction project failures in the construction industry of Karachi. In addition to that, difference in perception between professionals belonging to different construction projects and organizational structures has also been evaluated. The results of this study show that factors related to project planning and management are rated higher by professionals in general. Secondly, it was also observed that client satisfaction and its related factors were rated higher by organizations with project based management structures. (author)
Full Text Available Abstract Background There is a lack of high quality, child-centred and effective health information to support development of self-care practices and expertise in children with acute and long-term conditions. In type 1 diabetes, clinical guidelines indicate that high-quality, child-centred information underpins achievement of optimal glycaemic control with the aim of minimising acute readmissions and reducing the risk of complications in later life. This paper describes the development of a range of child-centred diabetes information resources and outlines the study design and protocol for a randomized controlled trial to evaluate the information resources in routine practice. The aim of the diabetes information intervention is to improve children and young people's quality of life by increasing self-efficacy in managing their type 1 diabetes. Methods/Design We used published evidence, undertook qualitative research and consulted with children, young people and key stakeholders to design and produce a range of child-centred, age-appropriate children's diabetes diaries, carbohydrate recording sheets, and assembled child-centred, age-appropriate diabetes information packs containing published information in a folder that can be personalized by children and young people with pens and stickers. Resources have been designed for children/young people 6-10; 11-15; and 16-18 years. To evaluate the information resources, we designed a pragmatic randomized controlled trial to assess the effectiveness, cost effectiveness, and implementation in routine practice of individually tailored, age-appropriate diabetes diaries and information packs for children and young people age 6-18years, compared with currently available standard practice. Children and young people will be stratified by gender, length of time since diagnosis ( 2years and age (6-10; 11-15; and 16-18 years. The following data will be collected at baseline, 3 and 6 months: PedsQL (generic
Sánchez-Carracedo, David; Fauquet, Jordi; López-Guimerà, Gemma; Leiva, David; Puntí, Joaquim; Trepat, Esther; Pàmias, Montserrat; Palao, Diego
Challenges in the prevention of disordered eating field include moving from efficacy to effectiveness and developing an integrated approach to the prevention of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. This effectiveness trial tested whether this program has effects when previously trained community providers in an integrated approach to prevention implement the intervention. The research design involved a multi-center non-randomized controlled trial with baseline, post-test and 1-year follow-up measures. The sample included girls in the 8th grade from six schools (n = 152 girls) in a city near Barcelona (intervention group), and from eleven schools (n = 413 girls) in four neighboring towns (control group). The MABIC risk factors of disordered eating were assessed as main outcomes. Girls in the intervention group showed significantly greater reductions in beauty ideal internalization, disordered eating attitudes and weight-related teasing from pretest to 1-year follow-up compared to girls in the control group, suggesting that this program is effective under real-world conditions. Copyright © 2015 Elsevier Ltd. All rights reserved.
Thomas, Avis J; Eberly, Lynn E; Neaton, James D; Smith, George Davey
Latinos are now the largest minority in the United States, but their distinctive health needs and mortality patterns remain poorly understood. Proportional hazards regressions were used to compare Latino versus White risk- and income-adjusted mortality over 25 years' follow-up from 5,846 Latino and 300,647 White men screened for the Multiple Risk Factor Intervention Trial. Men were aged 35-57 years and residing in 14 states when screened in 1973-1975. Data on coronary heart disease risk factors, self-reported race/ethnicity, and home addresses were obtained at baseline; income was estimated by linking addresses to census data. Mortality follow-up through 1999 was obtained using the National Death Index. The fully adjusted Latino/White hazard ratio for all-cause mortality was 0.82 (95% confidence interval (CI): 0.77, 0.87), based on 1,085 Latino and 73,807 White deaths; this pattern prevailed over time and across states (thus, likely across Latino subgroups). Hazard ratios were significantly greater than one for stroke (hazard ratio = 1.30, 95% CI: 1.01, 1.68), liver cancer (hazard ratio = 2.02, 95% CI: 1.21, 3.37), and infection (hazard ratio = 1.69, 95% CI: 1.24, 2.32). A substudy found only minor racial/ethnic differences in the quality of Social Security numbers, birth dates, soundex-adjusted names, and National Death Index searches. Results were not likely an artifact of return migration or incomplete mortality data.
Mei, Wei; Seeling, Matthes; Franck, Martin; Radtke, Finn; Brantner, Benedikt; Wernecke, Klaus-Dieter; Spies, Claudia
Despite advances in postoperative pain management, the proportion of patients with moderate to severe postoperative pain is still ranging 20-80%. In this retrospective study, we investigated 1736 patients to determine the incidence of postoperative pain in need of intervention (PPINI)defined as numeric rating scale >4 at rest in the post anaesthesia care unit early after awakening from general anaesthesia, and to identify possible risk factors. The proportion of patients with PPINI was 28.5%. On multivariate analysis, younger age (OR=1.300 [1.007-1.678], p=0.044), female gender (OR=1.494 [1.138-1.962], p=0.004), obesity (OR=1.683 [1.226-2.310], p=0.001), use of nitrous oxide (OR=1.621 [1.110-2.366], p=0.012), longer duration of surgery (OR=1.165 [1.050-1.292], p=0.004), location of surgery (musculoskeletal OR=2.026 [1.326-3.095], p=0.001; intraabdominal OR=1.869 [1.148-3.043], p=0.012), and ASA-PS I-II (OR=1.519 [1.131-2.039], P=0.005) were identified as independent risk factors for PPINI. Patients with PPINI experienced significantly more PONV (10.3% vs. 6.2%, p=0.003), more psychomotor agitation (5.5% vs. 2.7%, p=0.004), needed more application of opioid in PACU (62.8% vs. 24.2%, p<0.001), stayed significantly longer in PACU (89.6min [70-120] vs. 80min [60-100], p<0.001), had a longer median length of hospital stay (6.6 days [4.0-8.8] vs. 6.0 days [3.2-7.8
Chan, Ka Fai
Project finance is a financing arrangement for projects, and it is characterised by the creation of a legally independent project company financed with non- or limited recourse loans. It is observed that the popularity of project finance is increasing in the recent decades, despite of the impact of Asian financial crisis. Especially in emerging markets, project finance is very common among the public-private partnership projects. It is possible that project finance yields some benefits in pro...
Haag, Georg-Martin; Herrmann, Thomas; Jaeger, Dirk; Stremmel, Wolfgang; Schemmer, Peter; Sauer, Peter; Gotthardt, Daniel Nils
Malignant bile duct obstruction is a common problem among cancer patients with hepatic or lymphatic metastases. Endoscopic retrograde cholangiography (ERC) with the placement of a stent is the method of choice to improve biliary flow. Only little data exist concerning the outcome of patients with malignant biliary obstruction in relationship to microbial isolates from bile. Bile samples were taken during the ERC procedure in tumor patients with biliary obstruction. Clinical data including laboratory values, tumor-specific treatment and outcome data were prospectively collected. 206 ERC interventions in 163 patients were recorded. In 43 % of the patients, systemic treatment was (re-) initiated after successful biliary drainage. A variety of bacteria and fungi was detected in the bile samples. One-year survival was significantly worse in patients from whom multiresistant pathogens were isolated than in patients, in whom other species were detected. Increased levels of inflammatory markers were associated with a poor one-year survival. The negative impact of these two factors was confirmed in multivariate analysis. In patients with pancreatic cancer, univariate analysis showed a negative impact on one-year survival in case of detection of Candida species in the bile. Multivariate analysis confirmed the negative prognostic impact of Candida in the bile in pancreatic cancer patients. Outcome in tumor patients with malignant bile obstruction is associated with the type of microbial biliary colonization. The proof of multiresistant pathogens or Candida, as well as the level of inflammation markers, have an impact on the prognosis of the underlying tumor disease.
Full Text Available This study aims to identify analyze and describe the factors that affect the project maintenance delay on Harun Nafsi - HM. Rifadin Street in Samarinda East Kalimantan. This research uses qualitative research method by utilizing questionnaires. The 30 participating respondents consist of 14 project implementers and 16 field implementers. The data are analyzed by descriptive statistical technique factor analysis and linear regression analysis. The results show that the factors influencing the delay of maintenance project of Harun Nafis - HM Rifadin Street include 1 time factor and workmanship factor 2 human resources and natural factors 3 geographical conditions late approval plans change and labor strikes and 4 non-optimal working levels and changes in the scope of the project during the work are still ongoing. Based on multiple linear regression analysis coefficient of determination value of 0.824 is obtained. It means that the four factors studied affect 82.4 of project delays and the rest of 27.6 is influenced by other variables out of this study. The results of this study also indicate that the dominant factor for road maintenance project delays is the fourth factor of the factors mentioned. The effort that the contractor needs to undertake is not to expand the employment contract if the project is underway or the contractor does not have the capability to complete another project.
Full Text Available E-government implementations in developing countries still face difficulties, leading to a large failure ratio. This is too high a cost for developing countries. Analysis of the reasons behind success and failure of e-government projects is still an interesting domain of investigation. Several approaches were advanced and success and failure factors have been stipulated, but factors pertinent to Public Administration have yet to be investigated and analyzed. This work builds on the results of earlier research, analyzing the factors behind the change in performance of the different sites of a specific project, reasons of their original success, and the relapse of one site. It reviews in detail the factors advanced by previous works and integrates for the first time the results obtained by 3 different research methodologies. It clarifies the causality between different factors presumed to individually affect the e-government implementations, thus enabling the disambiguation between the main and secondary less effective causes of failure. The success and failure factors significance and relative importance are identified, revealing the recommended track of action for the set-back remedy.
St. George, Sara M.; Huang, Shi; Vidot, Denise C.; Smith, Justin D.; Brown, C. Hendricks; Prado, Guillermo
This study highlights how Familias Unidas, a Hispanic-specific, evidence-based, family centered preventive intervention, progressed from intervention development (type 1 translation; T1) through rigorous evaluation (T2) and examines the role of intervention fidelity—adherence and competence—in a T3 trial. Effects of participant, provider, and organizational variables on direct (observational) and indirect (self-reported) fidelity were examined as were effects of fidelity. Two structural equat...
Samuelsson, A; Isaksson, B; Hanberger, H; Olhager, E
Between 2006 and 2011, 11 patients with Serratia marcescens sepsis and 47 patients colonized due to the spread of various clones were observed. These recurrent clusters brought about interventions to reduce spread between patients. To evaluate the effect of stepwise interventions to prevent S. marcescens colonization/sepsis and to analyse risk factors for late-onset sepsis (LOS). An open retrospective observational study was performed to evaluate the interventions. A retrospective case-control study was performed to analyse the risk factors for LOS. S. marcescens sepsis and colonization decreased after the stepwise adoption of hygiene interventions. Low gestational age, low birth weight, indwelling central venous or umbilical catheter, and ventilator treatment were identified as risk factors for LOS. Compliance with basic hygiene guidelines was the only intervention monitored continuously from late 2007. Compliance increased gradually to a steady high level in early 2009. There was a decrease in S. marcescens LOS, clustering after the second quarter of 2008. After the first quarter of 2009, S. marcescens colonization decreased. It was not possible to identify the specific effects of each intervention, but it is likely that an update of the hospital's antibiotic policy affected the occurrence of S. marcescens LOS. The delayed effect of interventions on S. marcescens colonization was probably due to the time it takes for new routines to have an effect, illustrated by the gradual increase in compliance with basic hygiene guidelines. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Protocol for project IMPACT (improving millions hearts for provider and community transformation): a quasi-experimental evaluation of an integrated electronic health record and community health worker intervention study to improve hypertension management among South Asian patients.
Lopez, Priscilla M; Zanowiak, Jennifer; Goldfeld, Keith; Wyka, Katarzyna; Masoud, Ahmad; Beane, Susan; Kumar, Rashi; Laughlin, Phoebe; Trinh-Shevrin, Chau; Thorpe, Lorna; Islam, Nadia
The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative. Building upon this initiative, we present the protocol and preliminary results of a research study, Project IMPACT, designed to fill this gap in knowledge. Project IMPACT is a stepped wedge quasi-experimental study designed to test the feasibility, adoption, and impact of integrating CHW-led health coaching with electronic health record (EHR)-based interventions to improve hypertension control among South Asian patients in New York City primary care practices. EHR intervention components include the training and implementation of hypertension-specific registry reports, alerts, and order sets. Fidelity to the EHR intervention is assessed by collecting the type, frequency, and utilization of intervention components for each practice. CHW intervention components consist of health coaching sessions on hypertension and related risk factors for uncontrolled hypertensive patients. The outcome, hypertension control (informs the effectiveness of these interventions in team-based care approaches, thereby, helping to develop relevant sustainability strategies for improving hypertension control among targeted racial/ethnic minority populations at small primary care practices. This study protocol has been approved and is made available on Clinicaltrials.gov by NCT
Cugelman, Brian; Thelwall, Mike; Dawes, Phil
Researchers and practitioners have developed numerous online interventions that encourage people to reduce their drinking, increase their exercise, and better manage their weight. Motivations to develop eHealth interventions may be driven by the Internet's reach, interactivity, cost-effectiveness, and studies that show online interventions work. However, when designing online interventions suitable for public campaigns, there are few evidence-based guidelines, taxonomies are difficult to apply, many studies lack impact data, and prior meta-analyses are not applicable to large-scale public campaigns targeting voluntary behavioral change. This meta-analysis assessed online intervention design features in order to inform the development of online campaigns, such as those employed by social marketers, that seek to encourage voluntary health behavior change. A further objective was to increase understanding of the relationships between intervention adherence, study adherence, and behavioral outcomes. Drawing on systematic review methods, a combination of 84 query terms were used in 5 bibliographic databases with additional gray literature searches. This resulted in 1271 abstracts and papers; 31 met the inclusion criteria. In total, 29 papers describing 30 interventions were included in the primary meta-analysis, with the 2 additional studies qualifying for the adherence analysis. Using a random effects model, the first analysis estimated the overall effect size, including groupings by control conditions and time factors. The second analysis assessed the impacts of psychological design features that were coded with taxonomies from evidence-based behavioral medicine, persuasive technology, and other behavioral influence fields. These separate systems were integrated into a coding framework model called the communication-based influence components model. Finally, the third analysis assessed the relationships between intervention adherence and behavioral outcomes. The
The aim of the Nordic BER-3 project has been to harmonize the Nordic intervention levels after a nuclear accident. The paper deals with the findings and recommendations to be presented to the Nordic authorities as background material for common decisions on the most likely protective actions. In the report sheltering, evaluation and relocation are treated in detail. Iodine prophylaxis and foodstuff restrictions are briefly commented on. The basis for this work is the internationally accepted basic principles for interventions
Full Text Available Abstract Background The number of overweight children in America has doubled to an estimated 10 million in the past 20 years. Establishing healthy dietary behaviors must begin early in childhood and include parents. The Healthy Toddlers intervention focuses on promoting healthy eating habits in 1- to 3-year-old children utilizing the Social Cognitive Theory and a learner-centered approach using Adult Learning principles. This Healthy Toddlers Trial aims to determine the efficacy of a community-based randomized controlled trial of an in-home intervention with economically and educationally disadvantaged mothers of toddlers. The intervention focuses on: (a promoting healthy eating behaviors in toddlers while dietary habits are forming; and (b providing initial evidence for the potential of Healthy Toddlers as a feasible intervention within existing community-based programs. Methods/Design This describes the study protocol for a randomized control trial, a multi-state project in Colorado, Michigan, and Wisconsin with economically and educationally disadvantaged mother-toddler dyads; toddlers are between 12 and 36 months. The Healthy Toddlers intervention consists of eight in-home lessons and four reinforcement telephone contacts, focusing on fruit, vegetable, and sweetened beverage consumption and parental behaviors, taught by paraprofessional instructors. Healthy Toddlers uses a randomized, experimental, short-term longitudinal design with intervention and control groups. In-home data collection (anthropometric measurements, feeding observations, questionnaires, 3-day dietary records occurs at baseline, immediately following the intervention, and 6 months after the intervention. Main toddler outcomes include: a increased fruit and vegetable consumption and decreased sweetened beverage consumption; and b improved toddler-eating skills (self-feeding and self-serving. Main parent outcomes include: a improved psychosocial attributes (knowledge
The aims of this study were to investigate work related and individual factors as predictors of insident neck pain among video display unit (VDU) workers, to assess the effects of an ergonomic intervention and education on musculoskeletal symptoms, and to study the repeatability and validity of an expert assessment method of VDU workstation ergonomics. A method to assess the risk factors for upper limb disorders was developed, and its validity and repeatability were studied. The annual inc...
Fátima H. Cecchetto
Full Text Available Abstract Background: Childhood obesity is an important health problem worldwide. In this context, there is a need for the development and evaluation of innovative educational interventions targeting prevention and formation of health habits. Objectives: To ascertain the impact of ludic workshops on children’s knowledge, self-care, and body weight. Methods: This was a randomized, clinical study with 79 students aged 7-11 years, conducted from March to November 2012. Anthropometric measurements were collected and two questionnaires (Typical Day of Physical Activities and Food Intake, in Portuguese, and the CARDIOKIDS, a questionnaire of knowledge about cardiovascular risk factors were applied at baseline, at the end of intervention, and three months thereafter. The intervention consisted of eight playful workshops, which involved the presentation of a play. Results: Seventy-nine students were randomized to the intervention (n = 40 or the control group (n = 39. Mean age was 10.0 ± 1.1 years. After eight weeks, the intervention group showed significant improvement in the knowledge score (p < 0.001. There was an increase in physical activity scores in both groups, but with no difference between the groups at the end of intervention (p = 0.209. A reduction in the BMI percentile was observed in the intervention group, but there was no significant statistical difference between the two groups after the intervention. Conclusions: Playful interventions may improve knowledge and physical activity levels in children and, when combined with other strategies, may be beneficial to prevent child obesity and improve self-care.
Full Text Available Background: Obesity in adolescence is the strongest risk factor for obesity in adulthood. This study aimed to evaluate the effects of a comprehensive lifestyle intervention on different anthropometric indices in 12–16-year-old boy adolescents after 12 Weeks of Intervention. Methods: A total of 96 male adolescents from two schools participated in this study. The schools were randomly assigned to intervention (53 students and control school (43 students. Height and weight of students were measured and their body mass index (BMI was calculated. Body fat percent (BF and body muscle percent (BM was assessed using a bioimpedance analyzer considering the age, gender, and height of students at baseline and after intervention. The obesity reduction intervention was implemented in the intervention school based on the Ottawa charter for health promotion. Results: Twelve weeks of intervention decreased BF percent in the intervention group in comparison with the control group (decreased by 1.81% in the intervention group and increased by 0.39% in the control group, P < 0.01. However, weight, BMI, and BM did not change significantly. Conclusions: The result of this study showed that a comprehensive lifestyle intervention decreased the body fat percent in obese adolescents, although these changes was not reflected in the BMI. It is possible that BMI is not a good indicator in assessment of the success of obesity management intervention.
Full Text Available Private investors have been encouraged to participate in the development and operation of urban rail projects in China through Public-Private Partnerships (PPPs, given the fact that subnational governments are suffering from urgent development demands and severe fiscal pressure. However, there is no formal assessment to determine the private involvement in a PPP project. This problem is particularly critical in the sector of urban rail, in which the huge investment cannot rely on the private sector alone. This study hence aimed to uncover and identify the influencing factors. Multiple research methods, including content analysis, case study and focus group discussion were adopted to achieve the research purpose. Seven types of influencing factors were identified, including project financial model, government fiscal commitment, risk allocation, public accountability, efficiency considerations, policy and regulations, and organisational marketing strategies. The findings add to the current knowledge base by uncovering the drivers behind private involvement in a PPP project. They are also beneficial for industry practitioners as a basis/checklist to determine the private involvement.
Full Text Available One of the primary concerns in development of oil and gas resources is to find the critical success factors associated with different important projects. Purchasing and procurement plays a key role in these projects. There is no doubt that in history of similar studies, there are not much studies to determine key factors. The proposed study of this paper presents an empirical study to find these factors in one of the most important gas filed in Iran is now South Pars Gas Field. The study distributes a questionnaire consists of various questions associated with purchasing activities. We investigate the feedbacks gathered from decision makers using factor analysis. The results of our survey reveal that there are three categories of organizational strategy, the relative importance of strategy and risk according to factor analysis. Each factor consists of many other factors and the relative importance of all factors are investigated.
Dekkers, J.C.; Wier, M.F. van; Arins, G.A.M.; Hendriksen, I.J.M.; Pronk, N.P.; Smid, T.; Mechelen, W. van
Background: Overweight (Body Mass Index [BMI] ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) are associated with increased cardiovascular risk, posing a considerable burden to public health. The main aim of this study was to investigate lifestyle intervention effects on cardiovascular risk factors in
Bugge, Anna; Hermansen, Bianca El-Naaman; Froberg, Karsten
samples were obtained and subsequently analyzed for CVD risk factors. The intervention group (IG) had a higher increase in S4SF, but a more favorable change in WHR, systolic blood pressure and blood glucose compared to controls (CG). Furthermore IG-boys had a more favorable development in HOMA-IR compared...
Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Hernandez Robles, Eden; Heredia, Natalia; Spears, Claire A.; Correa-Fernández, Virmarie; Eakin, Elizabeth; Resnicow, Ken; Basen-Engquist, Karen; Wetter, David W.
More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social…
Kok, Maryse C; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline E W; Kane, Sumit; Ormel, Hermen; Tijm, Mandy M; de Koning, Korrie A M
Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors influence CHW performance. A systematic review was conducted to identify intervention design
Hebert, Elizabeth Baltus
Due to the numerous interventions available for children with autism, parents are faced with challenging decisions regarding treatments from the time of diagnosis and throughout their child's life. This exploratory qualitative study investigated the reasons behind parents' decisions about interventions for their child with autism. In-depth…
LU Le; HU Zhanyi
Projective reconstruction is a key step for 3D metric reconstruction from a sequence of images captured by an uncalibrated camera. Due to its inherent robustness, the factorization method is widely used in literatures. However, the main shortcoming of the standard factorization method is that it requires the corresponding points to appear across ALL the images. When large changes of view angles occur in the image sequence, or the scene is easy to be self-occluded, nearly it will be very difficult to have some corresponding points visible across all the images. But it is much easier for only several images to have enough correspondences required by factorization method. These images are called as a subsequence in the whole image set. In this paper,a sub-sequence factorization method is proposed to cope with the problem. The basic principle of the sub-sequence factorization method is to divide a long image sequence into several short subsequences according to its spatial continuity, and the standard factorization method is employed for each subsequence.Then, a novel alignment process is invoked to transform different reconstructions under different subsequences into one reference coordinates system. It is more practical as it only demands that there are enough correspondences in each subsequence, not the whole sequence. The proposed sub-sequence factorization method preserves the robustness aspect embedded in the standard factorization method. The experiments on synthetic and real images validate our proposed new method.
The Texas Childhood Obesity Research Demonstration project (TX CORD) uses a systems-oriented approach to address obesity that includes individual and family interventions, community-level action, as well as environmental and policy initiatives. Given that randomization is seldom possible in communit...
Ingabire, Chantal Marie; Hakizimana, Emmanuel; Kateera, Fredrick; Rulisa, Alexis; Van Den Borne, Bart; Nieuwold, Ingmar; Muvunyi, Claude; Koenraadt, Constantianus J M; Van Vugt, Michele; Mutesa, Leon; Alaii, Jane
Active community participation in malaria control is key to achieving malaria pre-elimination in Rwanda. This paper describes development, implementation and evaluation of a community-based malaria elimination project in Ruhuha sector, Bugesera district, Eastern province of Rwanda. Guided by an intervention mapping approach, a needs assessment was conducted using household and entomological surveys and focus group interviews. Data related to behavioural, epidemiological, entomological and economical aspects were collected. Desired behavioural and environmental outcomes were identified concurrently with behavioural and environmental determinants. Theoretical methods and their practical applications were enumerated to guide programme development and implementation. An operational plan including the scope and sequence as well as programme materials was developed. Two project components were subsequently implemented following community trainings: (1) community malaria action teams (CMATs) were initiated in mid-2014 as platforms to deliver malaria preventive messages at village level, and (2) a mosquito larval source control programme using biological substances was deployed for a duration of 6 months, implemented from January to July 2015. Process and outcome evaluation has been conducted for both programme components to inform future scale up. The project highlighted malaria patterns in the area and underpinned behavioural and environmental factors contributing to malaria transmission. Active involvement of the community in collaboration with CMATs contributed to health literacy, particularly increasing ability to make knowledgeable decisions in regards to malaria prevention and control. A follow up survey conducted six months following the establishment of CMATs reported a reduction of presumed malaria cases at the end of 2014. The changes were related to an increase in the acceptance and use of available preventive measures, such as indoor residual spraying and
Stanton, Michael; Robinson, Jennifer; Kirkpatrick, Susan; Farzinkhou, Sarah; Avery, Erin; Rigdon, Joseph; Offringa, Lisa; Trepanowski, John; Hauser, Michelle; Hartle, Jennifer; Cherin, Rise; King, Abby C.; Ioannidis, John P.A.; Desai, Manisha; Gardner, Christopher D.
Numerous studies have attempted to identify successful dietary strategies for weight loss, and many have focused on Low-Fat vs. Low-Carbohydrate comparisons. Despite relatively small between-group differences in weight loss found in most previous studies, researchers have consistently observed relatively large between-subject differences in weight loss within any given diet group (e.g., ~25 kg weight loss to ~5 kg weight gain). The primary objective of this study was to identify predisposing individual factors at baseline that help explain differential weight loss achieved by individuals assigned to the same diet, particularly a pre-determined multi-locus genotype pattern and insulin resistance status. Secondary objectives included discovery strategies for further identifying potential genetic risk scores. Exploratory objectives included investigation of an extensive set of physiological, psychosocial, dietary, and behavioral variables as moderating and/or mediating variables and/or secondary outcomes. The target population was generally healthy, free-living adults with BMI 28-40 kg/m2 (n=600). The intervention consisted of a 12-month protocol of 22 one-hour evening instructional sessions led by registered dietitians, with ~15-20 participants/class. Key objectives of dietary instruction included focusing on maximizing the dietary quality of both Low-Fat and Low-Carbohydrate diets (i.e., Healthy Low-Fat vs. Healthy Low-Carbohydrate), and maximally differentiating the two diets from one another. Rather than seeking to determine if one dietary approach was better than the other for the general population, this study sought to examine whether greater overall weight loss success could be achieved by matching different people to different diets. Here we present the design and methods of the study. PMID:28027950
Stanton, Michael V; Robinson, Jennifer L; Kirkpatrick, Susan M; Farzinkhou, Sarah; Avery, Erin C; Rigdon, Joseph; Offringa, Lisa C; Trepanowski, John F; Hauser, Michelle E; Hartle, Jennifer C; Cherin, Rise J; King, Abby C; Ioannidis, John P A; Desai, Manisha; Gardner, Christopher D
Numerous studies have attempted to identify successful dietary strategies for weight loss, and many have focused on Low-Fat vs. Low-Carbohydrate comparisons. Despite relatively small between-group differences in weight loss found in most previous studies, researchers have consistently observed relatively large between-subject differences in weight loss within any given diet group (e.g., ~25kg weight loss to ~5kg weight gain). The primary objective of this study was to identify predisposing individual factors at baseline that help explain differential weight loss achieved by individuals assigned to the same diet, particularly a pre-determined multi-locus genotype pattern and insulin resistance status. Secondary objectives included discovery strategies for further identifying potential genetic risk scores. Exploratory objectives included investigation of an extensive set of physiological, psychosocial, dietary, and behavioral variables as moderating and/or mediating variables and/or secondary outcomes. The target population was generally healthy, free-living adults with BMI 28-40kg/m 2 (n=600). The intervention consisted of a 12-month protocol of 22 one-hour evening instructional sessions led by registered dietitians, with ~15-20 participants/class. Key objectives of dietary instruction included focusing on maximizing the dietary quality of both Low-Fat and Low-Carbohydrate diets (i.e., Healthy Low-Fat vs. Healthy Low-Carbohydrate), and maximally differentiating the two diets from one another. Rather than seeking to determine if one dietary approach was better than the other for the general population, this study sought to examine whether greater overall weight loss success could be achieved by matching different people to different diets. Here we present the design and methods of the study. Copyright © 2016 Elsevier Inc. All rights reserved.
Sullivan, Michael J L; Adams, Heather; Rhodenizer, Trina; Stanish, William D
The objective of this study was to determine whether the addition of a psychosocial intervention improved return-to-work rates beyond those associated with participation in a functional restoration physical therapy intervention. Subjects who had sustained whiplash injuries participated in the Progressive Goal Attainment Program (PGAP), which is a 10-week psychosocial intervention program that aims to increase activity involvement and minimize psychological barriers to rehabilitation progress. A sample of 60 subjects enrolled in a functional restoration physical therapy intervention were used as a historical cohort comparison group. Subjects who received the functional restoration physical therapy intervention were compared with a sample of 70 subjects who received PGAP in addition to physical therapy. Participation in PGAP plus physical therapy resulted in a higher return-to-work rate (75%) than participation in physical therapy alone (50%). Differences between treatment conditions were most pronounced for the subgroup of subjects who had the largest number of psychosocial risk factors. The findings suggest that a psychosocial risk reduction intervention can be an effective means of improving function and facilitating return to work in people who are at risk for prolonged pain-related disability.
Diab, Marwan; Peltonen, Kirsi; Qouta, Samir R; Palosaari, Esa; Punamäki, Raija-Leena
The study examines, first, the effectiveness of a psychosocial intervention based on Teaching Recovery Techniques (TRT) to increase resiliency among Palestinian children, exposed to a major trauma of war. Second, it analyses the role of family factors (maternal attachment and family atmosphere) as moderating the intervention impacts on resilience. School classes in Gaza were randomized into intervention (N=242) and control (N=240) groups. The percentage of girls (49.4%) and boys (50.6%) were equal, and the child age was 10-13 years in both groups. Children reported positive indicators of their mental health (prosocial behaviour and psychosocial well-being) at baseline (T1), post-intervention (T2) and at a six-month follow-up (T3). At T1 they accounted their exposure to war trauma. Mothers reported about their willingness to serve as an attachment figure, and the child reported about the family atmosphere. Resilience was conceptualized as a presence of positive indications of mental health despite trauma exposure. Against our hypothesis, the intervention did not increase the level of resilience statistically significantly, nor was the effect of the intervention moderated by maternal attachment responses or family atmosphere. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kandula, Namratha R; Patel, Yasin; Dave, Swapna; Seguil, Paola; Kumar, Santosh; Baker, David W; Spring, Bonnie; Siddique, Juned
Disseminating and implementing evidence-based, cardiovascular disease (CVD) prevention lifestyle interventions in community settings and in ethnic minority populations is a challenge. We describe the design and methods for the South Asian Heart Lifestyle Intervention (SAHELI) study, a pilot study designed to determine the feasibility and initial efficacy of a culturally-targeted, community-based lifestyle intervention to improve physical activity and diet behaviors among medically underserved South Asians (SAs). Participants with at least one CVD risk factor will be randomized to either a lifestyle intervention or a control group. Participants in both groups will be screened in a community setting and receive a primary care referral after randomization. Intervention participants will receive 6weeks of group classes, followed by 12weeks of individual telephone support where they will be encouraged to initiate and maintain a healthy lifestyle goal. Control participants will receive their screening results and monthly mailings on CVD prevention. Primary outcomes will be changes in moderate/vigorous physical activity and saturated fat intake between baseline, 3-, and 6-month follow-up. Secondary outcomes will be changes in weight, clinical risk factors, primary care visits, self-efficacy, and social support. This study will be one of the first to pilot-test a lifestyle intervention for SAs, one of the fastest growing racial/ethnic groups in the U.S. and one with disparate CVD risk. Results of this pilot study will provide preliminary data about the efficacy of a lifestyle intervention on CVD risk in SAs and inform community-engaged CVD prevention efforts in an increasingly diverse U.S. population. © 2013.
Gil, Andrés G; Wagner, Eric F; Tubman, Jonathan G
This study presents preliminary analyses examining the effects of an alcohol and other drug use (AOD) intervention with minority juvenile offenders. Furthermore, the study investigates the impact of cultural factors on baseline AOD use among Hispanic and African American youth, as well as on treatment outcome. Participants were 213 juvenile offenders referred for treatment (mean age = 15.7 years), 97 of whom have completed treatment to date. The intervention was carried out in clinics placed within the neighborhoods in which the participants resided. Intervention Alcohol Treatment Targeting Adolescents in Need (ATTAIN) is a controlled clinical trial evaluating the effectiveness of a brief motivational, cognitive behavioral intervention, guided self-change (GSC). Participants are assigned randomly to the individual format of guided self-change (I-GSC), the family involved format of guided self-Change (F-GSC), choice of one of these two, or a waiting list control condition. Only participants involved in active intervention are included in the present report. Data were collected via structured face-to-face interviews. Alcohol and marijuana use measures were collected using the Time-line Follow-back interview (TLFB). There were significant reductions in alcohol and marijuana use for all ethnic groups from baseline to post-intervention. Cultural factors (discrimination, acculturation, ethnic pride and cultural mistrust) were associated with pre-intervention levels of alcohol and marijuana use. Among Hispanics, pre-intervention level of substance use were higher among foreign-born than US-born youth. Analyses conducted with the US-born Hispanic group showed that ethnic orientation and ethnic pride were associated positively with greater reductions in alcohol use. The intervention provided through ATTAIN appears to be effective with a multi-ethnic population of juvenile delinquents. Cultural factors, such as ethnic orientation and ethnic mistrust, appear to constitute
Jardi Besa, X.; Munoz Cervantes, A.
At the onset of nuclear projects in Spain, there was an import of nuclear technology. In a second phase, there was a transfer of technology. Subsequently, there was an adaptation of the technology. In this evolution, comparable to that of other countries, were involved several countries, overcoming the difficulties of human factors involved. The current nuclear projects multinationals have a new difficulty: the different industrial technological environments. This paper will address the organizational challenges of multinational engineering projects, in the type of project and the human factors of the participating companies.
Moos, Rudolf H
Between 7% and 15% of individuals who participate in psychosocial interventions for substance use disorders may be worse off after treatment than before. Intervention-related predictors of iatrogenic effects include lack of bonding; lack of goal direction and monitoring; confrontation, criticism, and high emotional arousal; models and norms for substance use; and stigma and inaccurate expectations. Life context and personal predictors include lack of support, criticism, and more severe substance use and psychological problems. Ongoing monitoring and safety standards are needed to identify and counteract adverse consequences of intervention programs.
Oikarinen, Anne; Engblom, Janne; Kääriäinen, Maria; Kyngäs, Helvi
Since a history of stroke or transient ischaemic attack is a major risk factor for a recurrent event, lifestyle counselling during the hospital phase is an essential component of treatment and may increase the probability of lifestyle change. To study the effect of risk factor-targeted lifestyle counselling intervention on working-age stroke patients' adherence to lifestyle changes. A quasi-experimental, nonequivalent control group pretest-post-test design. Stroke patients in an acute neurological unit were divided into a control group (n = 75) receiving standard counselling and an experimental group (n = 75) receiving risk factor-targeted counselling. Lifestyle data and clinical outcomes were collected at hospital between January 2010 and October 2011, while data on adherence to lifestyle changes 3, 6, and 12 months after discharge. The baseline lifestyle habits did not differ significantly other than in alcohol behaviour. Both groups increased their intake, but the intervention group to a lesser degree. However, the experimental group significantly lost their weight for the first 3 and 6 months; at 3 months reduction in cigarette consumption and at 6 months significant increases in smoking cessation were also achieved. All improved some of their lifestyle habits. Intervention was associated with support from nurses as well as from family and friends. Adherence scores were higher in the experimental group. Some short-term advantages in lifestyle habits due to the intervention were noted. Participants in both groups improved some of their lifestyle habits. © 2016 Nordic College of Caring Science.
Full Text Available Objectives: Falls and fall-related physiological and psychological events are major problems for elderly people. The objective of this research was to examine the effect of an interventional training program on fall-related psychological factors among the elderly men in Arak. Methods & Materials: In this quasi experiment research on male older adults in Arak, 27 participants randomly assigned to Control group (mean age=70.21±6.65 and Experimental group (mean age=66.07±4.38. Experimental group members participated in a 12 week interventional training program. Results: The findings showed that training intervention program improved fall-related psychological factors (Fall Self-Efficacy/Fear of Fall and Activities-specific Balance Confidence/Balance Self-Efficacy in experimental group. No significant changes appeared in fall-related psychological factors in control group members who did not perform any regular training program. Conclusion: According to the findings, regular interventional training program can decrease fear of fall and increase balance confidence in performing the activities of everyday life by improving physical and motor fitness levels. These improvements can lead to physical and psychological health, increase in quality of life among older adults, and eventually successful aging.
Sedentariness and physical inactivity are often reported within white-collar workers, including university campus employees. However, the prevalence of the associated sedentary risk factors and risk reduction intervention strategies within a university campus workplace are less known. This study investigates whether the prevalence of sedentary risk factors within university campus employees could be reduced with a campus based exercise intervention. 56 UK university employees (age = 50.7 ± 10.2, stature = 1.68.8 ± 8.6, body mass = 73.9 ± 15.1) were tested for body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and maximal cardiorespiratory capacity (V̇O2max). The prevalence was analyzed across genders and job roles. An exercise intervention followed for the sedentary employees involving walking and running for 25 min twice/week for 10 weeks at an intensity corresponding to individual's ventilatory threshold (VT). The university workplace demonstrated a prevalence of higher BMI, SBP and DBP than the recommended healthy thresholds, with gender having a significant effect. Males' BMI, SBP and DBP were higher than in females (p employees have a high prevalence of sedentary risk factors across different genders and job roles. These risks can be reduced by an exercise-based intervention administered within the campus workplace, which should be considered in university workplace policies.
Shan Hong; Huang Mingsheng; Jiang Zaipo; Zhu Kangshun; Yang Yang; Chen Guihua
Objective: To investigate the prognosis and prognostic risk factors of hepatic artery complications after orthotopic liver transplantation (OLT) treated with the interventional techniques. Methods: The clinical data of 21 patients with hepatic artery complication after liver transplantation receiving thrombolysis, PTA, and stent placement in our institute from November 2003 to April 2007 were retrospectively analyzed. Based on the prognosis of grafts, 21 patients were divided into poor-prognosis group and non-poor-prognosis group. Fifteen variables (including biliary complication, hepatic artery restenosis, early or late artery complication, and so on) were analyzed in both groups with binary logistic regression analysis to screen out the risk factors related to prognosis of pereutaneous interventional treatment for hepatic artery complications after OLT. Results: Twenty-one patients were followed for mean 436 days, median 464 days (3-1037 days). The poor-prognosis group included 11 patients (5 cases received retransplantation, and 6 died). The mean survival time of grafts in poor-prognosis group was 191 days, and median survival time was 73 days (3-616 days). The mean survival time of grafts in non-poor-prognosis group which included 10 patients was 706 days, and median survival time was 692 days (245-1037 days). Univariate analysis showed there were significant difference in biliary complication, total bilimbin and indirect bilirubin between the two groups. The binary, logistic regression analysis showed the risk factor related to prognosis was with biliary complication before the interventional management (P=0.027, OR=22.818). Conclusion: Biliary complication before interventional management is the risk factor related to poor prognosis of patients with hepatic artery stenosis or thrombosis receiving interventional treatment. (authors)
Memon, N.A.; Memon, F.A.
Generation of construction waste is a worldwide issue that concerns not only governments but also the building actors involved in construction industry. For developing countries like Pakistan, rising levels of waste generation, due to the rapid growth of towns and cities have become critical issue. Therefore this study is aimed to detect the factors, which are the main causes of construction waste generation. Questionnaire survey has been conducted to achieve this task and RIW (Relative Importance Weight) method has been used to analyze the results of this study. The important factors contributing to the generation of construction as identified in this study are: frequent changes/ revision in design during construction process; poor scheduling; unavailability of storage; poor workmanship; poor layout; inefficient planning and scheduling of resources and lack of coordination among supervision staff deployed at site. Based on the identified factors, the study also has presented some suggestions for the reduction of construction waste in building construction projects of Pakistan. (author)
DING Zhi-kun; NG Fung-fai; WANG Jia-yuan
This paper describes a structural equation modeling (SEM) analysis of factors influencing architects' trust in project design teams. We undertook a survey of architects, during which we distributed 193 questionnaires in 29 A-level architectural We used Amos 6.0 for SEM to identify significant personal construct based factors affecting interpersonal trust. The results show that only social interaction between architects significantly affects their interpersonal trust. The explained variance of trust is not very high in the model. Therefore, future research should add more factors into the current model. The practical implication is that team managers should promote the social interactions between team members such that the interpersonal trust level between team members can be improved.
Zhang Fang-Fang; Liu Shu-Tang; Yu Wei-Yong
To increase the variety and security of communication, we present the definitions of modified projective synchronization with complex scaling factors (CMPS) of real chaotic systems and complex chaotic systems, where complex scaling factors establish a link between real chaos and complex chaos. Considering all situations of unknown parameters and pseudo-gradient condition, we design adaptive CMPS schemes based on the speed-gradient method for the real drive chaotic system and complex response chaotic system and for the complex drive chaotic system and the real response chaotic system, respectively. The convergence factors and dynamical control strength are added to regulate the convergence speed and increase robustness. Numerical simulations verify the feasibility and effectiveness of the presented schemes. (general)
Full Text Available Public Private Partnership (PPP Housing scheme in Nigeria is intended to complement government effort toward increasing housing stock and providing affordable housing in the country. However, Bauchi state government adopted the construction of 5,000 phases PPP Housing. But 6 years after the commencement of the scheme, only a few numbers of housing units were completed and commissioned. Therefore, it becomes imperative to carry out research on the impact level of those factors affecting the implementation of the scheme. The aim of the study is to investigate impact level of factors affecting the implementation of PPP housing projects in Bauchi state with a view to find out possible ways that will improve the implementation of the scheme. The descriptive and explorative research design was adopted for this study. 54 structured Questionnaires were administered to construction professional’s staff under private housing developers and relevant government agencies in Bauchi state. 42 valid Questionnaires were retrieved and analysed with SPSS software. The result of the quantitative data analysis shows that creation of favourable investment environment and government support have very high Impact on the implementation of Bauchi PPP housing projects. Therefore, this study recommends that government and other stakeholders should give more attention to the creation of favourable investment environment, support in policy formulation and managerial strategies in the future for improving the implementation of PPP housing projects.
Francisca NEGRE BENNASAR
Full Text Available This paper presents an experience in Hospital Pedagogy organized by the University of the Balearic Islands. This project is called INEDITHOS and its main objective is to work into improve the quality of life of children and youth with Rare Diseases. The project works in three lines of intervention: psycho-pedagogical support to patients and their families, research to respond to the needs that are detected in this area and the training of university students who collaborates in the project, using the Service Learning methodology. The long trajectory of the project that began in 2003 has made it possible to consolidate the three interventions resulting in a non-profit association with the same name. This result is complemented by the growing involvement of other Associations such as ABAIMAR and FEDER with which close collaboration is maintained. It is also worth noting the increase in the number of volunteers, which allows to offer attention to a higher number of affected while improving the quality of the interventions made thanks to the collaboration and involvement of students and teachers who, through the methodology of Learning and Service, carry out activities and elaborate end-of-degree and master’s work based on the needs identified in the volunteer interventions. INEDITHOS has introduced Rare Diseases in the university context sensitizing a large part of the Educational Community.
Full Text Available The paper first presents basic information about the Scrum method. Then it summarizes the state of art in the domain of Scrum implementation, especially as far as the critical factors of its success are concerned. On the basis of literature survey a new model classifying Scrum implementation critical factors is proposed. The model divides Scrum implementation critical factors into five categories: Project Team factors, Psychological and cultural factors, Process and Method, Environment and Technology. The model is then developed and verified using the case study method. The research was carried out in a French IT company by means of a participating observation. The company was implementing Scrum, which ended up as a success. A journal of the Scrum implementation was conducted, presenting the experiences of the Scrum Team, their opinions and changes in the Scrum method which were introduced. On its basis critical factors, crucial for the success of Scrum implementation, classified according to the above mentioned model, were identified, completing those which had been found in the literaturę.
This study investigated the rate of success for IT projects using agile and standard project management methodologies. Any successful project requires use of project methodology. Specifically, large projects require formal project management methodologies or models, which establish a blueprint of processes and project planning activities. This…
Full Text Available End-stage kidney disease is a strong risk factor for cardiovascular-specific mortality. Polyphenol-rich interventions may attenuate cardiovascular disease risk factors; however, this has not been systematically evaluated in the hemodialysis population. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines, the following databases were searched: Cochrane Library (http://www.cochranelibrary.com/, MEDLINE (https://health.ebsco.com/products/medline-with-full-text, Embase (https://www.elsevier.com/solutions/embase-biomedical-research, and CINAHL (https://www.ebscohost.com/nursing/products/cinahl-databases/cinahl-complete. Meta-analyses were conducted for measures of lipid profile, inflammation, oxidative stress, and blood pressure. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool and quality of the body of evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE methodology. Twelve studies were included for review. Polyphenol-rich interventions included soy, cocoa, pomegranate, grape, and turmeric. Polyphenol-rich interventions significantly improved diastolic blood pressure (Mean Difference (MD −5.62 mmHg (95% Confidence Interval (CI −8.47, −2.78; I2 = 2%; p = 0.0001, triglyceride levels (MD −26.52 mg/dL (95% CI −47.22, −5.83; I2 = 57%; p = 0.01, and myeloperoxidase (MD −90.10 (95% CI −135.84, −44.36; I2 = 0%; p = 0.0001. Included studies generally had low or unclear risks of bias. The results of this review provide preliminary support for the use of polyphenol-rich interventions for improving cardiovascular risk markers in haemodialysis patients. Due to the limited number of studies for individual polyphenol interventions, further studies are required to provide recommendations regarding individual polyphenol intervention and dose.
Marx, Wolfgang; Kelly, Jaimon; Marshall, Skye; Nakos, Stacey; Campbell, Katrina; Itsiopoulos, Catherine
End-stage kidney disease is a strong risk factor for cardiovascular-specific mortality. Polyphenol-rich interventions may attenuate cardiovascular disease risk factors; however, this has not been systematically evaluated in the hemodialysis population. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the following databases were searched: Cochrane Library (http://www.cochranelibrary.com/), MEDLINE (https://health.ebsco.com/products/medline-with-full-text), Embase (https://www.elsevier.com/solutions/embase-biomedical-research), and CINAHL (https://www.ebscohost.com/nursing/products/cinahl-databases/cinahl-complete). Meta-analyses were conducted for measures of lipid profile, inflammation, oxidative stress, and blood pressure. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool and quality of the body of evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Twelve studies were included for review. Polyphenol-rich interventions included soy, cocoa, pomegranate, grape, and turmeric. Polyphenol-rich interventions significantly improved diastolic blood pressure (Mean Difference (MD) -5.62 mmHg (95% Confidence Interval (CI) -8.47, -2.78); I ² = 2%; p = 0.0001), triglyceride levels (MD -26.52 mg/dL (95% CI -47.22, -5.83); I ² = 57%; p = 0.01), and myeloperoxidase (MD -90.10 (95% CI -135.84, -44.36); I ² = 0%; p = 0.0001). Included studies generally had low or unclear risks of bias. The results of this review provide preliminary support for the use of polyphenol-rich interventions for improving cardiovascular risk markers in haemodialysis patients. Due to the limited number of studies for individual polyphenol interventions, further studies are required to provide recommendations regarding individual polyphenol intervention and dose.
Full Text Available The projects of Knowledge Management in the consulting industry have become a necessity to obtain sustainable competitive advantages. Between all the factors that influence in the success of a Knowledge Management project, the strategic ones have a decisive weight according to existing literature. Although many studies raise the issue of strategy’s influence on Knowledge Management success, few have measured them. This paper aims to identify the elements that configure the strategic dimension and measure its contribution in order to maximize the profit. The research methodology is based on a Structural Equation Model to validate the hypothesis. The findings highlight the huge influence of strategy in Knowledge Management project’s success in the consultancy industry.
Ellen, Jonathan M; Greenberg, Lauren; Willard, Nancy; Korelitz, James; Kapogiannis, Bill G; Monte, Dina; Boyer, Cherrie B; Harper, Gary W; Henry-Reid, Lisa M; Friedman, Lawrence B; Gonin, René
With the emphasis on structural-level interventions that target social determinants of human immunodeficiency virus (HIV) transmission to curb the HIV epidemic, there is a need to develop evaluation models that can detect changes in individual factors associated with HIV-related structural changes. To describe whether structural changes developed and achieved by community coalitions are associated with an effect on individual factors associated with the risk of contracting HIV. In this serial cross-sectional survey design, data were collected from 8 cities during 4 rounds of annual surveys from March 13, 2007, through July 29, 2010. Study recruitment took place at venues where the population of focus was known to congregate, such as clubs, bars, community centers, and low-income housing. The convenience sample of at-risk youth (persons aged 12-24 years) included 5337 individuals approached about the survey and 3142 (58.9%) who were screened for eligibility. Of the 2607 eligible participants, 2559 (98.2%) ultimately agreed to participate. Achievement of locally identified structural changes that targeted public and private entities (eg, federal agencies, homeless shelters, and school systems) with the goal of fostering changes in policy and practice to ultimately facilitate positive behavioral changes aimed at preventing HIV. Number of sexual partners, partner characteristics, condom use, and history of sexually transmitted infections and HIV testing. Exposure to structural changes was not statistically significantly associated with any of the outcome measures, although some results were in the direction of a positive structural change effect (eg, a 10-unit increase in a structural change score had an odds ratio of 0.88 [95% CI, 0.76-1.03; P = .11] for having an older sexual partner and an odds ratio of 0.91 [95% CI, 0.60-1.39; P = .39] for using a condom half the time or less with a casual partner). This study evaluated a broad representation of at
De Cocker, Katrien; De Bourdeaudhuij, Ilse; Cardon, Greet; Vandelanotte, Corneel
Office workers demonstrate high levels of sitting on workdays. As sitting is positively associated with adverse health risks in adults, a theory-driven web-based computer-tailored intervention to influence workplace sitting, named 'Start to Stand,' was developed. The intervention was found to be effective in reducing self-reported workplace sitting among Flemish employees. The aim of this study was to investigate through which mechanisms the web-based computer-tailored intervention influenced self-reported workplace sitting. Employees (n = 155) participated in a clustered randomised controlled trial and reported socio-demographics (age, gender, education), work-related (hours at work, employment duration), health-related (weight and height, workplace sitting and physical activity) and psychosocial (knowledge, attitudes, self-efficacy, social support, intention regarding (changing) sitting behaviours) variables at baseline and 1-month follow-up. The product-of-coefficients test of MacKinnon based on multiple linear regression analyses was conducted to examine the mediating role of five psychosocial factors (knowledge, attitudes, self-efficacy, social support, intention). The influence of one self-regulation skill (action planning) in the association between the intervention and self-reported workplace sitting time was investigated via moderation analyses. The intervention had a positive influence on knowledge (p = 0.040), but none of the psychosocial variables did mediate the intervention effect on self-reported workplace sitting. Action planning was found to be a significant moderator (p workplace sitting only occurred in the group completing an action plan. Future interventions aimed at reducing employees' workplace sitting are suggested to focus on self-regulatory skills and promote action planning when using web-based computer-tailored advice. Clinicaltrials.gov NCT02672215 ; (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT02672215 ).
Luchsinger, José; Mittelman, Mary; Mejia, Miriam; Silver, Stephanie; Lucero, Robert J; Ramirez, Mildred; Kong, Jian; Teresi, Jeanne A
Dementia prevalence and its burden on families are increasing. Caregivers of persons with dementia have more depression and stress than the general population. Several interventions have proven efficacy in decreasing depression and stress in selected populations of caregivers. Hispanics in New York City tend to have a higher burden of dementia caregiving compared to non-Hispanic whites (NHW) because Hispanics have a higher prevalence of dementia, tend to have high family involvement, and tend to have higher psychosocial and economic stressors. Thus, we chose to test the effectiveness of a dementia caregiving intervention, the New York University Caregiver Intervention (NYUCI), with demonstrated efficacy in spouse caregivers in Hispanic relative caregivers of persons with dementia. Including the community health worker (CHW) intervention in both arms alleviates general psychosocial stressors and allows the assessment of the effectiveness of the intervention. Compared to two original efficacy studies of the NYUCI, which included only spouse caregivers, our study includes all relative caregivers, including common law spouses, children, siblings, a nephew and nieces. This study will be the first randomised trial to test the effectiveness of the NYUCI in Hispanic caregivers including non-spouses. The design of the study is a randomised controlled trial (RCT). Participants are randomised to two arms: case management by a CHW and an intervention arm including the NYUCI in addition to case management by the CHW. The duration of intervention is 6 months. The main outcomes in the trial are changes in the Geriatric Depression Scale (GDS) and the Zarit Caregiver Burden Scale (ZCBS) from baseline to 6 months. This trial is approved by the Columbia University Medical Center Institutional Review Board (AAAI0022), and funded by the National Institute on Minority Health and Health Disparities. The funding agency has no role in dissemination. www.ClinicalTrials.gov NCT01306695.
Draper, Catherine E; Micklesfield, Lisa K; Kahn, Kathleen; Tollman, Stephen M; Pettifor, John M; Dunger, David B; Norris, Shane A
South Africa (SA) is undergoing multiple transitions with an increasing burden of non-communicable diseases and high levels of overweight and obesity in adolescent girls and women. Adolescence is key to addressing trans-generational risk and a window of opportunity to intervene and positively impact on individuals' health trajectories into adulthood. Using Intervention Mapping (IM), this paper describes the development of the Ntshembo intervention, which is intended to improve the health and well-being of adolescent girls in order to limit the inter-generational transfer of risk of metabolic disease, in particular diabetes risk. This paper describes the application of the first four steps of IM. Evidence is provided to support the selection of four key behavioural objectives: viz. to eat a healthy, balanced diet, increase physical activity, reduce sedentary behaviour, and promote reproductive health. Appropriate behaviour change techniques are suggested and a theoretical framework outlining components of relevant behaviour change theories is presented. It is proposed that the Ntshembo intervention will be community-based, including specialist adolescent community health workers who will deliver a complex intervention comprising of individual, peer, family and community mobilisation components. The Ntshembo intervention is novel, both in SA and globally, as it is: (1) based on strong evidence, extensive formative work and best practice from evaluated interventions; (2) combines theory with evidence to inform intervention components; (3) includes multiple domains of influence (community through to the individual); (4) focuses on an at-risk target group; and (5) embeds within existing and planned health service priorities in SA.
İbrahim H. Seyrek
Full Text Available Based on 145 process innovation teams, we have studied factors supporting team learning and their impact on the success of the process innovation projects. As a result, we have found that team vision, recording and reviewing project related information, filing, following a structural development process and co-location of team members are factors supporting team learning and project success. Also, two dimensions of learning, information acquisition and information implementation, are positively related to the success of the process innovation projects
Rasmussen, Troels A.; Merritt, Timothy R.
CNC cutting machines have become essential tools for designers and architects enabling rapid prototyping, model-building and production of high quality components. Designers often cut from new materials, discarding the irregularly shaped remains. We introduce ProjecTables, a visual augmented...... reality system for interactive packing of model parts onto sheet materials. ProjecTables enables designers to (re)use scrap materials for CNC cutting that would have been previously thrown away, at the same time supporting aesthetic choices related to wood grain, avoiding surface blemishes, and other...... relevant material properties. We conducted evaluations of ProjecTables with design students from Aarhus School of Architecture, demonstrating that participants could quickly and easily place and orient model parts reducing material waste. Contextual interviews and ideation sessions led to a deeper...
Vallès-Fernandez, Roser; Rosell-Murphy, Magdalena; Correcher-Aventin, Olga; Mengual-Martínez, Lucas; Aznar-Martínez, Núria; Prieto-De Lamo, Gemma; Franzi-Sisó, Alícia; Puig-Manresa, Jordi; Ma Bonet-Simó, Josep
Different studies have shown insufficient blood pressure (BP) control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT) with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. multicentric study quasi-experimental before - after with control group. The non-randomised allocation of the intervention will be done at PHCT level. 18 PHCT in the Barcelona province (Spain). all patients with a diagnosis of hypertension (population based study). patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure). The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non-normally distributed variables. Significance level (alpha) will be set at improvement plan might benefit the coordination of different professionals of
Full Text Available Abstract Background Different studies have shown insufficient blood pressure (BP control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. Methods and design Design: multicentric study quasi-experimental before – after with control group. The non-randomised allocation of the intervention will be done at PHCT level. Setting: 18 PHCT in the Barcelona province (Spain. Sample: all patients with a diagnosis of hypertension (population based study. Exclusion criteria: patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. Intervention: a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. Measurements: age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure. The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Analysis: Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non
Zubair Ahmed Memon
Full Text Available Many studies have shown that the construction industry one of the most hazardous industries with its high rates of fatalities and injuries and high financial losses incurred through work related accident. To reduce or overcome the safety issues on construction sites, different safety programs are introduced by construction firms. A questionnaire survey study was conducted to highlight the influence of the Construction Safety Factors on safety program implementation. The input from the questionnaire survey was analyzed by using AIM (Average Index Method and rank correlation test was conducted between different groups of respondents to measure the association between different groups of respondent. The finding of this study highlighted that management support is the critical factor for implementing the safety program on projects. From statistical test, it is concluded that all respondent groups were strongly in the favor of management support factor as CSF (Critical Success Factor. The findings of this study were validated on selected case studies. Results of the case studies will help to know the effect of the factors on implementing safety programs during the execution stage.
Hallam, Rena A.; Rous, Beth; Grove, Jaime; LoBianco, Tony
Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party…
Sin, Jacqueline; Henderson, Claire; Pinfold, Vanessa; Norman, Ian
Siblings of individuals with first episode psychosis are natural partners to promote service users' recovery and are themselves vulnerable to mental ill health due to the negative impact of psychosis within the family. This study aims to develop and undertake a preliminary evaluation of the efficacy of an online multi-component psychoeducational intervention for siblings of individuals with first episode psychosis. The impetus for the intervention arose from siblings' expressed needs for peer support and information on psychosis, coping and management strategies for common symptoms and ways to promote recovery. The project design draws on the Medical Research Council framework for the design and evaluation of complex interventions. Mixed methods comprising collection of qualitative focus group data, systematic review and expert advisory group consultation are used to develop the theoretical basis for and design of the intervention. This protocol focuses on the modelling and piloting phase which uses a randomised controlled trial with factorial design to test the efficacy of the intervention. Outcome data on participants' mental wellbeing, knowledge, perceived self-efficacy and experiences of caregiving will be assessed at baseline, at end of the intervention (10 weeks later) and at 10 week follow-up. In addition, a post-intervention semi-structured interview with 20% of the participants will explore their experiences and acceptability of the intervention. This multi-component online psychoeducational intervention aims to enhance siblings' knowledge about psychosis and their coping capacity, thus potentially improving their own mental wellbeing and promoting their contribution to service users' recovery. The factorial design randomised controlled trial with a supplementary process evaluation using semi-structured interviews and usage-monitoring will collect preliminary evidence of efficacy, feasibility and acceptability, as well as feedback about the barriers and
The working context for speech and language therapists (SLTs) delivering interventions to adults who have a learning disability has changed following the reorganization of care provision from hospitals to the community. Consequently, SLTs often deliver their care within a social model of disability through indirect intervention in collaboration with carers. However, there has been little research into how this approach works in practice. To gain insight into the working context by identifying the key factors that influence indirect SLT interventions as perceived by SLTs and by paid carers from a range of service providers. To explore the implications of the results for the delivery of indirect SLT interventions and provide direction for further research. Semi-structured interviews were used to collect data from an opportunistic sample of five SLTs working in Community Learning Disability Teams (CLDTs) and 12 carers from residential and day care services who had had experience of working with SLTs. The data were analysed inductively using a grounded theory framework. Two broad themes emerged for SLTs: roles and expectations, and changing carer behaviour through training. The key themes for carers were roles and values, awareness of communication needs, and motivation and opportunity to implement interventions. Four broad factors are suggested as having the potential to influence indirect interventions: diversity in the working context; possible conflict between the guiding values of SLTs and carers, particularly residential carers; collaboration and support for implementation; and SLT doubts about the effectiveness of formal carer communication training. The results add to the evidence that the delivery of indirect speech and language therapy interventions to people with learning disabilities is a complex activity demanding specialist skills from SLTs. The findings suggest that these should include expertise in professional collaborative and relational skills, and
Ito, Shinya; Hashimoto, Mari; Aduma, Saori; Yasumura, Seiji
Locomotion training in a home visit-type preventive-care program has been reported elsewhere. However, continuation of appropriate exercises in a home setting is difficult, and few reports are available on locomotion training in a home setting. The objective of this study was to evaluate the effectiveness of locomotion training over 3 months in a home visit-type preventive-care program for improvement of motor function among elderly people. Nine hundred and fifty-eight elderly people in Tendo City in Japan who were not currently attending any preventive-care program were invited to participate in the study, and 87 were enrolled. In the pre-intervention and post-intervention assessments, we administered an interview survey (the Kihon Checklist), the timed one-leg standing test with eyes open and the sit-to-stand test, at the participants' homes. The intervention involved one set of training exercises with the participants standing on each leg for 1 min and squatting five or six times. The participants were asked to repeat one set of the exercises three times a day at home. In addition, the participants were regularly asked over the telephone about their performance of the exercises. Physical strength, cognitive function, and total scores of the Kihon Checklist were significantly lower after the intervention than before. In addition, the one-leg standing test time was significantly longer after the intervention (mean ± SD, 23.9 ± 35.4) than before (15.7 ± 20.5), and the sit-to-stand test time was significantly shorter after the intervention (13.0 ± 6.2) than before (14.8 ± 8.3). Locomotion training in a home-visit preventive-care program with telephone support effectively improved the motor function of elderly people who were not currently attending any preventive-care program organized by the long-term care insurance system.
Ding, Qiaoqiao; Zan, Yunlong; Huang, Qiu; Zhang, Xiaoqun
The reconstruction of dynamic images from few projection data is a challenging problem, especially when noise is present and when the dynamic images are vary fast. In this paper, we propose a variational model, sparsity enforced matrix factorization (SEMF), based on low rank matrix factorization of unknown images and enforced sparsity constraints for representing both coefficients and bases. The proposed model is solved via an alternating iterative scheme for which each subproblem is convex and involves the efficient alternating direction method of multipliers (ADMM). The convergence of the overall alternating scheme for the nonconvex problem relies upon the Kurdyka-Łojasiewicz property, recently studied by Attouch et al (2010 Math. Oper. Res. 35 438) and Attouch et al (2013 Math. Program. 137 91). Finally our proof-of-concept simulation on 2D dynamic images shows the advantage of the proposed method compared to conventional methods.
Råberg Kjøllesdal, Marte K; Hjellset, Victoria T; Bjørge, Benedikte; Holmboe-Ottesen, Gerd; Wandel, Margareta
To explore perceptions of diabetes risk factors among Pakistani immigrant women, as part of their explanatory model of the disease, and the changes in these perceptions after a culturally adapted intervention. Intervention study, carried out in Oslo, Norway, comprising 198 women. At baseline, about 75% of the women perceived sugar to be a risk factor for diabetes, about 30% mentioned physical inactivity and stress and close to 20% mentioned overweight. Twelve per cent could not identify any risk factors. When asked about foods to include in a diet to prevent diabetes, vegetables were mentioned by 45%, while 33% did not know any foods to include. Among those attending ≥60% of the educational sessions, the proportions mentioning little physical activity (pfood to include was reduced to 10% (p=0.004). Except for little physical activity, similar changes in responses were not registered in the control group. There is a need for improved knowledge about diabetes prevention among Pakistani immigrant women, and a culturally adapted intervention may contribute to this.
Emmanuel Herrera González
Full Text Available This study shows the main socio- affective factors related to school difficulties of a group of three girls and three boys identified as "star" in the Programa Psicomotricidad e Intervención (Psychomotor and Intervention Program. The study was developed through a mixed methodology, in which the Human Figure Test, the Kinetic Family Drawing and an interview with the mother of each student were applied. The most important results revealed the existence of family conflicting factors that affect the emotional state of children, generating negative feelings about themselves that affect their social interactions and their school performance.
Thelwall, Mike; Dawes, Phil
Background Researchers and practitioners have developed numerous online interventions that encourage people to reduce their drinking, increase their exercise, and better manage their weight. Motivations to develop eHealth interventions may be driven by the Internet’s reach, interactivity, cost-effectiveness, and studies that show online interventions work. However, when designing online interventions suitable for public campaigns, there are few evidence-based guidelines, taxonomies are difficult to apply, many studies lack impact data, and prior meta-analyses are not applicable to large-scale public campaigns targeting voluntary behavioral change. Objectives This meta-analysis assessed online intervention design features in order to inform the development of online campaigns, such as those employed by social marketers, that seek to encourage voluntary health behavior change. A further objective was to increase understanding of the relationships between intervention adherence, study adherence, and behavioral outcomes. Methods Drawing on systematic review methods, a combination of 84 query terms were used in 5 bibliographic databases with additional gray literature searches. This resulted in 1271 abstracts and papers; 31 met the inclusion criteria. In total, 29 papers describing 30 interventions were included in the primary meta-analysis, with the 2 additional studies qualifying for the adherence analysis. Using a random effects model, the first analysis estimated the overall effect size, including groupings by control conditions and time factors. The second analysis assessed the impacts of psychological design features that were coded with taxonomies from evidence-based behavioral medicine, persuasive technology, and other behavioral influence fields. These separate systems were integrated into a coding framework model called the communication-based influence components model. Finally, the third analysis assessed the relationships between intervention adherence
Shen, Chen; Wan, Alice; Kwok, Lit Tung; Pang, Sally; Wang, Xin; Stewart, Sunita M; Lam, Tai Hing; Chan, Sophia Siu Chee
Family communication is important to maintain family relationships and family well-being. To enhance family communication and family well-being, a community-based "Learning Families Project," based on the social ecological model was developed in Kwun Tong in Hong Kong, a district with high prevalence of family problems. This quasi-experimental study included two nearby government subsidized low-rent housing estates separated by busy main roads, as the intervention [Tsui Ping (South) Estate] and control (Shun Tin Estate) estate. The main intervention was resident training programs, such as talks, day camps, and thematic activities. No program was implemented in the control estate. Participants in the intervention group received assessments before the intervention (T1), immediately after the intervention (T2), and 6 weeks after the intervention (T3). Control group participants were assessed at baseline (March to April 2011) and follow-up (December 2011 to March 2012). Assessments of family communication (time and perceived adequacy) and family well-being (harmony, happiness, and health) at T1 and T3 were obtained in the intervention group to examine within-group changes. In addition, these differences in outcomes in the intervention group were compared with those in the control group to examine the effectiveness of the intervention. Family communication time and perceived communication adequacy increased significantly in the intervention group ( n = 515) with a small effect size (Cohen effect d : 0.10 and 0.24, respectively). Compared with the control group ( n = 476), the improvements in family communication time and perceived communication adequacy (Cohen effect d : 0.13 and 0.14, respectively), and perceived family harmony and happiness (Cohen effect d : 0.12 and 0.12, respectively) were significantly greater in the intervention group, adjusting for age and education, suggesting the intervention was effective in improving family communication and
Roedel, Frederico G.; Schirru, Roberto
New nuclear power plants are being designed with the digital Instrumentation and Control (I and C) as the backbone for the functions of protection, control, monitoring and display and with digital Human-System Interface (HSI). In this new environment, rather than play physical control actions, the operators begin to act as decision makers and, within this context, the Human Factors Engineering (HFE) has become an integral part of the projects. As the operational experience with the use of digital I and C systems and HSI is limited since, besides the small number of applications, it is proprietary, the objective of this work is to carry out an assessment in order to identify the most relevant aspects of a digital HSI project. The proposed model is based on concepts of fuzzy logic, uses MATLAB for data processing, defines criteria for evaluation and quantification of impacts in the project and has been applied to the General Principles and the Guidelines presented in the NUREG-0700. The assessment indicated that the Guidelines for User-Interface Interaction and Management, for Information Display and for Computer-Based Procedures System should be carefully evaluated in the design of a digital HSI considering the new Users Tasks Demand, the Organization of HSI Elements and the Work Environment. (author)
Roedel, Frederico G.; Schirru, Roberto, E-mail: firstname.lastname@example.org, E-mail: email@example.com [Coordenacao de Pos-Graduacao e Pesquisa de Engenharia (COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Departamento de Engenharia Nuclear
New nuclear power plants are being designed with the digital Instrumentation and Control (I and C) as the backbone for the functions of protection, control, monitoring and display and with digital Human-System Interface (HSI). In this new environment, rather than play physical control actions, the operators begin to act as decision makers and, within this context, the Human Factors Engineering (HFE) has become an integral part of the projects. As the operational experience with the use of digital I and C systems and HSI is limited since, besides the small number of applications, it is proprietary, the objective of this work is to carry out an assessment in order to identify the most relevant aspects of a digital HSI project. The proposed model is based on concepts of fuzzy logic, uses MATLAB for data processing, defines criteria for evaluation and quantification of impacts in the project and has been applied to the General Principles and the Guidelines presented in the NUREG-0700. The assessment indicated that the Guidelines for User-Interface Interaction and Management, for Information Display and for Computer-Based Procedures System should be carefully evaluated in the design of a digital HSI considering the new Users Tasks Demand, the Organization of HSI Elements and the Work Environment. (author)
Conclusions: The ILERVAS project will reveal the prevalence of subclinical vascular disease and hidden kidney disease, determine whether or not their early diagnosis brings health benefits and will also allow investigation of new risk factors.
Martín-Baranera, M; Planas, I; Palau, J; Sanz, F
The Institut Municipal d'Assistència Sanitària (IMAS) is a health care organization in Barcelona, comprising two general hospitals, a psychiatric hospital, a surgical clinic, a geriatric center, some primary care clinics, and a research institute. Since 1984, IMAS has been engaged in creating a multicenter integrated hospital information system (IMASIS). Currently, IMASIS offers the possibility to manage administrative data, laboratory results, pathology and cytology reports, radiology reports, and pharmacy inpatient orders; it also shares this information on-line among IMAS centers. IMASIS users may also work with a word processor, a spreadsheet, a database, or a statistical package and have access to MEDLINE. A second phase of IMASIS development began in December 1993 focused on clinical information management. The goal was to move towards an integrated multimedia medical record . As a first step, the implementation experiences of the most advanced hospital information systems around the world were studied. Some of these experiences detected behavioral, cultural, and organizational factors  as the main sources of delay, or even failure, in HIS projects. A preliminary analysis to define such factors, assess their potential impact, and introduce adequate measures to deal with them seemed unavoidable before structuring of the project. In our approach to physician attitudes analysis, two survey techniques were applied. First, every hospital service head was contacted to schedule an interview, with either a service representative or a group of staff physicians and residents. The aim was to provide detailed information about project objectives and collect personal opinions, problems encountered in the current HIS, and specific needs of every medical and surgical specialty (including imaging needs). Every service head was asked to distribute a questionnaire among all clinicians, which assessed frequency of use of IMASIS current applications, user's satisfaction
Full Text Available Background: Declining physical activity (PA and associated health risk factors are well established. Workplace strategies to increase PA may be beneficial to ameliorate extensive sedentary behavior. This study assessed the effectiveness of two PA interventions in workplace settings. Methods: Interventions were conducted over 40 days targeting insufficiently active (<150 min/wk PA and/or obese (BMI ≥ 30 kg/m2 adults; participants were randomly allocated to instructor-led exercise sessions either after-work (n = 25 or in-work (n = 23 with a 60 minPA/day common goal, or a wait-listed control group (n = 23. The programme commenced with low-moderate physical activities and progressed to high intensity game style activities by week six. Adherence and compliance were determined using both objective measures of daily PA time from HR monitors and self-report responses to PA questionnaires. Cardiovascular and metabolic risk factors were measured pre- and post-intervention. Changes across the study were analysed using Chi square and repeat-measures ANOVA. Results: Adherence rates (completed pre and post-testing were not different between groups (76.0 vs 65.2%. Compliance for the instructor-led sessions was higher for the after-work group (70.4% vs 26.4%, respectively. Increased total PA and aerobic fitness, and decreased weight in both intervention groups were found relative to controls. The after-work group undertook more vigorous PA, and had greater weight loss and fasting blood glucose improvement, relative to in-work participants and controls. Conclusions: These workplace interventions resulted in rapid and dramatic increases in PA behaviour and important health benefits. Short, in-work PA sessions were less efficacious than longer after-work sessions.
Gollhofer, Sandra M; Wiskemann, Joachim; Schmidt, Martina E; Klassen, Oliver; Ulrich, Cornelia M; Oelmann, Jan; Hof, Holger; Potthoff, Karin; Steindorf, Karen
Over the past years knowledge about benefits of physical activity after cancer is evolving from randomized exercise intervention trials. However, it has been argued that results may be biased by selective participation. Therefore, we investigated factors influencing participation in a randomized exercise intervention trial for breast cancer patients. Non-metastatic breast cancer patients were systematically screened for a randomized exercise intervention trial on cancer-related fatigue. Participants and nonparticipants were compared concerning sociodemographic characteristics (age, marital status, living status, travel time to the training facility), clinical data (body-mass-index, tumor stage, tumor size and lymph node status, comorbidities, chemotherapy), fatigue, and physical activity. Reasons for participation or declination were recorded. 117 patients (52 participants, 65 nonparticipants) were evaluable for analysis. Multiple regression analyses revealed significantly higher odds to decline participation among patients with longer travel time (p = 0.0012), living alone (p = 0.039), with more comorbidities (0.031), previous chemotherapy (p = 0.0066), of age ≥ 70 years (p = 0.025), or being free of fatigue (p = 0.0007). No associations were found with BMI or physical activity. By far the most frequently reported reason for declination of participation was too long commuting time to the training facility. Willingness of breast cancer patients to participate in a randomized exercise intervention study differed by sociodemographic factors and health status. Neither current physical activity level nor BMI appeared to be selective for participation. Reduction of personal inconveniences and time effort, e.g. by decentralized training facilities or flexible training schedules, seem most promising for enhancing participation in exercise intervention trials. Registered at ClinicalTrials.gov: NCT01468766 (October 2011)
Woda, Aimee; Belknap, Ruth Ann; Haglund, Kristin; Sebern, Margaret; Lawrence, Ashley
The purpose of this study was to understand the influences of heart failure (HF) self-care among low income, African Americans. Compared to all other racial groups, African Americans have the highest risk of developing HF, coupled with high mortality and morbidity rates. Using the photovoice method, participants related important lifestyle factors through photography. The participants and researcher met for reflection and discussion 2 h per week for six weeks. Four themes emerged: family support gives me the push I need, social interaction lifts me up, improving my mind to lift depression can improve my heart, and it is important but challenging to follow the HF diet. The findings from this study may assist policy makers, health care professionals, patients, and support systems in understanding the complexity of engaging in HF self-care. This understanding may lead to the development of appropriate patient-centered assessments and interventions. Copyright © 2015 Elsevier Inc. All rights reserved.
Birnie, David; Healey, Jeff S; Krahn, Andrew D; Ahmad, Kamran; Crystal, Eugene; Khaykin, Yaariv; Chauhan, Vijay; Philippon, Francois; Exner, Derek; Thibault, Bernard; Hruczkowski, Tomascz; Nery, Pablo; Keren, Arieh; Redfearn, Damian
The volume and complexity of interventional electrophysiology procedures have increased greatly over the last 20 years. Anecdotal reports from Canada and elsewhere have suggested an important prevalence of neck and back problems in interventional electrophysiologists. To quantify the scope of neck and back problems, we surveyed 70 interventional electrophysiologists in Canada using an electronic survey with in person and email reminders. We also surveyed an age- and gender-matched group of noninterventional cardiologists. We received responses from a total of 58 of 70 interventional electrophysiologists (response rate 82.8%). There was a significantly higher prevalence of cervical spondylosis among electrophysiologists compared to matched noninterventional cardiologists (20.7% compared to 5.5%, P = 0.033). There was a trend for increased prevalence of lumbar spondylosis (25.9% compared to 16.7%, P = 0.298). Among electrophysiologists, those with cervical spondylosis were older (49.83 ± 10.48 years compared to 44.57 ± 9.20, P = 0.092) and had worked in the specialty for longer in comparison to unaffected physicians (19.67 ± 10.06 years compared to 13.37 ± 8.97 years, P = 0.039). All other variables including gender, height, weight, BMI, type of lead, weekly average lead time, and % of time standing in electrophysiology laboratory were not different. On multivariable analysis there were no independent predictors of disease. There is a significant increased prevalence of cervical spondylosis among interventional electrophysiologists. Programs to improve ergonomics and minimize time spent wearing lead are needed. The same vigilance that is used to ensure radiation safety in the laboratory should be applied to create ergonomic safety. © 2011 Wiley Periodicals, Inc.
Bioque, Miquel; Llerena, Adrián; Cabrera, Bibiana; Mezquida, Gisela; Lobo, Antonio; González-Pinto, Ana; Díaz-Caneja, Covadonga M; Corripio, Iluminada; Aguilar, Eduardo J; Bulbena, Antoni; Castro-Fornieles, Josefina; Vieta, Eduard; Lafuente, Amàlia; Mas, Sergi; Parellada, Mara; Saiz-Ruiz, Jerónimo; Cuesta, Manuel J; Bernardo, Miguel
The characterization of the first episode of psychosis and how it should be treated are principal issues in actual research. Realistic, naturalistic studies are necessary to represent the entire population of first episode of psychosis attended in daily practice. Sixteen participating centers from the PEPs project recruited 335 first episode of psychosis patients, aged 7 to 35 years. This article describes and discusses the psychopharmacological interventions and safety profiles at baseline and during a 60-day pharmacovigilance period. The majority of first episode of psychosis patients received a second-generation antipsychotic (96.3%), orally (95%), and in adjusted doses according to the product specifications (87.2%). A total of 24% were receiving an antipsychotic polytherapy pattern at baseline, frequently associated with lower or higher doses of antipsychotics than the recommended ones. Eight patients were taking clozapine, all in monotherapy. Males received higher doses of antipsychotic (P=.043). A total of 5.2% of the patients were being treated with long-acting injectable antipsychotics; 12.2% of the patients received anticholinergic drugs, 12.2% antidepressants, and 13.7% mood stabilizers, while almost 40% received benzodiazepines; and 35.52% reported at least one adverse drug reaction during the pharmacovigilance period, more frequently associated with higher antipsychotic doses and antipsychotic polytherapy (85.2% vs 45.5%, Psecurity issues, support future research of determinate pharmacological strategies for the treatment of early phases of psychosis, such as the role of clozapine, long-acting injectable antipsychotics, antipsychotic combination, and the use of benzodiazepines. © The Author 2015. Published by Oxford University Press on behalf of CINP.
Marchal, Bruno; Van Belle, Sara; De Brouwere, Vincent; Witter, Sophie
The importance of complexity in health care policy-making and interventions, as well as research and evaluation is now widely acknowledged, but conceptual confusion reigns and few applications of complexity concepts in research design have been published. Taking user fee exemption policies as an entry point, we explore the methodological consequences of 'complexity' for health policy research and evaluation. We first discuss the difference between simple, complicated and complex and introduce key concepts of complex adaptive systems theory. We then apply these to fee exemption policies. We describe how the FEMHealth research project attempts to address the challenges of complexity in its evaluation of fee exemption policies for maternal care. We present how the development of a programme theory for fee exemption policies was used to structure the overall design. This allowed for structured discussions on the hypotheses held by the researchers and helped to structure, integrate and monitor the sub-studies. We then show how the choice of data collection methods and tools for each sub-study was informed by the overall design. Applying key concepts from complexity theory proved useful in broadening our view on fee exemption policies and in developing the overall research design. However, we encountered a number of challenges, including maintaining adaptiveness of the design during the evaluation, and ensuring cohesion in the disciplinary diversity of the research teams. Whether the programme theory can fulfil its claimed potential to help making sense of the findings is yet to be tested. Experience from other studies allows for some moderate optimism. However, the biggest challenge complexity throws at health system researchers may be to deal with the unknown unknowns and the consequence that complex issues can only be understood in retrospect. From a complexity theory point of view, only plausible explanations can be developed, not predictive theories. Yet here
Abdul Rahman Ismail
Full Text Available This paper presents the development of PLS-SEM Path Model of delay factors of Saudi Arabia construction industry focussing on Mecca City. The model was developed and assessed using SmartPLS v3.0 software and it consists of 37 factors/manifests in 7 groups/independent variables and one dependent variable which is delay of the construction projects. The model was rigorously assessed at measurement and structural components and the outcomes found that the model has achieved the required threshold values. At structural level of the model, among the seven groups, the client and consultant group has the highest impact on construction delay with path coefficient β-value of 0.452 and the project management and contract administration group is having the least impact to the construction delay with β-value of 0.016. The overall model has moderate explaining power ability with R2 value of 0.197 for Saudi Arabia construction industry representation. This model will able to assist practitioners in Mecca city to pay more attention in risk analysis for potential construction delay.
Alejandro Rodriguez Montero
Full Text Available The purpose of this study was to determine the relationship between motivational factors, sex and age on the participants at a project of swimming. The study included 107 subjects (71% of the total of active participants in the project, of which 51 were men and 56 women, aged between 18 and 63 years (36,27 ± 10,67. The sample was divided into four age categories (18-29 years, 30-39 years, 40-49 years and 50 and over and by sex. To know the reasons that lead people to engage physical exercise, self-report questionnaire Motives for the Practice of Physical Exercises (AMPEF, adapted by and Pintanel Niñerola Capdevila (2004 was applied. The results of the individual analysis showed that the factors: positive health and prevention; well-being and fun; muscular strength and endurance are important reasons for both men and women in all age categories, with values ≥ 7 (between 1 to 10. There were no significant differences in the total score between variables. The data reported are consistent with those reported in the literature. It is concluded that the main reasons for people to be physically active are: health, fun, well-being and improvement of physical, also found significant differences in the reasons relating to the challenge and competition between men and women, results also agree with previous publications.
Jensen, Berit Elin S; Hansen, Jane M; Junker, Anders B
INTRODUCTION: Dual antiplatelet therapy is standard treatment following percutaneous coronary intervention (PCI) and stenting. However, such therapy increases the risk of upper gastrointestinal bleeding (UGIB). The risk factors of UGIB are well-documented and proton pump inhibitor (PPI) treatment...... reduces the risk. The aim was to describe the prevalence of risk factors of UGIB in dual antiplatelet-treated patients. METHODS: A questionnaire was used to assess the prevalence of risk factors of upper gastrointestinal bleeding among dual antiplatelet-treated first-time PCI patients in Western Denmark......: A total of 1,358 patients with a mean age of 64.1 years (range: 33-92 years) were included. The distribution of risk factors was as follows: dyspepsia: 681 patients (50.1%); previous ulcer: 110 (8.1%; 2.3% with bleeding); use of NSAIDs: 214 (15.8%); corticosteroids (2.9%), SSRIs (5.8%) and anticoagulants...
Kelly V Ruggles
Full Text Available To inform the design of a combination intervention strategy targeting HIV-infected unhealthy alcohol users in Maharashtra, India, that could be tested in future randomized control trials.Using probabilistic compartmental simulation modeling we compared intervention strategies targeting HIV-infected unhealthy alcohol users on antiretroviral therapy (ART in Maharashtra, India. We tested interventions targeting four behaviors (unhealthy alcohol consumption, risky sexual behavior, depression and antiretroviral adherence, in three formats (individual, group based, community and two durations (shorter versus longer. A total of 5,386 possible intervention combinations were tested across the population for a 20-year time horizon and intervention bundles were narrowed down based on incremental cost-effectiveness analysis using a two-step probabilistic uncertainty analysis approach.Taking into account uncertainty in transmission variables and intervention cost and effectiveness values, we were able to reduce the number of possible intervention combinations to be used in a randomized control trial from over 5,000 to less than 5. The most robust intervention bundle identified was a combination of three interventions: long individual alcohol counseling; weekly Short Message Service (SMS adherence counseling; and brief sex risk group counseling.In addition to guiding policy design, simulation modeling of HIV transmission can be used as a preparatory step to trial design, offering a method for intervention pre-selection at a reduced cost.
Ruggles, Kelly V; Patel, Anik R; Schensul, Stephen; Schensul, Jean; Nucifora, Kimberly; Zhou, Qinlian; Bryant, Kendall; Braithwaite, R Scott
To inform the design of a combination intervention strategy targeting HIV-infected unhealthy alcohol users in Maharashtra, India, that could be tested in future randomized control trials. Using probabilistic compartmental simulation modeling we compared intervention strategies targeting HIV-infected unhealthy alcohol users on antiretroviral therapy (ART) in Maharashtra, India. We tested interventions targeting four behaviors (unhealthy alcohol consumption, risky sexual behavior, depression and antiretroviral adherence), in three formats (individual, group based, community) and two durations (shorter versus longer). A total of 5,386 possible intervention combinations were tested across the population for a 20-year time horizon and intervention bundles were narrowed down based on incremental cost-effectiveness analysis using a two-step probabilistic uncertainty analysis approach. Taking into account uncertainty in transmission variables and intervention cost and effectiveness values, we were able to reduce the number of possible intervention combinations to be used in a randomized control trial from over 5,000 to less than 5. The most robust intervention bundle identified was a combination of three interventions: long individual alcohol counseling; weekly Short Message Service (SMS) adherence counseling; and brief sex risk group counseling. In addition to guiding policy design, simulation modeling of HIV transmission can be used as a preparatory step to trial design, offering a method for intervention pre-selection at a reduced cost.
Thomas, Gunnarsson; Magnus, Eliasson
Due to recent changes in Swedish commercial nuclear safety system requirements, OKG decided to make the changes required by the new safety requirements, apply for a 30-year license extension, and to concurrently make changes for a major power uprate; this project is called the Plant Life Extension project (PLEX). It was decided, in addition to several plant modifications, to re build the old control room to a new modern screen-based control room located in the same space as the old one, and with the same number of operators. This paper explains the approach taken when modernizing the control room as a part of the Oskarshamn 2 Modernization project PLEX, the results, and the lessons learned from this ongoing work. The combination of changes results in a modernization project that is expected to increase output power by approximately 50 MWe through increased efficiency and to result in an increase in thermal power from 1800 MWt to 2300 MWt (28%) and electrical power from 620 MWe to 840 MWe due to the power uprate. The license to operate OKG2 expires in 2012 The PLEX project is one of the most ambitious nuclear power plant modernization projects ever implemented, world-wide. The application of human factors engineering (HFE) and control room and HSI design is a complex challenge. The original main control room from 1975 in Oskarshamn 2, was quite compact and provided a fairly good overview of the process. New requirements for enhanced safety and other design changes in the process systems and instrumentation led to a step-wise installation of new information and control equipment in the control room. Since the control room was quite limited in space, the control room grew larger, and the new equipment was installed farther away from the operator workplaces into an adjacent control room. This was even the cas