Costs to implement an effective transition-to-parenthood program for couples: Analysis of the Family Foundations program

Science.gov (United States)

Jones, Damon E.; Feinberg, Mark E.; Hostetler, Michelle

2014-01-01

The transition to parenthood involves many stressors that can have implications for the couple relationship as well as the developmental environment of the child. Scholars and policymakers have recognized the potential for interventions that can help couples navigate these stressors to improve parenting and coparenting strategies. Such evidence-based programs are scarcely available, however, and little is known about the resources necessary to carry out these programs. This study examines the costs and resources necessary to implement Family Foundations, a program that addresses the multifaceted issues facing first-time parents through a series of pre- and post-natal classes. Costs were determined using a 6-step analytic process and are based on the first implementation of the program carried out through a five-year demonstration project. This assessment demonstrates how overall costs change across years as new cohorts of families are introduced, and how cost breakdowns differ by category as needs shift from training group leaders to sustaining program services. Information from this cost analysis helps clarify how the program could be made more efficient in subsequent implementations. We also consider how results may be used in future research examining economic benefits of participation in the program. PMID:24603052

Oil program implementation plan FY 1996--2000

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-04-01

This document reaffirms the US Department of Energy (DOE) Office of Fossil Energy commitment to implement the National Oil Research Program in a way to maximize assurance of energy security, economic growth, environmental protection, jobs, improved economic competitiveness, and improved US balance of trade. There are two sections and an appendix in this document. Section 1 is background information that guided its formulation and a summary of the Oil Program Implementation Plan. This summary includes mission statements, major program drivers, oil issues and trends, budget issues, customers/stakeholders, technology transfer, measures of program effectiveness, and benefits. Section 2 contains more detailed program descriptions for the eight technical areas and the NIPER infrastructure. The eight technical areas are reservoir characterization; extraction research; exploration, drilling, and risk-based decision management; analysis and planning; technology transfer; field demonstration projects; oil downstream operations; and environmental research. Each description contains an overview of the program, descriptions on main areas, a discussion of stakeholders, impacts, planned budget projections, projected schedules with Gantt charts, and measures of effectiveness. The appendix is a summary of comments from industry on an earlier draft of the plan. Although changes were made in response to the comments, many of the suggestions will be used as guidance for the FY 1997--2001 plan.

Costs to implement an effective transition-to-parenthood program for couples: analysis of the Family Foundations program.

Science.gov (United States)

Jones, Damon E; Feinberg, Mark E; Hostetler, Michelle L

2014-06-01

The transition to parenthood involves many stressors that can have implications for the couple relationship as well as the developmental environment of the child. Scholars and policymakers have recognized the potential for interventions that can help couples navigate these stressors to improve parenting and coparenting strategies. Such evidence-based programs are scarcely available, however, and little is known about the resources necessary to carry out these programs. This study examines the costs and resources necessary to implement Family Foundations, a program that addresses the multifaceted issues facing first-time parents through a series of pre- and post-natal classes. Costs were determined using a 6-step analytic process and are based on the first implementation of the program carried out through a five-year demonstration project. This assessment demonstrates how overall costs change across years as new cohorts of families are introduced, and how cost breakdowns differ by category as needs shift from training group leaders to sustaining program services. Information from this cost analysis helps clarify how the program could be made more efficient in subsequent implementations. We also consider how results may be used in future research examining economic benefits of participation in the program. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Comparison of Four Software Programs for Implementing Decision Analytic Cost-Effectiveness Models.

Science.gov (United States)

Hollman, Chase; Paulden, Mike; Pechlivanoglou, Petros; McCabe, Christopher

2017-08-01

The volume and technical complexity of both academic and commercial research using decision analytic modelling has increased rapidly over the last two decades. The range of software programs used for their implementation has also increased, but it remains true that a small number of programs account for the vast majority of cost-effectiveness modelling work. We report a comparison of four software programs: TreeAge Pro, Microsoft Excel, R and MATLAB. Our focus is on software commonly used for building Markov models and decision trees to conduct cohort simulations, given their predominance in the published literature around cost-effectiveness modelling. Our comparison uses three qualitative criteria as proposed by Eddy et al.: "transparency and validation", "learning curve" and "capability". In addition, we introduce the quantitative criterion of processing speed. We also consider the cost of each program to academic users and commercial users. We rank the programs based on each of these criteria. We find that, whilst Microsoft Excel and TreeAge Pro are good programs for educational purposes and for producing the types of analyses typically required by health technology assessment agencies, the efficiency and transparency advantages of programming languages such as MATLAB and R become increasingly valuable when more complex analyses are required.

Protocol: Adaptive Implementation of Effective Programs Trial (ADEPT): cluster randomized SMART trial comparing a standard versus enhanced implementation strategy to improve outcomes of a mood disorders program.

Science.gov (United States)

Kilbourne, Amy M; Almirall, Daniel; Eisenberg, Daniel; Waxmonsky, Jeanette; Goodrich, David E; Fortney, John C; Kirchner, JoAnn E; Solberg, Leif I; Main, Deborah; Bauer, Mark S; Kyle, Julia; Murphy, Susan A; Nord, Kristina M; Thomas, Marshall R

2014-09-30

Despite the availability of psychosocial evidence-based practices (EBPs), treatment and outcomes for persons with mental disorders remain suboptimal. Replicating Effective Programs (REP), an effective implementation strategy, still resulted in less than half of sites using an EBP. The primary aim of this cluster randomized trial is to determine, among sites not initially responding to REP, the effect of adaptive implementation strategies that begin with an External Facilitator (EF) or with an External Facilitator plus an Internal Facilitator (IF) on improved EBP use and patient outcomes in 12 months. This study employs a sequential multiple assignment randomized trial (SMART) design to build an adaptive implementation strategy. The EBP to be implemented is life goals (LG) for patients with mood disorders across 80 community-based outpatient clinics (N = 1,600 patients) from different U.S. regions. Sites not initially responding to REP (defined as implementation costs, and organizational change. This study design will determine whether an off-site EF alone versus the addition of an on-site IF improves EBP uptake and patient outcomes among sites that do not respond initially to REP. It will also examine the value of delaying the provision of EF/IF for sites that continue to not respond despite EF. ClinicalTrials.gov identifier: NCT02151331.

Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity.

Science.gov (United States)

Mihalic, Sharon F; Fagan, Abigail A; Argamaso, Susanne

2008-01-18

Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness). Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as

Implementing the LifeSkills Training drug prevention program: factors related to implementation fidelity

Directory of Open Access Journals (Sweden)

Fagan Abigail A

2008-01-01

Full Text Available Abstract Background Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. Methods This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Results Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers, ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence. Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage. Student behavior and use of interactive teaching techniques (quality of delivery were positively related. No variables were related to student participation (student responsiveness. Conclusion Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that

Implementing corporate wellness programs: a business approach to program planning.

Science.gov (United States)

Helmer, D C; Dunn, L M; Eaton, K; Macedonio, C; Lubritz, L

1995-11-01

1. Support of key decision makers is critical to the successful implementation of a corporate wellness program. Therefore, the program implementation plan must be communicated in a format and language readily understood by business people. 2. A business approach to corporate wellness program planning provides a standardized way to communicate the implementation plan. 3. A business approach incorporates the program planning components in a format that ranges from general to specific. This approach allows for flexibility and responsiveness to changes in program planning. 4. Components of the business approach are the executive summary, purpose, background, ground rules, approach, requirements, scope of work, schedule, and financials.

Designing, testing, and implementing a sustainable nurse home visiting program: right@home.

Science.gov (United States)

Goldfeld, Sharon; Price, Anna; Kemp, Lynn

2018-05-01

Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is hampered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence-based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

The effectiveness and implementation of mentoring program for newly graduated nurses: A systematic review.

Science.gov (United States)

Zhang, Yuanyuan; Qian, Yan; Wu, Juemin; Wen, Fule; Zhang, Yaqing

2016-02-01

Newly graduated nurses suffer from occupational stress during the transition from school to employment as a result of inadequacy, interpersonal relationships, and the overwhelming workload. Mentoring programs have proved effective in facilitating this transition. To evaluate the effectiveness of a mentoring program on the mentor, mentee, and organization. The Cochrane Library, Medline, Ovid, Elsevier, Embase, CINAHL, CBM, CNKI, and WanFang Data databases were searched to identify relevant publications in English or Chinese up to October 2014. This is a systematic review. This review identified nine potentially eligible studies, and the methodological quality levels of the included studies were all ranked as level B. These studies revealed that the turnover rate can be decreased through a mentoring program. Additionally, mentoring can enhance nursing competency and establish a supportive workforce environment, resulting in positive outcomes. This review reveals that a mentoring program has positive effects on the mentors, mentees, and organizations. A successful mentorship program should include rigorous mentor selection and adequate training. Additionally, potential barriers such as time constraints and scheduling limitations should be taken into consideration during implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

The design and implementation of vehicle scrapping programs

International Nuclear Information System (INIS)

Sahu, R.; Baxter, R.A.

1993-01-01

A number of metropolitan air basins in the US are currently faced with increased difficulty in attaining national and regional clean air standards. Significant controls on stationary sources over the years have allowed mobile sources to become the primary source of air emission in many areas. Programs allowing the use of mobile source offsets for stationary source emission by removal of older, higher emitting vehicles through scrappage programs are, therefore, conceptually attractive and are starting to be implemented. However, achieving success in such scrappage programs is a challenge given the associated technical, economic and social issues. This paper presents a discussion of the important issues that must be considered if vehicle scrappage programs are to be successful, including recent guidance and views of the EPA and state governments on the credits associated with the programs. Although the main focus of such programs is the reduction of criteria pollutants (CO, ROG, NO x , and PM 10 ), the impact on air toxics also has to be considered. The paper will then focus on the technical design of vehicle scrappage programs such that the resulting credits are real, verifiable, enforceable, and cost-effective. Information available under existing vehicle I/M programs along with economic, vehicle maintenance, and geographic data will be used with statistical techniques in order to meet predetermined program goals regarding emissions reduction and cost-effectiveness. A later case-study paper will discuss the actual implementation of such as program in an ozone non-attainment area

Implementation of a Psychoeducational Program for Cancer Survivors and Family Caregivers at a Cancer Support Community Affiliate: A Pilot Effectiveness Study.

Science.gov (United States)

Dockham, Bonnie; Schafenacker, Ann; Yoon, Hyojin; Ronis, David L; Kershaw, Trace; Titler, Marita; Northouse, Laurel

2016-01-01

Psychoeducational interventions, tested for efficacy in randomized clinical trials, are seldom implemented in clinical practice where cancer survivors and their family caregivers can benefit from them. This study examined the effectiveness of the FOCUS Program on cancer survivors' and their family caregivers' outcomes when implemented at a Cancer Support Community (CSC) affiliate by agency social workers. Study aims were to (1) test effects of the program on survivor and caregiver outcomes as a unit and (2) determine program feasibility in terms of enrollment, retention, intervention fidelity, and satisfaction. A preintervention and postintervention pilot effectiveness study was conducted with 34 cancer survivor-caregiver dyads (ie, pairs). The FOCUS Program, originally delivered by nurses in dyads' homes, was modified to a small-group format and delivered by CSC social workers. The primary outcome was quality of life (QOL). Intermediary outcomes were benefits of illness/caregiving, communication, support, and self-efficacy. Analyses included repeated-measures analysis of variance. Dyads had significant improvements in total QOL; physical, emotional, and functional QOL; benefits of illness; and self-efficacy. Effect sizes were similar to prior randomized clinical trial findings. Although dyads were difficult to recruit (enrollment, 60%), both retention (92%) and intervention fidelity (94%) were high. It was possible to implement the FOCUS Program at a CSC affiliate by agency staff, obtain positive intervention effects, and maintain intervention fidelity. Researchers and clinicians need to collaborate to implement more evidence-based interventions in practice settings for cancer survivors and their family caregivers.

Implementing an Employee Assistance Program.

Science.gov (United States)

Gam, John; And Others

1983-01-01

Describes in detail the implementation of an employee assistance program in a textile plant. Reviews the historical development, referral process, and termination guidelines of the program and contains descriptive statistics for six periods of the program's operation. (Author/JAC)

The INEL approach: Environmental Restoration Program management and implementation methodology

International Nuclear Information System (INIS)

1996-01-01

The overall objectives of the INEL Environmental Restoration (ER) Program management approach are to facilitate meeting mission needs through the successful implementation of a sound, and effective project management philosophy. This paper outlines the steps taken to develop the ER program, and explains further the implementing tools and processes used to achieve what can be viewed as fundamental to a successful program. The various examples provided will demonstrate how the strategies for implementing these operating philosophies are actually present and at work throughout the program, in spite of budget drills and organizational changes within DOE and the implementing contractor. A few of the challenges and successes of the INEL Environmental Restoration Program have included: a) completion of all enforceable milestones to date, b) acceleration of enforceable milestones, c) managing funds to reduce uncosted obligations at year end by utilizing greater than 99% of FY-95 budget, d) an exemplary safety record, e) developing a strategy for partial Delisting of the INEL by the year 2000, f) actively dealing with Natural Resource Damages Assessment issues, g) the achievement of significant project cost reductions, h) and implementation of a partnering charter and application of front end quality principles

Toward optimal implementation of cancer prevention and control programs in public health: a study protocol on mis-implementation.

Science.gov (United States)

Padek, Margaret; Allen, Peg; Erwin, Paul C; Franco, Melissa; Hammond, Ross A; Heuberger, Benjamin; Kasman, Matt; Luke, Doug A; Mazzucca, Stephanie; Moreland-Russell, Sarah; Brownson, Ross C

2018-03-23

Much of the cancer burden in the USA is preventable, through application of existing knowledge. State-level funders and public health practitioners are in ideal positions to affect programs and policies related to cancer control. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to more positive cancer outcomes. This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: We assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control, from primary prevention to survivorship. Phase 2: Using data from phase 1 to identify organizations in which mis-implementation is particularly high or low, the team will conduct eight comparative case studies to get a richer understanding of mis-implementation and to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: Agent-based modeling will be used to identify dynamic interactions between individual capacity, organizational capacity, use of evidence, funding, and external factors driving mis-implementation. The team will then translate and disseminate findings from phases 1 to 3 to practitioners and practice-related stakeholders to support the reduction of mis-implementation. This study is innovative and significant because it will (1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; (2) bring together a strong, transdisciplinary team with

Food Safety Programs Based on HACCP Principles in School Nutrition Programs: Implementation Status and Factors Related to Implementation

Science.gov (United States)

Stinson, Wendy Bounds; Carr, Deborah; Nettles, Mary Frances; Johnson, James T.

2011-01-01

Purpose/Objectives: The objectives of this study were to assess the extent to which school nutrition (SN) programs have implemented food safety programs based on Hazard Analysis and Critical Control Point (HACCP) principles, as well as factors, barriers, and practices related to implementation of these programs. Methods: An online survey was…

Systems engineering implementation plan for the liquid effluents services program

International Nuclear Information System (INIS)

Lowe, S.S.

1995-01-01

A graded approach is being taken by the Liquid Effluents Services Program in implementing systems engineering because of the advanced state of the program. The approach is cost-effective and takes credit for related work already completed, yet retains the benefits of systems engineering. This plan describes how the Liquid Effluents Services Program will implement systems engineering so there is a common understanding. Systems engineering work to be performed and the products of that work are identified. The relation to the current planning process and integration with the sitewide systems engineering effort is described

Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program

Directory of Open Access Journals (Sweden)

R. Laws

2016-08-01

Full Text Available Abstract Background While there is a growing interest in the field of research translation, there are few published examples of public health interventions that have been effectively scaled up and implemented in the community. This paper provides a case study of the community-wide implementation of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT, an obesity prevention program for parents with infants aged 3–18 months. The study explored key factors influencing the translation of the Program into routine practice and the respective role of policy makers, researchers and implementers. Methods Case studies were conducted of five of the eight prevention areas in Victoria, Australia who implemented the Program. Cases were selected on the basis of having implemented the Program for 6 months or more. Data were collected from January to June 2015 and included 18 individual interviews, one focus group and observation of two meetings. A total of 28 individuals, including research staff (n = 4, policy makers (n = 2 and implementers (n = 22, contributed to the data collected. Thematic analysis was conducted using cross case comparisons and key themes were verified through member checking. Results Key facilitators of implementation included availability of a pre-packaged evidence based program addressing a community need, along with support and training provided by research staff to local implementers. Partnerships between researchers and policy makers facilitated initial program adoption, while local partnerships supported community implementation. Community partnerships were facilitated by local coordinators through alignment of program goals with existing policies and services. Workforce capacity for program delivery and administration was a challenge, largely overcome by embedding the Program into existing roles. Adapting the Program to fit local circumstance was critical for feasible and sustainable delivery, however

Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes.

Science.gov (United States)

Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Miller, Elizabeth

2018-05-10

implementers and recipients alike can inform future dissemination and implementation efforts of CBIM. Further, by pinpointing where and how coaches were successful in implementing the program and what resonated with athletes, can help better understand how CBIM is effective in promoting athletes to stop violence against women and girls. Coach and athlete reflections on CBIM implementation provide insights for optimizing future program delivery and dissemination.

Attitudinal Perspectives: A Factor to Implementation of a Dual Language Program

Directory of Open Access Journals (Sweden)

Michael Whitacre

2015-01-01

Full Text Available The central focus of this study was to determine the overall perceptions of school administrators, and the district bilingual coordinator on transferring theory to classroom practice, implementation, as viewed by those involved in the implementation process of the Gómez and Gómez Model of Dual Language Education. Responses were solicited from administrative personnel involved in the implementation of the Gómez and Gómez Model of Dual Language. Results revealed overall administrative attitudes were positive to the theoretical ideology and mixed as related to the actual implementation of the dual language program. The greatest areas of concern were; what to do when students enter the program who are either not Spanish dominant or who have not been in a dual language program. The second area of concern was with how to effectively evaluate teachers as they are observed for implementation of the dual langue program. Lastly, most administrators felt there was a lack of faculty proficient in Spanish.

Implementation challenges of a motor operated valve program

International Nuclear Information System (INIS)

Ferguson, T.L.

1995-01-01

Electric motor operated valves (MOVs) have become a global focus of attention for Nuclear Power Plant (NPP) operators due to reported operability problems in the last decade. Many NPPs have or are in the process of setting up maintenance programs to address MOV operability issues. Bruce B is in the initial stages of implementing such a program. This paper outlines some of the challenges that have been encountered and how they are being approached to establish an effective program. (author)

Sustained Implementation Support Scale: Validation of a Measure of Program Characteristics and Workplace Functioning for Sustained Program Implementation.

Science.gov (United States)

Hodge, Lauren M; Turner, Karen M T; Sanders, Matthew R; Filus, Ania

2017-07-01

An evaluation measure of enablers and inhibitors to sustained evidence-based program (EBP) implementation may provide a useful tool to enhance organizations' capacity. This paper outlines preliminary validation of such a measure. An expert informant and consumer feedback approach was used to tailor constructs from two existing measures assessing key domains associated with sustained implementation. Validity and reliability were evaluated for an inventory composed of five subscales: Program benefits, Program burden, Workplace support, Workplace cohesion, and Leadership style. Exploratory and confirmatory factor analysis with a sample of 593 Triple P-Positive Parenting Program-practitioners led to a 28-item scale with good reliability and good convergent, discriminant, and predictive validity. Practitioners sustaining implementation at least 3 years post-training were more likely to have supervision/peer support, reported higher levels of program benefit, workplace support, and positive leadership style, and lower program burden compared to practitioners who were non-sustainers.

Real-time Kernel Implementation Practice Program for Embedded Software Engineers' Education and its Evaluation

Science.gov (United States)

Yoshida, Toshio; Matsumoto, Masahide; Seo, Katsuhiko; Chino, Shinichiro; Sugino, Eiji; Sawamoto, Jun; Koizumi, Hisao

A real-time kernel (henceforth RTK) is in the center place of embedded software technology, and the understanding of RTK is indispensable for the embedded system design. To implement RTK, it is necessary to understand languages that describe RTK software program code, system programming manners, software development tools, CPU on that RTK runs and the interface between software and hardware, etc. in addition to understanding of RTK itself. This means RTK implementation process largely covers embedded software implementation process. Therefore, it is thought that RTK implementation practice program is very effective as a means of the acquisition of common embedded software skill in addition to deeper acquisition of RTK itself. In this paper, we propose to apply RTK implementing practice program to embedded software engineers educational program. We newly developed very small and step-up type RTK named μK for educational use, and held a seminar that used μK as a teaching material for the students of information science and engineers of the software house. As a result, we confirmed that RTK implementation practice program is very effective for the acquisition of embedded software common skill.

The Cascading Effects of Multiple Dimensions of Implementation on Program Outcomes: a Test of a Theoretical Model.

Science.gov (United States)

Berkel, Cady; Mauricio, Anne M; Sandler, Irwin N; Wolchik, Sharlene A; Gallo, Carlos G; Brown, C Hendricks

2017-12-14

This study tests a theoretical cascade model in which multiple dimensions of facilitator delivery predict indicators of participant responsiveness, which in turn lead to improvements in targeted program outcomes. An effectiveness trial of the 10-session New Beginnings Program for divorcing families was implemented in partnership with four county-level family courts. This study included 366 families assigned to the intervention condition who attended at least one session. Independent observers provided ratings of program delivery (i.e., fidelity to the curriculum and process quality). Facilitators reported on parent attendance and parents' competence in home practice of program skills. At pretest and posttest, children reported on parenting and parents reported child mental health. We hypothesized effects of quality on attendance, fidelity and attendance on home practice, and home practice on improvements in parenting and child mental health. Structural Equation Modeling with mediation and moderation analyses were used to test these associations. Results indicated quality was significantly associated with attendance, and attendance moderated the effect of fidelity on home practice. Home practice was a significant mediator of the links between fidelity and improvements in parent-child relationship quality and child externalizing and internalizing problems. Findings provide support for fidelity to the curriculum, process quality, attendance, and home practice as valid predictors of program outcomes for mothers and fathers. Future directions for assessing implementation in community settings are discussed.

Physician practice responses to financial incentive programs: exploring the concept of implementation mechanisms.

Science.gov (United States)

Cohen, Genna R; Erb, Natalie; Lemak, Christy Harris

2012-01-01

To develop a framework for studying financial incentive program implementation mechanisms, the means by which physician practices and physicians translate incentive program goals into their specific office setting. Understanding how new financial incentives fit with the structure of physician practices and individual providers' work may shed some insight on the variable effects of physician incentives documented in numerous reviews and meta-analyses. Reviewing select articles on pay-for-performance evaluations to identify and characterize the presence of implementation mechanisms for designing, communicating, implementing, and maintaining financial incentive programs as well as recognizing participants' success and effects on patient care. Although uncommonly included in evaluations, evidence from 26 articles reveals financial incentive program sponsors and participants utilized a variety of strategies to facilitate communication about program goals and intentions, to provide feedback about participants' progress, and to assist-practices in providing recommended services. Despite diversity in programs' geographic locations, clinical targets, scope, and market context, sponsors and participants deployed common strategies. While these methods largely pertained to communication between program sponsors and participants and the provision of information about performance through reports and registries, they also included other activities such as efforts to engage patients and ways to change staff roles. This review covers a limited body of research to develop a conceptual framework for future research; it did not exhaustively search for new articles and cannot definitively link particular implementation mechanisms to outcomes. Our results underscore the effects implementation mechanisms may have on how practices incorporate new programs into existing systems of care which implicates both the potential rewards from small changes as well as the resources which may be

Implementing Suicide Prevention Programs: Costs and Potential Life Years Saved in Canada.

Science.gov (United States)

Vasiliadis, Helen-Maria; Lesage, Alain; Latimer, Eric; Seguin, Monique

2015-09-01

Little is known about the costs and effects of suicide prevention programs at the population level. We aimed to determine (i) the costs associated with a suicide death and using prospective values (ii) the costs and effects of transferring, into a Canadian context, the results of the European Nuremberg Alliance against Depression (NAD) trial with the addition of 4 community-based suicide prevention strategies. These included the training of family physicians in the detection and treatment of depression, population campaigns aimed at increasing awareness about depression, the training of community leaders among first responders and follow-up of individuals who attempted suicide. This study includes a prospective value implementation study design. Using published data and information from interviews with Canadian decision makers, we assessed the costs of a suicide death in the province of Quebec and the costs of potentially implementing the NAD multi-modal suicide prevention programs, and the incremental cost-effectiveness ratio (ICER), from a health care system and societal perspective, associated with the NAD program while considering the friction cost method (FCM) and human capital approach (HCA) (discounted at 3%.) The costs considered included those incurred for the suicide prevention program and direct medical and non-medical costs as well as those related to a police investigation and funeral costs. Indirect costs associated with loss of productivity and short term disability were also considered. Sensitivity analyses were also carried out. Costs presented were in 2010 dollars. The annual total cost of implementing the suicide prevention programs in Quebec reached CAD23,982,293. The most expensive components of the program included the follow-up of individuals who had attempted suicide and psychotherapy for bereaved individuals. These accounted for 39% and 34% of total costs. The ICER associated with the implementation of the programs reached on average CAD3

Building Sustainable Professional Development Programs: Applying Strategies From Implementation Science to Translate Evidence Into Practice.

Science.gov (United States)

Baldwin, Constance D; Chandran, Latha; Gusic, Maryellen E

2017-01-01

Multisite and national professional development (PD) programs for educators are challenging to establish. Use of implementation science (IS) frameworks designed to convert evidence-based intervention methods into effective health care practice may help PD developers translate proven educational methods and models into successful, well-run programs. Implementation of the national Educational Scholars Program (ESP) is used to illustrate the value of the IS model. Four adaptable elements of IS are described: (1) replication of an evidence-based model, (2) systematic stages of implementation, (3) management of implementation using three implementation drivers, and (4) demonstration of program success through measures of fidelity to proven models and sustainability. Implementation of the ESP was grounded on five established principles and methods for successful PD. The process was conducted in four IS stages over 10 years: Exploration, Installation, Initial Implementation, and Full Implementation. To ensure effective and efficient processes, attention to IS implementation drivers helped to manage organizational relationships, build competence in faculty and scholars, and address leadership challenges. We describe the ESP's fidelity to evidence-based structures and methods, and offer three examples of sustainability efforts that enabled achievement of targeted program outcomes, including academic productivity, strong networking, and career advancement of scholars. Application of IS frameworks to program implementation may help other PD programs to translate evidence-based methods into interventions with enhanced impact. A PD program can follow systematic developmental stages and be operationalized by practical implementation drivers, thereby creating successful and sustainable interventions that promote the academic vitality of health professions educators.

Implementation of a tobacco-free workplace program at a local mental health authority.

Science.gov (United States)

Correa-Fernández, Virmarie; Wilson, William T; Shedrick, Deborah A; Kyburz, Bryce; L Samaha, Hannah; Stacey, Timothy; Williams, Teresa; Lam, Cho Y; Reitzel, Lorraine R

2017-06-01

Tobacco-free workplace policies that incorporate evidence-based practices can increase the reach and effectiveness of tobacco dependence treatment among underserved populations but may be underutilized due to limited knowledge about implementation processes. This paper describes the implementation of a comprehensive tobacco-free workplace program at a behavioral healthcare community center in Texas. The center participated in a tobacco-free workplace program implementation project that provided guidance and resources and allowed center autonomy in implementation. Six employee-based subcommittees guided implementation of program components including consumer and staff surveys, policy development, signage, tobacco use assessments, communication, and nicotine replacement distribution. Timeline development, successes, challenges, lessons learned, and sustainability initiatives are delineated. Concerns about the tobacco-free workplace policy from the center's staff and consumers were gradually replaced by strong support for the initiative. Program success was enabled by consistent support from the center's leadership, publicity of program efforts, and educational campaigns. The center surpassed the program expectations when it adopted a tobacco-free hiring policy, which was not an initial program goal. This center's path to a tobacco-free workplace provides an implementation and sustainability model for other behavioral health community centers and other organizations to become tobacco free.

Translating Theory Into Practice: Implementing a Program of Assessment.

Science.gov (United States)

Hauer, Karen E; O'Sullivan, Patricia S; Fitzhenry, Kristen; Boscardin, Christy

2018-03-01

A program of assessment addresses challenges in learner assessment using a centrally planned, coordinated approach that emphasizes assessment for learning. This report describes the steps taken to implement a program of assessment framework within a medical school. A literature review on best practices in assessment highlighted six principles that guided implementation of the program of assessment in 2016-2017: (1) a centrally coordinated plan for assessment aligns with and supports a curricular vision; (2) multiple assessment tools used longitudinally generate multiple data points; (3) learners require ready access to information-rich feedback to promote reflection and informed self-assessment; (4) mentoring is essential to facilitate effective data use for reflection and learning planning; (5) the program of assessment fosters self-regulated learning behaviors; and (6) expert groups make summative decisions about grades and readiness for advancement. Implementation incorporated stakeholder engagement, use of multiple assessment tools, design of a coaching program, and creation of a learner performance dashboard. The assessment team monitors adherence to principles defining the program of assessment and gathers and responds to regular feedback from key stakeholders, including faculty, staff, and students. Next steps include systematically collecting evidence for validity of individual assessments and the program overall. Iterative review of student performance data informs curricular improvements. The program of assessment also highlights technology needs that will be addressed with information technology experts. The outcome ultimately will entail showing evidence of validity that the program produces physicians who engage in lifelong learning and provide high-quality patient care.

Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

Science.gov (United States)

Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F

2016-03-01

In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results. Copyright © 2015 Elsevier Ltd. All rights reserved.

The American College of Surgeons/Association of Program Directors in Surgery National Skills Curriculum: adoption rate, challenges and strategies for effective implementation into surgical residency programs.

Science.gov (United States)

Korndorffer, James R; Arora, Sonal; Sevdalis, Nick; Paige, John; McClusky, David A; Stefanidis, Dimitris

2013-07-01

The American College of Surgeons/Association of Program Directors in Surgery (ACS/APDS) National Skills Curriculum is a 3-phase program targeting technical and nontechnical skills development. Few data exist regarding the adoption of this curriculum by surgical residencies. This study attempted to determine the rate of uptake and identify implementation enablers/barriers. A web-based survey was developed by an international expert panel of surgical educators (5 surgeons and 1 psychologist). After piloting, the survey was sent to all general surgery program directors via email link. Descriptive statistics were used to determine the residency program characteristics and perceptions of the curriculum. Implementation rates for each phase and module were calculated. Adoption barriers were identified quantitatively and qualitatively using free text responses. Standardized qualitative methodology of emergent theme analysis was used to identify strategies for success and details of support required for implementation. Of the 238 program directors approached, 117 (49%) responded to the survey. Twenty-one percent (25/117) were unaware of the ACS/APDS curriculum. Implementation rates for were 36% for phase I, 19% for phase II, and 16% for phase III. The most common modules adopted were the suturing, knot-tying, and chest tube modules of phase I. Over 50% of respondents identified lack of faculty protected time, limited personnel, significant costs, and resident work-hour restrictions as major obstacles to implementation. Strategies for effective uptake included faculty incentives, adequate funding, administrative support, and dedicated time and resources. Despite the availability of a comprehensive curriculum, its diffusion into general surgery residency programs remains low. Obstacles related to successful implementation include personnel, learner, and administrative issues. Addressing these issues may improve the adoption rate of the curriculum. Copyright © 2013 Mosby, Inc

Effect of care management program structure on implementation: a normalization process theory analysis.

Science.gov (United States)

Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A

2016-08-15

Care management in primary care can be effective in helping patients with chronic disease improve their health status, however, primary care practices are often challenged with implementation. Further, there are different ways to structure care management that may make implementation more or less successful. Normalization process theory (NPT) provides a means of understanding how a new complex intervention can become routine (normalized) in practice. In this study, we used NPT to understand how care management structure affected how well care management became routine in practice. Data collection involved semi-structured interviews and observations conducted at 25 practices in five physician organizations in Michigan, USA. Practices were selected to reflect variation in physician organizations, type of care management program, and degree of normalization. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with NPT as a guiding framework. Seventy interviews and 25 observations were completed. Two key structures for care management organization emerged: practice-based care management where the care managers were embedded in the practice as part of the practice team; and centralized care management where the care managers worked independently of the practice work flow and was located outside the practice. There were differences in normalization of care management across practices. Practice-based care management was generally better normalized as compared to centralized care management. Differences in normalization were well explained by the NPT, and in particular the collective action construct. When care managers had multiple and flexible opportunities for communication (interactional workability), had the requisite knowledge, skills, and personal characteristics (skill set workability), and the organizational support and resources (contextual integration), a trusting professional relationship

The effects of teacher fidelity of implementation of pathways to health on student outcomes.

Science.gov (United States)

Little, Melissa A; Riggs, Nathaniel R; Shin, Hee-Sung; Tate, Eleanor B; Pentz, Mary Ann

2015-03-01

Previous research has demonstrated the importance of ensuring that programs are implemented as intended by program developers in order to achieve desired program effects. The current study examined implementation fidelity of Pathways to Health (Pathways), a newly developed obesity prevention program for fourth- through sixth-grade children. We explored the associations between self-reported and observed implementation fidelity scores and whether implementation fidelity differed across the first 2 years of program implementation. Additionally, we examined whether implementation fidelity affected program outcomes and whether teacher beliefs were associated with implementation fidelity. The program was better received, and implementation fidelity had more effects on program outcomes in fifth grade than in fourth grade. Findings suggest that implementation in school-based obesity programs may affect junk food intake and intentions to eat healthfully and exercise. School support was associated with implementation fidelity, suggesting that prevention programs may benefit from including a component that boosts school-wide support. © The Author(s) 2013.

Model for implementing cognitive behavioural therapy for smartphone app based smoking cessation program

Directory of Open Access Journals (Sweden)

Abdullah Alsharif

2015-11-01

Full Text Available Smoking cessation programs are widely implemented to assist smokers in the process of quitting smoking. Cognitive Behavioural Therapy (CBT is a psychological approach that is increasingly used in smoking cessation programs. CBT has also been implemented for smoking cessation programs and has been successful in helping smokers to quit. Another advantage of CBT is that it can be combined with different tools and technologies and hence made to deliver effective health intervention programs. The recent advancements in smartphone technologies have been widely explored to develop smoking cessation apps as tools to assist with quitting smoking. However, most existing smartphone apps lack follow-up and adherence to clinical guidelines for treatment. To date, there are no studies which have explored implementing CBT modules into smoking cessation apps. Therefore, there is a need for implementing behavioural change mechanisms in smoking cessation apps to help smokers quit effectively. In this study, we propose a new approach that combines mobile health technology and CBT methods to provide an effective smoking cessation program. The ubiquitous presence of smartphones and the various communication benefits they provide are utilized by our proposed system to provide a CBT paradigm into smoking cessation app systems and hence enhance their success potential. Currently, the proposed system is at the implementation stage, which is soon to be followed by a clinical trial to study the impact of this system on smoking cessation.

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

Science.gov (United States)

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

2015-01-22

The failure rates for implementing complex innovations in healthcare organizations are high. Estimates range from 30% to 90% depending on the scope of the organizational change involved, the definition of failure, and the criteria to judge it. The innovation implementation framework offers a promising approach to examine the organizational factors that determine effective implementation. To date, the utility of this framework in a healthcare setting has been limited to qualitative studies and/or group level analyses. Therefore, the goal of this study was to quantitatively examine this framework among individual participants in the National Cancer Institute's Community Clinical Oncology Program using structural equation modeling. We examined the innovation implementation framework using structural equation modeling (SEM) among 481 physician participants in the National Cancer Institute's Community Clinical Oncology Program (CCOP). The data sources included the CCOP Annual Progress Reports, surveys of CCOP physician participants and administrators, and the American Medical Association Physician Masterfile. Overall the final model fit well. Our results demonstrated that not only did perceptions of implementation climate have a statistically significant direct effect on implementation effectiveness, but physicians' perceptions of implementation climate also mediated the relationship between organizational implementation policies and practices (IPP) and enrollment (p innovation implementation framework between IPP, implementation climate, and implementation effectiveness among individual physicians. This finding is important, as although the model has been discussed within healthcare organizations before, the studies have been predominately qualitative in nature and/or at the organizational level. In addition, our findings have practical applications. Managers looking to increase implementation effectiveness of an innovation should focus on creating an environment that

Adherence and delivery: Implementation quality and program outcomes for the 7th grade keepin’ it REAL program

Science.gov (United States)

Pettigrew, Jonathan; Graham, John W.; Miller-Day, Michelle; Hecht, Michael L.; Krieger, Janice L.; Shin, Young Ju

2014-01-01

Poor implementation quality (IQ) is known to reduce program effects making it important to consider IQ for evaluation and dissemination of prevention programs. However, less is known about the ways specific implementation variables relate to outcomes. In this study, two versions of the keepin’ it REAL, 7th grade drug prevention intervention were implemented in 78 classrooms in 25 schools in rural districts in Pennsylvania and Ohio. IQ was measured through observational coding of 276 videos. IQ variables included adherence to the curriculum, teacher engagement (attentiveness, enthusiasm, seriousness, clarity, positivity), student engagement (attention, participation), and a global rating of teacher delivery quality. Factor analysis showed that teacher engagement, student engagement, and delivery quality formed one factor, which was labeled delivery. A second factor was adherence to the curriculum. Self-report student surveys measured substance use, norms (beliefs about prevalence and acceptability of use), and efficacy (beliefs about one’s ability to refuse substance offers) at two waves (pretest, immediate posttest). Mixed model regression analysis which accounted for missing data and controlled for pretest levels examined implementation quality’s effects on individual level outcomes, statistically controlling for cluster level effects. Results show that when implemented well, students show positive outcomes compared to students receiving a poorly implemented program. Delivery significantly influenced substance use and norms, but not efficacy. Adherence marginally significantly predicted use and significantly predicted norms, but not efficacy. Findings underscore the importance of comprehensively measuring and accounting for IQ, particularly delivery, when evaluating prevention interventions. PMID:24442403

Effective prevention programs for tobacco use.

Science.gov (United States)

Pentz, M A

1999-01-01

Several types of prevention programs have shown effects on delaying or reducing youth tobacco use for periods of 1-5 years or more. These are referred to as evidence-based programs. However, they are not widely used. At the same time, with few exceptions, adolescent tobacco use rates have been stable or have increased in the 1990s. The challenge for prevention is to identify critical components shared by effective prevention programs--that is, components most associated with effect, and then to evaluate factors that are most likely to promote adoption, implementation, and diffusion of effective programs across schools and communities in the United States. Effective tobacco prevention programs focus on counteracting social influences on tobacco use, include either direct training of youth in resistance and assertiveness skills or, for policy and community organization interventions, direct or indirect (through adults) training in community activism, and are mainly theory-based, with an emphasis on three levels of theory: (a) personal (attitudes, normative expectations, and beliefs); (b) social (social or group behavior); and/or (c) environmental (communications and diffusion). Program effects increase with the use of booster sessions, standardized implementor training and support, multiple program components, and multiple levels of theory. Overall, multi-component community programs that have a school program as a basis, with supportive parent, media, and community organization components, have shown the most sustained effects on tobacco use. Positive program adoption by the school or community, extent and quality of program implementation, and existence of credible networks of leaders to promote the program are critical for any effect. Research on predictors of adoption, implementation, and diffusion of evidence-based programs is scanty relative to outcome research. In addition, more research is needed on why multi-component programs appear to be most effective

Tank waste remediation system privatization infrastructure program configuration management implementation plan

International Nuclear Information System (INIS)

Schaus, P.S.

1998-01-01

This Configuration Management Implementation Plan (CMIP) was developed to assist in managing systems, structures, and components (SSCS), to facilitate the effective control and statusing of changes to SSCS, and to ensure technical consistency between design, performance, and operational requirements. Its purpose is to describe the approach Privatization Infrastructure will take in implementing a configuration management program, to identify the Program's products that need configuration management control, to determine the rigor of control, and to identify the mechanisms for that control

School Indoor Air Quality Assessment and Program Implementation.

Science.gov (United States)

Prill, R.; Blake, D.; Hales, D.

This paper describes the effectiveness of a three-step indoor air quality (IAQ) program implemented by 156 schools in the states of Washington and Idaho during the 2000-2001 school year. An experienced IAQ/building science specialist conducted walk-through assessments at each school. These assessments documented deficiencies and served as an…

Developing an active implementation model for a chronic disease management program.

Science.gov (United States)

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

2013-04-01

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

Implementation of radiation safety program in a medical institution

International Nuclear Information System (INIS)

Palanca, Elena D.

1999-01-01

A medical institution that utilizes radiation for the diagnosis and treatment of diseases of malignancies develops and implements a radiation safety program to keep occupational exposures of radiation workers and exposures of non-radiation workers and the public to the achievable and a more achievable minimum, to optimize the use of radiation, and to prevent misadministration. The hospital radiation safety program is established by a core medical radiation committee composed of trained radiation safety officers and head of authorized users of radioactive materials and radiation machines from the different departments. The radiation safety program sets up procedural guidelines of the safe use of radioactive material and of radiation equipment. It offers regular training to radiation workers and radiation safety awareness courses to hospital staff. The program has a comprehensive radiation safety information system or radsis that circularizes the radiation safety program in the hospital. The radsis keeps the drafted and updated records of safety guides and policies, radioactive material and equipment inventory, personnel dosimetry reports, administrative, regulatory and licensing activity document, laboratory procedures, emergency procedures, quality assurance and quality control program process, physics and dosimetry procedures and reports, personnel and hospital staff training program. The medical radiation protection committee is tasked to oversee the actual implementation of the radiation safety guidelines in the different radiation facilities in the hospital, to review personnel exposures, incident reports and ALARA actions, operating procedures, facility inspections and audit reports, to evaluate the existing radiation safety procedures, to make necessary changes to these procedures, and make modifications of course content of the training program. The effective implementation of the radiation safety program provides increased confidence that the physician and

Implementing the AECL decommissioning quality assurance program at the Chalk River and Whiteshell Laboratories

International Nuclear Information System (INIS)

Colotelo, C.A.; Attas, E.M.; Stephens, M.E.

2006-01-01

This paper describes the approach and progress in developing, implementing and maintaining a quality assurance (QA) program for decommissioning at the nuclear facilities managed by Atomic Energy of Canada Limited (AECL). Decommissioning activities conducted by AECL are varied in nature, so the QA program must provide adequate flexibility, while maintaining consistency with accepted quality standards. Well-written documentation adhering to the applicable decommissioning standards is a key factor. Manager commitment and input during the writing of the documentation are also important to ensure relevance of the QA program and effectiveness of implementation. Training in the use of the quality assurance plan and procedures is vital to the understanding of the QA program. Beyond the training aspect there is a need for the quality assurance program to be supported by a QA subject expert who is able to advise the group in implementing the Quality Program with consistency over the range of decommissioning work activities and to provide continual assessment of the quality assurance program for efficiency and effectiveness, with a concomitant continuous improvement process. (author)

75 FR 48934 - Coral Reef Conservation Program Implementation Guidelines

Science.gov (United States)

2010-08-12

...-01] RIN 0648-ZC19 Coral Reef Conservation Program Implementation Guidelines AGENCY: National Oceanic... Guidelines (Guidelines) for the Coral Reef Conservation Program (CRCP or Program) under the Coral Reef... assistance for coral reef conservation projects under the Act. NOAA revised the Implementation Guidelines for...

Implementing Cardiopulmonary Resuscitation Training Programs in High Schools: Iowa's Experience.

Science.gov (United States)

Hoyme, Derek B; Atkins, Dianne L

2017-02-01

To understand perceived barriers to providing cardiopulmonary resuscitation (CPR) education, implementation processes, and practices in high schools. Iowa has required CPR as a graduation requirement since 2011 as an unfunded mandate. A cross-sectional study was performed through multiple choice surveys sent to Iowa high schools to collect data about school demographics, details of CPR programs, cost, logistics, and barriers to implementation, as well as automated external defibrillator training and availability. Eighty-four schools responded (26%), with the most frequently reported school size of 100-500 students and faculty size of 25-50. When the law took effect, 51% of schools had training programs already in place; at the time of the study, 96% had successfully implemented CPR training. Perceived barriers to implementation were staffing, time commitment, equipment availability, and cost. The average estimated startup cost was $1000 US, and the yearly maintenance cost was <$500 with funds typically allocated from existing school resources. The facilitator was a school official or volunteer for 81% of schools. Average estimated training time commitment per student was <2 hours. Automated external defibrillators are available in 98% of schools, and 61% include automated external defibrillator training in their curriculum. Despite perceived barriers, school CPR training programs can be implemented with reasonable resource and time allocations. Copyright © 2016 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2012-01-01

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

A multithreaded parallel implementation of a dynamic programming algorithm for sequence comparison.

Science.gov (United States)

Martins, W S; Del Cuvillo, J B; Useche, F J; Theobald, K B; Gao, G R

2001-01-01

This paper discusses the issues involved in implementing a dynamic programming algorithm for biological sequence comparison on a general-purpose parallel computing platform based on a fine-grain event-driven multithreaded program execution model. Fine-grain multithreading permits efficient parallelism exploitation in this application both by taking advantage of asynchronous point-to-point synchronizations and communication with low overheads and by effectively tolerating latency through the overlapping of computation and communication. We have implemented our scheme on EARTH, a fine-grain event-driven multithreaded execution and architecture model which has been ported to a number of parallel machines with off-the-shelf processors. Our experimental results show that the dynamic programming algorithm can be efficiently implemented on EARTH systems with high performance (e.g., speedup of 90 on 120 nodes), good programmability and reasonable cost.

Anglo-Saxon experience in the implementation of correctional treatment and the Polish individual rehabilitation program

Directory of Open Access Journals (Sweden)

Maciej Bernasiewicz

2012-12-01

Full Text Available The authors cite American and British research on the effectiveness of correctional treatment. On that basis, they describe several crucial factors that affect the success of rehabilitation (e.g., educators’ skills, working with families of juvenile offenders. The article broadly discusses the specific juvenile residential treatment program that has been implemented in Florida. The conclusions of this program are drawn from the research conducted through interviews with juvenile offenders (young adults who have effectively completed the process of rehabilitation in correctional facilities. Furthermore, the authors discuss an individual program of rehabilitation (IPR implemented in Polish correctional facilities. Using the experience and the impact of correctional treatment in the West, it is proposed to introduce certain modifications in the planning and implementation of Polish correctional treatment programs (IPR s.

Data Decision-Making and Program-Wide Implementation of the Pyramid Model. Roadmap to Effective Intervention Practices #7

Science.gov (United States)

Fox, Lise; Veguilla, Myrna; Perez Binder, Denise

2014-01-01

The Technical Assistance Center on Social Emotional Intervention for Young Children (TACSEI) Roadmap on "Data Decision-Making and Program-Wide Implementation of the Pyramid Model" provides programs with guidance on how to collect and use data to ensure the implementation of the Pyramid Model with fidelity and decision-making that…

Implementing an anti-smoking program in rural-remote communities: challenges and strategies.

Science.gov (United States)

Tall, Julie A; Brew, Bronwyn K; Saurman, Emily; Jones, Therese C

2015-01-01

Rural-remote communities report higher smoking rates and poorer health outcomes than that of metropolitan areas. While anti-smoking programs are an important measure for addressing smoking and improving health, little is known of the challenges faced by primary healthcare staff implementing those programs in the rural-remote setting. The aim of this study was to explore the challenges and strategies of implementing an anti-smoking program by primary healthcare staff in rural-remote Australia. Guided by a phenomenological approach, semi-structured interviews and focus groups were conducted with health service managers, case managers and general practitioners involved in program implementation in Australian rural-remote communities between 2008 and 2010. Program implementation was reported to be challenged by limited primary and mental healthcare resources and client access to services; limited collaboration between health services; the difficulty of accessing staff training; high levels of community distress and disadvantage; the normalisation of smoking and its deleterious impact on smoking abstinence among program clients; and low morale among health staff. Strategies identified to overcome challenges included appointing tobacco-dedicated staff; improving health service collaboration, access and flexibility; providing subsidised pharmacotherapies and boosting staff morale. Findings may assist health services to better tailor anti-smoking programs for the rural-remote setting, where smoking rates are particularly high. Catering for the unique challenges of the rural-remote setting is necessary if anti-smoking programs are to be efficacious, cost-effective and capable of improving rural-remote health outcomes.

Overview of implementation of DARPA GPU program in SAIC

Science.gov (United States)

Braunreiter, Dennis; Furtek, Jeremy; Chen, Hai-Wen; Healy, Dennis

2008-04-01

This paper reviews the implementation of DARPA MTO STAP-BOY program for both Phase I and II conducted at Science Applications International Corporation (SAIC). The STAP-BOY program conducts fast covariance factorization and tuning techniques for space-time adaptive process (STAP) Algorithm Implementation on Graphics Processor unit (GPU) Architectures for Embedded Systems. The first part of our presentation on the DARPA STAP-BOY program will focus on GPU implementation and algorithm innovations for a prototype radar STAP algorithm. The STAP algorithm will be implemented on the GPU, using stream programming (from companies such as PeakStream, ATI Technologies' CTM, and NVIDIA) and traditional graphics APIs. This algorithm will include fast range adaptive STAP weight updates and beamforming applications, each of which has been modified to exploit the parallel nature of graphics architectures.

Strategies in disability management. Corporate disability management programs implemented at the work site.

Science.gov (United States)

Kalina, C M

1999-10-30

Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.

Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

Science.gov (United States)

Kelsey, Meredith; Layzer, Jean

2014-03-01

This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Mentoring program design and implementation in new medical schools

Science.gov (United States)

Fornari, Alice; Murray, Thomas S.; Menzin, Andrew W.; Woo, Vivian A.; Clifton, Maurice; Lombardi, Marion; Shelov, Steven

2014-01-01

Purpose Mentoring is considered a valuable component of undergraduate medical education with a variety of programs at established medical schools. This study presents how new medical schools have set up mentoring programs as they have developed their curricula. Methods Administrators from 14 US medical schools established since 2006 were surveyed regarding the structure and implementation of their mentoring programs. Results The majority of new medical schools had mentoring programs that varied in structure and implementation. Although the programs were viewed as valuable at each institution, challenges when creating and implementing mentoring programs in new medical schools included time constraints for faculty and students, and lack of financial and professional incentives for faculty. Conclusions Similar to established medical schools, there was little uniformity among mentoring programs at new medical schools, likely reflecting differences in curriculum and program goals. Outcome measures are needed to determine whether a best practice for mentoring can be established. PMID:24962112

Implementation Measurement for Evidence-Based Violence Prevention Programs in Communities.

Science.gov (United States)

Massetti, Greta M; Holland, Kristin M; Gorman-Smith, Deborah

2016-08-01

Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.

Turtle Graphics implementation using a graphical dataflow programming approach

OpenAIRE

Lovejoy, Robert Steven

1992-01-01

Approved for public release; distribution is unlimited This thesis expands the concepts of object-oriented programming to implement a visual dataflow programming language. The main thrust of this research is to develop a functional prototype language, based upon the Turtle Graphics tool provided by LOGO programming language, for children to develop both their problem solving skills as well as their general programming skills. The language developed for this thesis was implemented in the...

A Case Study on the Implementation of a Positive Youth Development Program (Project P.A.T.H.S. in Hong Kong: Learning from the Experimental Implementation Phase

Directory of Open Access Journals (Sweden)

Tak Yan Lee

2008-01-01

Full Text Available This investigation of the implementation of a positive youth development program (Project P.A.T.H.S. was part of a large study undertaken comprehensively to explore how effective the Tier 1 Program was in practice and how the results can shed light on future developments. Utilizing a case study approach, individual and focus group interviews were conducted in 2007 to examine the factors that influence the process and quality of implementation of the Tier 1 Program of the Project P.A.T.H.S. The focus of this study was on how the implementers of a school made use of the experience gained in the Experimental Implementation Phase (EIP in 2005/06 to improve the program implementation quality in the Full Implementation Phase (FIP in 2006/07. Results showed that the program implementation in the FIP was generally high and the program was well received by the implementers. Factors that facilitated the implementation of the program were identified, including the adoption of an incremental change strategy, the incorporation of the program into both formal and informal curricula, positive perceptions of the program among staff and agency social workers, sufficient school administrative support, excellent cooperation between the school and the social work agency, presence of a dedicated school contact person and instructors who engaged themselves in continuous quality improvement of the implementation, and an emphasis on application of what had been learned. Difficulties encountered by the school in the process of implementation were also observed. Based on the present findings, key process variables that facilitate or impede the implementation of positive youth development programs are discussed. Implications for future program implementation are also discussed.

Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence.

Science.gov (United States)

Reilly, Rachel; Evans, Katharine; Gomersall, Judith; Gorham, Gillian; Peters, Micah D J; Warren, Steven; O'Shea, Rebekah; Cass, Alan; Brown, Alex

2016-04-06

Indigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of disease progression is an important priority for practitioners and policy-makers. A systematic review of mixed evidence was undertaken to examine the evidence relating to the effectivness, cost-effectiveness and acceptability of chronic kidney disease management programs designed for Indigenous people, as well as barriers and enablers of implementation of such programs. Published and unpublished studies reporting quantitative and qualitative data on health sector-led management programs and models of care explicitly designed to manage, slow progression or otherwise improve the lives of Indigenous people with CKD published between 2000 and 2014 were considered for inclusion. Data on clinical effectiveness, ability to self-manage, quality of life, acceptability, cost and cost-benefit, barriers and enablers of implementation were of interest. Quantitative data was summarized in narrative and tabular form and qualitative data was synthesized using the Joanna Briggs Institute meta-aggregation approach. Ten studies were included. Six studies provided evidence of clinical effectiveness of CKD programs designed for Indigenous people, two provided evidence of cost and cost-effectiveness of a CKD program, and two provided qualitative evidence of barriers and enablers of implementation of effective and/or acceptable CKD management programs. Common features of effective and acceptable programs were integration within existing services, nurse-led care, intensive follow-up, provision of culturally-appropriate education, governance structures supporting community ownership, robust clinical systems supporting communication and a central role for Indigenous Health Workers. Given

Implementation and evaluation of a training program as part of the Cooperative Biological Engagement Program in Azerbaijan

Directory of Open Access Journals (Sweden)

April eJohnson

2015-10-01

Full Text Available A training program for animal and human health professionals has been implemented in Azerbaijan through a joint agreement between the United States Defense Threat Reduction Agency and the Government of Azerbaijan. The training program is administered as part of the Cooperative Biological Engagement Program, and targets key employees in Azerbaijan’s disease surveillance system including physicians, veterinarians, epidemiologists, and laboratory personnel. Training is aimed at improving detection, diagnosis, and response to especially dangerous pathogens, although the techniques and methodologies can be applied to other pathogens and diseases of concern. Biosafety and biosecurity training is provided to all trainees within the program. Prior to 2014, a variety of international agencies and organizations provided training, which resulted in gaps related to lack of coordination of training materials and content. In 2014 a new training program was implemented in order to address those gaps. This paper provides an overview of the Cooperative Biological Engagement Program training program in Azerbaijan, a description of how the program fits into existing national training infrastructure, and an evaluation of the new program’s effectiveness to date. Long-term sustainability of the program is also discussed.

Implementing an Information Security Program

Energy Technology Data Exchange (ETDEWEB)

Glantz, Clifford S.; Lenaeus, Joseph D.; Landine, Guy P.; O' Neil, Lori Ross; Leitch, Rosalyn; Johnson, Christopher; Lewis, John G.; Rodger, Robert M.

2017-11-01

The threats to information security have dramatically increased with the proliferation of information systems and the internet. Chemical, biological, radiological, nuclear, and explosives (CBRNe) facilities need to address these threats in order to protect themselves from the loss of intellectual property, theft of valuable or hazardous materials, and sabotage. Project 19 of the European Union CBRN Risk Mitigation Centres of Excellence Initiative is designed to help CBRN security managers, information technology/cybersecurity managers, and other decision-makers deal with these threats through the application of cost-effective information security programs. Project 19 has developed three guidance documents that are publically available to cover information security best practices, planning for an information security management system, and implementing security controls for information security.

41 CFR 102-38.360 - What must an executive agency do to implement the eFAS program?

Science.gov (United States)

2010-07-01

... PROPERTY 38-SALE OF PERSONAL PROPERTY Implementation of the Federal Asset Sales Program § 102-38.360 What must an executive agency do to implement the eFAS program? (a) An executive agency must review the effectiveness of all sales solutions, and compare them to the effectiveness (e.g., cost, level of service, and...

A Strategic Approach to Implementation of Medical Mentorship Programs.

Science.gov (United States)

Caruso, Thomas J; Steinberg, Diane H; Piro, Nancy; Walker, Kimberly; Blankenburg, Rebecca; Rassbach, Caroline; Marquez, Juan L; Katznelson, Laurence; Dohn, Ann

2016-02-01

Mentors influence medical trainees' experiences through career enhancement and psychosocial support, yet some trainees never receive benefits from involved mentors. Our goals were to examine the effectiveness of 2 interventions aimed at increasing the number of mentors in training programs, and to assess group differences in mentor effectiveness, the relationship between trainees' satisfaction with their programs given the presence of mentors, and the relationship between the number of trainees with mentors and postgraduate year (PGY). In group 1, a physician adviser funded by the graduate medical education department implemented mentorships in 6 residency programs, while group 2 involved a training program with funded physician mentoring time. The remaining 89 training programs served as controls. Chi-square tests were used to determine differences. Survey responses from group 1, group 2, and controls were 47 of 84 (56%), 34 of 78 (44%), and 471 of 981 (48%, P = .38), respectively. The percentages of trainees reporting a mentor in group 1, group 2, and the control group were 89%, 97%, and 79%, respectively (P = .01). There were no differences in mentor effectiveness between groups. Mentored trainees were more likely to be satisfied with their programs (P = .01) and to report that faculty supported their professional aspirations (P = .001). Across all programs, fewer first-year trainees (59%) identified a mentor compared to PGY-2 through PGY-8 trainees (84%, P program is an effective way to create an educational environment that maximizes trainees' perceptions of mentorship and satisfaction with their training programs.

42 CFR 414.406 - Implementation of programs.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Implementation of programs. 414.406 Section 414.406 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) § 414.406 Implementation...

Factors Impacting Program Delivery: The Importance of Implementation Research in Extension

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Ryan J. Gagnon

2015-06-01

Full Text Available Cooperative Extension is in a unique position, given its relationship with research-based, Land-Grant Universities, to advance the scholarship of implementation research. A stronger shift towards evidence-based practice has been occurring, oriented towards the assessment of programs for outcomes. This paper explores core concepts related to program implementation and delves into factors that influence successful implementation of Extension programs and services. The importance of implementation within the Extension Program Development Model is explored, along with emerging issues and trends.

CSSP implementation plan for space plasma physics programs

International Nuclear Information System (INIS)

Baker, D.N.; Williams, D.J.; Johns Hopkins Univ., Laurel, MD)

1985-01-01

The Committee on Solar and Space Physics (CSSP) has provided NASA with guidance in the areas of solar, heliospheric, magnetospheric, and upper atmospheric research. The budgetary sitation confronted by NASA has called for a prioritized plane for the implementation of solar and space plasma physics programs. CSSP has developed the following recommendations: (1) continue implementation of both the Upper Atmosphere Research Satellite and Solar Optical Telescope programs; (2) initiate the International Solar Terrestrial Physics program; (3) plan for later major free-flying missions and carry out the technology development they require; (4) launch an average of one solar and space physics Explorer per yr beginning in 1990; (5) enhance current Shuttle/Spacelab programs; (6) develop facility-class instrumentation; (7) augment the solar terrestrial theory program by FY 1990; (8) support a compute modeling program; (9) strengthen the research and analysis program; and (10) maintain a stable suborbital program for flexible science objectives in upper atmosphere and space plasma physics

Implementing the MOVE! weight-management program in the Veterans Health Administration, 2007-2010: a qualitative study.

Science.gov (United States)

Weiner, Bryan J; Haynes-Maslow, Lindsey; Kahwati, Leila C; Kinsinger, Linda S; Campbell, Marci K

2012-01-01

One-third of US veterans receiving care at Veterans Health Administration (VHA) medical facilities are obese and, therefore, at higher risk for developing multiple chronic diseases. To address this problem, the VHA designed and nationally disseminated an evidence-based weight-management program (MOVE!). The objective of this study was to examine the organizational factors that aided or inhibited the implementation of MOVE! in 10 VHA medical facilities. Using a multiple, holistic case study design, we conducted 68 interviews with medical center program coordinators, physicians formally appointed as program champions, managers directly responsible for overseeing the program, clinicians from the program's multidisciplinary team, and primary care physicians identified by program coordinators as local opinion leaders. Qualitative data analysis involved coding, memorandum writing, and construction of data displays. Organizational readiness for change and having an innovation champion were most consistently the 2 factors associated with MOVE! implementation. Other organizational factors, such as management support and resource availability, were barriers to implementation or exerted mixed effects on implementation. Barriers did not prevent facilities from implementing MOVE! However, they were obstacles that had to be overcome, worked around, or accepted as limits on the program's scope or scale. Policy-directed implementation of clinical weight-management programs in health care facilities is challenging, especially when no new resources are available. Instituting powerful, mutually reinforcing organizational policies and practices may be necessary for consistent, high-quality implementation.

Secondary Data Analyses of Conclusions Drawn by the Program Implementers of a Positive Youth Development Program in Hong Kong

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Andrew M. H. Siu

2010-01-01

Full Text Available The Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes is designed for adolescents with significant psychosocial needs, and its various programs are designed and implemented by social workers (program implementers for specific student groups in different schools. Using subjective outcome evaluation data collected from the program participants (Form C at 207 schools, the program implementers were asked to aggregate data and write down five conclusions (n = 1,035 in their evaluation reports. The conclusions stated in the evaluation reports were further analyzed via secondary data analyses in this study. Results showed that the participants regarded the Tier 2 Program as a success, and was effective in enhancing self-understanding, interpersonal skills, and self-management. They liked the experiential learning approach and activities that are novel, interesting, diversified, adventure-based, and outdoor in nature. They also liked instructors who were friendly, supportive, well-prepared, and able to bring challenges and give positive recognition. Most of the difficulties encountered in running the programs were related to time constraints, clashes with other activities, and motivation of participants. Consistent with the previous evaluation findings, the present study suggests that the Tier 2 Program was well received by the participants and that it was beneficial to the development of the program participants.

IMPLEMENTATION OF PROGRAM THE VILLAGE EMPOWERMENT IN RIAU PROVINCE

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trio saputra

2017-03-01

Full Text Available Village empowerment program Implementation (PPD is a program of the Riau provincial government and the community empowerment directed to rural villages to accelerate poverty reduction through economic development and rural communities. The method used in this research is qualitative discriftif, collecting data through interviews, observation and documentation. The theory used is Edward III of policy implementation. Four variables in the analysis of public policies is Communications, Resources, attitudes and bureaucratic structures. PPD Communications implemented in two ways, namely as a reference guide book uniformity of language policy and technical meetings Tiered as form of direct communication between stakeholders in dealing with problems that arise. Resources consist of human resources and budget. The attitude and commitment of the determination visible implementing decree on the implementation team, commitment to cooperation and commitment duplication of programs by the district / city. While PPD graded organizational structure that is provincial, district / city and district. Each level has a structure and job descriptions of each.

Long Live Love+: Evaluation of the Implementation of an Online School-Based Sexuality Education Program in the Netherlands

Science.gov (United States)

van Lieshout, Sanne; Mevissen, Fraukje; de Waal, Esri; Kok, Gerjo

2017-01-01

Schools are a common setting for adolescents to receive health education, but implementation of these programs with high levels of completeness and fidelity is not self-evident. Programs that are only partially implemented (completeness) or not implemented as instructed (fidelity) are unlikely to be effective. Therefore, it is important to…

Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

Science.gov (United States)

Dennis, Sarah; Hetherington, Sharon A; Borodzicz, Jerrad A; Hermiz, Oshana; Zwar, Nicholas A

2015-04-01

Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration

Evaluation of the Tier 1 Program of Project P.A.T.H.S.: Secondary Data Analyses of Conclusions Drawn by the Program Implementers

Directory of Open Access Journals (Sweden)

Daniel T. L. Shek

2008-01-01

Full Text Available The Tier 1 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes is a curricula-based positive youth development program. In the experimental implementation phase, 52 schools participated in the program. Based on subjective outcome evaluation data collected from the program participants (Form A and program implementers (Form B in each school, the program implementers were invited to write down five conclusions based on an integration of the evaluation findings (N = 52. The conclusions stated in the 52 evaluation reports were further analyzed via secondary data analyses in this paper. Results showed that most of the conclusions concerning perceptions of the Tier 1 Program, instructors, and effectiveness of the programs were positive in nature. There were also conclusions reflecting the respondents’ appreciation of the program. Finally, responses on the difficulties encountered and suggestions for improvements were observed. In conjunction with the previous evaluation findings, the present study suggests that the Tier 1 Program was well received by the stakeholders and the program was beneficial to the development of the program participants.

Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: a mixed methods program evaluation.

Science.gov (United States)

Manca, Donna Patricia; Aubrey-Bassler, Kris; Kandola, Kami; Aguilar, Carolina; Campbell-Scherer, Denise; Sopcak, Nicolette; O'Brien, Mary Ann; Meaney, Christopher; Faria, Vee; Baxter, Julia; Moineddin, Rahim; Salvalaggio, Ginetta; Green, Lee; Cave, Andrew; Grunfeld, Eva

2014-10-08

The objectives of this paper are to describe the planned implementation and evaluation of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER 2) program which originated from the BETTER trial. The pragmatic trial, informed by the Chronic Care Model, demonstrated the effectiveness of an approach to Chronic Disease Prevention and Screening (CDPS) involving the use of a new role, the prevention practitioner. The desired goals of the program are improved clinical outcomes, reduction in the burden of chronic disease, and improved sustainability of the health-care system through improved CDPS in primary care. The BETTER 2 program aims to expand the implementation of the intervention used in the original BETTER trial into communities across Canada (Alberta, Ontario, Newfoundland and Labrador, the Northwest Territories and Nova Scotia). This proactive approach provides at-risk patients with an intervention from the prevention practitioner, a health-care professional. Using the BETTER toolkit, the prevention practitioner determines which CDPS actions the patient is eligible to receive, and through shared decision-making and motivational interviewing, develops a unique and individualized 'prevention prescription' with the patient. This intervention is 1) personalized; 2) addressing multiple conditions; 3) integrated through linkages to local, regional, or national resources; and 4) longitudinal by assessing patients over time. The BETTER 2 program brings together primary care providers, policy/decision makers and researchers to work towards improving CDPS in primary care. The target patient population is adults aged 40-65. The reach, effectiveness, adoption, implementation, maintain (RE-AIM) framework will inform the evaluation of the program through qualitative and quantitative methods. A composite index will be used to quantitatively assess the effectiveness of the prevention practitioner intervention. The CDPS actions

Pile Structure Program, Projected Start Date : January 1, 2010 (Implementation).

Energy Technology Data Exchange (ETDEWEB)

Collins, Chris; Corbett, Catherine [Lower Columbia River Estuary Partnership; Ebberts, Blaine [U.S. Army Corps of Engineers

2009-07-27

The 2008 Federal Columbia River Power System Biological Opinion includes Reasonable and Prudent Alternative 38-Piling and Piling Dike Removal Program. This RPA directs the Action Agencies to work with the Estuary Partnership to develop and implement a piling and pile dike removal program. The program has since evolved to include modifying pile structures to enhance their habitat value and complexity by adding large woody debris. The geographic extent of the Pile Structure Program (PSP) includes all tidally-influenced portions of the lower Columbia River below Bonneville Dam; however, it will focus on the mainstem. The overarching goal of the PSP is to enhance and restore ecosystem structure and function for the recovery of federally listed salmonids through the active management of pile structures. To attain this goal, the program team developed the following objectives: (1) Develop a plan to remove or modify pile structures that have lower value to navigation channel maintenance, and in which removal or modification will present low-risk to adjacent land use, is cost-effective, and would result in increased ecosystem function. (2) Determine program benefits for juvenile salmonids and the ecosystem through a series of intensively monitored pilot projects. (3) Incorporate best available science and pilot project results into an adaptive management framework that will guide future management by prioritizing projects with the highest benefits. The PSP's hypotheses, which form the basis of the pilot project experiments, are organized into five categories: Sediment and Habitat-forming Processes, Habitat Conditions and Food Web, Piscivorous Fish, Piscivorous Birds, and Toxic Contaminant Reduction. These hypotheses are based on the effects listed in the Estuary Module (NOAA Fisheries in press) and others that emerged during literature reviews, discussions with scientists, and field visits. Using pilot project findings, future implementation will be adaptively managed

Implementation of a worksite educational program focused on promoting healthy eating habits

OpenAIRE

Tanagra, Dimitra; Panidis, Dimitris; Tountas, Yannis; Remoudaki, Elina; Alexopoulos, Evangelos C.

2014-01-01

Objective: To estimate the effectiveness of a short-term educational-counseling worksite program focused on lipid intake, by monitoring the possible change on nutrition knowledge and eating habits. Methods: an 8-week educational program based on the Health Belief Model was implemented in a honey packaging and sales company in Greece. 20 out of the 29 employees initially enrolled completed the program. Knowledge level and eating habits were evaluated prior and after the intervention by the “Nu...

Bruce Power's nuclear pressure boundary quality assurance program requirements, implementation and transition

International Nuclear Information System (INIS)

Krane, J.C.

2009-01-01

The development of a full scope nuclear pressure boundary quality assurance program in Canada requires extensive knowledge of the structure and detailed requirements of codes and standards published by the Canadian Standards Association (CSA) and American Society of Mechanical Engineers (ASME). Incorporation into company governance documents and implementation of these requirements while managing the transition to more recent revisions of these codes and standards represents a significant challenge for Bruce Power, Canada's largest independent nuclear operator. This paper explores the key developments and innovative changes that are used to ensure successful regulatory compliance and effective implementation of the Bruce Power Pressure Boundary Quality Assurance Program. Challenges and mitigating strategies to sustain this large compliance based program at Bruce Power's 8 unit nuclear power plant site will also be detailed. (author)

Pressure Safety Program Implementation at ORNL

Energy Technology Data Exchange (ETDEWEB)

Lower, Mark [ORNL; Etheridge, Tom [ORNL; Oland, C. Barry [XCEL Engineering, Inc.

2013-01-01

The Oak Ridge National Laboratory (ORNL) is a US Department of Energy (DOE) facility that is managed by UT-Battelle, LLC. In February 2006, DOE promulgated worker safety and health regulations to govern contractor activities at DOE sites. These regulations, which are provided in 10 CFR 851, Worker Safety and Health Program, establish requirements for worker safety and health program that reduce or prevent occupational injuries, illnesses, and accidental losses by providing DOE contractors and their workers with safe and healthful workplaces at DOE sites. The regulations state that contractors must achieve compliance no later than May 25, 2007. According to 10 CFR 851, Subpart C, Specific Program Requirements, contractors must have a structured approach to their worker safety and health programs that at a minimum includes provisions for pressure safety. In implementing the structured approach for pressure safety, contractors must establish safety policies and procedures to ensure that pressure systems are designed, fabricated, tested, inspected, maintained, repaired, and operated by trained, qualified personnel in accordance with applicable sound engineering principles. In addition, contractors must ensure that all pressure vessels, boilers, air receivers, and supporting piping systems conform to (1) applicable American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code (2004) Sections I through XII, including applicable code cases; (2) applicable ASME B31 piping codes; and (3) the strictest applicable state and local codes. When national consensus codes are not applicable because of pressure range, vessel geometry, use of special materials, etc., contractors must implement measures to provide equivalent protection and ensure a level of safety greater than or equal to the level of protection afforded by the ASME or applicable state or local codes. This report documents the work performed to address legacy pressure vessel deficiencies and comply

Needs assessment and implementation of an employee assistance program: promoting a healthier work force.

Science.gov (United States)

Monfils, M K

1995-05-01

1. The functions of a continuous quality improvement tool used by Deming--the Plan, Do, Check, Act Cycle--can be applied to the assessment, implementation, and ongoing evaluation of an Employee Assistance Program (EAP). 2. Various methods are available to assess the need for an EAP. As much data as possible should be collected to qualify and quantify the need so that management can make an informed decision and develop measures to determine program effectiveness. 3. Once an EAP is implemented, it should be monitored continually against the effectiveness measures initially developed. Using a continuous quality improvement process, the occupational health nurse and the EAP provider can establish a dynamic relationship that allows for growth beyond the original design and increased effectiveness of service to employees.

Implementation of laparoscopic hysterectomy: maintenance of skills after a mentorship program.

Science.gov (United States)

Twijnstra, A R H; Blikkendaal, M D; Kolkman, W; Smeets, M J G H; Rhemrev, J P T; Jansen, F W

2010-01-01

To evaluate the implementation and maintenance of advanced laparoscopic skills after a structured mentorship program in laparoscopic hysterectomy (LH). Cohort retrospective analysis of 104 successive LHs performed by two gynecologists during and after a mentorship program. LHs were compared for indication, patient characteristics and intraoperative characteristics. As a frame of reference, 94 LHs performed by the mentor were analyzed. With regard to indication, blood loss and adverse outcomes, both trainees performed LHs during their mentorship program comparable with the LHs performed by the mentor. The difference in mean operating time between trainees and mentor was not clinically significant. Both trainees progressed along a learning curve, while operating time remained statistically constant and comparable to that of the mentor. After completing the mentorship program, both gynecologists maintained their acquired skills as blood loss, adverse outcome rates and operating time were comparable with the results during their traineeship. A mentorship program is an effective and durable tool for implementing a new surgical procedure in a teaching hospital with respect to patient safety aspects, as indications, operating time and adverse outcome rates are comparable to those of the mentor in his own hospital during and after completing the mentorship program. Copyright © 2010 S. Karger AG, Basel.

A Guide for Planning and Implementing Successful Mental Health Educational Programs.

Science.gov (United States)

Blanco-Vieira, Thiago; Ramos, Fernando Augusto da Cunha; Lauridsen-Ribeiro, Edith; Ribeiro, Marcos Vinícius Vieira; Meireles, Elisa Andrade; Nóbrega, Brunno Araújo; Motta Palma, Sonia Maria; Ratto, Maria de Fátima; Caetano, Sheila Cavalcante; Ribeiro, Wagner Silva; Rosário, Maria Conceição do

2018-01-01

Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation. The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers. We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices. These results will be helpful for planning and improving the quality of future educational programs in mental health.

International Review of the Development and Implementation of Energy Efficiency Standards and Labeling Programs

Energy Technology Data Exchange (ETDEWEB)

Zhou, Nan; Zheng, Nina; Fridley, David

2012-02-28

. Fourth, sufficient program resources for program implementation and evaluation are critical to the effectiveness of standards and labeling programs and cost-sharing between national and local governments can help ensure adequate resources and uniform implementation. Lastly, check-testing and punitive measures are important forms of enforcement while the cancellation of registration or product sales-based fines have also proven effective in reducing non-compliance. The international comparative analysis also revealed the differing degree to which the level of government decentralization has influenced S&L programs and while no single country has best practices in all elements of standards and labeling development and implementation, national examples of best practices for specific elements do exist. For example, the U.S. has exemplified the use of rigorous analyses for standard-setting and robust data source with the RECS database while Japan's Top Runner standard-setting principle has motivated manufacturers to exceed targets. In terms of standards implementation and enforcement, Australia has demonstrated success with enforcement given its long history of check-testing and enforcement initiatives while mandatory information-sharing between EU jurisdictions on compliance results is another important enforcement mechanism. These examples show that it is important to evaluate not only the drivers of different paths of standards and labeling development, but also the country-specific context for best practice examples in order to understand how and why certain elements of specific S&L programs have been effective.

Costs of implementing and maintaining comprehensive school health: the case of the Annapolis Valley Health Promoting Schools program.

Science.gov (United States)

Ohinmaa, Arto; Langille, Jessie-Lee; Jamieson, Stuart; Whitby, Caroline; Veugelers, Paul J

2011-01-01

Comprehensive school health (CSH) is increasingly receiving renewed interest as a strategy to improve health and learning. The present study estimates the costs associated with implementing and maintaining CSH. We reviewed the accounting information of all schools in the Annapolis Valley Health Promoting Schools (AVHPS) program in 2008/2009. We considered support for nutrition and physical activity programs by the public system, grants, donations, fundraising and volunteers. The annual public funding to AVHPS to implement and maintain CSH totaled $344,514, which translates, on average, to $7,830 per school and $22.67 per student. Of the public funding, $140,500 was for CSH, $86,250 for breakfast programs, $28,750 for school food policy programs, and the remainder for other subsidized programs. Grants, donations and fundraising were mostly locally acquired. They totaled $127,235, which translates, on average, to $2,892 per school or $8.37 per student. The value of volunteer support was estimated to be equivalent to the value of grants, donations and fundraising combined. Of all grants, donations, fundraising and volunteers, 20% was directed to physical activity programs and 80% to nutrition programs. The public costs to implement and maintain CSH are modest. They leveraged substantial local funding and in-kind contributions, underlining community support for healthy eating and active living. Where CSH is effective in preventing childhood overweight, it is most likely cost-effective too, as costs for future chronic diseases are mounting. CSH programs that are proven effective and cost-effective have enormous potential for broad implementation and for reducing the public health burden associated with obesity.

Embedding research to improve program implementation in Latin America and the Caribbean.

Science.gov (United States)

Tran, Nhan; Langlois, Etienne V; Reveiz, Ludovic; Varallyay, Ilona; Elias, Vanessa; Mancuso, Arielle; Becerra-Posada, Francisco; Ghaffar, Abdul

2017-06-08

In the last 10 years, implementation research has come to play a critical role in improving the implementation of already-proven health interventions by promoting the systematic uptake of research findings and other evidence-based strategies into routine practice. The Alliance for Health Policy and Systems Research and the Pan American Health Organization implemented a program of embedded implementation research to support health programs in Latin America and the Caribbean (LAC) in 2014-2015. A total of 234 applications were received from 28 countries in the Americas. The Improving Program Implementation through Embedded Research (iPIER) scheme supported 12 implementation research projects led by health program implementers from nine LAC countries: Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, Panama, Peru, and Saint Lucia. Through this experience, we learned that the "insider" perspective, which implementers bring to the research proposal, is particularly important in identifying research questions that focus on the systems failures that often manifest in barriers to implementation. This paper documents the experience of and highlights key conclusions about the conduct of embedded implementation research. The iPIER experience has shown great promise for embedded research models that place implementers at the helm of implementation research initiatives.

Hanford Environmental Management Program implementation plan

International Nuclear Information System (INIS)

1988-08-01

The Hanford Environmental Management Program (HEMP) was established to facilitate compliance with the applicable environmental statues, regulations, and standards on the Hanford Site. The HEMP provides a structured approach to achieve environmental management objectives. The Hanford Environmental Management Program Plan (HEMP Plan) was prepared as a strategic level planning document to describe the program management, technical implementation, verification, and communications activities that guide the HEMP. Four basic program objectives are identified in the HEMP Plan as follows: establish ongoing monitoring to ensure that Hanford Site operations comply with environmental requirements; attain regulatory compliance through the modification of activities; mitigate any environmental consequences; and minimize the environmental impacts of future operations at the Hanford Site. 2 refs., 24 figs., 27 tabs

APhA 2011 REMS white paper: Summary of the REMS stakeholder meeting on improving program design and implementation.

Science.gov (United States)

American Pharmacists Association; Bough, Marcie

2011-01-01

To develop an improved risk evaluation and mitigation strategies (REMS) system for maximizing effective and safe patient medication use while minimizing burden on the health care delivery system. 34 stakeholders gathered October 6-7, 2010, in Arlington, VA, for the REMS Stakeholder Meeting, convened by the American Pharmacists Association (APhA). Participants included national health care provider associations, including representatives for physicians, physician assistants, nurses, nurse practitioners, and pharmacists, as well as representatives for patient advocates, drug distributors, community pharmacists (chain and independent), drug manufacturer associations (brand, generic, and biologic organizations), and health information technology, standards, and safety organizations. Staff from the Food and Drug Administration (FDA) Center for Drug Evaluation and Research participated as observers. The meeting built on themes from the APhA's 2009 REMS white paper. The current REMS environment presents many challenges for health care providers due to the growing number of REMS programs and the lack of standardization or similarities among various REMS programs. A standardized REMS process that focuses on maximizing patient safety and minimizing impacts on patient access and provider implementation could offset these challenges. A new process that includes effective provider interventions and standardized tools and systems for implementing REMS programs may improve patient care and overcome some of the communication issues providers and patients currently face. Metrics could be put in place to evaluate the effectiveness of REMS elements. By incorporating REMS program components into existing technologies and data infrastructures, achieving REMS implementation that is workflow neutral and minimizes administrative burden may be possible. An appropriate compensation model could ensure providers have adequate resources for patient care and REMS implementation. Overall

Using information management to implement a clinical resource management program.

Science.gov (United States)

Rosenstein, A H

1997-12-01

This article provides a consultant's account of a 250-bed community hospital's experience in implementing the Clinical Resource Management (CRM) program, a four-stage process of using information to identify opportunities for improvement, developing an effective resource management team, implementing process improvement activities, and measuring the impact on outcomes of care. CASE STUDY EXAMPLE--CONGESTIVE HEART FAILURE: The chair of the departments of internal medicine and family practice selected congestive heart failure for in-depth study. A task force focused on treatment and patient disposition in the emergency room (ER), where most of the nonelective admissions originated. A set of standardized ER orders was developed that emphasized rapid and effective diuresis through the initiation of a progressive diuretic dosing schedule directly linked to patient response. Factors critical to the success of the CRM program included allocating adequate time to promote and sell the value and importance of the program, as well as securing the support of both information systems and physicians. The main barriers to success involved limitations in the information system infrastructure and delays attributable to committee review. Short-term results from the CRM program were encouraging, with average lengths of stay reduced by 0.5 days and average costs of care reduced by 12% for the ten diagnoses studied with no adverse results. Nonstudy diagnoses showed no notable improvement. Recognizing the growing importance of information management not only for clinical decision support but for accommodating all the necessary internal and external reporting requirements will require a significant commitment and investment in technology and personnel resources.

SRS ES and H Standards Compliance Program Implementation Plan

International Nuclear Information System (INIS)

Hearn, W.H.

1993-01-01

On March 8, 1990, the Defense Nuclear Facilities Safety Board (DNFSB) issued Recommendation 90-2 to the Secretary of Energy. This recommendation, based upon the DNFSB's initial review and evaluation of the content and implementation of standards relating to the design, construction, operations, and decommissioning of defense nuclear facilities of the U.S. Department of Energy (DOE), called for three actions: identification of specific standards that apply to design, construction, operation and decommissioning of DOE facilities; assessment of the adequacy of those standards for protecting public health and safety; and determination of the extent to which they have and are being implemented. The purpose of this Implementation Plan is to define the single program for all sitewide and facility 90-2 ES and H Standards Compliance efforts, which will satisfy the HQ Implementation Plan, avoid duplicate efforts, be as simple and achievable as possible, include cost-saving innovations, use a graded approach based on facility hazards and future needs of facilities, and support configuration control for facility requirements. The Defense Waste Processing Facility (DWPF) has been designated a pilot facility for the 90-2 program and has progressed with their facility program ahead of the site-level program. The DWPF, and other Government-Owned Contractor-Operated (GOCO) facilities that progress on an enhanced schedule, will serve as pilot facilities for the site-level program. The lessons learned with their requirement identifications, and their assessments of the adequacy of and their compliance with these requirements will be used to improve the efficiency of the site-level and subsequent programs

Implementation of the Air Program Information Management System (APIMS) Inspection Module

Science.gov (United States)

2009-05-01

7 5 T H A I R B A S E W I N G Implementation of the Air Program Information Management System (APIMS) Inspection Module 2009 Environment...Implementation of the Air Program Information Management System (APIMS) Inspection Module 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER

Implementation lessons: the importance of assessing organizational "fit" and external factors when implementing evidence-based teen pregnancy prevention programs.

Science.gov (United States)

Demby, Hilary; Gregory, Alethia; Broussard, Marsha; Dickherber, Jennifer; Atkins, Shantice; Jenner, Lynne W

2014-03-01

In recent years, the demand for evidence-based teen pregnancy prevention programs has increased, but practitioners often struggle to replicate and implement them as designed in real-world community settings. The purpose of this article is to describe the barriers and facilitators encountered during pilot year attempts to implement an evidence-based teen pregnancy prevention program within three types of organizations: (1) small community-based organizations; (2) a school-based organization; and (3) a large decentralized city-sponsored summer youth program. We frame our discussion of these experiences within the context of a systemic, multilevel framework for implementation consisting of (1) core implementation components; (2) organizational components; and (3) external factors. This article explores the organizational and external implementation factors we experienced during the implementation process, describes our lessons learned throughout this process, and offers strategies for other practitioners to proactively address these factors from the start of program planning. These findings may provide useful insight for other organizations looking to implement multi-session, group-level interventions with fidelity. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

DEMOGRAPHIC-ANAMNESTIC PARAMETERS WHICH AFFECT IMPLEMENTATION OF BABY FRIENDLY PROGRAM

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Bozidar Jovanovic

2005-12-01

Full Text Available Various studies and extensive researches, particularly during recent years, on the advantages of breastfeeding and the use of breast milk in infant`s nourishment, have stressed its immeasurable benefit to mothers, infants, family and society. The objective of the research was to ascertain demographic and anamnestic factors affecting the implementation of the baby friendly program. The study was undertaken at OGC CC Kragujevac and based on data from 432 women. The mean age of the examinees was 25,9 years and they were 6 months younger than the corresponding examinees from similar world researches. In most cases, the examinees were from urban areas and lived in bigger families, which did not affect the implementation of the program. With equal probability, it was the first or second pregnancy and in most cases, there were no hospitalizations during the pregnancy in both tested groups. Medications are more often used during the implementation of the baby friendly program. The reason for positive influence of the use of medications during the pregnancy on implementation of the baby friendly program probably lies in better supervision of the pregnancy. The gestation age did not influence the selection into the program. By means of higher level of supervision and by the use of medications during pregnancy, we can positively influence mother`s and infant`s starting with the baby friendly programme implementation.

Molecular implementation of simple logic programs.

Science.gov (United States)

Ran, Tom; Kaplan, Shai; Shapiro, Ehud

2009-10-01

Autonomous programmable computing devices made of biomolecules could interact with a biological environment and be used in future biological and medical applications. Biomolecular implementations of finite automata and logic gates have already been developed. Here, we report an autonomous programmable molecular system based on the manipulation of DNA strands that is capable of performing simple logical deductions. Using molecular representations of facts such as Man(Socrates) and rules such as Mortal(X) logical deductions and delivers the result. This prototype is the first simple programming language with a molecular-scale implementation.

Ontario's emergency department process improvement program: the experience of implementation.

Science.gov (United States)

Rotteau, Leahora; Webster, Fiona; Salkeld, Erin; Hellings, Chelsea; Guttmann, Astrid; Vermeulen, Marian J; Bell, Robert S; Zwarenstein, Merrick; Rowe, Brian H; Nigam, Amit; Schull, Michael J

2015-06-01

In recent years, Lean manufacturing principles have been applied to health care quality improvement efforts to improve wait times. In Ontario, an emergency department (ED) process improvement program based on Lean principles was introduced by the Ministry of Health and Long-Term Care as part of a strategy to reduce ED length of stay (LOS) and to improve patient flow. This article aims to describe the hospital-based teams' experiences during the ED process improvement program implementation and the teams' perceptions of the key factors that influenced the program's success or failure. A qualitative evaluation was conducted based on semistructured interviews with hospital implementation team members, such as team leads, medical leads, and executive sponsors, at 10 purposively selected hospitals in Ontario, Canada. Sites were selected based, in part, on their changes in median ED LOS following the implementation period. A thematic framework approach as used for interviews, and a standard thematic coding framework was developed. Twenty-four interviews were coded and analyzed. The results are organized according to participants' experience and are grouped into four themes that were identified as significantly affecting the implementation experience: local contextual factors, relationship between improvement team and support players, staff engagement, and success and sustainability. The results demonstrate the importance of the context of implementation, establishing strong relationships and communication strategies, and preparing for implementation and sustainability prior to the start of the project. Several key factors were identified as important to the success of the program, such as preparing for implementation, ensuring strong executive support, creation of implementation teams based on the tasks and outcomes of the initiative, and using multiple communication strategies throughout the implementation process. Explicit incorporation of these factors into the

Embedding research to improve program implementation in Latin America and the Caribbean

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Nhan Tran

2017-06-01

Full Text Available ABSTRACT In the last 10 years, implementation research has come to play a critical role in improving the implementation of already-proven health interventions by promoting the systematic uptake of research findings and other evidence-based strategies into routine practice. The Alliance for Health Policy and Systems Research and the Pan American Health Organization implemented a program of embedded implementation research to support health programs in Latin America and the Caribbean (LAC in 2014–2015. A total of 234 applications were received from 28 countries in the Americas. The Improving Program Implementation through Embedded Research (iPIER scheme supported 12 implementation research projects led by health program implementers from nine LAC countries: Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, Panama, Peru, and Saint Lucia. Through this experience, we learned that the “insider” perspective, which implementers bring to the research proposal, is particularly important in identifying research questions that focus on the systems failures that often manifest in barriers to implementation. This paper documents the experience of and highlights key conclusions about the conduct of embedded implementation research. The iPIER experience has shown great promise for embedded research models that place implementers at the helm of implementation research initiatives.

Responsive Feeding: Implications for Policy and Program Implementation12

Science.gov (United States)

Engle, Patrice L.; Pelto, Gretel H.

2011-01-01

In this article, we examine responsive feeding as a nutrition intervention, with an emphasis on the development and incorporation of responsive feeding into policies and programs over the last 2 decades and recommendations for increasing the effectiveness of responsive feeding interventions. A review of policy documents from international agencies and high-income countries reveals that responsive feeding has been incorporated into nutrition policies. Official guidelines from international agencies, nongovernmental organizations, and professional organizations often include best practice recommendations for responsive feeding. Four potential explanations are offered for the rapid development of policies related to responsive feeding that have occurred despite the relatively recent recognition that responsive feeding plays a critical role in child nutrition and growth and the paucity of effectiveness trials to determine strategies to promote responsive feeding. Looking to the future, 3 issues related to program implementation are highlighted: 1) improving intervention specificity relative to responsive feeding; 2) developing protocols that facilitate efficient adaptation of generic guidelines to national contexts and local conditions; and 3) development of program support materials, including training, monitoring, and operational evaluation. PMID:21270361

Implementing an effective wellness program

Energy Technology Data Exchange (ETDEWEB)

Dickson, N. [Bruce Power Inc., Toronto, ON (Canada)

2004-07-01

Bruce Power is one of the largest nuclear sites in the world, with more than 3,700 employees. The utility strives to be one of Canada's most dynamic and innovative teams. The values of Bruce Power include: safety first; profit through progress; openness; respect and recognition; and professional and personal integrity. With respect to health and safety, Bruce Power strives to have zero medically treated injuries. Details of the healthy workplace committee were presented as well as details of the health and wellness program. Charts of health and mental health screening strategies were presented. Other programs include: an excellent benefits package; flexible working hours; family care days; banked time; an electronic suggestion box; and station condition records. It was noted that there is a strong external focus on health and safety as well. Details of community involvement and sponsorship were presented, along with details of on-site fitness facilities and fitness membership subsidies. Details of the National Quality Institute certification were also provided, including physical environment; lifestyle behaviours; and psycho-social environment. The importance of strong leadership in encouraging feedback, team talk and continuous leadership development was emphasized. Strategies to strengthen leadership include new hiring criteria for managers; management days; first line manager academy; a mentoring program; and task observation and coaching. Communication strategies include articles in weekly newspapers; monthly safety meeting video segments; posters and electronic signs; and voice mail messages from the chief executive officer. Details of the Eat Smart and Weight Challenge certification were provided. The management at human resources faces the challenge of continual change, demographics, and the fact that wellness is difficult to measure. tabs., figs.

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

Science.gov (United States)

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

2013-01-01

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

Development and Implementation of Worksite Health and Wellness Programs: A Focus on Non-Communicable Disease.

Science.gov (United States)

Cahalin, Lawrence P; Kaminsky, Leonard; Lavie, Carl J; Briggs, Paige; Cahalin, Brendan L; Myers, Jonathan; Forman, Daniel E; Patel, Mahesh J; Pinkstaff, Sherry O; Arena, Ross

2015-01-01

The development and implementation of worksite health and wellness programs (WHWPs) in the United States (US) hold promise as a means to improve population health and reverse current trends in non-communicable disease incidence and prevalence. However, WHWPs face organizational, economic, systematic, legal, and logistical challenges which have combined to impact program availability and expansion. Even so, there is a burgeoning body of evidence indicating WHWPs can significantly improve the health profile of participating employees in a cost effective manner. This foundation of scientific knowledge justifies further research inquiry to elucidate optimal WHWP models. It is clear that the development, implementation and operation of WHWPs require a strong commitment from organizational leadership, a pervasive culture of health and availability of necessary resources and infrastructure. Since organizations vary significantly, there is a need to have flexibility in creating a customized, effective health and wellness program. Furthermore, several key legal issues must be addressed to facilitate employer and employee needs and responsibilities; the US Affordable Care Act will play a major role moving forward. The purposes of this review are to: 1) examine currently available health and wellness program models and considerations for the future; 2) highlight key legal issues associated with WHWP development and implementation; and 3) identify challenges and solutions for the development and implementation of as well as adherence to WHWPs. Copyright © 2015 Elsevier Inc. All rights reserved.

Individual and setting level predictors of the implementation of a skin cancer prevention program: a multilevel analysis

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Brownson Ross C

2010-05-01

Full Text Available Abstract Background To achieve widespread cancer control, a better understanding is needed of the factors that contribute to successful implementation of effective skin cancer prevention interventions. This study assessed the relative contributions of individual- and setting-level characteristics to implementation of a widely disseminated skin cancer prevention program. Methods A multilevel analysis was conducted using data from the Pool Cool Diffusion Trial from 2004 and replicated with data from 2005. Implementation of Pool Cool by lifeguards was measured using a composite score (implementation variable, range 0 to 10 that assessed whether the lifeguard performed different components of the intervention. Predictors included lifeguard background characteristics, lifeguard sun protection-related attitudes and behaviors, pool characteristics, and enhanced (i.e., more technical assistance, tailored materials, and incentives are provided versus basic treatment group. Results The mean value of the implementation variable was 4 in both years (2004 and 2005; SD = 2 in 2004 and SD = 3 in 2005 indicating a moderate implementation for most lifeguards. Several individual-level (lifeguard characteristics and setting-level (pool characteristics and treatment group factors were found to be significantly associated with implementation of Pool Cool by lifeguards. All three lifeguard-level domains (lifeguard background characteristics, lifeguard sun protection-related attitudes and behaviors and six pool-level predictors (number of weekly pool visitors, intervention intensity, geographic latitude, pool location, sun safety and/or skin cancer prevention programs, and sun safety programs and policies were included in the final model. The most important predictors of implementation were the number of weekly pool visitors (inverse association and enhanced treatment group (positive association. That is, pools with fewer weekly visitors and pools in the enhanced

Implementation fidelity of a nurse-led falls prevention program in acute hospitals during the 6-PACK trial.

Science.gov (United States)

Morello, Renata T; Barker, Anna L; Ayton, Darshini R; Landgren, Fiona; Kamar, Jeannette; Hill, Keith D; Brand, Caroline A; Sherrington, Catherine; Wolfe, Rory; Rifat, Sheral; Stoelwinder, Johannes

2017-06-02

fidelity was variable across wards, overall it was found to be acceptable during the RCT. Implementation failure is unlikely to be a key factor for the observed lack of program effectiveness in the 6-PACK trial. The 6-PACK cluster RCT is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000332921 (29 March 2011).

The implementation of full ATLAS detector simulation program

International Nuclear Information System (INIS)

Rimoldi, A.; Dell'Acqua, A.; Stavrianakou, M.; Amako, K.; Kanzaki, J.; Morita, Y.; Murakami, K.; Sasaki, T.; Saeki, T.; Ueda, I.; Tanaka, S.; Yoshida, H.

2001-01-01

The ATLAS detector is one of the most sophisticated and huge detectors ever designed up to now. A detailed, flexible and complete simulation program is needed in order to study the characteristics and possible problems of such a challenging apparatus and to answer to all raising questions in terms of physics, design optimization, etc. To cope with these needs the authors are implementing an application based on the simulation framework FADS/Goofy (Framework for ATLAS Detector Simulation /Geant4-based Object-Oriented Folly) in the Geant4 environment. The user's specific code implementation is presented in details for the different applications implemented until now, from the various components of the ATLAS spectrometer to some particular testbeam facilities. Particular emphasis is put in describing the simulation of the Muon Spectrometer and its subsystems as a test case for the implementation of the whole detector simulation program: the intrinsic complexity in the geometry description of the Muon System is one of the more demanding problems that are faced. The magnetic field handling, the physics impact in the event processing in presence of backgrounds from different sources and the implementation of different possible generators (including Pythia) are also discussed

Analysis and Implement of Broadcast Program Monitoring Data

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Song Jin Bao

2016-01-01

Full Text Available With the rapid development of the radio and TV industry and the implementation of INT (the integration of telecommunications networks, cable TV networks and the Internet, the contents of programs and advertisements is showing massive, live and interactive trends. In order to meet the security of radio and television, the broadcast of information have to be controlled and administered. In order to master the latest information of public opinion trends through radio and television network, it is necessary research the specific industry applications of broadcast program monitoring. In this paper, the importance of broadcast monitoring in public opinion analysis is firstly analysed. The monitoring radio and television programs broadcast system architecture is proposed combining with the practice, focusing on the technical requirements and implementation process of program broadcast, advertisement broadcast and TV station broadcast monitoring. The more efficient information is generated through statistical analysis, which provides data analysis for radio and television public opinion analysis.

Effectiveness of mentoring programs for youth: a meta-analytic review.

Science.gov (United States)

DuBois, David L; Holloway, Bruce E; Valentine, Jeffrey C; Cooper, Harris

2002-04-01

We used meta-analysis to review 55 evaluations of the effects of mentoring programs on youth. Overall, findings provide evidence of only a modest or small benefit of program participation for the average youth. Program effects are enhanced significantly, however, when greater numbers of both theory-based and empirically based "best practices" are utilized and when strong relationships are formed between mentors and youth. Youth from backgrounds of environmental risk and disadvantage appear most likely to benefit from participation in mentoring programs. Outcomes for youth at-risk due to personal vulnerabilities have varied substantially in relation to program characteristics, with a noteworthy potential evident for poorly implemented programs to actually have an adverse effect on such youth. Recommendations include greater adherence to guidelines for the design and implementation of effective mentoring programs as well as more in-depth assessment of relationship and contextual factors in the evaluation of programs.

The programming language 'PEARL' and its implementation

International Nuclear Information System (INIS)

Pelz, K.

1978-01-01

This paper describes the real time programming language PEARL, its history and design principles and the portability techniques involved in the implementation of a subset of the language on four computer systems. (Auth.)

The impact of middle manager affective commitment on perceived improvement program implementation success.

Science.gov (United States)

Fryer, Ashley-Kay; Tucker, Anita L; Singer, Sara J

Recent literature suggests that middle manager affective commitment (emotional attachment, identification, and involvement) to an improvement program may influence implementation success. However, less is known about the interplay between middle manager affective commitment and frontline worker commitment, another important driver of implementation success. We contribute to this research by surveying middle managers who directly manage frontline workers on nursing units. We assess how middle manager affective commitment is related to their perceptions of implementation success and whether their perceptions of frontline worker support mediate this relationship. We also test whether a set of organizational support factors foster middle manager affective commitment. We adapt survey measures of manager affective commitment to our research context of hospitals. We surveyed 67 nurse managers from 19 U.S. hospitals. We use hierarchical linear regression to assess relationships among middle manager affective commitment to their units' falls reduction program and their perceptions of three constructs related to the program: frontline worker support, organizational support, and implementation success. Middle manager affective commitment to their unit's falls reduction program is positively associated with their perception of implementation success. This relationship is mediated by their perception of frontline worker support for the falls program. Moreover, middle managers' affective commitment to their unit's falls program mediates the relationship between perceived organizational support for the program and perceived implementation success. We, through this research, offer an important contribution by providing empirical support of factors that may influence successful implementation of an improvement program: middle manager affective commitment, frontline worker support, and organizational support for an improvement program. Increasing levels of middle manager affective

Implementation Plan for the Office of Nuclear Energy Knowledge Management Program

Energy Technology Data Exchange (ETDEWEB)

Kimberlyn C. Mousseau

2011-12-01

The primary purpose of the Department of Energy (DOE), Office of Nuclear Energy (NE) Knowledge Management (KM) Program is to capture, share, disseminate, and ensure the ability to apply the knowledge created by the major nuclear energy Research and Development (R&D) programs. In support of the KM program, the Implementation Plan for the Office of NE KM Program outlines the knowledge management and distributed data environment that is required for its success. In addition to enumerating some strategic goals and objectives, this document characterizes the initial program and identifies computer-based areas of investment required for increased knowledge sharing and collaboration. It identifies and addresses investments already in existence and describes how these investments can be further enhanced and implemented to support a distributed KM program. The Idaho National Laboratory (INL) is leading the effort to identify and address these investments through the implementation of a distributed KM program that includes participants from ten of the major DOE national laboratories.

A Qualitative Exploration of Implementation Factors in a School-Based Mindfulness and Yoga Program: Lessons Learned from Students and Teachers

Science.gov (United States)

Dariotis, Jacinda K.; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T.; Mendelson, Tamar

2016-01-01

Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators – students and their classroom teachers – merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings. PMID:28670007

Implementing a Comprehensive Program for the Prevention of Conduct Problems in Rural Communities: The Fast Track Experience1

Science.gov (United States)

Bierman, Karen L.

2012-01-01

Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program. PMID:9338956

Schools' Responses to Voucher Policy: Participation Decisions and Early Implementation Experiences in the Indiana Choice Scholarship Program

Science.gov (United States)

Austin, Megan J.

2015-01-01

Little is known about the supply side of voucher programs, despite schools' central role in program effectiveness. Using survey and interview data on the Indiana Choice Scholarship Program (ICSP), I analyze schools' participation decisions and early implementation experiences to understand better how schools respond to program regulations. I find…

33 CFR 385.13 - Projects implemented under additional program authority.

Science.gov (United States)

2010-07-01

... Implementation Report is prepared and approved in accordance with § 385.26; and (3) Not exceed a total cost of... RESTORATION PLAN CERP Implementation Processes § 385.13 Projects implemented under additional program authority. (a) To expedite implementation of the Plan, the Corps of Engineers and non-Federal sponsors may...

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

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Abuya Timothy

2012-07-01

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

A policy analysis of the implementation of a Reproductive Health Vouchers Program in Kenya.

Science.gov (United States)

Abuya, Timothy; Njuki, Rebecca; Warren, Charlotte E; Okal, Jerry; Obare, Francis; Kanya, Lucy; Askew, Ian; Bellows, Ben

2012-07-23

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

Implementation of inpatient models of pharmacogenetics programs.

Science.gov (United States)

Cavallari, Larisa H; Lee, Craig R; Duarte, Julio D; Nutescu, Edith A; Weitzel, Kristin W; Stouffer, George A; Johnson, Julie A

2016-12-01

The operational elements essential for establishing an inpatient pharmacogenetic service are reviewed, and the role of the pharmacist in the provision of genotype-guided drug therapy in pharmacogenetics programs at three institutions is highlighted. Pharmacists are well positioned to assume important roles in facilitating the clinical use of genetic information to optimize drug therapy given their expertise in clinical pharmacology and therapeutics. Pharmacists have assumed important roles in implementing inpatient pharmacogenetics programs. This includes programs designed to incorporate genetic test results to optimize antiplatelet drug selection after percutaneous coronary intervention and personalize warfarin dosing. Pharmacist involvement occurs on many levels, including championing and leading pharmacogenetics implementation efforts, establishing clinical processes to support genotype-guided therapy, assisting the clinical staff with interpreting genetic test results and applying them to prescribing decisions, and educating other healthcare providers and patients on genomic medicine. The three inpatient pharmacogenetics programs described use reactive versus preemptive genotyping, the most feasible approach under the current third-party payment structure. All three sites also follow Clinical Pharmacogenetics Implementation Consortium guidelines for drug therapy recommendations based on genetic test results. With the clinical emergence of pharmacogenetics into the inpatient setting, it is important that pharmacists caring for hospitalized patients are well prepared to serve as experts in interpreting and applying genetic test results to guide drug therapy decisions. Since genetic test results may not be available until after patient discharge, pharmacists practicing in the ambulatory care setting should also be prepared to assist with genotype-guided drug therapy as part of transitions in care. Copyright © 2016 by the American Society of Health

Connecting Marketing and Implementation Research and Library Program Development: A Case Study of the Implementation of [U.S.] National Guidelines and Standards.

Science.gov (United States)

Haycock, Ken; Cavill, Pat

This case study examined: (1) what market research is required for planning for the implementation of "Information Power: Building Partnerships for Learning," the 1998 national guidelines for effective school library media programs; (2) what issues need to be addressed and what target audiences are required to effect change, as well as…

Strategies and policies for improving energy efficiency programs: Closing the loop between evaluation and implementation

International Nuclear Information System (INIS)

Vine, Edward

2008-01-01

Program implementers often use evaluation results to improve the performance of their programs, but, as described in this paper, this is not always the case. Based on a review of the literature, participation in workshops, and interviews with over 50 program implementers, evaluators, and regulators in the United States and Canada, the utilization of evaluation results is investigated by asking the following questions: (1) How are program evaluation results used by program implementers and other stakeholders? (2) How are program evaluation results communicated to program implementers and other stakeholders? (3) Are the needs of program implementers being met by program evaluation? (4) What is the role of the utility regulator in facilitating the use of program evaluation results? (5) What other mechanisms can facilitate the use of program evaluation results? While there is some consensus on the answers to these questions, the type of interest in and use of evaluation varies by functional role (e.g., evaluator versus implementer), maturity of the energy efficiency market, institutional context (e.g., evaluation and implementation conducted inside the same organization, or evaluation and implementation conducted by separate entities), and by regulatory demands and evaluation interests

Teachers' Readiness to Implement Nutrition Education Programs: Beliefs, Attitudes, and Barriers

Science.gov (United States)

Perikkou, Anastasia; Kokkinou, Eleni; Panagiotakos, Demosthenes B.; Yannakoulia, Mary

2015-01-01

Teachers' attitudes about school food environments and their readiness to implement school-based nutrition programs were investigated. A total of 1,436 primary-school teachers filled out a questionnaire on their demographic and professional characteristics and their attitudes, beliefs, and barriers for implementing health educational programs. The…

RAY TRACING IMPLEMENTATION IN JAVA PROGRAMMING LANGUAGE

OpenAIRE

Aybars UĞUR; Mustafa TÜRKSEVER

2002-01-01

In this paper realism in computer graphics and components providing realism are discussed at first. It is mentioned about illumination models, surface rendering methods and light sources for this aim. After that, ray tracing which is a technique for creating two dimensional image of a three-dimensional virtual environment is explained briefly. A simple ray tracing algorithm was given. "SahneIzle" which is a ray tracing program implemented in Java programming language which ...

200 Areas Remedial Investigation/Feasibility Study Implementation Plan - Environmental Restoration Program

International Nuclear Information System (INIS)

Knepp, A. J.

1999-01-01

The 200 Areas Remedial Investigation/Feasibility Study Implementation Plan - Environmental Restoration Program (Implementation Plan) addresses approximately 700 soil waste sites (and associated structures such as pipelines) resulting from the discharge of liquids and solids from processing facilities to the ground (e.g., ponds, ditches, cribs,burial grounds) in the 200 Areas and assigned to the Environmental Restoration Program. The Implementation Plan outlines the framework for implementing assessment activities in the 200 Areas to ensure consistency in documentation, level of characterization, and decision making. The Implementation Plan also consolidates background information and other typical work plan materials, to serve as a single referenceable source for this type of information

Implementation fidelity trajectories of a health promotion program in multidisciplinary settings: managing tensions in rehabilitation care.

Science.gov (United States)

Hoekstra, Femke; van Offenbeek, Marjolein A G; Dekker, Rienk; Hettinga, Florentina J; Hoekstra, Trynke; van der Woude, Lucas H V; van der Schans, Cees P

2017-12-01

��= - 1032, p = .303). Differences in organizational-level implementation fidelity trajectories did not result in outcome differences at patient-level. This suggests that an effective implementation fidelity trajectory is contingent on the local organization's conditions. More specifically, achieving stable high implementation fidelity required the management of tensions: realizing a localized change vision, while safeguarding the program's standardized core components and engaging the scarce physicians throughout the process. When scaling up evidence-informed health promotion programs, we propose to tailor the management of implementation tensions to local organizations' starting position, size, and circumstances. The Netherlands National Trial Register NTR3961 . Registered 18 April 2013.

[Healthy eating: implementation of a practice-oriented training program].

Science.gov (United States)

Kulakova, E N; Nastausheva, T L; Usacheva, E A

2016-01-01

Health professionals need to have current knowledge and skills in nutrition. The knowledge and skills have to be acquired in programs of continuing medical education, but also in undergraduate medical education. The main purpose of this work was to develop and implement a practice-oriented training program in nutrition and healthy eating for medical students. The subject named "Nutrition" was implemented into second-year medical curriculum. We defined a theoretical framework and terms such as nutrition, healthy eating, and evidence-based nutrition. In order to get learning outcomes we constructed a method of patients counseling and training "Individual food pyramid". The making of "Individual food pyramid" is a key integrate element of the program. It helps to memorize, understand and apply the basic principles of healthy eating in real life contexts. The final program consists of two sections: "General Nutrition" and "Special Nutrition". The most important intended learning outcome is student's lifestyle improvement. The program is practice-oriented and outcome-based.

Implementing a campus wide recycling program

International Nuclear Information System (INIS)

Alvarez, L.

2002-01-01

'Full text:' The University of Windsor is currently expanding its recycling program to include all buildings on campus, but faces two challenges: 1) uncertainty about the current waste composition and distribution on campus; and 2) uncertainty about the effectiveness of increased recycling. This project assesses the current waste composition and the attitudes of the students towards recycling, and evaluates the effectiveness of proposed recycling activities. At present, paper is the only material that is collected throughout the entire campus. Except for two buildings, all other potentially recyclable materials within buildings, such as metal, glass, and plastic beverage containers, are discarded. The main focus of this research is on beverage containers as they represent clearly identifiable materials, but other materials were examined as well. To quantify the waste, different buildings on campus were classified according to their function: academic,operational and administrative. The waste composition study indicated that approximately 33% of the campus waste which is landfilled is composed of potentially recyclable material. A survey was then conducted to gauge the campus population's views on recycling issues that could affect the design of a recycling program. Interestingly, 97% of the respondents indicated a high willingness to recycle, but were uncertain as to how and where to recycle on campus. The project is currently assessing potential diversion rates using new, clearly identifiable recycling receptacles placed within selected classrooms for all major materials. There is a significant tradeoff however because the cost for new receptacles is considerable: multiple materials containers are often placed in high pedestrian traffic locations (e.g., hallways) and not always in classrooms,of which there are often many. This project will evaluate the basic benefits and costs of implementing a more comprehensive recycling program, and recommend how other

Effective Summer Programming: What Educators and Policymakers Should Know

Science.gov (United States)

McEachin, Andrew; Augustine, Catherine H.; McCombs, Jennifer

2018-01-01

The evidence suggests that many types of summer learning programs have the potential to reduce summer learning losses and perhaps create learning gains. However, implementing a summer program does not guarantee positive effects on students' learning. A key question then is: What factors make a summer learning program effective? This article, drawn…

Quality assurance programs developed and implemented by the US Department of Energy's Analytical Services Program for environmental restoration and waste management activities

International Nuclear Information System (INIS)

Lillian, D.; Bottrell, D.

1993-01-01

The U.S. Department of Energy's (DOE's) Office of Environmental Restoration and Waste Management (EM) has been tasked with addressing environmental contamination and waste problems facing the Department. A key element of any environmental restoration or waste management program is environmental data. An effective and efficient sampling and analysis program is required to generate credible environmental data. The bases for DOE's EM Analytical Services Program (ASP) are contained in the charter and commitments in Secretary of Energy Notice SEN-13-89, EM program policies and requirements, and commitments to Congress and the Office of Inspector General (IG). The Congressional commitment by DOE to develop and implement an ASP was in response to concerns raised by the Chairman of the Congressional Environment, Energy, and Natural Resources Subcommittee, and the Chairman of the Congressional Oversight and Investigations Subcommittee of the Committee on Energy and Commerce, regarding the production of analytical data. The development and implementation of an ASP also satisfies the IG's audit report recommendations on environmental analytical support, including development and implementation of a national strategy for acquisition of quality sampling and analytical services. These recommendations were endorsed in Departmental positions, which further emphasize the importance of the ASP to EM's programs. In September 1990, EM formed the Laboratory Management Division (LMD) in the Office of Technology Development to provide the programmatic direction needed to establish and operate an EM-wide ASP program. In January 1992, LMD issued the open-quotes Analytical Services Program Five-Year Plan.close quotes This document described LMD's strategy to ensure the production of timely, cost-effective, and credible environmental data. This presentation describes the overall LMD Analytical Services Program and, specifically, the various QA programs

Global Access Programs: A Collaborative Approach for Effective Implementation and Management.

Science.gov (United States)

Ainge, Debra; Aitken, Suzanne; Corbett, Mark; De-Keyzer, David

Global access programs (GAPs) provide access to medicinal products for patients with serious medical conditions and no commercially available treatment options. Providing early access to medicines can be challenging for a pharmaceutical company. The demand for a GAP often occurs at a time when other activities are the prime focus, such as delivery of pivotal clinical trials or gaining of marketing authorization. Furthermore, the skills, experience, and infrastructure necessary to implement and manage a successful GAP vary significantly from those required for regular clinical trial execution, and the regulatory environment presents its own challenges, with regulations often poorly defined and with considerable inter-country variation. This article considers the triggers for early access requests and examines the need for companies to develop a global strategy for GAPs in order to respond appropriately to requests for early access. It also provides a comprehensive overview of the processes for GAP set-up, implementation, management, and closure, along with the considerations affecting the type and scope of GAP, such as demand, regulatory feasibility, license status of the product, drug pricing structure, company strategy, costs, and product supply. Also discussed is the need for appropriate personnel to implement and manage the GAP, and when to consider collaboration with an external GAP provider. In summary, GAPs require careful and efficient planning and management, from set-up to closure. Well-run GAPs provide an ethical and regulatory-compliant pathway for access of new treatments to patients with serious conditions and an unmet medical need.

Classroom Teachers' Perceptions of the Implementation and Effects of Full Inclusion.

Science.gov (United States)

Sardo-Brown, Deborah; Hinson, Stephanie

1995-01-01

Describes a survey of 51 graduate students/full-time teachers at schools implementing full inclusion programs. Participants expressed their views concerning implementation methods, effects on instructional practices, community reactions, and advantages and disadvantages. Schools need to do a better job of explaining the rationale for full…

Utility Green Pricing Programs: Design, Implementation, and Consumer Response

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Swezey, B.; Aabakken, J.

2004-02-01

The term green pricing refers to programs offered by utilities in traditionally regulated electricity markets, which allow customers to support the development of renewable energy sources by paying a small premium on their electric bills. Since the introduction of the concept in the United States, the number of unique utility green pricing programs has expanded from just a few programs in 1993 to more than 90 in 2002. About 10% of U.S. utilities offered a green pricing option to about 26 million consumers by the end of 2002. This report provides: (1) aggregate industry data on consumer response to utility programs, which indicate the collective impact of green pricing on renewable energy development nationally; and (2) market data that can be used by utilities as a benchmark for gauging the relative success of their green pricing programs. Specifically, the paper presents current data and trends in consumer response to green pricing, as measured by renewable energy sales, participants, participation rates, and new renewable energy capacity supported. It presents data on various aspects of program design and implementation, such as product pricing, ownership of supplies, retention rates, marketing costs, the effectiveness of marketing techniques, and methods of enrolling and providing value to customers.

Implementing Interpersonal Psychotherapy in a Psychiatry Residency Training Program

Science.gov (United States)

Lichtmacher, Jonathan; Eisendrath, Stuart J.; Haller, Ellen

2006-01-01

Objective: Interpersonal psychotherapy (IPT) for depression is a brief, well researched treatment for acute major depression. This article describes the implementation of IPT as an evidence-based treatment for depression in a psychiatry residency program. Method: The authors tracked the implementation process over 5 years as interpersonal…

Practical approaches to implementing facility wide equipment strengthening programs

International Nuclear Information System (INIS)

Kincaid, R.H.; Smietana, E.A.

1989-01-01

Equipment strengthening programs typically focus on components required to ensure operability of safety related equipment or to prevent the release of toxic substances. Survival of non-safety related equipment may also be crucial to ensure rapid recovery and minimize business interruption losses. Implementing a strengthening program for non-safety related equipment can be difficult due to the large amounts of equipment involved and limited budget availability. EQE has successfully implemented comprehensive equipment strengthening programs for a number of California corporations. Many of the lessons learned from these projects are applicable to DOE facilities. These include techniques for prioritizing equipment and three general methodologies for anchoring equipment. Pros and cons of each anchorage approach are presented along with typical equipment strengthening costs

American Historical Association Faculty Development Program: Planning and Implementation.

Science.gov (United States)

Hoffmann, Charles

The planning and implementation processes of the Long Island Faculty Development Program are described. Originally sponsored by the American Historical Association's Faculty Development Program to improve history instruction, this project includes faculty representatives from four Long Island universities, colleges, and junior colleges. The…

Kyiv institutional buildings sector energy efficiency program: Lending and implementation assessment

Energy Technology Data Exchange (ETDEWEB)

Secrest, T.J.; Freeman, S.L. [Pacific Northwest National Lab., Richland, WA (United States); Popelka, A. [Tysak Engineering, Acton, MA (United States); Shestopal, P.A.; Gagurin, E.V. [Agency for Rational Energy Use and Ecology, Kyiv (Ukraine)

1997-08-01

The government of Ukraine, through the State Committee of Energy Conservation (State Committee), is considering the implementation of energy efficiency measures in state and municipal institutional buildings in the city of Kyiv. The State Committee entered into a Memorandum of Cooperation with the US Department of Energy (DOE) to conduct an assessment of the institutional buildings sector efficiency potential. This assessment will be used to support a potential loan by the World Bank for implementing a buildings efficiency improvement program in Kyiv. This report provides an assessment of the options for structuring the lending scenarios and the implementation of the program. Components to the lending structure are options for the disbursement of funds, options for the loan service, and other financial options and considerations. Program implementation includes management structures, reporting, installation activities, and post-installation activities such as training and verification.

Factors influencing the implementation of a lifestyle counseling program in patients with venous leg ulcers: a multiple case study

Directory of Open Access Journals (Sweden)

van de Glind Irene M

2012-10-01

Full Text Available Abstract Background Implementation of lifestyle interventions in patient care is a major challenge. Understanding factors that influence implementation is a first step in programs to enhance uptake of these interventions. A lifestyle-counseling intervention, Lively Legs, delivered by trained nurses, can effectively improve the lifestyle in patients with venous leg ulcers. The aim of this study was to identify factors that hindered or facilitated implementation of this intervention in outpatient dermatology clinics and in home care. Methods A mixed-methods multiple case study in five purposefully selected healthcare settings in the Netherlands was conducted. Measurements to identify influencing factors before and after implementation of Lively Legs included interviews, focus groups, questionnaires, and nurses’ registration. Analyses focused on qualitative data as the main data source. All data were compared across multiple cases to draw conclusions from the study as a whole. Results A total of 53 patients enrolled in the Lively Legs program, which was delivered by 12 trained nurses. Barriers for implementation were mainly organizational. It was difficult to effectively organize reaching and recruiting patients for the program, especially in home care. Main barriers were a lack of a standardized healthcare delivery process, insufficient nursing time, and a lack of motivated nurses to deliver the program. Facilitating factors were nurse-driven coordination of care and a standardized care process to tie Lively Legs into, as this resulted in better patient recruitment and better program implementation. Conclusions This study identified a range of factors influencing the implementation of a lifestyle-counseling program, mainly related to the organization of healthcare. Using a case study method proved valuable in obtaining insight into influencing factors for implementation. This study also shed light on a more general issue, which is that leg ulcer

Cabo Verde telemedicine program: initial results of nationwide implementation.

Science.gov (United States)

Latifi, Rifat; Dasho, Erion; Merrell, Ronald C; Lopes, Miguel; Azevedo, Vanda; Bekteshi, Flamur; Osmani, Kalterina L; Qesteri, Orland; Kucani, Julian; Lecaj, Ismet

2014-11-01

Telemedicine and e-health have been suggested as one solution for closing the health disparity gap between the developed world and the developing world. Yet evidence is lacking from current successful programs in the developing world and, in particular, from sub-Saharan Africa. The primary objective of our study was to present the preliminary results of our efforts in building the Integrated Telemedicine and e-Health Program for Cabo Verde (ITeHP-CV), with an emphasis on initial utilization and results. This is a prospective study of data collected while we worked to establish a fully functional, integrated national telemedicine network and virtual education network in Cabo Verde. We used the International Virtual e-Hospital Foundation strategic approach known as "initiate-build-operate-transfer" over a 26-month period (November 2011-December 2013). We describe herein the five main pillars of this process that have been implemented: (1) capacity building; (2) network development and deployment of equipment; (3) implementation of clinical telemedicine; (4) implementation of activities related to continuing medical education, delivered from within the country and from abroad; and (5) establishment and use of the electronic virtual library. Based on comprehensive technical and medical assessment of the country's needs, 10 fully functional telemedicine centers in all nine inhabited islands of the Republic of Cabo Verde have been established. RESULTS are presented under the five main pillars of capacity building, network deployment, implementation of clinical telemedicine, implementation of continuing medical education activities, and establishment of the electronic virtual library. The ITeHP-CV has been successfully launched, and the initial results are encouraging. The continuity of the program and sustainability are primary goals once the program is transferred fully to the Ministry of Health of Cabo Verde. A long-term follow-up study is required in order to ensure

An Implementation of the Object-Oriented Concurrent Programming Language SINA

NARCIS (Netherlands)

Triphathi, Anand; Berge, Eric; Aksit, Mehmet

SINA is an object-oriented language for distributed and concurrent programming. The primary focus of this paper is on the object-oriented concurrent programming mechanisms of SINA and their implementation. This paper presents the SINA constructs for concurrent programming and inter-object

Evaluating dosage effects for the positive action program: How implementation impacts internalizing symptoms, aggression, school hassles, and self-esteem.

Science.gov (United States)

Smokowski, Paul R; Guo, Shenyang; Wu, Qi; Evans, Caroline B R; Cotter, Katie L; Bacallao, Martica

2016-01-01

Positive Action (PA) is a school-based intervention for elementary-, middle-, and high-school students that aims to decrease problem behaviors (e.g., violence, substance use) and increase positive behaviors (e.g., academic achievement, school engagement). PA has a long history of documented success achieving these aims, making it an Evidence Based Practice (EBP). Intervention research on EBP's has established the importance of implementation fidelity, especially with regard to program dosage; failure to properly implement an EBP can have negative consequences on targeted outcomes, especially if participants are exposed to a low dosage of the program (e.g., fewer lessons than specified). Much of the current research on PA has neglected to examine how program dosage impacts PA's effect on targeted outcomes. Using propensity score models, multiple imputation, and a 2-level hierarchical linear model, the current study fills this gap and examines how different dosages of PA as measured by years participating in PA and number of PA lessons, impacts adolescent internalizing symptoms, aggression, perceptions of school hassles, and self-esteem over a 3-year period. The current sample included middle school students in grades 6, 7, and 8 (N = 5,894). The findings indicate that students who received 3 years of the PA intervention and a high number of PA lessons had a significantly higher self-esteem score than those who received 0 years of PA or zero lessons. Participants who received 1 year of PA also reported significantly lower school hassle scores than those who received 0 years. Dosage had no statistically significant effects on aggression or internalizing score. Implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Effective flow-accelerated corrosion programs in nuclear facilities

International Nuclear Information System (INIS)

Esselman, Thomas C.; McBrine, William J.

2004-01-01

Piping Flow-Accelerated Corrosion Programs in nuclear power generation facilities are classically comprised of the selection of inspection locations with the assistance of a predictive methodology such as the Electric Power Research Institute computer codes CHECMATE or CHECWORKS, performing inspections, conducting structural evaluations on the inspected components, and implementing the appropriate sample expansion and corrective actions. Performing such a sequence of steps can be effective in identifying thinned components and implementing appropriate short term and long term actions necessary to resolve flow-accelerated corrosion related problems. A maximally effective flow-accelerated corrosion (FAC) program requires an understanding of many programmatic details. These include the procedural control of the program, effective use of historical information, managing the activities performed during a limited duration outage, allocating resources based on risk allocation, having an acute awareness of how the plant is operated, investigating components removed from the plant, and several others. This paper will describe such details and methods that will lead to a flow-accelerated corrosion program that effectively minimizes the risk of failure due to flow-accelerated corrosion and provide full and complete documentation of the program. (author)

Implementation of a comprehensive pharmaceutical care program for an underserved population.

Science.gov (United States)

Mascardo, Lisa A; Spading, Kimberly A; Abramowitz, Paul W

2012-07-15

The implementation of a prescription benefit program for low-income patients emphasizing clinical pharmacist services and strict formulary control is described, with a review of program expenditures and cost avoidance. In 2006, University of Iowa Hospitals and Clinics (UIHC) launched a program to provide a limited prescription benefit to indigent patients under the IowaCare Medicaid demonstration waiver. Sudden dramatic growth in IowaCare enrollment, combined with sharp budget cuts, forced UIHC pharmacy leaders to implement creative cost-control strategies: (1) the establishment of an ambulatory care clinic staffed by a clinical pharmacy specialist, (2) increased reliance on an almost exclusively generic formulary, (3) collaboration with social services staff to help secure medication assistance for patients requiring brand-name drugs, (4) optimized purchasing through the federal 340B Drug Pricing Program, and (5) the imposition of medication copayments and mailing fees for prescription refills. Now in its seventh year, the UIHC pharmacy program has expanded indigent patients' access to pharmaceutical care services while reducing their use of hospital and emergency room services and lowering program medication costs by an estimated 50% (from $2.6 million in fiscal year 2009 to $1.3 million in fiscal year 2010). The UIHC ambulatory care pharmacy implemented a prescription program in collaboration with social service workers to address the medication needs of the state's low-income and uninsured patients in a fiscally responsible manner by managing purchasing contracts, revising a generic formulary, implementing copayments and mailing fees, and reviewing medication profiles.

The power of engagement: implementation of a career ladder program.

Science.gov (United States)

Bourgeault, Robert; Newmark, Jason

2012-01-01

At Baystate Health in Massachusetts, the development and implementation of a career ladder program was implemented to reduce turnover and to improve employee satisfaction, morale, and recruitment efforts. There was significant initial expenditure in the program, as a result of promoting the large number of employees with significant experience and seniority. A smaller number of staff are expected to apply for advancement during successive cycles, allowing for decreased incremental expense going forward. Critical to the success of the program was understanding the time commitment, getting senior organizational support and staff buy-in, and justifying the associated expenses. The development and initiation of the program has done much to support a positive work environment with increased morale and higher performance among significant numbers of staff at all levels.

Implementing a pediatric pharmacy educational program for health-system pharmacists.

Science.gov (United States)

Meyers, Rachel S; Costello-Curtin, Jennifer

2011-12-15

To implement an educational program to improve pediatric content knowledge and confidence in providing pediatric care among health-system pharmacists. Pharmacists were asked to voluntarily participate in this prospective, observational education program. A demographic assessment, pre- and post-intervention confidence assessments, and pre- and post-lecture competency assessments were conducted to evaluate the program. Five of the 6 confidence scores improved from the preintervention to the postintervention stage. Test scores for 2 of the 8 postlecture tests improved significantly, and the average test scores for all postlecture tests combined were significantly higher than those for the prelecture tests. This study demonstrated significant improvements in both confidence and competence in pediatric pharmacotherapy among health-system pharmacists following implementation of a pediatric pharmacy education program.

Y-12 Site environmental protection program implementation plan (EPPIP)

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-11-01

The Y-12 Plant Environmental Protection Program is conducted to: (1) protect public health and the environment from chemical and radiological releases occurring from current plant operations and past waste management and operational practices; (2) ensure compliance with federal, state, and local environmental regulations and DOE directives; (3) identify potential environmental problems; (4) evaluate existing environmental contamination and determine the need for remedial actions and mitigative measures; (5) monitor the progress of ongoing remedial actions and cleanup measures; and (6) inform the public of environmental issues relating to DOE operations. DOE Order 5400.1, General Environmental Protection Program, defines the general requirements for environmental protection programs at DOE facilities. This Environmental Protection Program Implementation Plan (EPPIP) defines the methods by which the Y-12 Plant staff will comply with the order by: (1) referencing environmental protection goals and objectives and identifying strategies and timetables for attaining them; (2) providing the overall framework for the design and implementation of the Y-12 Environmental Protection Program; and (3) assigning responsibilities for complying with the requirements of the order. The EPPIP is revised and updated annually.

Y-12 Site environmental protection program implementation plan (EPPIP)

International Nuclear Information System (INIS)

1996-11-01

The Y-12 Plant Environmental Protection Program is conducted to: (1) protect public health and the environment from chemical and radiological releases occurring from current plant operations and past waste management and operational practices; (2) ensure compliance with federal, state, and local environmental regulations and DOE directives; (3) identify potential environmental problems; (4) evaluate existing environmental contamination and determine the need for remedial actions and mitigative measures; (5) monitor the progress of ongoing remedial actions and cleanup measures; and (6) inform the public of environmental issues relating to DOE operations. DOE Order 5400.1, General Environmental Protection Program, defines the general requirements for environmental protection programs at DOE facilities. This Environmental Protection Program Implementation Plan (EPPIP) defines the methods by which the Y-12 Plant staff will comply with the order by: (1) referencing environmental protection goals and objectives and identifying strategies and timetables for attaining them; (2) providing the overall framework for the design and implementation of the Y-12 Environmental Protection Program; and (3) assigning responsibilities for complying with the requirements of the order. The EPPIP is revised and updated annually

The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for ensuring quality implementation of health promotion programs.

Science.gov (United States)

Truong, Hoai-An; Taylor, Catherine R; DiPietro, Natalie A

2012-02-10

To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.

Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs.

Science.gov (United States)

Jankowski, Irene M; Nadzam, Deborah Morris

2011-06-01

Patients continue to suffer from pressure ulcers (PUs), despite implementation of evidence-based pressure ulcer (PU) prevention protocols. In 2009, Joint Commission Resources (JCR) and Hill-Rom created the Nurse Safety Scholar-in-Residence (nurse scholar) program to foster the professional development of expert nurse clinicians to become translators of evidence into practice. The first nurse scholar activity has focused on PU prevention. Four hospitals with established PU programs participated in the PU prevention implementation project. Each hospital's team completed an inventory of PU prevention program components and provided copies of accompanying documentation, along with prevalence and incidence data. Site visits to the four participating hospitals were arranged to provide opportunities for more in-depth analysis and support. Following the initial site visit, the project team at each hospital developed action plans for the top three barriers to PU program implementation. A series of conference calls was held between the site visits. Pressure Ulcer Program Gaps and Recommendations. The four hospitals shared common gaps in terms of limitations in staff education and training; lack of physician involvement; limited involvement of unlicensed nursing staff; lack of plan for communicating at-risk status; and limited quality improvement evaluations of bedside practices. Detailed recommendations were identified for addressing each of these gaps. these Recommendations for eliminating gaps have been implemented by the participating teams to drive improvement and to reduce hospital-acquired PU rates. The nurse scholars will continue to study implementation of best practices for PU prevention.

Quality assurance programs developed and implemented by the US Department of Energy`s Analytical Services Program for environmental restoration and waste management activities

Energy Technology Data Exchange (ETDEWEB)

Lillian, D.; Bottrell, D. [Dept. of Energy, Germntown, MD (United States)

1993-12-31

The U.S. Department of Energy`s (DOE`s) Office of Environmental Restoration and Waste Management (EM) has been tasked with addressing environmental contamination and waste problems facing the Department. A key element of any environmental restoration or waste management program is environmental data. An effective and efficient sampling and analysis program is required to generate credible environmental data. The bases for DOE`s EM Analytical Services Program (ASP) are contained in the charter and commitments in Secretary of Energy Notice SEN-13-89, EM program policies and requirements, and commitments to Congress and the Office of Inspector General (IG). The Congressional commitment by DOE to develop and implement an ASP was in response to concerns raised by the Chairman of the Congressional Environment, Energy, and Natural Resources Subcommittee, and the Chairman of the Congressional Oversight and Investigations Subcommittee of the Committee on Energy and Commerce, regarding the production of analytical data. The development and implementation of an ASP also satisfies the IG`s audit report recommendations on environmental analytical support, including development and implementation of a national strategy for acquisition of quality sampling and analytical services. These recommendations were endorsed in Departmental positions, which further emphasize the importance of the ASP to EM`s programs. In September 1990, EM formed the Laboratory Management Division (LMD) in the Office of Technology Development to provide the programmatic direction needed to establish and operate an EM-wide ASP program. In January 1992, LMD issued the {open_quotes}Analytical Services Program Five-Year Plan.{close_quotes} This document described LMD`s strategy to ensure the production of timely, cost-effective, and credible environmental data. This presentation describes the overall LMD Analytical Services Program and, specifically, the various QA programs.

Long Live Love+: evaluation of the implementation of an online school-based sexuality education program in the Netherlands.

Science.gov (United States)

van Lieshout, Sanne; Mevissen, Fraukje; de Waal, Esri; Kok, Gerjo

2017-06-01

Schools are a common setting for adolescents to receive health education, but implementation of these programs with high levels of completeness and fidelity is not self-evident. Programs that are only partially implemented (completeness) or not implemented as instructed (fidelity) are unlikely to be effective. Therefore, it is important to identify which determinants affect completeness and fidelity of program implementation. As part of the launch of Long Live Love+ (LLL+), an online school-based sexuality education program for adolescents aged 15-17, we performed a process evaluation among teachers and students to measure the levels of completeness and fidelity, identify factors influencing teachers' implementation, and to evaluate the students' response. Sixteen Biology teachers from nine secondary schools throughout the Netherlands who implemented LLL+ were interviewed and 60 students participated in 13 focus group discussions. Results showed that teachers' completeness ranged between 22-100% (M = 75%). Fidelity was high, but many teachers added elements. Teachers and students enjoyed LLL+, particularly the diversity in the exercises and its interactive character. The most important factors that influenced implementation were time and organizational constraints, lack of awareness on the impact of completeness and fidelity, and student response. These factors should be taken into account when developing school-based prevention programs. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

78 FR 57336 - Disadvantaged Business Enterprise: Program Implementation Modifications

Science.gov (United States)

2013-09-18

... 2105-AE08 Disadvantaged Business Enterprise: Program Implementation Modifications AGENCY: Office of the... Business Enterprise (DBE) Program. In a later notice published on October 25, 2012, the Department extended... writing on specific aspects of the NPRM noted below. DATES: A public listening session will be held on...

An Implementation Research Approach to Evaluating Health Insurance Programs: Insights from India

Directory of Open Access Journals (Sweden)

Krishna D. Rao

2016-05-01

Full Text Available One of the distinguishing features of implementation research is the importance given to involve implementers in all aspects of research, and as users of research. We report on a recent implementation research effort in India, in which researchers worked together with program implementers from one of the longest serving government funded insurance schemes in India, the Rajiv Aarogyasri Scheme (RAS in the state of undivided Andhra Pradesh, that covers around 70 million people. This paper aims to both inform on the process of the collaborative research, as well as, how the nature of questions that emerged out of the collaborative exercise differed in scope from those typically asked of insurance program evaluations. Starting in 2012, and over the course of a year, staff from the Aarogyasri Health Care Trust (AHCT, and researchers held a series of meetings to identify research questions that could serve as a guide for an evaluation of the RAS. The research questions were derived from the application of a Logical Framework Approach (“log frame” to the RAS. The types of questions that emerged from this collaborative effort were compared with those seen in the published literature on evaluations of insurance programs in low- and middle-income countries (LMICs. In the published literature, 60% of the questions pertained to output/outcome of the program and the remaining 40%, relate to processes and inputs. In contrast, questions generated from the RAS participatory research process between implementers and researchers had a remarkably different distribution – 81% of questions looked at program input/processes, and 19% on outputs and outcomes. An implementation research approach can lead to a substantively different emphasis of research questions. While there are several challenges in collaborative research between implementers and researchers, an implementation research approach can lead to incorporating tacit knowledge of program implementers

Closing the Research-Practice Gap: Factors Affecting Adoption and Implementation of a Children's Mental Health Program

Science.gov (United States)

Henderson, Joanna L.; MacKay, Sherri; Peterson-Badali, Michele

2006-01-01

Despite the availability of effective interventions, they are not widely used in community mental health centers. This study examined the adoption and implementation of The Arson Prevention Program for Children (TAPP-C), a program for juvenile firesetters developed at a teaching hospital and disseminated to community settings. Questionnaire data…

Food Service Perspectives on National School Lunch Program Implementation.

Science.gov (United States)

Tabak, Rachel G; Moreland-Russell, Sarah

2015-09-01

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

Implementing a Batterer's Intervention Program in a Correctional Setting: A Tertiary Prevention Model

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Yorke, Nada J.; Friedman, Bruce D.; Hurt, Pat

2010-01-01

This study discusses the pretest and posttest results of a batterer's intervention program (BIP) implemented within a California state prison substance abuse program (SAP), with a recommendation for further programs to be implemented within correctional institutions. The efficacy of utilizing correctional facilities to reach offenders who…

The Interaction Effects of Program Training, Dosage, and Implementation Quality on Targeted Student Outcomes for The RULER Approach to Social and Emotional Learning

Science.gov (United States)

Reyes, Maria Regina; Brackett, Marc A.; Rivers, Susan E.; Elbertson, Nicole A.; Salovey, Peter

2012-01-01

This study examined how training, dosage, and implementation quality of a social and emotional learning program, The RULER Approach, were related to students' social and emotional competencies. There were no main effects for any of the variables on student outcomes, but students had more positive outcomes when their teachers (a) attended more…

Positive School and Classroom Environment: Precursors of Successful Implementation of Positive Youth Development Programs

Directory of Open Access Journals (Sweden)

Rachel C. F. Sun

2008-01-01

Full Text Available This case study was based on a school where the Tier 1 Program of the Project P.A.T.H.S. was integrated into the formal curriculum. In this case study, an interview with the school principal, vice-principal, and social worker was conducted in order to understand their perceptions of administrative arrangements and issues in the school, implementation characteristics, program effectiveness, program success, and overall impression. Results showed that several positive school and classroom attributes were conducive to program success, including positive school culture and belief in students' potentials, an inviting school environment, an encouraging classroom environment, high involvement of school administrative personnel, and systematic program arrangement.

Developing, Implementing, and Evaluating a Condom Promotion Program Targeting Sexually Active Adolescents.

Science.gov (United States)

Alstead, Mark; Campsmith, Michael; Halley, Carolyn Swope; Hartfield, Karen; Goldblum, Gary; Wood, Robert W.

1999-01-01

Describes the development, implementation, and evaluation of an HIV prevention program promoting condom use among sexually active adolescents. It mobilized target communities to guide program development and implementation; created a mass media campaign to promote correct condom use; and recruited public agencies and organizations to distribute…

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

Science.gov (United States)

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

2015-02-24

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

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

Science.gov (United States)

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

2015-01-01

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

National Aeronautics and Space Administration Marshall Space Flight Center Space Transportation Directorate Risk Management Implementation Program

Science.gov (United States)

Duarte, Luis Alberto; Kross, Denny (Technical Monitor)

2001-01-01

The US civil aerospace program has been a great contributor to the creation and implementation of techniques and methods to identify, analyze, and confront risk. NASA has accomplished mission success in many instances, but also has had many failures. Anomalies have kept the Agency from achieving success on other occasions, as well. While NASA has mastered ways to prevent risks, and to quickly and effectively react and recover from anomalies or failures, it was not until few years ago that a comprehensive Risk Management process started being implemented in some of its programs and projects. A Continuous Risk Management (CRM) cycle process was developed and has been promoted and used successfully in programs and projects across the Agency.

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

Science.gov (United States)

Döpp, Carola M E; Graff, Maud J L; Rikkert, Marcel G M Olde; Nijhuis van der Sanden, Maria W G; Vernooij-Dassen, Myrra J F J

2013-11-07

A multifaceted implementation (MFI) strategy was used to implement an evidence-based occupational therapy program for people with dementia (COTiD program). This strategy was successful in increasing the number of referrals, but not in improving occupational therapists' (OTs) adherence. Therefore, a process evaluation was conducted to identify factors that influenced the effectiveness of the MFI strategy. A mixed-method approach of qualitative and quantitative research was used to evaluate the implementation process. The MFI strategy as planned and as executed were reported and evaluated based on the framework of Hulscher et al. (2003; 2006). Data on OTs attitudes and expected barriers were collected at baseline from 94 OTs using a 19-item questionnaire. Data on the experiences were collected after finishing the implementation using focus groups with OTs and telephone interviews with physicians and managers. For quantitative data, frequencies and correlations were calculated and qualitative data were analyzed using inductive content analysis. The implementation strategy as executed had a stronger focus than planned on increasing OTs promotional skills due to an initial lack of referrals. This resulted in less attention for increasing OTs' skills in using the COTiD program as initially intended. At baseline, OTs had a positive attitude toward the program, however, 75% did not feel experienced enough and only 14.3% felt competent in using the program. Focus groups and interviews revealed various determinants that influenced implementation. Most managers were positive about the program. However, the degree of operational support of managers for OTs regarding the implementation was not always adequate. Managers stated that a well-defined place for occupational therapy within the dementia care network was lacking although this was perceived necessary for successful implementation. Several physicians perceived psychosocial interventions not to be in their area of

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

OpenAIRE

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

2015-01-01

Background and purpose: Career advancement programs are currently implemented in many countries. In Iran, the first career advancement program was Nurses? Career Advancement Pathway. The purpose of this study was to explore nurse leaders? experiences about implementing the Nurses? Career Advancement Pathway program in Iran. Methods: This exploratory qualitative study was conducted in 2013. Sixteen nurse managers were recruited from the teaching hospitals affiliated to Shahid Behesthi, Qazvin,...

Factors associated with sustainability of 2 quality improvement programs after achieving early implementation success. A qualitative case study.

Science.gov (United States)

Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy

2017-12-01

Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological

Implementing effective policy in a national mental health re-engagement program for Veterans

Science.gov (United States)

Smith, Shawna N.; Lai, Zongshan; Almirall, Daniel; Goodrich, David E.; Abraham, Kristen M.; Nord, Kristina M.; Kilbourne, Amy M.

2016-01-01

Policy is a powerful motivator of clinical change, but implementation success can depend on organizational characteristics. This paper used validated measures of organizational resources, culture and climate to predict uptake of a nationwide VA policy aimed at implementing Re-Engage, a brief care management program that re-establishes contact with Veterans with serious mental illness lost to care. Patient care databases were used to identify 2,738 Veterans lost to care. Local Recovery Coordinators (LRCs) were to update disposition for 2,738 Veterans at 158 VA facilities and, as appropriate, facilitate a return to care. Multivariable regression assessed organizational culture and climate as predictors of early policy compliance (via LRC presence) and uptake at six months. Higher composite climate and culture scores were associated with higher odds of having a designated LRC, but were not predictive of higher uptake. Sites with LRCs had significantly higher rates of updated documentation than sites without LRCs. PMID:27668352

Assessment of eight HPV vaccination programs implemented in lowest income countries

Directory of Open Access Journals (Sweden)

Ladner Joël

2012-05-01

Full Text Available Abstract Background Cervix cancer, preventable, continues to be the third most common cancer in women worldwide, especially in lowest income countries. Prophylactic HPV vaccination should help to reduce the morbidity and mortality associated with cervical cancer. The purpose of the study was to describe the results of and key concerns in eight HPV vaccination programs conducted in seven lowest income countries through the Gardasil Access Program (GAP. Methods The GAP provides free HPV vaccine to organizations and institutions in lowest income countries. The HPV vaccination programs were entirely developed, implemented and managed by local institutions. Institutions submitted application forms with institution characteristics, target population, communication delivery strategies. After completion of the vaccination campaign (3 doses, institutions provided a final project report with data on doses administered and vaccination models. Two indicators were calculated, the program vaccination coverage and adherence. Qualitative data were also collected in the following areas: government and community involvement; communication, and sensitization; training and logistics resources, and challenges. Results A total of eight programs were implemented in seven countries. The eight programs initially targeted a total of 87,580 girls, of which 76,983 received the full 3-dose vaccine course, with mean program vaccination coverage of 87.8%; the mean adherence between the first and third doses of vaccine was 90.9%. Three programs used school-based delivery models, 2 used health facility-based models, and 3 used mixed models that included schools and health facilities. Models that included school-based vaccination were most effective at reaching girls aged 9-13 years. Mixed models comprising school and health facility-based vaccination had better overall performance compared with models using just one of the methods. Increased rates of program coverage and

Assessment of eight HPV vaccination programs implemented in lowest income countries.

Science.gov (United States)

Ladner, Joël; Besson, Marie-Hélène; Hampshire, Rachel; Tapert, Lisa; Chirenje, Mike; Saba, Joseph

2012-05-23

Cervix cancer, preventable, continues to be the third most common cancer in women worldwide, especially in lowest income countries. Prophylactic HPV vaccination should help to reduce the morbidity and mortality associated with cervical cancer. The purpose of the study was to describe the results of and key concerns in eight HPV vaccination programs conducted in seven lowest income countries through the Gardasil Access Program (GAP). The GAP provides free HPV vaccine to organizations and institutions in lowest income countries. The HPV vaccination programs were entirely developed, implemented and managed by local institutions. Institutions submitted application forms with institution characteristics, target population, communication delivery strategies. After completion of the vaccination campaign (3 doses), institutions provided a final project report with data on doses administered and vaccination models. Two indicators were calculated, the program vaccination coverage and adherence. Qualitative data were also collected in the following areas: government and community involvement; communication, and sensitization; training and logistics resources, and challenges. A total of eight programs were implemented in seven countries. The eight programs initially targeted a total of 87,580 girls, of which 76,983 received the full 3-dose vaccine course, with mean program vaccination coverage of 87.8%; the mean adherence between the first and third doses of vaccine was 90.9%. Three programs used school-based delivery models, 2 used health facility-based models, and 3 used mixed models that included schools and health facilities. Models that included school-based vaccination were most effective at reaching girls aged 9-13 years. Mixed models comprising school and health facility-based vaccination had better overall performance compared with models using just one of the methods. Increased rates of program coverage and adherence were positively correlated with the number of

SSCL magnet systems quality program implementation for laboratory and industry

International Nuclear Information System (INIS)

Warner, D.G.; Bever, D.L.

1992-01-01

The development and delivery of reliable and producible magnets for the Superconducting Super Collider Laboratory (SSCL) require the teamwork of a large and diverse workforce composed of personnel with backgrounds in laboratory research, defense, and energy. The SSCL Magnet Quality Program is being implemented with focus on three definitive objectives: (1) communication of requirements, (2) teamwork, and (3) verification. Examination of the SSCL Magnet Systems Division's (MSD) current and planned approach to implementation of the SSCL Magnet Quality Program utilizing these objectives is discussed

Drug use prevention: factors associated with program implementation in Brazilian urban schools.

Science.gov (United States)

Pereira, Ana Paula Dias; Sanchez, Zila M

2018-03-07

A school is a learning environment that contributes to the construction of personal values, beliefs, habits and lifestyles, provide convenient settings for the implementation of drug use prevention programs targeting adolescents, who are the population group at highest risk of initiating drug use. The objective of the present study was to investigate the prevalence of factors associated with implementing drug use prevention programs in Brazilian public and private middle and high urban schools. The present population-based cross-sectional survey was conducted with a probability sample of 1151 school administrators stratified by the 5 Brazilian administrative divisions, in 2014. A close-ended, self-reported online questionnaire was used. Logistic regression analysis was used to identify factors associated with implementing drug use prevention programs in schools. A total of 51.1% of the schools had adopted drug use prevention programs. The factors associated with program implementation were as follows: belonging to the public school network; having a library; development of activities targeting sexuality; development of "Health at School Program" activities; offering extracurricular activities; and having an administrator that participated in training courses on drugs. The adoption of drug use prevention practices in Brazilian schools may be expanded with greater orchestration of schools through specialized training of administrators and teachers, expansion of the School Health Program and concomitant development of the schools' structural and curricular attributes.

Development and implementation of documents control and records management system for KNPP units 5 and 6 modernization program

International Nuclear Information System (INIS)

Manchev, B.L.; Ilieva, M.; Nenkova, B. G. . E-mail of corresponding author: ilieva@riskeng.bg; Ilieva, M.)

2005-01-01

It was proposed to KNPP to develop and implement a Dcuments Control and Records Management System for an efficient and effective Configuration Management (CM) Program. It will provide reasonable assurance that consistency among design requirements, physical configuration and facility documentation is established and maintained during the Modernization Program and throughout the life of KNPP Units 5 and 6. The fully implemented CM Program will consider and track the modifications resulting from the Units 5 and 6 Modernization Program and will be consistent with internationally recognized principles and customized to fit within the KNPP organizational structure and philosophy (ANSI/NIRMA CM 1.0 - 2000, Configuration Management Of Nuclear Facilities). Development and implementation phase of Documents Control and Records Management System and SmartDoc information system, as well as ideas for further development are presented in this report. (author)

Implementing a citizen's DWI reporting program using the Extra Eyes model

Science.gov (United States)

2008-09-01

This manual is a guide for law enforcement agencies and community organizations in creating and implementing a citizens DWI reporting program in their communities modeling the Operation Extra Eyes program. Extra Eyes is a program that engages volu...

Development and Implementation of a Peer Mentoring Program for Early Career Gerontological Faculty

Science.gov (United States)

Bryant, Ashley Leak; Brody, Ab; Perez, Adriana; Shillam, Casey; Edelman, Linda S.; Bond, Stewart M.; Foster, Victoria; Siegel, Elena

2016-01-01

Purpose In conjunction with the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE), formerly known as the Building Academic Geriatric Nursing Capacity Initiative (BAGNC), the Hartford Gerontological Nursing Leaders (HGNL) developed and executed a program beginning in 2011 to enhance both (a) the experience of newly selected scholars and fellows to the NHCGNE and (b) the ongoing professional development of the HGNL. The purpose of this article is to describe key strategies used to develop and execute the mentoring program and to present the formative and summative program evaluation. Design The program was launched in January 2011 with seven peer mentor and mentee matches. In June 2012, the peer mentoring committee solicited feedback on the development of the peer mentoring program and changes were made for the subsequent cohorts. Findings An additional 12 matches were made in the following 2 years (2012 and 2013), for a total of 31 matches to date. We have learned several key lessons from our three cohorts regarding how to structure, implement, and carefully evaluate a peer mentoring program. Conclusions Informal evaluation of our peer mentoring program noted several challenges for both peer mentors and mentees. Having knowledge of and addressing those challenges may increase the overall quality and effectiveness of peer mentoring programs and, in turn, benefit academic nursing by strengthening the faculty workforce. Clinical Relevance Findings from development and implementation of a peer mentoring program for gerontological faculty could lead to new and adaptable programs in a variety of clinical and education settings. PMID:25808927

Development and implementation of a peer mentoring program for early career gerontological faculty.

Science.gov (United States)

Bryant, Ashley Leak; Aizer Brody, Abraham; Perez, Adriana; Shillam, Casey; Edelman, Linda S; Bond, Stewart M; Foster, Victoria; Siegel, Elena O

2015-05-01

The Hartford Gerontological Nursing Leaders (HGNL) formerly known as the Building Academic Geriatric Nursing Capacity Initiative (BAGNC), in conjunction with the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE), developed and executed a peer mentoring program beginning in 2011 to enhance both (a) the experience of newly selected scholars and fellows to the NHCGNE and (b) the ongoing professional development of HGNL members. The purpose of this article is to describe key strategies used to develop and execute the peer mentoring program and to present formative program evaluation. The program was launched in January 2011 with seven peer mentor and mentee matches. In June 2012, the peer mentoring committee solicited feedback on the development of the peer mentoring program and changes were made for the subsequent cohorts. An additional 12 matches were made in the following 2 years (2012 and 2013), for a total of 31 matches to date. We have learned several key lessons from our three cohorts regarding how to structure, implement, and carefully evaluate a peer mentoring program. Informal evaluation of our peer mentoring program noted several challenges for both peer mentors and mentees. Having knowledge of and addressing those challenges may increase the overall quality and effectiveness of peer mentoring programs and, in turn, benefit academic nursing by strengthening the faculty workforce. Findings from development and implementation of a peer mentoring program for gerontological faculty could lead to new and adaptable programs in a variety of clinical and education settings. © 2015 Sigma Theta Tau International.

[Implementation and evaluation of case management in Catalonia: the ISP-SMD program].

Science.gov (United States)

Balsera Gómez, J; Rodríguez Medina, C; Caba Calvet, R; Vega Prada, R; Ruiz Ureña, H; Berruezo Ortiz, L; Clusa Gironella, D; Rodríguez Montes, M J; Haro Abad, J M

2002-01-01

The pilot study of the Individualized Service Program for people with Severe Mental Disorders (ISP-SMD) consists of the implementation of case management services in Catalonia. The ISP-SMD has been implemented in two health care sectors and will be expanded to the rest of Catalonia in the next years. The program serves people with persistent mental disorders who have serious social or family problems and/or who have inadequate mental health service use (high use of inpatient services, no use of community services). The ISP-SMD is a community intervention program that focuses its activities on direct care and coordination between services. Thirty patients have been included in the evaluation. The results of the pilot study have shown that, compared to the year before entering the program, the patients show better clinical status, they decrease their unmet need level, they have more appropriate use of health services and have lower treatment costs. Satisfaction of the patients, family members and professionals with the program is very high. It is possible to adapt and implement case management services in Catalonia. When implemented, they improve patient quality of life.

Implementing Health-Promoting Leadership in Municipal Organizations: Managers’ Experiences with a Leadership Program

Directory of Open Access Journals (Sweden)

Robert Larsson

2015-03-01

Full Text Available The aim of this study was to analyze how line and middle managers experience and describe barriers and enablers in the implementation of a health-promoting leadership program in municipal organizations. A qualitative case study design was applied to examine the leadership program in a case involving implementation of an organizational health intervention. Data were mainly collected using semi-structured interviews with line and middle managers participating in the leadership program. Interviews with senior managers, notes from meetings/workshops, and written action plans were used as complementary data. The interview data were analyzed using a thematic analysis, and the complementary data using a summative content analysis. The findings show that the interviewed line and middle managers experienced this leadership program as a new approach in leadership training because it is based primarily on employee participation. Involvement and commitment of the employees was considered a crucial enabler in the implementation of the leadership program. Other enablers identified include action plans with specific goals, earlier experiences of organizational change, and integration of the program content into regular routines and structures. The line and middle managers described several barriers in the implementation process, and they described various organizational conditions, such as high workload, lack of senior management support, politically initiated projects, and organizational change, as challenges that limited the opportunities to be drivers of change. Taken together, these barriers interfered with the leadership program and its implementation. The study contributes to the understanding of how organizational-level health interventions are implemented in public sector workplaces.

Change Management Model for Implementing an Effective First-Year Experience Program in the Community College Setting

Science.gov (United States)

Tucker, Joy C.

2015-01-01

This study provides evidence that systematic management of change can facilitate the implementation of first-year experience programming that leads to improved results in retention and student success for community college students. The study includes four major themes: (a) first-year experience, (b) change management, (c) change leadership, and…

Emissions Scenarios, Costs, and Implementation Considerations of REDD Programs

Energy Technology Data Exchange (ETDEWEB)

Sathaye, Jayant; Andrasko, Ken; Chan, Peter

2011-04-11

Greenhouse gas emissions from the forestry sector are estimated to be 8.4 GtCO2-eq./year or about 17percent of the global emissions. We estimate that the cost forreducing deforestation is low in Africa and several times higher in Latin America and Southeast Asia. These cost estimates are sensitive to the uncertainties of how muchunsustainable high-revenue logging occurs, little understood transaction and program implementation costs, and barriers to implementation including governance issues. Due to lack of capacity in the affected countries, achieving reduction or avoidance of carbon emissions will require extensive REDD-plus programs. Preliminary REDD-plus Readiness cost estimates and program descriptions for Indonesia, Democratic Republic of the Congo, Ghana, Guyana and Mexico show that roughly one-third of potential REDD-plus mitigation benefits might come from avoided deforestation and the rest from avoided forest degradation and other REDD-plus activities.

Mindfulness-Based Cognitive Approach for Seniors (MBCAS): Program Development and Implementation.

Science.gov (United States)

Zellner Keller, Brigitte; Singh, Nirbhay N; Winton, Alan S W

2014-01-01

A number of cognitive interventions have been developed to enhance cognitive functioning in the growing population of the elderly. We describe the Mindfulness-Based Cognitive Approach for Seniors (MBCAS), a new training program designed especially for seniors. It was conceived in the context of self-development for seniors who wish to enhance their relationship with their inner and outer selves in order to navigate their aging process more easily and fluently. Physical and psychosocial problems related to aging, as well as some temporal issues, were taken into account in developing this program. Unlike clinically oriented mindfulness-based programs, which are generally delivered during an 8-week period, the MBCAS training program is presented over a period of 8 months. The main objectives of this program are to teach seniors to observe current experiences with nonjudgmental awareness, to identify automatic behaviors or reactions to current experiences that are potentially nonadaptive, and to enhance and reinforce positive coping with typical difficulties that they face in their daily lives. Details of the program development and initial implementation are presented, with suggestions for evaluating the program's effectiveness.

Development and Implementation of Science and Technology Ethics Education Program for Prospective Science Teachers

Science.gov (United States)

Rhee, Hyang-yon; Choi, Kyunghee

2014-05-01

The purposes of this study were (1) to develop a science and technology (ST) ethics education program for prospective science teachers, (2) to examine the effect of the program on the perceptions of the participants, in terms of their ethics and education concerns, and (3) to evaluate the impact of the program design. The program utilized problem-based learning (PBL) which was performed as an iterative process during two cycles. A total of 23 and 29 prospective teachers in each cycle performed team activities. A PBL-based ST ethics education program for the science classroom setting was effective in enhancing participants' perceptions of ethics and education in ST. These perceptions motivated prospective science teachers to develop and implement ST ethics education in their future classrooms. The change in the prospective teachers' perceptions of ethical issues and the need for ethics education was greater when the topic was controversial.

Evaluation of early implementations of antibiotic stewardship program initiatives in nine Dutch hospitals

NARCIS (Netherlands)

van Limburg, Maarten; Sinha, Bhanu; Lo-Ten-Foe, Jerome R; van Gemert-Pijnen, Julia Ewc

2014-01-01

BACKGROUND: Antibiotic resistance is a global threat to patient safety and care. In response, hospitals start antibiotic stewardship programs to optimise antibiotic use. Expert-based guidelines recommend strategies to implement such programs, but local implementations may differ per hospital.

School Integration Program in Chile: gaps and challenges for the implementation of an inclusive education program

Directory of Open Access Journals (Sweden)

Mauro Tamayo Rozas

2018-06-01

Full Text Available Constructing inclusive societies, leaving no one behind, it is an ethical obligation. Developing inclusive educational programs allows ensuring equal opportunities in one of the most critical stages of development. The aim of this study is to describe the implementation of the School Integration Program (SIP in its different dimensions and in different zones of Chile. A descriptive and cross-sectional study of the perception of SIP Coordinators was performed in public and subsidized schools at the country through a web-based survey. A simple random convenience sampling of schools was performed, obtaining 1742 answers from educational establishments with SIP. Higher level of implementation of the program was identified in areas related to interdisciplinary work and comprehensive training, curricular and institutional aspects. On the other hand, deficiencies were identified in the implementation of accessibility, development of reasonable adjustments and participation of the educational community. Likewise, there are differences between the zones of Chile, with the North zone having the least progress. Although there are results in the work team and institutional development, the development of objective conditions and participation is still a pending task in the implementation of the SIP.

The Network Form of Implementing Educational Programs: Differences and Typology

Science.gov (United States)

Sobolev, Alexandr Borisovich

2016-01-01

The article describes peculiarities of implementation and major differences in network educational programs, currently introduced in Russia. It presents a general typology of models and forms for implementing interaction between educational institutions of Russia, including teacher institutes and federal universities, as well as a typology of…

RAY TRACING IMPLEMENTATION IN JAVA PROGRAMMING LANGUAGE

Directory of Open Access Journals (Sweden)

Aybars UĞUR

2002-01-01

Full Text Available In this paper realism in computer graphics and components providing realism are discussed at first. It is mentioned about illumination models, surface rendering methods and light sources for this aim. After that, ray tracing which is a technique for creating two dimensional image of a three-dimensional virtual environment is explained briefly. A simple ray tracing algorithm was given. "SahneIzle" which is a ray tracing program implemented in Java programming language which can be used on the internet is introduced. As a result, importance of network-centric ray tracing software is discussed.

Evaluation of early implementations of antibiotic stewardship program initiatives in nine Dutch hospitals

NARCIS (Netherlands)

van Limburg, A.H.M.; Sinha, Bhanu; Lo-Ten-Foe, Jerome R.; van Gemert-Pijnen, Julia E.W.C.

2014-01-01

Background Antibiotic resistance is a global threat to patient safety and care. In response, hospitals start antibiotic stewardship programs to optimise antibiotic use. Expert-based guidelines recommend strategies to implement such programs, but local implementations may differ per hospital. Earlier

Stepping up to the challenge: the development, implementation, and assessment of a statewide, regional, leadership program for school nutrition directors.

Science.gov (United States)

Bergman, Jacqueline J; Briggs, Marilyn M; Beall, Deborah L; Curwood, Sandy; Gray, Pilar; Soiseth, Scott; Taylor, Rodney K; Zidenberg-Cherr, Sheri

2015-01-01

A statewide professional development program was developed and implemented throughout California for school nutrition directors with the goal of creating healthy school environments and regional networks for collaboration and healthy school environment sustainability. Needs of school nutrition directors were identified through a needs assessment questionnaire. Results of the needs assessment questionnaire (n = 256) identified (a) planning cost-effective menus; (b) reducing calories, sodium, saturated fat, and trans fat in menus; and (c) using U.S. Department of Agriculture foods cost-effectively as the most useful topics. Highest rated topics informed the content of the professional development program. A post-professional development questionnaire identified key "insights, inspirations, and strategies" as (a) marketing of school foods program, (b) expansion of salad bars, and (c) collaboration with community partners. A 6-month follow-up questionnaire identified that 86% of participants made progress toward implementing at least one of their five insights, inspirations, and strategies in their school districts. Most common areas that were implemented were marketing and branding (32%), revamping salad bars (18%), and motivating staff (16%). School and Community Actions for Nutrition survey analysis showed a significant increase in the use of marketing methods in school nutrition programs from baseline to 6-month post-program implementation (p = .024). © 2014 Society for Public Health Education.

Preemptive clinical pharmacogenetics implementation: current programs in five US medical centers.

Science.gov (United States)

Dunnenberger, Henry M; Crews, Kristine R; Hoffman, James M; Caudle, Kelly E; Broeckel, Ulrich; Howard, Scott C; Hunkler, Robert J; Klein, Teri E; Evans, William E; Relling, Mary V

2015-01-01

Although the field of pharmacogenetics has existed for decades, practioners have been slow to implement pharmacogenetic testing in clinical care. Numerous publications describe the barriers to clinical implementation of pharmacogenetics. Recently, several freely available resources have been developed to help address these barriers. In this review, we discuss current programs that use preemptive genotyping to optimize the pharmacotherapy of patients. Array-based preemptive testing includes a large number of relevant pharmacogenes that impact multiple high-risk drugs. Using a preemptive approach allows genotyping results to be available prior to any prescribing decision so that genomic variation may be considered as an inherent patient characteristic in the planning of therapy. This review describes the common elements among programs that have implemented preemptive genotyping and highlights key processes for implementation, including clinical decision support.

[The German program for disease management guidelines--implementation with pathways and quality management].

Science.gov (United States)

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2007-07-15

In Germany, physicians enrolled in disease management programs are legally obliged to follow evidence-based clinical practice guidelines. That is why a Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 aiming at implementation of best-practice evidence-based recommendations for nationwide as well as regional disease management programs. Against this background the article reviews programs, methods and tools for implementing DM-CPGs via clinical pathways as well as regional guidelines for outpatient care. Special reference is given to the institutionalized program of adapting DM-CPGs for regional use by primary-care physicians in the State of Hesse.

Implementation of the Danish return-to-work program

DEFF Research Database (Denmark)

Aust, Birgit; D. Nielsen, Maj Britt; Grundtvig, Gry

2015-01-01

OBJECTIVES: The aim of this study was to evaluate the implementation of the Danish national return-to-work (RTW) program in 21 Danish municipalities. METHODS: We conducted a structured process evaluation on (i) reach and recruitment, (ii) fidelity, (iii) dose-delivered, (iv) dose-received, and (v...... (defined as implementation consistent with the principles of the interdisciplinary RTW process). Five municipalities had high and eight had low fidelity scores. Similar large differences were found with regard to dose-delivered, particularly in the quality of cooperation with beneficiaries, employers...

After reliability centred maintenance. Preventive maintenance living program implementation at Bruce Power

International Nuclear Information System (INIS)

Harazim, Michael L.; Ferguson, Brian J.

2003-01-01

Industrial preventive maintenance (PM) programs represent a large part of plant O and M costs. PM Optimization (PMO) projects represent an effective mechanism for identifying unnecessary PM, extending PM intervals and infusing predictive maintenance (PdM) methods. However, once optimized, what process prevents the PM program from returning to a state of disarray? This is the function of a PM living program (PMLP). In 1997, an independent performance assessment identified concerns with the applicability and effectiveness of all Ontario Power Generation, Inc. (OPGI) PM programs. In response, OPGI instituted an Integrated Maintenance Program (IMP) including Reliability Centred Maintenance (RCM) and a PMLP. It should be noted that the PMLP was developed for the 3 OPGI nuclear Sites (i.e. Bruce, Pickering, and Darlington). Effective 1 May 2001, the Bruce Site has been leased to a group of investors lead by British Energy. This paper is written in historical context and therefore refers to the Bruce Site as part of OPGI. The PMLP is made up of five elements: 1) process control, 2) change control, 3) worker feedback, 4) program performance metrics, and 5) deferral module. A PMLP software tool, originally applied to Duke Energy nuclear plants, was enhanced and customized specifically for the OPGI PMLP, and then implemented at all three of OPGI's nuclear sites. The objective of the OPGI PMLP was to: Provide processes/procedures for continual optimization of all site PM tasks, Ensure effective and timely revision of PM tasks in the work management system, Ensure PM tasks remain applicable/effective at all times, Maintain and enhance PM consistency on a component, system and Site basis, Ensure that new predictive maintenance techniques are applied and integrated with the PM program, Ensure that mandated PM tasks are identified and executed, Provide a mechanism for craft feedback, Meet regulatory requirements for PM program effectiveness, and Provide PM task deferral

Implementation and evaluation of an incentivized Internet-mediated walking program for obese adults.

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Zulman, Donna M; Damschroder, Laura J; Smith, Ryan G; Resnick, Paul J; Sen, Ananda; Krupka, Erin L; Richardson, Caroline R

2013-12-01

In response to rising health care costs associated with obesity rates, some health care insurers are adopting incentivized technology-enhanced wellness programs. The purpose of this study is to evaluate the large-scale implementation of an incentivized Internet-mediated walking program for obese adults and to examine program acceptance, adherence, and impact. A mixed-methods evaluation was conducted to investigate program implementation, acceptance, and adherence rates, and physical activity rates among program participants. Program implementation was shaped by national and state policies, data security concerns, and challenges related to incentivizing participation. Among 15,397 eligible individuals, 6,548 (43 %) elected to participate in the walking program, achieving an average of 6,523 steps/day (SD 2,610 steps). Participants who uploaded step counts for 75 % of days for a full year (n = 2,885) achieved an average of 7,500 steps (SD 3,093). Acceptance and participation rates in this incentivized Internet-mediated walking program suggest that such interventions hold promise for engaging obese adults in physical activity.

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

Science.gov (United States)

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

2017-01-01

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

Implementation of Portfolio Assessment in a Competency-based Dental Hygiene Program.

Science.gov (United States)

Gadbury-Amyot, Cynthia C.; Holt, Lorie P.; Overman, Pamela R.; Schmidt, Colleen R.

2000-01-01

Describes the implementation of a portfolio assessment program in the dental hygiene program at the University of Missouri School of Dentistry. Tables provide examples of program competencies and related portfolio entries, the complete scoring rubric for portfolios, and the student portfolio evaluation survey. Concludes that although portfolio…

Savannah River Site Environmental Implementation Plan. Volume 2, Protection programs

Energy Technology Data Exchange (ETDEWEB)

1989-08-01

Formal sitewide environmental planning at the . Savannah River Site (SRS) began in 1986 with the development and adoption of the Strategic Environmental Plan. The Strategic Environmental Plan describes the philosophy, policy, and overall program direction of environmental programs for the operation of the SRS. The Strategic Environmental Plan (Volume 2) provided the basis for development of the Environmental Implementation Plan (EIP). The EIP is the detailed, comprehensive environmental master plan for operating contractor organizations at the SRS. The EIP provides a process to ensure that all environmental requirements and obligations are being met by setting specific measurable goals and objectives and strategies for implementation. The plan is the basis for justification of site manpower and funding requests for environmental projects and programs over a five-year planning period.

U.S. Department of Energy defense waste management program implementation plan

International Nuclear Information System (INIS)

Jordan, E.A.

1988-01-01

The Program Implementation Plan describes the Department of Energy's current approach to managing its defense high-level, low-level, and transuranic radioactive waste. It documents implementation of the policies described in the 1983 Defense Waste Management Plan

Implementation of transdiagnostic treatment for emotional disorders in residential eating disorder programs: A preliminary pre-post evaluation.

Science.gov (United States)

Thompson-Brenner, Heather; Boswell, James F; Espel-Huynh, Hallie; Brooks, Gayle; Lowe, Michael R

2018-03-19

Data are lacking from empirically supported therapies implemented in residential programs for eating disorders (EDs). Common elements treatments may be well-suited to address the complex implementation and treatment challenges that characterize these settings. This study assessed the preliminary effect of implementing a common elements therapy on clinician treatment delivery and patient (N = 616) symptom outcomes in two residential ED programs. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders was adapted to address ED and co-occurring psychopathology and implemented across sites. Therapists' treatment fidelity was rated independently to assess implementation success. Additionally, longitudinal (pre-post) design compared treatment outcomes among patients treated before and after implementation. Patient outcomes included ED and depressive symptoms, experiential avoidance, anxiety sensitivity, and mindfulness. Following training and implementation, clinicians demonstrated adequate to good fidelity. Relative to pre-implementation, post-implementation patients showed significantly greater improvements in experiential avoidance, anxiety sensitivity, and mindfulness at discharge (ps ≤ .04) and more favorable outcomes on ED symptom severity, depression, and experiential avoidance at 6-month follow up (ps ≤ .0001). Preliminary pilot data support the feasibility of implementing transdiagnostic common elements therapy in residential ED treatment, and suggest that implementation may benefit transdiagnostic outcomes for patients.

EVALUATION OF THE IMPLEMENTATION OF OPERATIONS AND MAINTENANCE PROGRAMS IN NEW JERSEY SCHOOLS

Science.gov (United States)

The Asbestos Hazard Emergency Response Act (AHERA) required all schools to develop and implement an asbestos management plan (AMP). The key component of the AMP is the operations and maintenance (O&M) program. A study was conducted to evaluate the implementation of O&M programs a...

Development, implementation and management of a drug testing program in the workplace

Energy Technology Data Exchange (ETDEWEB)

Burtis, C.A.

1990-01-01

To combat the rising use of drugs in the workplace many American companies have implemented drug testing programs and are testing employees and job applicants for use of illegal drugs. In addition, on September 15, 1986, Executive Order No.12564 was issued by President Reagan, which requires all federal agencies to develop programs and policies, one of the goals of which is to achieve a drug-free federal workplace. Included in this Executive Order is the requirement that federal agencies implement drug testing has become a prevalent practice as a means to detect and deter drug use in the workplace. Before a drug testing program is implemented, it is imperative that policies and procedures are developed that (1) ensure the accuracy of test results, (2) protect the validity and integrity of the specimen, (3) guarantee due process, and (4) maintain confidentiality. To make certain that these prerequisites were met in the government drug testing programs, the US Department of Health and Human Services (HHS) was directed to develop technical and scientific guidelines for conducting such programs. 15 refs., 1 fig., 2 tabs.

Designing and implementing a resiliency program for family medicine residents.

Science.gov (United States)

Brennan, Julie; McGrady, Angele

2015-01-01

Family medicine residents are at risk for burnout due to extended work hours, lack of control over their work schedule, and challenging work situations and environments. Building resiliency can prevent burnout and may improve a resident's quality of life and health behavior. This report describes a program designed to build resiliency, the ability to bounce back from stress, in family medicine residents in a medium sized U.S. residency training program. Interactive sessions emphasized building self-awareness, coping skills, strengths and meaning in work, time management, self-care, and connections in and outside of medicine to support resident well-being. System changes which fostered wellness were also implemented. These changes included increasing the availability of fresh fruits in the conference and call room, purchasing an elliptical exercise machine for the on call room, and offering a few minutes of mindfulness meditation daily to the inpatient residents. Results to date show excellent acceptance of the program by trainees, increased consumption of nutritious foods, more personal exercise, and self-reported decreased overreactions to stress. Resiliency programs can effectively serve to meet accreditation requirements while fostering residents' abilities to balance personal and professional demands. © The Author(s) 2015.

Implementing 'Continuous Improvement' in the U.S. Nuclear Regulatory Commission's Decommissioning Program

International Nuclear Information System (INIS)

Orlando, D. A.; Buckley, J. T.; Johnson, R. L.; Gillen, D. M.

2006-01-01

The United States Nuclear Regulatory Commission's (US NRC's) comprehensive decommissioning program encompasses the decommissioning of all US NRC licensed facilities, ranging from the termination of routine licenses for sealed sources, to the closure of complex materials sites and nuclear power reactor facilities. Of the approximately 200 materials licenses that are terminated each year, most are routine and require little, if any, remediation to meet the US NRC unrestricted release criteria. However, some present technical and policy challenges that require large expenditures of resources, including a few complex materials sites that have requested license termination under the restricted-use provisions of 10 CFR 20.1403. Fiscal constraints to reduce budgeted resources in the decommissioning program, as well as concerns over the time to complete the decommissioning process have led to actions to improve the program and use resources more efficiently. In addition, the US NRC's Strategic Plan requires efforts to identify and implement improvements to US NRC programs in order to improve efficiency, effectiveness, timeliness, and openness, of the US NRC's activities, while maintaining the necessary focus on safety. Decommissioning regulations, and more recently the analysis of several issues associated with implementing those regulations, also have been significant catalysts for improvements in the decommissioning program. Actions in response to these catalysts have resulted in a program focused on the management of complex sites in a comprehensive, consistent, and risk-informed manner, as opposed to the past practice of focusing on sites deemed to be problematic. This paper describes the current status of the decommissioning of US NRC-licensed nuclear facilities, including an overview of recent decommissioning project completion efforts. It provides a detailed summary of past, current, and future improvements in the US NRC decommissioning program including the

The Implementation of Industrial Cluster Development Program in Padurenan Village, Kudus

Directory of Open Access Journals (Sweden)

R. Heffi Achid Muharrom

2014-12-01

Full Text Available Small medium enterprise (SME has a significant contribution to the national economic growth, and the Government has been trying to enhance the competitiveness of SME by using industrial cluster approach.This research tries to discuss the implementation of embroidery and apparel industrial cluster development program in Padurenan Village, Kudus Regency, also to analyze supporting and constraining factors that influence the implementation. The descriptive research method with qualitative approach is used in this research.The result shows that many activities conducted through a synergy among stakeholders have been implemented succesfully and proven to provide a positive impact for the developmet of embroidery and apparel SME in Padurenan. Enhancing the commitment and communication among actors involved in the program are needed for further development.Keywords:  Embroidery and apparel industry, industrial cluster, policy implementation

Enhancing leadership and relationships by implementing a peer mentoring program.

Science.gov (United States)

Gafni Lachter, Liat R; Ruland, Judith P

2018-03-30

Peer-mentoring is often described as effective means to promote professional and leadership skills, yet evidence on practical models of such programs for occupational therapy students are sparse. The purpose of this study was to evaluate the outcomes of a peer-mentoring program designed for graduate occupational therapy students. Forty-seven second-year student volunteers were randomly assigned to individually mentor first-year students in a year-long program. Students met biweekly virtually or in person to provide mentorship on everyday student issues, according to mentees' needs. Faculty-led group activities prior and during the peer-mentoring program took place to facilitate the mentorship relationships. Program effectiveness was measured using the Multi-factor Leadership Questionnaire (Avolio & Bass, MLQ: Multifactor Leadership Questionnaire, 2004) and an open-ended feedback survey. Results of multi-variate MANOVA for repeated measures indicating significant enhancement in several leadership skills (F(12,46) = 4.0, P = 0.001, η 2  = 0.579). Qualitative data from feedback surveys indicated that an opportunity to help; forming relationships; and structure as enabler were perceived as important participation outcomes. Students expressed high satisfaction and perceived value from their peer-mentoring experience. As we seek ways to promote our profession and the leadership of its members, it is recommended to consider student peer-mentoring to empower them to practice and advance essential career skills from the initial stages of professional development. Evidence found in this study demonstrates that peer-mentoring programs can promote leadership development and establishment of networks in an occupational therapy emerging professional community, at a low cost. The peer-mentoring blueprint and lessons learned are presented with hopes to inspire others to implement peer-mentoring programs in their settings. © 2018 Occupational Therapy Australia.

NEPA implementation: The Department of Energy's program to manage spent nuclear fuel

International Nuclear Information System (INIS)

Shipler, D.B.

1994-05-01

The Department of Energy (DOE) is implementing the National Environmental Protection Act (NEPA) in its management of spent nuclear fuel. The DOE strategy is to address the short-term safety concerns about existing spent nuclear fuel, to study alternatives for interim storage, and to develop a long-range program to manage spent nuclear fuel. This paper discusses the NEPA process, the environmental impact statements for specific sites as well as the overall program, the inventory of DOE spent nuclear fuel, the alternatives for managing the fuel, and the schedule for implementing the program

Clinical and financial considerations for implementing an ICU telemedicine program.

Science.gov (United States)

Kruklitis, Robert J; Tracy, Joseph A; McCambridge, Matthew M

2014-06-01

As the population in the United States increases and ages, the need to provide high-quality, safe, and cost-effective care to the most critically ill patients will be of great importance. With the projected shortage of intensivists, innovative changes to improve efficiency and increase productivity will be necessary. Telemedicine programs in the ICUs (tele-ICUs) are a successful strategy to improve intensivist access to critically ill patients. Although significant capital and maintenance costs are associated with tele-ICUs, these costs can be offset by indirect financial benefits, such as decreased length of stay. To achieve the positive clinical outcomes desired, tele-ICUs must be carefully designed and implemented. In this article, we discuss the clinical benefits of tele-ICUs. We review the financial considerations, including direct and indirect reimbursement and development and maintenance costs. Finally, we review design and implementation considerations for tele-ICUs.

U.S. Department of Energy, defense waste management program implementation plan

International Nuclear Information System (INIS)

Chee, T.

1988-01-01

This paper reports that the program implementation plan describes the Department of Energy's current approach to managing its defense high-level, low-level, and transuranic radioactive waste. It documents implementation of the policies described in the 1983 Defense Waste Management Plan

Evaluation Methodologies for Estimating the Likelihood of Program Implementation Failure

Science.gov (United States)

Durand, Roger; Decker, Phillip J.; Kirkman, Dorothy M.

2014-01-01

Despite our best efforts as evaluators, program implementation failures abound. A wide variety of valuable methodologies have been adopted to explain and evaluate the "why" of these failures. Yet, typically these methodologies have been employed concurrently (e.g., project monitoring) or to the post-hoc assessment of program activities.…

School Age Center Connections: Site-Based Management Strategies for Implementation of Quality Programs.

Science.gov (United States)

Willis, Dahna R.

This paper describes the outcomes of a practicum that initiated site-based-management strategies to support the consistent implementation of a quality school-age child-care program. Implemented at a multisite child-care center, the program sought to enhance staff members' job satisfaction and maximize their opportunities for professional growth…

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

Science.gov (United States)

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

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

The Causality Study of External Environment Analysis (EEA), Internal Environment Analysis (IEA), Strategy Implementation on Study Program Performance at Vocational High School (VHS) in Nias Archipelago, Indonesia

Science.gov (United States)

Waruwu, Binahati; Sitompul, Harun; Manullang, Belferik

2016-01-01

The purposes of this study are to find out the significant effect of: (1) EEA on strategy implementation, (2) IEA on strategy implementation, (3) EEA on study program performance, (4) IEA on study program performance, and (5) strategy implementation on study program performance of Vocational High School (VHS) in Nias Archipelago. The population of…

Implementing an overdose education and naloxone distribution program in a health system.

Science.gov (United States)

Devries, Jennifer; Rafie, Sally; Polston, Gregory

To design and implement a health system-wide program increasing provision of take-home naloxone in patients at risk for opioid overdose, with the downstream aim of reducing fatalities. The program includes health care professional education and guidelines, development, and dissemination of patient education materials, electronic health record changes to promote naloxone prescriptions, and availability of naloxone in pharmacies. Academic health system, San Diego, California. University of California, San Diego Health (UCSDH), offers both inpatient and outpatient primary care and specialty services with 563 beds spanning 2 hospitals and 6 pharmacies. UCSDH is part of the University of California health system, and it serves as the county's safety net hospital. In January 2016, a multisite academic health system initiated a system-wide overdose education and naloxone distribution program to prevent opioid overdose and opioid overdose-related deaths. An interdisciplinary, interdepartmental team came together to develop and implement the program. To strengthen institutional support, naloxone prescribing guidelines were developed and approved for the health system. Education on naloxone for physicians, pharmacists, and nurses was provided through departmental trainings, bulletins, and e-mail notifications. Alerts in the electronic health record and preset naloxone orders facilitated co-prescribing of naloxone with opioid prescriptions. Electronic health record reports captured naloxone prescriptions ordered. Summary reports on the electronic health record measured naloxone reminder alerts and response rates. Since the start of the program, the health system has trained 252 physicians, pharmacists, and nurses in overdose education and take-home naloxone. There has been an increase in the number of prescriptions for naloxone from a baseline of 4.5 per month to an average of 46 per month during the 3 months following full implementation of the program including

Implementation of a comprehensive blood conservation program can reduce blood use in a community cardiac surgery program.

Science.gov (United States)

Xydas, Steve; Magovern, Christopher J; Slater, James P; Brown, John M; Bustami, Rami; Parr, Grant V; Thurer, Robert L

2012-04-01

The study objective was to determine the effects of implementing a blood conservation algorithm on blood product use and outcomes in a community cardiac surgery program. A blood management strategy including lower hemoglobin transfusion threshold and algorithm-driven decisions was adopted. Intraoperatively, point-of-care testing was used to avoid inappropriate component transfusion. A low prime perfusion circuit was adopted. Blood was withdrawn from patients before initiating bypass when possible. Patients undergoing coronary and valve procedures were included. Outlier patients receiving more than 10 units packed red blood cells were excluded. Data were collected for 6 months as a baseline group (group I). A 3-month period of program implementation was allotted. Data were subsequently collected for 6 months and comprised the study patients (group II). Prospective data were collected on demographics, blood use, and outcomes. Group I comprised 481 patients, and group II comprised 551 patients. Group II received fewer units of packed red blood cells, fresh-frozen plasma, and cryoprecipitate than group I. There was no difference in platelets transfused. Total blood product use was reduced by 40% in group II (P conservation algorithm can be rapidly introduced, leading to reductions in blood and component use with no detrimental effect on early outcomes. Point-of-care testing can direct component transfusion in coagulopathic cases, with most coagulopathic patients requiring platelets. Further research will determine the effects of reduced transfusions on long-term outcomes. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

The Collier Chautauqua program: A formative evaluation of the implementation of the Iowa Chautauqua model of professional development and its effectiveness in improving science teaching

Science.gov (United States)

Dass, Pradeep Maxwell

1997-11-01

A formative evaluation of the implementation of the Iowa Chautauqua model of professional development in Collier County, Florida, was conducted during 1995-97, focusing on implementation issues and teacher enhancement. Major findings are as follows: Implementation issues. (1) Development of a shared vision through collaborative interaction between teachers, school administrators, and district administrators is critical to successful program implementation. (2) When a new program is implemented on a district-wide basis, the success of implementation depends upon how well the program matches local goals and needs and how ready the district and teachers are to make changes necessary for implementing the tenets of the program. (3) Development of proper understanding of desired pedagogical approaches requires modeling of these approaches in program activities, with explicit attention drawn to the modeling. (4) Successful implementation of desired pedagogical approaches in the classroom is critically influenced by the support and continual feedback teachers receive from district administrators, building administrators, and their peers. (5) Unwavering commitment of district and school administrators is essential for encouraging more teachers to participate in the program, leading to district-wide implementation without making it mandatory. Teacher Enhancement. (1) Participants developed leadership skills in mentorship, teamwork, presenting at professional meetings, and assuming responsibility within the program. (2) Participants learned to focus more on student questions and concerns, value prior conceptions of students, and develop instructional activities accordingly. They grew in their understanding and use of the constructivist pedagogy. (3) Participants attitude toward teaching in general and science in particular improved markedly, leading to new excitement and enthusiasm toward their profession. (4) Participants became more confident about teaching science

Optimizing Implementation of Obesity Prevention Programs: A Qualitative Investigation Within a Large-Scale Randomized Controlled Trial.

Science.gov (United States)

Kozica, Samantha L; Teede, Helena J; Harrison, Cheryce L; Klein, Ruth; Lombard, Catherine B

2016-01-01

The prevalence of obesity in rural and remote areas is elevated in comparison to urban populations, highlighting the need for interventions targeting obesity prevention in these settings. Implementing evidence-based obesity prevention programs is challenging. This study aimed to investigate factors influencing the implementation of obesity prevention programs, including adoption, program delivery, community uptake, and continuation, specifically within rural settings. Nested within a large-scale randomized controlled trial, a qualitative exploratory approach was adopted, with purposive sampling techniques utilized, to recruit stakeholders from 41 small rural towns in Australia. In-depth semistructured interviews were conducted with clinical health professionals, health service managers, and local government employees. Open coding was completed independently by 2 investigators and thematic analysis undertaken. In-depth interviews revealed that obesity prevention programs were valued by the rural workforce. Program implementation is influenced by interrelated factors across: (1) contextual factors and (2) organizational capacity. Key recommendations to manage the challenges of implementing evidence-based programs focused on reducing program delivery costs, aided by the provision of a suite of implementation and evaluation resources. Informing the scale-up of future prevention programs, stakeholders highlighted the need to build local rural capacity through developing supportive university partnerships, generating local program ownership and promoting active feedback to all program partners. We demonstrate that the rural workforce places a high value on obesity prevention programs. Our results inform the future scale-up of obesity prevention programs, providing an improved understanding of strategies to optimize implementation of evidence-based prevention programs. © 2015 National Rural Health Association.

Implementing Quality Service-Learning Programs in Community Colleges

Science.gov (United States)

Vaknin, Lauren Weiner; Bresciani, Marilee J.

2013-01-01

This cross-case comparative study at Western Community College and the University of the Coast explored through a constructive lens the characteristics that lead to sustainable, high quality service-learning programs and how they are implemented at institutions of higher education. The researchers determined that both Western Community College and…

Effectiveness of implementing a dyadic psychoeducational intervention for cancer patients and family caregivers.

Science.gov (United States)

Titler, Marita G; Visovatti, Moira A; Shuman, Clayton; Ellis, Katrina R; Banerjee, Tanima; Dockham, Bonnie; Yakusheva, Olga; Northouse, Laurel

2017-11-01

This study examined the effectiveness, feasibility, and satisfaction with implementation of the FOCUS program in two US Cancer Support Community affiliates in Ohio and California as well as the cost to deliver the program. FOCUS is an evidence-based psychoeducational intervention for dyads (cancer patients and caregivers). A pre-post-intervention design was employed. Eleven, five-session Focus programs were delivered by licensed professionals in a small group format (three-four dyads/group) to 36 patient-caregiver dyads. An Implementation Training Manual, a FOCUS Intervention Protocol Manual, and weekly conference calls were used to foster implementation. Participants completed questionnaires prior to and following completion of each five-session FOCUS program to measure primary (emotional distress, quality of life) and secondary outcomes (benefits of illness, self-efficacy, and dyadic communication). Enrollment and retention rates and fidelity to FOCUS were used to measure feasibility. Cost estimates were based on time and median hourly wages. Repeated analysis of variance was used to analyze the effect of FOCUS on outcomes for dyads. Descriptive statistics were used to examine feasibility, satisfaction, and cost estimates. FOCUS had positive effects on QOL (p = .014), emotional (p = .012), and functional (p = .049) well-being, emotional distress (p = .002), benefits of illness (p = .013), and self-efficacy (p = .001). Intervention fidelity was 85% with enrollment and retention rates of 71.4 and 90%, respectively. Participants were highly satisfied. Cost for oversight and delivery of the five-session FOCUS program was $168.00 per dyad. FOCUS is an economic and effective intervention to decrease distress and improve the quality of life for dyads.

THE BUDGET PROGRAM: ECONOMIC CONTENT AND PRACTICE OF IMPLEMENTATION

Directory of Open Access Journals (Sweden)

Iryna Shevchenko

2017-09-01

Full Text Available The aim of the article is to analyse the practice of the economic content of budget programs’ implementation in Ukraine. The definition of the budget program is given. It is noted that, in the Ukrainian legislative area, there is a wide range of programs, namely: programs of economic and social development of Ukraine; Government activity programs; state target programs; local programs for the socio-economic and cultural development. The author reviews in more detail the differences between the budget program and the state target program since it is these types of programs that are most confusing. It is emphasized that there is a certain interconnection between budget and state target programs and a strategic document. Thus, in order to achieve the corresponding goal and fulfil the tasks set out in the paper and aim at solving urgent problems of development, it is necessary to develop concrete ways in the context of branches of the economy. Methodology. The study of the indicators of planned and fully financed state budget programs, planned and spent expenditures for the financing of budget programs for 2011– 2015, as well as the polynomial trend of planned expenditures for the financialization of budget programs for 2011– 2017, is conducted. The interrelation between elements of budget programs and their characteristic features is studied. Indicators of the implementation of budget programs applied in international practice are considered and analysed, namely: Great Britain, Australia, New Zealand, USA. Results. The author systematized the views of scientists on the performance indicators of budget programs. The analysis of the professional literature on this issue allowed generalizing the main classification features, which, according to the author, should be fixed at the legislative level. Practical implication. The author proposed an additional classification mark “Depending on the degree of risk of non-fulfilment of the program�

Columbia River Basin Fish and Wildlife Program Annual Implementation Work Plan for fiscal year 1992

International Nuclear Information System (INIS)

1991-09-01

The Columbia River Basin Fish and Wildlife Program Annual Implementation Work Plan (AIWP) for Fiscal Year (FY) 1992 presents Bonneville Power Administration's (BPA) plans for implementing the Columbia River Basin Fish and Wildlife Program (Program) in FY 1992. The AIWP focuses on individual Action Items found in the 1987 Program for which BPA has determined that it has authority and responsibility to implement. Each of the entries in the AIWP includes objectives, background, progress to date in achieving the objectives, and a summary of plans for implementation in FY 1992. Most Action Items are implemented through one or more BPA-funded projects. Each Action Item entry is followed by a list of completed, ongoing, and planned projects, along with objectives, results, schedules, and milestones for each project. In October 1988, BPA and the Columbia Basin Fish and Wildlife Authority (CBFWA) initiated a collaborative and cooperative Implementation Planning Process (IPP). The IPP provided opportunities in FY 1991 for the fish and wildlife agencies. Tribes, and other interested parties to be involved in planning FY 1992 Program implementation. This planing process contributed to the development of this year's AIWP. The joint BPA/CBFWA IPP is expected to continue in FY 1992. The FY 1992 AIWP emphasizes continuation of 143 ongoing, or projected ongoing Program projects, tasks, or task orders, most of which involve protection, mitigation, or enhancement of anadromous fishery resources. The FY 1992 AIWP also contains 10 new Program projects or tasks that are planned to start in FY 1992

Implementation of the thinking skills for work program in a psychosocial clubhouse.

Science.gov (United States)

McGurk, Susan R; Schiano, Diane; Mueser, Kim T; Wolfe, Rosemarie

2010-01-01

Cognitive remediation programs aimed at improving role functioning have been implemented in a variety of different mental health treatment settings, but not in psychosocial clubhouses. This study sought to determine the feasibility and preliminary outcomes of providing a cognitive remediation program (the Thinking Skills for Work program), developed and previously implemented in supported employment programs at mental health agencies, in a psychosocial club-house. Twenty-three members with a history of difficulties getting or keeping jobs, who were participating in a supported employment program at a psychosocial clubhouse, were enrolled in the Thinking Skills for Work program. A neurocognitive battery was administered at baseline and 3 months later after completion of the computer cognitive training component of the program. Hours of competitive work were tracked for the 2 years before enrollment and 2 years following enrollment. Other work-related activities (school, volunteer) were also tracked for 2 years following enrollment. Twenty-one members (91%) completed 6 or more computer cognitive training sessions. Participants demonstrated significant improvements on neurocognitive measures of processing speed, verbal learning and memory, and executive functions. Sixty percent of the members obtained a competitive job during the 2-year follow-up, and 74% were involved in some type of work-related activity. Participants worked significantly more competitive hours over the 2 years after joining the Thinking Skills for Work program than before. The findings support the feasibility and promise of implementing the Thinking Skills for Work program in the context of supported employment provided at psychosocial clubhouses.

Implementation of a National Workplace Wellness Program for Health Workers in Botswana

OpenAIRE

Ledikwe, Jenny H.; Semo, Bazghina-werq; Sebego, Miram; Mpho, Maureen; Mothibedi, Heather; Mawandia, Shreshth; O?Malley, Gabrielle

2017-01-01

The Botswana workplace wellness program (WWP) for health care workers (HCWs) was initiated in 2007. WWP implementation was assessed using a sequential, explanatory, mixed methods design including a national implementation assessment (27 health districts) and in-depth interviews (n?=?38). Level of implementation varied across districts with health screening, therapeutic recreation, and health promotion implemented more frequently than occupational health activities and psychosocial services. F...

The development, implementation, and assessment of an innovative faculty mentoring leadership program.

Science.gov (United States)

Tsen, Lawrence C; Borus, Jonathan F; Nadelson, Carol C; Seely, Ellen W; Haas, Audrey; Fuhlbrigge, Anne L

2012-12-01

Effective mentoring is an important component of academic success. Few programs exist to both improve the effectiveness of established mentors and cultivate a multispecialty mentoring community. In 2008, in response to a faculty survey on mentoring, leaders at Brigham and Women's Hospital developed the Faculty Mentoring Leadership Program as a peer learning experience for midcareer and senior faculty physician and scientist mentors to enhance their skills and leadership in mentoring and create a supportive community of mentors. A planning group representing key administrative, educational, clinical, and research mentorship constituencies designed the nine-month course.Participants met monthly for an hour and a half during lunchtime. Two cofacilitators engaged the diverse group of 16 participants in interactive discussions about cases based on the participants' experiences. While the cofacilitators discussed with the participants the dyadic mentor-mentee relationship, they specifically emphasized the value of engaging multiple mentors and establishing mentoring networks. In response to postsession and postcourse (both immediately and after six months) self-assessments, participants reported substantive gains in their mentoring confidence and effectiveness, experienced a renewed sense of enthusiasm for mentoring, and took initial steps to build a diverse network of mentoring relationships.In this article, the authors describe the rationale, design, implementation, assessment, and ongoing impact of this innovative faculty mentoring leadership program. They also share lessons learned for other institutions that are contemplating developing a similar faculty mentoring program.

Remodularizing Java Programs for Improved Locality of Feature Implementations in Source Code

DEFF Research Database (Denmark)

Olszak, Andrzej; Jørgensen, Bo Nørregaard

2011-01-01

Explicit traceability between features and source code is known to help programmers to understand and modify programs during maintenance tasks. However, the complex relations between features and their implementations are not evident from the source code of object-oriented Java programs....... Consequently, the implementations of individual features are difficult to locate, comprehend, and modify in isolation. In this paper, we present a novel remodularization approach that improves the representation of features in the source code of Java programs. Both forward- and reverse restructurings...... are supported through on-demand bidirectional restructuring between feature-oriented and object-oriented decompositions. The approach includes a feature location phase based of tracing program execution, a feature representation phase that reallocates classes into a new package structure based on single...

IMPLEMENTATION OF EMPOWERMENT PROGRAM FOR FISHERMAN SOCIETY: A THEORETICAL REVIEW

Directory of Open Access Journals (Sweden)

Mh I.

2018-01-01

Full Text Available This article aimed at describing and explaining a set of theoretical review on the implementation of human empowerment program for fisherman society. This article was composed using review of related literature method. The result of the review points out some interesting findings: policy is a set of actions that contain some agreements agreed by a person or a group of people to solve certain problem or to achieve certain goal; implementation of a policy involves a long process in implementing the program which should be oriented to achieve the predetermined goals as stated in the policy; fisherman society can be classified into several categories, such as traditional fisherman, subsystem fisherman, pure fisherman, recreational and commercial fisherman; traditional fisherman refers to those who seize resources from the nature using traditional tools, small capital, and relatively simple organization; empowerment is an effort to develop certain capability or potential by driving, motivating and raising society’s awareness upon their own capability to be explored; society empowerment is an attempt to strengthen the dignity of certain society, to get themselves free from poverty or poor quality of life. In another word, empowerment is a program that helps a society to grow their ability and independence.

Implementation cost analysis of a community-based exercise program for seniors in South Florida.

Science.gov (United States)

Page, Timothy F; Batra, Anamica; Ghouse, Muddasir M; Palmer, Richard C

2014-07-01

The objective of the study was to measure the costs of implementing the EnhanceFitness program to elderly residents of South Florida. The Health Foundation of South Florida's Healthy Aging Regional Collaborative implemented EnhanceFitness as part of their initiative to make evidence-based healthy aging programs available to South Florida seniors. Cost data were collected from agencies participating in the delivery of EnhanceFitness classes in South Florida. Cost questionnaires were e-mailed to program coordinators from agencies participating in the delivery of EnhanceFitness classes. Program coordinators worked with accounting staff to complete the questionnaires. Questionnaires were returned via e-mail. Costs were presented from the perspective of participating agencies. Total costs were divided by the number of classes being offered by each agency to determine cost per class per month. Average monthly costs per class were $1,713 during the first year of implementation and $873 during the second year of implementation. The cost measurements, combined with information from the literature on cost savings attributable to EnhanceFitness participation, suggest that EnhanceFitness has the potential to generate a net societal cost savings among program participants. The results are useful for community agencies considering implementing EnhanceFitness for their populations. © 2014 Society for Public Health Education.

Implementation of an interprofessional team-based learning program involving seven undergraduate health and social care programs from two universities, and students' evaluation of their readiness for interprofessional learning.

Science.gov (United States)

Chan, Lap Ki; Ganotice, Fraide; Wong, Frances Kam Yuet; Lau, Chak Sing; Bridges, Susan M; Chan, Celia Hoi Yan; Chan, Namkiu; Chan, Phoebe Wing Lam; Chen, Hai Yong; Chen, Julie Yun; Chu, Jody Kwok Pui; Ho, Charlene C; Ho, Jacqueline Mei Chi; Lam, Tai Pong; Lam, Veronica Suk Fun; Li, Qingyun; Shen, Jian Gang; Tanner, Julian Alexander; Tso, Winnie Wan Yee; Wong, Arkers Kwan Ching; Wong, Gordon Tin Chun; Wong, Janet Yuen Ha; Wong, Nai Sum; Worsley, Alan; Yu, Lei King; Yum, Tin Pui

2017-11-21

Interprofessional learning is gaining momentum in revolutionizing healthcare education. During the academic year 2015/16, seven undergraduate-entry health and social care programs from two universities in Hong Kong took part in an interprofessional education program. Based on considerations such as the large number of students involved and the need to incorporate adult learning principles, team-based learning was adopted as the pedagogy for the program, which was therefore called the interprofessional team-based learning program (IPTBL). The authors describe the development and implementation of the IPTBL program and evaluate the effectiveness of the program implementation. Eight hundred and one students, who are predominantly Chinese, participated in the IPTBL. The quantitative design (a pretest-posttest experimental design) was utilized to examine the students' gains on their readiness to engage in interprofessional education (IPE). Three instructional units (IUs) were implemented, each around a clinical area which could engage students from complementary health and social care disciplines. Each IU followed a team-based learning (TBL) process: pre-class study, individual readiness assurance test, team readiness assurance test, appeal, feedback, and application exercise. An electronic platform was developed and was progressively introduced in the three IUs. The students' self-perceived attainment of the IPE learning outcomes was high. Across all four subscales of RIPLS, there was significant improvement in student's readiness to engage in interprofessional learning after the IPTBL. A number of challenges were identified: significant time involvement of the teachers, difficulty in matching students from different programs, difficulty in making IPTBL count towards a summative assessment score, difficulty in developing the LAMS platform, logistics difficulty in managing paper TBL, and inappropriateness of the venue. Despite some challenges in developing and

Implementing Probabilistic Abductive Logic Programming with Constraint Handling Rules

DEFF Research Database (Denmark)

Christiansen, Henning

2008-01-01

A class of Probabilistic Abductive Logic Programs (PALPs) is introduced and an implementation is developed in CHR for solving abductive problems, providing minimal explanations with their probabilities. Both all-explanations and most-probable-explanations versions are given. Compared with other...

Disseminating contingency management: impacts of staff training and implementation at an opiate treatment program.

Science.gov (United States)

Hartzler, Bryan; Jackson, T Ron; Jones, Brinn E; Beadnell, Blair; Calsyn, Donald A

2014-04-01

Guided by a comprehensive implementation model, this study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a Clinical Trials Network-affiliate opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, and adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (intervention cost, feasibility, and sustainability) were assessed at study conclusion in a qualitative interview with OTP management. Intervention effectiveness was also assessed via independent chart review of trial CM implementation vs. a historical control period. Results included: 1) robust, durable increases in delivery skill, knowledge, and adoption readiness among trained staff; 2) positive managerial perspectives of intervention cost, feasibility, and sustainability; and 3) significant clinical impacts on targeted patient indices. Collective results offer support for the study's collaborative intervention design and the applied, skills-based focus of staff training processes. Implications for CM dissemination are discussed. Published by Elsevier Inc.

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

Science.gov (United States)

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

2015-09-01

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

Perceived benefits and barriers of implementing nursing residency programs in Jordan.

Science.gov (United States)

AbuAlRub, R F; Abu Alhaija'a, M G

2018-03-02

To explore the challenges that face Jordanian nurses in the first year of employment; and understand the benefits and barriers of implementing a Nursing Residency Program from the perspectives of nurses and key informants. Many researchers reported that novice nurses do not have an adequate level of competence needed in the real clinical practice to meet the increasing demands of healthcare systems. A descriptive qualitative approach using individual interviews and focus group discussions was utilized. The sample was a purposive one that consisted of 30 Jordanian nurses and six key informants. Data were recorded and then transcribed. Content analysis was used to analyze the data. The results revealed several challenges that face nurses in their first year of experience such as reality shock, lack of self-confidence, and burnout and intent to leave. Some of the perceived barriers of implementing the Program were issues concerned with the responsible regulatory body, payment, and monitoring and evaluation. The findings asserted that the implementation of the Nursing Residency Program for new practicing nurses would enhance their competencies and self- confidence; and decrease the rate of reality shock and turnover within the first year of employment. Policy makers, nurse educators, and nurse administrators and clinical nurses need to collaborate to develop a formal system with binding policies and regulations concerning the implementation of Nursing Residency Program. There is also a need to address and modify current orientation programmes offered by hospitals for novice nurses to enhance their transition into clinical practice. © 2018 International Council of Nurses.

Reference drug programs: Effectiveness and policy implications☆

Science.gov (United States)

Schneeweiss, Sebastian

2010-01-01

In the current economic environment, health care systems are constantly struggling to contain rapidly rising costs. Drug costs are targeted by a wide variety of measures. Many jurisdictions have implemented reference drug programs (RDPs) or similar therapeutic substitution programs. This paper summarizes the mechanism and rationale of RDPs and presents evidence of their economic effectiveness and clinical safety. RDPs for pharmaceutical reimbursement are based on the assumption that drugs within specified medication groups are therapeutically equivalent and clinically interchangeable and that a common reimbursement level can thus be established. If the evidence documents that a higher price for a given drug does not buy greater effectiveness or reduced toxicity, then under RDP such extra costs are not covered. RDPs or therapeutic substitutions based on therapeutic equivalence are seen as logical extensions of generic substitution that is based on bioequivalence of drugs. If the goal is to achieve full drug coverage for as many patients as possible in the most efficient manner, then RDPs in combination with prior authorization programs are safer and more effective than simplistic fiscal drug policies, including fixed co-payments, co-insurances, or deductibles. RDPs will reduce spending in the less innovative but largest market, while fully covering all patients. Prior authorization will ensure that patients with a specified indication will benefit from the most innovative therapies with full coverage. In practice, however, not all patients and drugs will fit exactly into one of the two categories. Therefore, a process of medically indicated exemptions that will consider full coverage should accompany an RDP. In the current economic environment, health care systems are constantly struggling to contain rapidly rising costs. Drug costs are targeted by a wide variety of measures. Many jurisdictions have implemented reference drug programs, and others are considering

Effectiveness of computer ergonomics interventions for an engineering company: a program evaluation.

Science.gov (United States)

Goodman, Glenn; Landis, James; George, Christina; McGuire, Sheila; Shorter, Crystal; Sieminski, Michelle; Wilson, Tamika

2005-01-01

Ergonomic principles at the computer workstation may reduce the occurrence of work related injuries commonly associated with intensive computer use. A program implemented in 2001 by an occupational therapist and a physical therapist utilized these preventative measures with education about ergonomics, individualized evaluations of computer workstations, and recommendations for ergonomic and environmental changes. This study examined program outcomes and perceived effectiveness based on review of documents, interviews, and surveys of the employees and the plant manager. The program was deemed successful as shown by 59% of all therapist recommendations and 74% of ergonomic recommendations being implemented by the company, with an 85% satisfaction rate for the ergonomic interventions and an overall employee satisfaction rate of 70%. Eighty-one percent of the physical problems reported by employees were resolved to their satisfaction one year later. Successful implementation of ergonomics programs depend upon effective communication and education of the consumers, and the support, cooperation and collaboration of management and employees.

Standard Review Plan Maintenance Program implementing procedures document

International Nuclear Information System (INIS)

1996-11-01

The implementing Procedures Document (IPD) was developed by the Inspection Program Projects Branch, Office of Nuclear Reactor Regulation, with assistance from Pacific Northwest National Laboratory, for the Standard Review Plan Maintenance Program (SRP-MP). The SRP-MP was established to maintain the Standard Review Plan (SRP) on an on-going basis. The IPD provides guidance, including an overall approach and procedures, for SRP-MP tasks. The objective of the IPD is to ensure that modifications to SRP need to reflect current NRC requirements and guidance are identified and that a consistent methodology is used to develop and revise SRP sections

Constraint Solver Techniques for Implementing Precise and Scalable Static Program Analysis

DEFF Research Database (Denmark)

Zhang, Ye

solver using unification we could make a program analysis easier to design and implement, much more scalable, and still as precise as expected. We present an inclusion constraint language with the explicit equality constructs for specifying program analysis problems, and a parameterized framework...... developers to build reliable software systems more quickly and with fewer bugs or security defects. While designing and implementing a program analysis remains a hard work, making it both scalable and precise is even more challenging. In this dissertation, we show that with a general inclusion constraint...... data flow analyses for C language, we demonstrate a large amount of equivalences could be detected by off-line analyses, and they could then be used by a constraint solver to significantly improve the scalability of an analysis without sacrificing any precision....

Designing and Implementing a Mentoring Program to Support Clinically-Based Teacher Education

Science.gov (United States)

Henning, John E.; Gut, Dianne; Beam, Pamela

2015-01-01

This article describes one teacher preparation program's approach to designing and implementing a mentoring program to support clinically-based teacher education. The design for the program is based on an interview study that compared the mentoring experiences of 18 teachers across three different contexts: student teaching, early field…

Development and Implementation of a Mental Health Work Rehabilitation Program: Results of a Developmental Evaluation.

Science.gov (United States)

Sylvain, Chantal; Durand, Marie-José; Velasquez Sanchez, Astrid; Lessard, Nathalie; Maillette, Pascale

2018-05-23

Purpose Long-term work disability due to common mental disorders (CMDs) is a growing problem. Yet optimal interventions remain unclear and little is known about implementation challenges in everyday practice. This study aimed to support and evaluate, in real time, the development and implementation of a work rehabilitation program (WRP) designed to promote post-CMD return-to-work (RTW). Methods A 2-year developmental evaluation was performed using a participatory approach. At program outset, the researchers held five work meetings to revise the program's logic model and discuss its underlying change theory with clinicians. Data collection tools used throughout the study period were structured charts of activities conducted with workers (n = 41); in-depth interviews with program clinicians and managers (n = 9); and participant observation during work meetings. Quantitative data were analyzed using descriptive statistics. Qualitative data underwent thematic analysis using a processual approach. Results Three types of activity were developed and implemented: individual and group interventions targeting workers, and joint activities targeting partners (physicians, employers, others). While worker-targeted activities were generally implemented as planned, joint activities were sporadic. Analysis of the implementation process revealed five challenges faced by clinicians. Determinants included clinicians, host organization, sociopolitical context and resources provided by the evaluation. Conclusion The program studied is original in that it is based on the best available scientific knowledge, yet adapted to contextual particularities. The identified implementation challenges highlight the need for greater importance to be placed on the external, non-program context to ensure sustainable implementation in everyday practice.

Successful Bullying Prevention Programs: Influence of Research Design, Implementation Features, and Program Components

Directory of Open Access Journals (Sweden)

Bryanna Hahn Fox

2012-12-01

Full Text Available Bullying prevention programs have been shown to be generally effective in reducing bullying and victimization. However, the effects are relatively small in randomized experiments and greater in quasi-experimental and age-cohort designs. Programs that are more intensive and of longer duration (for both children and teachers are more effective, as are programs containing more components. Several program components are associated with large effect sizes, including parent training or meetings and teacher training. These results should inform the design and evaluation of anti-bullying programs in the future, and a system ofaccreditation of effective programs.

Preemptive Clinical Pharmacogenetics Implementation: Current programs in five United States medical centers

Science.gov (United States)

Dunnenberger, Henry M.; Crews, Kristine R.; Hoffman, James M.; Caudle, Kelly E.; Broeckel, Ulrich; Howard, Scott C.; Hunkler, Robert J.; Klein, Teri E.; Evans, William E.; Relling, Mary V.

2015-01-01

Although the field of pharmacogenetics has existed for decades, the implementation of, pharmacogenetic testing in clinical care has been slow. There are numerous publications, describing the barriers to clinical implementation of pharmacogenetics. Recently, several freely, available resources have been developed to help address these barriers. In this review we, discuss current programs that use preemptive genotyping to optimize the pharmacotherapy of, patients. Array-based preemptive testing includes a large number of relevant pharmacogenes, that impact multiple high-risk drugs. Using a preemptive approach allows genotyping results to, be available prior to any prescribing decision so that genomic variation may be considered as, an inherent patient characteristic in the planning of therapy. This review describes the common, elements among programs that have implemented preemptive genotyping and highlights key, processes for implementation, including clinical decision support. PMID:25292429

Formal semantic specifications as implementation blueprints for real-time programming languages

Science.gov (United States)

Feyock, S.

1981-01-01

Formal definitions of language and system semantics provide highly desirable checks on the correctness of implementations of programming languages and their runtime support systems. If these definitions can give concrete guidance to the implementor, major increases in implementation accuracy and decreases in implementation effort can be achieved. It is shown that of the wide variety of available methods the Hgraph (hypergraph) definitional technique (Pratt, 1975), is best suited to serve as such an implementation blueprint. A discussion and example of the Hgraph technique is presented, as well as an overview of the growing body of implementation experience of real-time languages based on Hgraph semantic definitions.

AES ALGORITHM IMPLEMENTATION IN PROGRAMMING LANGUAGES

Directory of Open Access Journals (Sweden)

Luminiţa DEFTA

2010-12-01

Full Text Available Information encryption represents the usage of an algorithm to convert an unknown message into an encrypted one. It is used to protect the data against unauthorized access. Protected data can be stored on a media device or can be transmitted through the network. In this paper we describe a concrete implementation of the AES algorithm in the Java programming language (available from Java Development Kit 6 libraries and C (using the OpenSSL library. AES (Advanced Encryption Standard is an asymmetric key encryption algorithm formally adopted by the U.S. government and was elected after a long process of standardization.

77 FR 65164 - Disadvantaged Business Enterprise: Program Implementation Modifications

Science.gov (United States)

2012-10-25

... 2105-AE08 Disadvantaged Business Enterprise: Program Implementation Modifications AGENCY: Office of the... the PRA's procedural requirements. Today, the Department is correcting this omission by including discussion of the Uniform Report collection and providing the public with 60 days from today to comment both...

Evaluating the impact of implementation factors on family-based prevention programming: methods for strengthening causal inference.

Science.gov (United States)

Crowley, D Max; Coffman, Donna L; Feinberg, Mark E; Greenberg, Mark T; Spoth, Richard L

2014-04-01

Despite growing recognition of the important role implementation plays in successful prevention efforts, relatively little work has sought to demonstrate a causal relationship between implementation factors and participant outcomes. In turn, failure to explore the implementation-to-outcome link limits our understanding of the mechanisms essential to successful programming. This gap is partially due to the inability of current methodological procedures within prevention science to account for the multitude of confounders responsible for variation in implementation factors (i.e., selection bias). The current paper illustrates how propensity and marginal structural models can be used to improve causal inferences involving implementation factors not easily randomized (e.g., participant attendance). We first present analytic steps for simultaneously evaluating the impact of multiple implementation factors on prevention program outcome. Then, we demonstrate this approach for evaluating the impact of enrollment and attendance in a family program, over and above the impact of a school-based program, within PROSPER, a large-scale real-world prevention trial. Findings illustrate the capacity of this approach to successfully account for confounders that influence enrollment and attendance, thereby more accurately representing true causal relations. For instance, after accounting for selection bias, we observed a 5% reduction in the prevalence of 11th grade underage drinking for those who chose to receive a family program and school program compared to those who received only the school program. Further, we detected a 7% reduction in underage drinking for those with high attendance in the family program.

Balancing compliance and cost when implementing a Quality Assurance program

International Nuclear Information System (INIS)

Pickering, S.Y.

1997-12-01

When implementing a Quality Assurance (QA) program, compliance and cost must be balanced. A QA program must be developed that hits the mark in terms of adequate control and documentation, but does not unnecessarily expand resources. As the Waste Isolation Pilot Plant (WIPP) has moved towards certification, Sandia National Laboratories has learned much about balancing compliance and costs. Some of these lessons are summarized here

Capacity building in rural Guatemala by implementing a solid waste management program

International Nuclear Information System (INIS)

Zarate, M.A.; Slotnick, J.; Ramos, M.

2008-01-01

The development and implementation of a solid waste management program served to build local capacity in San Mateo Ixtatan between 2002 and 2003 as part of a public health action plan. The program was developed and implemented in two phases: (1) the identification and education of a working team from the community; and (2) the completion of a solid waste classification and quantification study. Social capital and the water cycle were two public health approaches utilized to build a sustainable program. The activities accomplished gained support from the community and municipal authorities. A description of the tasks completed and findings of the solid waste classification and quantification performed by a local working group are presented in this paper

Implementation of the G8GP program on physical protection - experiences and results

International Nuclear Information System (INIS)

Hagemann, A.

2006-01-01

At the Kananaskis Summit in June 2002, G8 Leaders launched the Global Partnership against the Spread of Weapons and Materials of Mass Destruction committing to support projects to issues of non-proliferation, disarmament, counter terrorism and nuclear safety in Russia. Since then progress has been made in implementing projects. The German Federal Foreign Office contracted GRS to implement a program for improving the physical protection of nuclear or highly radioactive materials of relevance at facilities in the Russian Federation. This paper reports about this G8GP Program on physical protection, its implementation, gained experiences, current achievements and results. (author)

Gavi HPV Programs: Application to Implementation

Directory of Open Access Journals (Sweden)

Celina M. Hanson

2015-05-01

Full Text Available Developing countries disproportionately suffer from the burden of cervical cancer yet lack the resources to establish systematic screening programs that have resulted in significant reductions in morbidity and mortality in developed countries. Human Papillomavirus (HPV vaccination provides an opportunity for primary prevention of cervical cancer in low-resource settings through vaccine provision by Gavi The Vaccine Alliance. In addition to the traditional national introduction, countries can apply for a demonstration program to help them make informed decisions for subsequent national introduction. This article summarizes information from approved Gavi HPV demonstration program proposals and preliminary implementation findings. After two rounds of applications, 23 countries have been approved targeting approximately 400,000 girls for vaccination. All countries are proposing primarily school-based strategies with mixed strategies to locate and vaccinate girls not enrolled in school. Experiences to date include: Reaching marginalized girls has been challenging; Strong coordination with the education sector is key and overall acceptance has been high. Initial coverage reports are encouraging but will have to be confirmed in population based coverage surveys that will take place later this year. Experiences from these countries are consistent with existing literature describing other HPV vaccine pilots in low-income settings.

Pharmacists' views on implementing a disease state management program for low back pain.

Science.gov (United States)

Abdel Shaheed, Christina; Maher, Christopher G; Williams, Kylie A; McLachlan, Andrew J

2016-01-01

Pharmacists have the potential to take a lead role in the primary care management of people with acute low back pain. The aim of this study was to investigate pharmacists' views on implementing a care program for people with acute low back pain in the community pharmacy. Recruitment of pharmacists for this study took place between July 2012 and March 2013. A convenience sample of 30 pharmacists who collaborated in recruiting participants for a low back pain clinical trial in Sydney (n=15 pharmacist recruiters and n=15 non-recruiters) completed an open-ended questionnaire. There was no marked variation in responses between the two groups. Participating pharmacists were receptive to the idea of implementing a care program for people with low back pain, highlighting the need for adequate reimbursement and adequate training of staff to ensure it is successful. Pharmacists identified that the follow up of people receiving such a service is dependent on several factors such as effective reminder systems and the proximity of patients to the pharmacy.

Implementation and Sustainability of the Russian Federation Ministry of Defense Nuclear Personnel Reliability Program

International Nuclear Information System (INIS)

Lata, Vasiliy; Coates, Cameron W.

2010-01-01

Through a cooperative effort between the US Department of Energy and the Russian Federation (RF) Ministry of Defense (MOD) a Personnel Reliability Program (PRP) for the nuclear handlers within the RF MOD is at the stage of implementation. Sustaining the program is of major significance for long term success. This paper will discuss the elements of the RF PRP and the equipment needs for implementation. Program requirements, documentation needs, training, and assurances of appropriate equipment use will be addressed.

Effect of six sigma program on the number of surgeries cancellation.

Science.gov (United States)

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

2016-01-01

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

Image Quality Improvement after Implementation of a CT Accreditation Program

International Nuclear Information System (INIS)

Kim, You Sung; Jung, Seung Eun; Choi, Byung Gil; Shin, Yu Ri; Hwang, Seong Su; Ku, Young Mi; Lim, Yeon Soo; Lee, Jae Mun

2010-01-01

The purpose of this study was to evaluate any improvement in the quality of abdominal CTs after the utilization of the nationally based accreditation program. Approval was obtained from the Institutional Review Board, and informed consent was waived. We retrospectively analyzed 1,011 outside abdominal CTs, from 2003 to 2007. We evaluated images using a fill-up sheet form of the national accreditation program, and subjectively by grading for the overall CT image quality. CT scans were divided into two categories according to time periods; before and after the implementation of the accreditation program. We compared CT scans between two periods according to parameters pertaining to the evaluation of images. We determined whether there was a correlation between the results of a subjective assessment of the image quality and the evaluation scores of the clinical image. The following parameters were significantly different after the implementation of the accreditation program: identifying data, display parameters, scan length, spatial and contrast resolution, window width and level, optimal contrast enhancement, slice thickness, and total score. The remaining parameters were not significantly different between scans obtained from the two different periods: scan parameters, film quality, and artifacts. After performing the CT accreditation program, the quality of the outside abdominal CTs show marked improvement, especially for the parameters related to the scanning protocol

International Energy Agency Implementing Agreements and Annexes: A Guide for Building Technologies Program Managers

Energy Technology Data Exchange (ETDEWEB)

Evans, Meredydd; Runci, Paul; Meier, Alan

2008-08-01

This report presents results from a program evaluation of the U.S. Department of Energy?s Buildings Technologies Program (BTP) participation in collaborative international technology implementing agreements. The evaluation was conducted by researchers from the Pacific Northwest National Laboratory and the Lawrence Berkeley National Laboratory in the fall of 2007 and winter 2008 and was carried out via interviews with stakeholders in four implementing agreements in which BTP participates, reviews of relevant program reports, websites and other published materials. In addition to these findings, the report includes a variety of supporting materials such that aim to assist BTP managers who currently participate in IEA implementing agreements or who may be considering participation.

Implementation of SQLite database support in program gama-local

Directory of Open Access Journals (Sweden)

Vaclav Petras

2012-03-01

Full Text Available The program gama-local is a part of GNU Gama project and allows adjustment of local geodetic networks. Before realization of this project the program gama-local supported only XML as an input. I designed and implemented support for the SQLite database and thanks to this extension gama-local can read input data from the SQLite database. This article is focused on the specifics of the use of callback functions in C++ using the native SQLite C/C++ Application Programming Interface. The article provides solution to safe calling of callback functions written in C++. Callback functions are called from C library and C library itself is used by C++ program. Provided solution combines several programing techniques which are described in detail, so this article can serve as a cookbook even for beginner programmers.  This project was accomplished within my bachelor thesis.

German Language and Culture: 9-Year Program Guide to Implementation, Grades 4-5-6

Science.gov (United States)

Alberta Education, 2008

2008-01-01

This implementation guide is intended to support the Grade 4 to Grade 6 portion of the German Language and Culture Nine-year Program (the program of studies). It was developed primarily for teachers, yet it includes information that may be useful for administrators and other stakeholders in their efforts to plan for and implement the new Chinese…

Punjabi Language and Culture: 9-Year Program Guide to Implementation, Grades 4-5-6

Science.gov (United States)

Alberta Education, 2008

2008-01-01

This implementation guide is intended to support the Grade 4 to Grade 6 portion of the Punjabi Language and Culture Nine-Year Program (the program of studies.) It was developed primarily for teachers, yet it includes information that may be useful for administrators and other stakeholders in their efforts to plan for and implement the new Punjabi…

Implementation of a worksite educational program focused on promoting healthy eating habits.

Science.gov (United States)

Tanagra, Dimitra; Panidis, Dimitris; Tountas, Yannis; Remoudaki, Elina; Alexopoulos, Evangelos C

2013-01-01

To estimate the effectiveness of a short-term educational-counseling worksite program focused on lipid intake, by monitoring the possible change on nutrition knowledge and eating habits. an 8-week educational program based on the Health Belief Model was implemented in a honey packaging and sales company in Greece. 20 out of the 29 employees initially enrolled completed the program. Knowledge level and eating habits were evaluated prior and after the intervention by the "Nutrition Knowledge Questionnaire" and the "Food Habits Questionnaire". ANOVA, Spearman rho test and paired Wilcoxon test were employed in statistical analysis. Non smokers and those with higher educational level had healthier eating habits. Knowledge following the intervention was significantly improved concerning recommendations and basic food ingredients but as far as eating habits were concerned, scores were not improved significantly, while intake of fried food was increased. Short-term interventions may produce substantial improvement in knowledge but not necessarily modifications in unhealthy eating habits.

More scalability, less pain: A simple programming model and its implementation for extreme computing

International Nuclear Information System (INIS)

Lusk, E.L.; Pieper, S.C.; Butler, R.M.

2010-01-01

This is the story of a simple programming model, its implementation for extreme computing, and a breakthrough in nuclear physics. A critical issue for the future of high-performance computing is the programming model to use on next-generation architectures. Described here is a promising approach: program very large machines by combining a simplified programming model with a scalable library implementation. The presentation takes the form of a case study in nuclear physics. The chosen application addresses fundamental issues in the origins of our Universe, while the library developed to enable this application on the largest computers may have applications beyond this one.

A cost-effectiveness analysis of two different antimicrobial stewardship programs

OpenAIRE

Lucas Miyake Okumura; Bruno Salgado Riveros; Monica Maria Gomes-da-Silva; Izelandia Veroneze

2016-01-01

There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardshi...

Key ingredients for implementing intensive outpatient programs within patient-centered medical homes: A literature review and qualitative analysis.

Science.gov (United States)

Breland, Jessica Y; Asch, Steven M; Slightam, Cindie; Wong, Ava; Zulman, Donna M

2016-03-01

Intensive outpatient programs aim to transform care while conserving resources for high-need, high-cost patients, but little is known about factors that influence their implementation within patient-centered medical homes (PCMHs). In this mixed-methods study, we reviewed the literature to identify factors affecting intensive outpatient program implementation, then used semi-structured interviews to determine how these factors influenced the implementation of an intensive outpatient program within the Veterans Affairs' (VA) PCMH. Interviewees included facility leadership and clinical staff who were involved in a pilot Intensive Management Patient Aligned Care Team (ImPACT) intervention for high-need, high-cost VA PCMH patents. We classified implementation factors in the literature review and qualitative analysis using the Consolidated Framework for Implementation Research (CFIR). The literature review (n=9 studies) and analyses of interviews (n=15) revealed key implementation factors in three CFIR domains. First, the Inner Setting (i.e., the organizational and PCMH environment), mostly enabled implementation through a culture of innovation, good networks and communication, and positive tension for change. Second, Characteristics of Individuals, including creativity, flexibility, and interpersonal skills, allowed program staff to augment existing PCMH services. Finally, certain Intervention Characteristics (e.g., adaptability) enabled implementation, while others (e.g., complexity) generated implementation barriers. Resources and structural features common to PCMHs can facilitate implementation of intensive outpatient programs, but program success is also dependent on staff creativity and flexibility, and intervention adaptations to meet patient and organizational needs. Established PCMHs likely provide resources and environments that permit accelerated implementation of intensive outpatient programs. V. Published by Elsevier Inc.

What is the role of a project or program manager in implementing and maintaining a quality assurance program

International Nuclear Information System (INIS)

Anon.

1989-01-01

The task of managing a government-funded program has changed significantly from the days when a program manager managed the funds and depended on reports from a contractor to measure the program's progress. Today's manager of waste management program must be personally involved in every aspect of the program. The successful manager of a waste management program will lead the development of management controls to ensure successful accomplishment of project objectives. This paper describes the responsibilities of the project manager, the quality assurance staff and how they interface to develop and implement a quality assurance program for a waste management program

Effective Analysis of C Programs by Rewriting Variability

DEFF Research Database (Denmark)

Iosif-Lazar, Alexandru Florin; Melo, Jean; Dimovski, Aleksandar

2017-01-01

and effective analysis and verification of real-world C program families. Importance. We report some interesting variability-related bugs that we discovered using various state-of-the-art single-program C verification tools, such as Frama-C, Clang, LLBMC.......Context. Variability-intensive programs (program families) appear in many application areas and for many reasons today. Different family members, called variants, are derived by switching statically configurable options (features) on and off, while reuse of the common code is maximized. Inquiry....... Verification of program families is challenging since the number of variants is exponential in the number of features. Existing single-program analysis and verification tools cannot be applied directly to program families, and designing and implementing the corresponding variability-aware versions is tedious...

Family Economy and Its Implementation on Compulsory Education Program

Directory of Open Access Journals (Sweden)

Neni Hendaryati

2015-12-01

Full Text Available This research aims to determine and describe family economy and the implementation of nine-year compulsory education program at Kajenengan village, Bojong Sub District of Tegal in 2014. It was a qualitative descriptive study. The population of study was 1011 family leaders. This research used purposive sampling technique and 252 family leaders or about 25% of the population were as samples. Data were collected by observation, interview and documentation. Then, the data was analyzed by using data reduction, data display, and concluding. Findings show that the obstacles of social and economy faced by family: 47.20% of Kajenengan villagers are as farm labors, 28,57 % of  villagers get the average income per day from IDR 21,000 up to IDR 30,000,  33.73% of them have 5-6 family members in their nuclear family, and 32.80% of them who prioritize in education, especially on nine-years compulsory education program.  Then, there are only 8.73% of samples who implement the nine-year compulsory education program. Moreover, 47.62% family leaders say that most of their family members join the nine-year compulsory education and 43.65% of the family leaders say that all of their family members do not join the nine-year compulsory education at all.

Implementation of a new advanced graduate education program in oral implantology.

Science.gov (United States)

Gallucci, German O; Weber, Hans Peter; Kalenderian, Elsbeth

2012-10-01

The academic program for the Harvard School of Dental Medicine's Advanced Graduate Program in Oral Implantology is based on scientific evidence applied to educational quality, translational research, patient care, and service. The objective of the program is to enable highly motivated individuals with proven scholarship and excellence in patient care to achieve academic leadership in the clinical and scientific fields of implant dentistry and tissue regeneration. A detailed curriculum describing the academic program, as well as a business plan (which included a management plan describing the organizational structure, financial implications, and market forces) and implementation and communication plans, were developed before moving forward. With careful academic and business planning, the result was a vibrant implant program, in which all placements and restorations of implants are coordinated with regard to practice management. The program is integrated into the existing clinical care model and has been financially self-sustaining from its inception. Six students have participated in the last two years. On average, each student performed seventy-nine procedures on twenty-nine patients, generating over $46,000 in production. The curriculum includes didactics, hands-on clinical learning, and research activities. Research is a critical component as well. The results demonstrate that the time taken to develop a detailed curriculum and business plan for a new academic program, which anticipated and resolved potential barriers to success, was instrumental in the successful implementation of an oral implantology residency program.

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

Science.gov (United States)

Hamilton, Alison B; Mittman, Brian S; Williams, John K; Liu, Honghu H; Eccles, Alicia M; Hutchinson, Craig S; Wyatt, Gail E

2014-06-20

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

EVALUATION OF CORPORATE SOCIAL RESPONSIBILITY PROGRAM IMPLEMENTATION IN BOGOR PDAM TIRTA PAKUAN, WEST JAVA PROVINCE

Directory of Open Access Journals (Sweden)

Ismartaya Ismartaya

2017-07-01

Full Text Available The purpose of this research is to determine whether the evaluation corporate social responsibility program implementation in Bogor PDAM Tirta Pakuan has been implemented in accordance with the vision, mission, and objectives of the company. PDAM Tirta Pakuan has a vision of CSR as a pioneer in the implementation of social responsibility in Bogor city especially and Indonesia in general. Through this vision, PDAM Tirta Pakuan Bogor city, would really seriously on the implementation of the CSR programs. Based on these purposes, this research is done by evaluating the CSR programs which implemented by PDAM Tirta Pakuan Bogor city and use CIPP evaluation model to conduct an evaluation of the program. The type which used on this research is evaluation research with using a qualitative approach. The source of information used is the Chief Executive of CSR PDAM Tirta Pakuan Bogor. Data collected by the observation, interview and documentation. Test validity of this research by using triangulation technique, while data analysis is done by reducing the data, presenting and concluding. The result shows that the program Tirta Pakuan care as the company’s strategy goes according to the purposes and plans that have been made by the company.

Implementation and integration of program packages NAMMU and HYPAC

International Nuclear Information System (INIS)

Nedbal, T.

1986-05-01

This work is prepared for the Swedish Power Inspectorate (SKI). The SKI has from the Atomic Energy Research Establishment (AERE) at Harwell, U.K., acquired the computer model NAMMU for groundwater hydrology calculations. The code was first implemented on an AMDAHL 470, a IBM compatible computer, and then modified in order to integrate it with HYPAC, which is a program package for pre- and post-processing finite element data, developed by KEMAKTA AB. This report describes the modifications done to both NAMMU and HYPAC, and the verification of the coupled program system NAMMU-HYPAC. (author)

Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact.

Science.gov (United States)

Curran, Geoffrey M; Bauer, Mark; Mittman, Brian; Pyne, Jeffrey M; Stetler, Cheryl

2012-03-01

This study proposes methods for blending design components of clinical effectiveness and implementation research. Such blending can provide benefits over pursuing these lines of research independently; for example, more rapid translational gains, more effective implementation strategies, and more useful information for decision makers. This study proposes a "hybrid effectiveness-implementation" typology, describes a rationale for their use, outlines the design decisions that must be faced, and provides several real-world examples. An effectiveness-implementation hybrid design is one that takes a dual focus a priori in assessing clinical effectiveness and implementation. We propose 3 hybrid types: (1) testing effects of a clinical intervention on relevant outcomes while observing and gathering information on implementation; (2) dual testing of clinical and implementation interventions/strategies; and (3) testing of an implementation strategy while observing and gathering information on the clinical intervention's impact on relevant outcomes. The hybrid typology proposed herein must be considered a construct still in evolution. Although traditional clinical effectiveness and implementation trials are likely to remain the most common approach to moving a clinical intervention through from efficacy research to public health impact, judicious use of the proposed hybrid designs could speed the translation of research findings into routine practice.

Implementation of an interprofessional team-based learning program involving seven undergraduate health and social care programs from two universities, and students’ evaluation of their readiness for interprofessional learning

Directory of Open Access Journals (Sweden)

Lap Ki Chan

2017-11-01

Full Text Available Abstract Background Interprofessional learning is gaining momentum in revolutionizing healthcare education. During the academic year 2015/16, seven undergraduate-entry health and social care programs from two universities in Hong Kong took part in an interprofessional education program. Based on considerations such as the large number of students involved and the need to incorporate adult learning principles, team-based learning was adopted as the pedagogy for the program, which was therefore called the interprofessional team-based learning program (IPTBL. The authors describe the development and implementation of the IPTBL program and evaluate the effectiveness of the program implementation. Methods Eight hundred and one students, who are predominantly Chinese, participated in the IPTBL. The quantitative design (a pretest-posttest experimental design was utilized to examine the students’ gains on their readiness to engage in interprofessional education (IPE. Results Three instructional units (IUs were implemented, each around a clinical area which could engage students from complementary health and social care disciplines. Each IU followed a team-based learning (TBL process: pre-class study, individual readiness assurance test, team readiness assurance test, appeal, feedback, and application exercise. An electronic platform was developed and was progressively introduced in the three IUs. The students’ self-perceived attainment of the IPE learning outcomes was high. Across all four subscales of RIPLS, there was significant improvement in student’s readiness to engage in interprofessional learning after the IPTBL. A number of challenges were identified: significant time involvement of the teachers, difficulty in matching students from different programs, difficulty in making IPTBL count towards a summative assessment score, difficulty in developing the LAMS platform, logistics difficulty in managing paper TBL, and inappropriateness of the

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

Directory of Open Access Journals (Sweden)

Economos Christina D

2008-12-01

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

Kozloduy NPP units 5 and 6 modernization program. Measures implementation in outages

International Nuclear Information System (INIS)

Naydenov, N.; Mignone, O.

2004-01-01

The units 5 and 6 modernization program is a highly demanding program composed by many plant modifications and studies about plant conditions. The program measures implementation during the units outages represents a challenge by the need to compromise shut down duration with the workload related to measures installation. The units shutdown duration should be kept to the planned duration. In parallel, contractors work has to be organized, planned and performed to allow successful measures completion. In accordance with the contract requirements, contractors prepare installation documents which comprise all activities to be performed during the installation and testing of the measures. The subcontractors complement these installation documents with the project organization and execution documents, which include the manpower skills, qualifications, work orders, and other important installation instructions and information. Contractors prepared detailed installation schedules, and these were integrated by Parsons E and C in the Integrated installation schedule. The integrated schedule proved to be useful to identify possible area usage conflicts and manpower overlapping, with appropriate results for electrical, instrumentation and control work, and for the utilization of the polar crane in the containment building. Contractors installation schedules were updated on a weekly basis, showing variances versus the target, and manpower histograms for the resource loading. Organization of contractors work was supported by KNPP plant outage meetings, in which status and problems were addressed, and solution and/or corrective actions defined for further implementation. KNPP meetings were planned on a daily basis for most relevant or critical measures, or on a weekly basis for less intensive measures. KNPP meetings proved to be an excellent communication tool for keeping the measures under control and monitoring KNPP defined personnel responsible for authorizing changes, in

Implementation of a fall screening program in a high risk of fracture population.

Science.gov (United States)

Ritchey, Katherine; Olney, Amanda; Shofer, Jane; Phelan, Elizabeth A; Matsumoto, Alvin M

2017-10-31

Fall prevention is an important way to prevent fractures in person with osteoporosis. We developed and implemented a fall screening program in the context of routine osteoporosis care. This program was found to be feasible and showed that a significant proportion of persons with osteoporosis are at risk of falling. Falls are the most common cause of fracture in persons with osteoporosis. However, osteoporosis care rarely includes assessment and prevention of falling. We thus sought to assess the feasibility of a fall screening and management program integrated into routine osteoporosis care. The program was developed and offered to patients with osteoporosis or osteopenia seen at an outpatient clinic between May 2015 and May 2016. Feasibility was measured by physical therapist time required to conduct screening and ease of integrating the screening program into the usual clinic workflow. Self-report responses and mobility testing were conducted to describe the fall and fracture risk profile of osteoporosis patients screened. Effects on fall-related care processes were assessed via chart abstraction of patient participation in fall prevention exercise. Of the 154 clinic patients who presented for a clinic visit, 68% met screening criteria and completed in two thirds of persons. Screening was completed in a third of the time typically allotted for traditional PT evaluations and did not interfere with clinic workflow. Forty percent of those screened reported falling in the last year, and over half had two or more falls in the past year. Over half reported a balance or lower extremity impairment, and over 40% were below norms on one or more performance tests. Most patients who selected a group exercise fall prevention program completed all sessions while only a quarter completed either supervised or independent home-based programs. Implementation of a fall risk screening program in an outpatient osteoporosis clinic appears feasible. A substantial proportion of people

Corporate Wellness Programs: Implementation Challenges in the Modern American Workplace

Directory of Open Access Journals (Sweden)

Bahaudin G. Mujtaba

2013-01-01

Full Text Available Being healthy is important for living well and achieving longevity. In the business realm, furthermore, employers want healthy employees, as these workers tend to be more productive, have fewer rates of absenteeism, and use less of their health insurance resources. This article provides an overview of corporate “wellness” efforts in the American workplace and the concomitant challenges which employers will confront in implementing these programs. Consequently, employers and managers must reflect upon wellness policies and objectives, consult with professionals, and discuss the ramifications thereof prior to implementation. The authors herein explore how employers are implementing policies that provide incentives to employees who lead “healthy” lifestyles as well as ones that impose costs on employees who lead “unhealthy” lifestyles.The distinctive contribution of this article is that it proactively explores wellness program implementation challenges and also supplies “best practices” in the modern workplace, so employers can be better prepared when they promulgate wellness policies, and then take practical steps to help their employees become healthier and thereby help to reduce insurance costs. The article, moreover, addresses how wellness policy incentives—in the form of “carrots” as well as penalties—in the form of “sticks” could affect employees, especially “non-healthy” employees, as well as employers, particularly legally. Based on the aforementioned challenges, the authors make practical recommendations for employers and managers, so that they can fashion and implement wellness policies that are deemed to be legal, ethical, and efficacious.

Development, implementation and evaluation of a clinical research engagement and leadership capacity building program in a large Australian health care service.

Science.gov (United States)

Misso, Marie L; Ilic, Dragan; Haines, Terry P; Hutchinson, Alison M; East, Christine E; Teede, Helena J

2016-01-14

Health professionals need to be integrated more effectively in clinical research to ensure that research addresses clinical needs and provides practical solutions at the coal face of care. In light of limited evidence on how best to achieve this, evaluation of strategies to introduce, adapt and sustain evidence-based practices across different populations and settings is required. This project aims to address this gap through the co-design, development, implementation, evaluation, refinement and ultimately scale-up of a clinical research engagement and leadership capacity building program in a clinical setting with little to no co-ordinated approach to clinical research engagement and education. The protocol is based on principles of research capacity building and on a six-step framework, which have previously led to successful implementation and long-term sustainability. A mixed methods study design will be used. Methods will include: (1) a review of the literature about strategies that engage health professionals in research through capacity building and/or education in research methods; (2) a review of existing local research education and support elements; (3) a needs assessment in the local clinical setting, including an online cross-sectional survey and semi-structured interviews; (4) co-design and development of an educational and support program; (5) implementation of the program in the clinical environment; and (6) pre- and post-implementation evaluation and ultimately program scale-up. The evaluation focuses on research activity and knowledge, attitudes and preferences about clinical research, evidence-based practice and leadership and post implementation, about their satisfaction with the program. The investigators will evaluate the feasibility and effect of the program according to capacity building measures and will revise where appropriate prior to scale-up. It is anticipated that this clinical research engagement and leadership capacity building

Implementing an Applied Science Program

Science.gov (United States)

Rickman, Doug; Presson, Joan

2007-01-01

The work implied in the NASA Applied Science Program requires a delicate balancing act for the those doing it. At the implementation level there are multiple tensions intrinsic to the program. For example each application of an existing product to a decision support process requires deep knowledge about the data and deep knowledge about the decision making process. It is highly probable no one person has this range of knowledge. Otherwise the decision making process would already be using the data. Therefore, a team is required. But building a team usually requires time, especially across agencies. Yet the program mandates efforts of relatively short duration. Further, those who know the data are scientists, which makes them essential to the program. But scientists are evaluated on their publication record. Anything which diverts a scientist from the research for his next publication is an anathema to him and potential death to their career. Trying to get another agency to use NASA data does not strike most scientists as material inherently suitable for publication. Also, NASA wishes to rapidly implement often substantial changes to another agency's process. For many reasons, such as budget and program constraints, speed is important. But the owner of a decision making process is tightly constrained, usually by law, regulation, organization and custom. Changes when made are slow, cautious, even hesitant, and always done according a process specific to the situation. To manage this work MSFC must balance these and other tensions. Some things we have relatively little control over, such as budget. These we try to handle by structural techniques. For example by insisting all of our people work on multiple projects simultaneously we inherently have diversification of funding for all of our people. In many cases we explicitly use some elements of tension to be productive. For example the need for the scientists to constantly publish is motivation to keep tasks short and

Standard Review Plan Update and Development Program. Implementing Procedures Document

Energy Technology Data Exchange (ETDEWEB)

1992-05-01

This implementing procedures document (IPD) was prepared for use in implementing tasks under the standard review plan update and development program (SRP-UDP). The IPD provides comprehensive guidance and detailed procedures for SRP-UDP tasks. The IPD is mandatory for contractors performing work for the SRP-UDP. It is guidance for the staff. At the completion of the SRP-UDP, the IPD will be revised (to remove the UDP aspects) and will replace NRR Office Letter No. 800 as long-term maintenance procedures.

A cost-effectiveness analysis of two different antimicrobial stewardship programs

OpenAIRE

Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

2016-01-01

Abstract There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial s...

Implementation of Best Practices in Obesity Prevention in Child Care Facilities: The Arizona Empower Program, 2013-2015.

Science.gov (United States)

Papa, Jillian; Agostinelli, Joan; Rodriguez, Gertrudes; Robinson, Deborah

2017-09-07

Obesity is a major health concern in every US age group. Approximately one in 4 children in Arizona's Special Supplemental Nutrition Program for Women, Infants, and Children is overweight or obese. The Arizona Department of Health Services developed the Empower program to promote healthy environments in licensed child care facilities. The program consists of 10 standards, including one standard for each of these 5 areas: physical activity and screen time, breastfeeding, fruit juice and water, family-style meals, and staff training. The objective of this evaluation was to determine the level of implementation of these 5 Empower standards. A self-assessment survey was completed from July 2013 through June 2015 by 1,850 facilities to evaluate the level of implementation of 5 Empower standards. We calculated the percentage of facilities that reported the degree to which they implemented each standard and identified common themes in comments recorded in the survey. All facilities reported either full or partial implementation of the 5 standards. Of 1,678 facilities, 21.7% (n = 364) reported full implementation of all standards, and 78.3% (n = 1,314) reported at least partial implementation. Staff training, which has only one component, had the highest level of implementation: 77.4% (n = 1,299) reported full implementation. Only 44.0% (n = 738) reported full implementation of the standard on a breastfeeding-friendly environment. Arizona child care facilities have begun to implement the Empower program, but facilities will need more education, technical assistance, and support in some areas to fully implement the program.

Development and implementation of the heavy water program at Bruce Power

International Nuclear Information System (INIS)

Davloor, R.; Bourassa, C.

2014-01-01

Bruce Power operates 8 pressurized heavy water reactor units requiring more than 6000 mega grams (Mg) of heavy water. A Heavy Water Management Program that has been developed to administer this asset over the past 3 years. Through a corporate management system the Program provides governance, oversight and support to the stations. It is implemented through organizational structure, program and procedure documents and an information management system that provides benchmarked metrics, business intelligence and analytics for decision making and prediction. The program drives initiatives such as major maintenance activities, capital programs, detritiation strategies and ensures heavy water systems readiness for outages and rehabilitation of units. (author)

Development and implementation of the heavy water program at Bruce Power

Energy Technology Data Exchange (ETDEWEB)

Davloor, R.; Bourassa, C., E-mail: ram.davloor@brucepower.com, E-mail: carl.bourassa@brucepower.com [Bruce Power, Tiverton, ON (Canada)

2014-07-01

Bruce Power operates 8 pressurized heavy water reactor units requiring more than 6000 mega grams (Mg) of heavy water. A Heavy Water Management Program that has been developed to administer this asset over the past 3 years. Through a corporate management system the Program provides governance, oversight and support to the stations. It is implemented through organizational structure, program and procedure documents and an information management system that provides benchmarked metrics, business intelligence and analytics for decision making and prediction. The program drives initiatives such as major maintenance activities, capital programs, detritiation strategies and ensures heavy water systems readiness for outages and rehabilitation of units. (author)

Factors facilitating and inhibiting implementation of easy accessible sporting programs.

NARCIS (Netherlands)

Ooms, L.; Veenhof, C.

2012-01-01

Introduction: The organized sport sector has been identified as a potential setting for physical activity promotion. In The Netherlands, ten national sporting organizations were funded to develop and implement easy accessible sporting programs, especially for the least active population groups. A

76 FR 55136 - Implementation of the Alternative Dispute Resolution Program

Science.gov (United States)

2011-09-06

... NUCLEAR REGULATORY COMMISSION [NRC-2011-0208] Implementation of the Alternative Dispute Resolution... stakeholders on its Alternative Dispute Resolution (ADR) Program in the Office of Enforcement (OE). The meeting... INFORMATION: I. Background Congress enacted the Administrative Dispute Resolution Act (Act) which requires...

Factors associated with the implementation of programs for drug abuse prevention in schools

Directory of Open Access Journals (Sweden)

Ana Paula Dias Pereira

2016-01-01

Full Text Available ABSTRACT OBJECTIVE To analyze if characteristics of managers, schools, and curriculum are associated with the implementation of programs for drug abuse prevention in elementary and high schools. METHODS Cross-sectional study, with random sample of 263 school managers. Data were collected between 2012 and 2013 by a program that sends forms via internet. A closed self-filling questionnaire was applied online. Statistical analysis included Chi-square tests and logistic regression models. The outcome variable was the presence of program for drug abuse prevention inserted in the daily life and educational program of the school. The explanatory variables were divided into: demographic data of the manager; characteristics of the school and of the curriculum; health education; and drug use in the school. RESULTS We found that 42.5% (95%CI 36.1–49.1 of the evaluated schools had programs for drug abuse prevention. With the multiple logistic regression model, we observed that the more time the manager has worked with education, the chance of the school having a program increased at about 4.0%. Experimenting with innovative teaching techniques also increased at about six times the chance of the school developing a program for drug abuse prevention. The difficulties in the implementation of the programs were more present in state and municipal schools, when compared with private schools, due to, for instance: lack of teaching materials, lack of money, and competing demands for teaching other subjects. CONCLUSIONS The implementation of programs for drug abuse prevention in the city of Sao Paulo is associated with the experience of the manager in education and with the teaching strategies of the school.

Effects of a work injury prevention program for housekeeping in the hotel industry.

Science.gov (United States)

Landers, Merrill; Maguire, Lynn

2004-01-01

The aim of this retrospective study was to determine the effectiveness of a work injury prevention program in the housekeeping department of a hotel. Studies have validated the use of different injury prevention strategies to decrease the incidence of work-related injuries. Few studies, however, have reported the efficacy of an on-site work injury prevention program by a physical therapist. In 1995, implementation of a work injury prevention program by a physical therapist to 50 housekeeping supervisors, 60 house persons and 340 guest room attendants at a large hotel began. This program included a detailed work risk analysis of the work environment, development of job descriptions, identification of injury-related problematic work situations, and implementation of a job specific supervisor-training program. Supervisor, house person and guest room attendant training was also conducted at the end of 1995 and the beginning of 1997. Data of injury reports in 1995, 1996, and 1997 were analyzed to determine the results of the program. There was a reduction in total injury claims, total medical expenses, total lost work time and total restricted duty time. These results demonstrate the cost effectiveness of implementing a work injury prevention program for housekeeping guest room attendants in the hotel industry. Copyright 2004 IOS Press

An e-learning Programming Method And It's Implementation Based On Multimedia And Web

International Nuclear Information System (INIS)

Madenda, Sarifuddin; Tommy, F. R.

2001-01-01

New developments in information technology and telecommunication play an important rile in exchanging fast and accurate information which range from text, sound, graphic to video. These technologies seem to be very effective for Distance learning, Virtual University and E-learning. This paper presents an E-learning programming method and it's implementation based on multimedia and Web. An example of the study case corresponds to human organ, where the organ functions are presented as texts and sounds and the activities as graphic and video

Development and implementation of the waste diversion program at MDS Nordion's Cobalt Operations Facility

International Nuclear Information System (INIS)

Wasiak, T.

2004-01-01

Historically, the MDS Nordion (MDSN) Cobalt Operations Facility sent solid waste for disposal to Atomic Energy of Canada Ltd.'s Chalk River Laboratories (AECL-CRL). A large portion of this waste was not contaminated. Because this non-contaminated waste originated in the 'active area' of the MDSN facility, it was routinely disposed of as low-level active waste. In 2002, MDSN undertook an initiative to develop and implement a more sophisticated and more economical waste management program. The Waste Diversion Program (WDP) ensures continued environmental and public protection, and reduces the demand on Canada's limited capacity for storage of radioactive material and the associated operating costs. The goal of the WDP is to reduce the volume of waste currently being shipped to AECL-CRL's Waste Management Operation as low-level active waste. The presentation discusses key elements of both the development and the implementation of WDP. It focuses on the following areas: the regulatory environment surrounding the waste disposal issues in Canada and abroad. Methods used by MDSN for determination of radionuclides, which could be present in the facility. Choice of equipment and calculation of individual alarm levels for each identified radionuclide. Key elements of the practical implementation of the program. CNSC Regulatory approval process. The bottom line - dollars and cents. The primary objective of the WDP is to ensure that only waste, which meets regulatory requirements, is diverted from the solid active waste stream. This has been successfully accomplished in MDSN's Cobalt Operations Facility. The objective of the presentation is to share the knowledge and experience obtained in the development process, and thus provide a guideline for other nuclear facilities interested in establishing similar proactive and cost effective programs. (author)

Management issues related to effectively implementing a nutrition education program using peer educators.

Science.gov (United States)

Taylor, T; Serrano, E; Anderson, J

2001-01-01

To explore the influence of administrative aspects of a nutrition education program with peer educators delivering the program. Telephone interviews with peer educators trained to deliver La Cocina Saludable, a nutrition education program for Hispanics. Open- and closed-ended questions. Abuelas (grandmothers) recruited and trained as peer educators for the program. The sample included peer educators no longer teaching (22%), currently teaching (30%), and who never taught after training. Motives and incentives for becoming peer educators, challenges for peer educators, and reasons peer educators withdrew from the program. Descriptive statistics were used to analyze quantitative data from the closed-ended questions. Qualitative analysis was applied to data from open-ended questions. Working with community and learning about nutrition were prime motivators. Recruiting participants and coordination of classes appeared to be major challenges. Personal issues and traveling in a large geographic area were cited as the main reasons for quitting. The effectiveness of using peer educators for La Cocina Saludable may be improved through empowerment, additional training, a structured and equitable reimbursement system, and assistance to carry out administrative tasks.

Design and Implementation of Modular Software for Programming Mobile Robots

Directory of Open Access Journals (Sweden)

Alessandro Farinelli

2006-03-01

Full Text Available This article describes a software development toolkit for programming mobile robots, that has been used on different platforms and for different robotic applications. We address design choices, implementation issues and results in the realization of our robot programming environment, that has been devised and built from many people since 1998. We believe that the proposed framework is extremely useful not only for experienced robotic software developers, but also for students approaching robotic research projects.

Cost-Effectiveness of a Family Planning Voucher Program in Rural Pakistan.

Science.gov (United States)

Broughton, Edward Ivor; Hameed, Waqas; Gul, Xaher; Sarfraz, Shabnum; Baig, Imam Yar; Villanueva, Monica

2017-01-01

This study reports on the effectiveness and efficiency from the program funder's perspective of the Suraj Social Franchise (SSF) voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016. A decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs) to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program. A total of 168,206 married women of reproductive age (MWRA) received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient). The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62-5.31). The result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.

Effectiveness of an Emotional Intelligence Program in Elementary Education

Directory of Open Access Journals (Sweden)

Isabel Mª Merchán

2014-07-01

Full Text Available The aim of this article is to demonstrate the positive effects of the implementation of a program to develop emotional competence in first year students of primary education. This population has been taking as public school students in the city of Badajoz during the course 2012-2013, selecting a sample of 78 pupils aged between 5 and 7 years, divided into experimental group and control group. The methodological procedure focuses on a descriptive-interpretative approach with two data collection techniques: sociometric test and test emotional intelligence. Designed and implemented a program of emotional intelligence with students in the experimental group, measured before and after the intervention the level of emotional competence and social relations of the class group. Similarly, measurements were taken of the degree of emotional competence and social relations of the students in the control group, which did not participate in the intervention. The results show that the program was effective to increase the emotional intelligence of students that make up the experimental group improved with it the degree of friendship and social relations of the class group.

Facilitators for the development and implementation of health promoting policy and programs – a scoping review at the local community level

Directory of Open Access Journals (Sweden)

Daniel Weiss

2016-02-01

Full Text Available Abstract Background Health promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels – due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement. Methods We used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions. Results The articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within

Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

Science.gov (United States)

McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R

2012-10-01

To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management

Koka: Programming with Row Polymorphic Effect Types

Directory of Open Access Journals (Sweden)

Daan Leijen

2014-06-01

Full Text Available We propose a programming model where effects are treated in a disciplined way, and where the potential side-effects of a function are apparent in its type signature. The type and effect of expressions can also be inferred automatically, and we describe a polymorphic type inference system based on Hindley-Milner style inference. A novel feature is that we support polymorphic effects through row-polymorphism using duplicate labels. Moreover, we show that our effects are not just syntactic labels but have a deep semantic connection to the program. For example, if an expression can be typed without an _exn_ effect, then it will never throw an unhandled exception. Similar to Haskell's `runST` we show how we can safely encapsulate stateful operations. Through the state effect, we can also safely combine state with let-polymorphism without needing either imperative type variables or a syntactic value restriction. Finally, our system is implemented fully in a new language called Koka and has been used successfully on various small to medium-sized sample programs ranging from a Markdown processor to a tier-splitted chat application. You can try out Koka live at www.rise4fun.com/koka/tutorial.

Implementation and Effectiveness of a Psychosocial Weight Management Program for Individuals with Schizophrenia

OpenAIRE

Niv, Noosha; Cohen, Amy N.; Hamilton, Alison; Reist, Christopher; Young, Alexander S.

2014-01-01

The objective of this study was to examine the effectiveness of a weight loss program for individuals with schizophrenia in usual care. The study included 146 adults with schizophrenia from two mental health clinics of the Department of Veterans Affairs. The 109 individuals who were overweight or obese were offered a 16-week, psychosocial, weight management program. Weight and BMI were assessed at baseline, 1 year later and at each treatment session. Only 51% of those who were overweight or o...

Implementing best practice in hospital multidisciplinary nutritional care: an example of using the knowledge-to-action process for a research program.

Science.gov (United States)

Laur, Celia; Keller, Heather H

2015-01-01

sustainability plan will be incorporated into the final study of the program (study 4) to sustain knowledge use. Use of frameworks can increase the likelihood of meaningful and sustainable improvements in health care practice. The example of this program of research demonstrates how existing evidence has been used to identify, create, and adapt knowledge, and how multidisciplinary teams have been used to effect changes in the hospital setting. Effective implementation is essential in nutritional health care, and this multidisciplinary program of research provides an example of how the KTA process can facilitate implementation and promote sustainability.

Personnel role by implementing anti-crisis programs in small and medium-size enterprises

Directory of Open Access Journals (Sweden)

Pak Andrey Borisovitch

2011-08-01

Full Text Available To recover from crisis, small and medium-size enterprises have to develop anti-crisis plans and programs and to monitor the implementation process. The implementation efficiency is provided by the personnel which needs appraisal, motivation and development.

Effective Practices for Evaluating Education and Public Outreach Programs

Science.gov (United States)

Wilkerson, S.

2013-12-01

Stephanie Baird Wilkerson, PhD Carol Haden EdD Magnolia Consulting,LLC Education and public outreach (EPO) program developers and providers seeking insights regarding effective practices for evaluating EPO activities programs benefit from understanding why evaluation is critical to the success of EPO activities and programs, what data collection methods are appropriate, and how to effectively communicate and report findings. Based on our extensive experience evaluating EPO programs, we will share lessons learned and examples of how these practices play out in actual evaluation studies. EPO program developers, providers, and evaluators must consider several factors that influence which evaluation designs and data collection methods will be most appropriate, given the nature of EPO programs. Effective evaluation practices of EPO programs take into account a program's phase of development, duration, and budget as well as a program's intended outcomes. EPO programs that are just beginning development will have different evaluation needs and priorities than will well-established programs. Effective evaluation practices consider the 'life' of a program with an evaluation design that supports a program's growth through various phases including development, revision and refinement, and completion. It would be premature and inappropriate to expect the attainment of longer-term outcomes of activities during program development phases or early stages of implementation. During program development, EPO providers should clearly define program outcomes that are feasible and appropriate given a program's scope and expected reach. In many respects, this directly relates to the amount of time, or duration, intended audiences participate in EPO programs. As program duration increases so does the likelihood that the program can achieve longer-term outcomes. When choosing which outcomes are reasonable to impact and measure, program duration should be considered. Effective evaluation

At What Cost? Examining the Cost Effectiveness of a Universal Social-Emotional Learning Program

Science.gov (United States)

Hunter, Leah J.; DiPerna, James C.; Hart, Susan Crandall; Crowley, Max

2018-01-01

Although implementation of universal social-emotional learning programs is becoming more common in schools, few studies have examined the cost-effectiveness of such programs. As such, the purpose of this article is two fold. First, we provide an overview of cost-effectiveness methods for school-based programs, and second, we share results of a…

Final Report for Award #DE-SC3956 Separating Algorithm and Implementation via programming Model Injection (SAIMI)

Energy Technology Data Exchange (ETDEWEB)

Strout, Michelle [Colorado State Univ., Fort Collins, CO (United States)

2015-08-15

Programming parallel machines is fraught with difficulties: the obfuscation of algorithms due to implementation details such as communication and synchronization, the need for transparency between language constructs and performance, the difficulty of performing program analysis to enable automatic parallelization techniques, and the existence of important "dusty deck" codes. The SAIMI project developed abstractions that enable the orthogonal specification of algorithms and implementation details within the context of existing DOE applications. The main idea is to enable the injection of small programming models such as expressions involving transcendental functions, polyhedral iteration spaces with sparse constraints, and task graphs into full programs through the use of pragmas. These smaller, more restricted programming models enable orthogonal specification of many implementation details such as how to map the computation on to parallel processors, how to schedule the computation, and how to allocation storage for the computation. At the same time, these small programming models enable the expression of the most computationally intense and communication heavy portions in many scientific simulations. The ability to orthogonally manipulate the implementation for such computations will significantly ease performance programming efforts and expose transformation possibilities and parameter to automated approaches such as autotuning. At Colorado State University, the SAIMI project was supported through DOE grant DE-SC3956 from April 2010 through August 2015. The SAIMI project has contributed a number of important results to programming abstractions that enable the orthogonal specification of implementation details in scientific codes. This final report summarizes the research that was funded by the SAIMI project.

Current progress in implementing the payments-equal-to-taxes (PETT) program in Nevada

International Nuclear Information System (INIS)

Lundgaard, E.L.; Ellis, C.B.

1993-01-01

The Nuclear Waste Policy Act of 1982, as amended (NWPA), requires the Secretary of Energy to make Payments-equal-to-Taxes (PETT) to local units of government that are affected by the potential repository at Yucca Mountain, Nevada. The PETT program is designed to provide affected jurisdictions with the revenue they would have received if the potential repository site was being characterized and possibly developed by a private entity rather than the Federal government. A paper presented at last year's conference described how the PETT Program would be implemented in the State of Nevada. This paper describes the current progress in implementing the program as it relates to the PETT associated with property taxes

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

Science.gov (United States)

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

2017-08-22

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

Barriers to and enablers of implementing antimicrobial stewardship programs in veterinary practices.

Science.gov (United States)

Hardefeldt, Laura Y; Gilkerson, J R; Billman-Jacobe, H; Stevenson, M A; Thursky, K; Bailey, K E; Browning, G F

2018-03-23

Antimicrobial stewardship (AMS) programs are yet to be widely implemented in veterinary practice and medical programs are unlikely to be directly applicable to veterinary settings. To gain an in-depth understanding of the factors that influence effective AMS in veterinary practices in Australia. A concurrent explanatory mixed methods design was used. The quantitative phase of the study consisted of an online questionnaire to assess veterinarians' attitudes to antimicrobial resistance (AMR) and antimicrobial use in animals, and the extent to which AMS currently is implemented (knowingly or unknowingly). The qualitative phase used semi-structured interviews to gain an understanding of the barriers to and enablers of AMS in veterinary practices. Data were collected and entered into NVivo v.11, openly coded and analyzed according to mixed methods data analysis principles. Companion animal, equine, and bovine veterinarians participated in the study. Veterinary practices rarely had antimicrobial prescribing policies. The key barriers were a lack of AMS governance structures, client expectations and competition between practices, cost of microbiological testing, and lack of access to education, training and AMS resources. The enablers were concern for the role of veterinary antimicrobial use in development of AMR in humans, a sense of pride in the service provided, and preparedness to change prescribing practices. Our study can guide development and establishment of AMS programs in veterinary practices by defining the major issues that influence the prescribing behavior of veterinarians. © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Spatially dependent burnup implementation into the nodal program based on the finite element response matrix method

International Nuclear Information System (INIS)

Yoriyaz, H.

1986-01-01

In this work a spatial burnup scheme and feedback effects has been implemented into the FERM ( 'Finite Element Response Matrix' )program. The spatially dependent neutronic parameters have been considered in three levels: zonewise calculation, assembly wise calculation and pointwise calculation. Flux and power distributions and the multiplication factor were calculated and compared with the results obtained by CITATIOn program. These comparisons showed that processing time in the Ferm code has been hundred of times shorter and no significant difference has been observed in the assembly average power distribution. (Author) [pt

Edit distance for marked point processes revisited: An implementation by binary integer programming

Energy Technology Data Exchange (ETDEWEB)

Hirata, Yoshito; Aihara, Kazuyuki [Institute of Industrial Science, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505 (Japan)

2015-12-15

We implement the edit distance for marked point processes [Suzuki et al., Int. J. Bifurcation Chaos 20, 3699–3708 (2010)] as a binary integer program. Compared with the previous implementation using minimum cost perfect matching, the proposed implementation has two advantages: first, by using the proposed implementation, we can apply a wide variety of software and hardware, even spin glasses and coherent ising machines, to calculate the edit distance for marked point processes; second, the proposed implementation runs faster than the previous implementation when the difference between the numbers of events in two time windows for a marked point process is large.

Measuring implementation of a school-based violence prevention program : Fidelity and teachers' responsiveness as predictors of proximal outcomes

NARCIS (Netherlands)

Schultes, Marie Therese; Stefanek, Elisabeth; van de Schoot, Rens; Strohmeier, Dagmar; Spiel, Christiane

2014-01-01

When school-based prevention programs are put into practice, evaluation studies commonly only consider one indicator of program implementation. The present study investigates how two different aspects of program implementation - fidelity and participant responsiveness - jointly influence proximal

Association of school performance indicators with implementation of the Healthy Kids, Smart Kids program: case study

Science.gov (United States)

Nansel, Tonja R.; Huang, Terry T.K.; Rovner, Alisha J.; Sanders-Butler, Yvonne

2009-01-01

Objective: The purpose of this analysis was to examine secular trends in school performance indicators in relationship to the implementation of a program targeting the school food and physical activity environment. Design: Data on available school performance indicators were obtained; retrospective analyses were conducted to assess trends in indicators in association with program implementation; each outcome was regressed on year, beginning with the year prior to program implementation. Setting: The Healthy Kids, Smart Kids program was a grass-roots effort to enhance the school food and physical activity environment in the Browns Mill Elementary School in Georgia. Subjects: Data included publicly available school records from the years 1995 to 2006. Results: The number of nurse, counseling, and disciplinary referrals per 100 students demonstrated a downward trend, while standardized test scores demonstrated an upward trend beginning the year of program implementation. School year was a significant predictor of all indicators. Conclusions: Promoting nutrition and physical activity within the school environment may be a promising approach for enhancing both student health and educational outcomes. PMID:19454125

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

Science.gov (United States)

Skivington, Kathryn; Lifshen, Marni; Mustard, Cameron

2016-11-22

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

Implementation of Estrus Synchronization and Artificial Insemination Program (GBIB in West Waringin Kota District, Central Kalimantan Province of Indonesia

Directory of Open Access Journals (Sweden)

Kristiana Tresia

2018-01-01

Full Text Available The government has launched a program of self-sufficiency in meat as an effort to overcome the shortage of beef supply to meet the needs of the community, especially when the day of religious festivities. GBIB program Implementation is expected to meet the needs of the community will be beef, as demand for beef is always soaring demand every year, especially ahead of religious festivals. To discuss and review the implementation of the program stretcher author uses the theory EDWARDS III to determine the success or failure of the implementation of the program in the district of Kota Waringin Barat. Issues to be examined are 1 the quality and quantity of resources, 2 communication and dissemination program, 3 Attitude 4 Bureaucracy. This will be the focus to see the successful implementation of the program of snapping / sync Lust and optimize of GBIB in the district of Kota Waringin. This study uses the concept of a qualitative descriptive approach with the aim of providing an overview of how the implementation of the field program and then analyzed using the theory of Edwards III. The results of this study show that: 1 Aspects of Resource (HR, Information, Privileges and amenities, some support as the support means the production of drugs / vitamins and breeding stock (straw superior adequate and well as the authority and the information available is quite good, while some aspects that do not support such as: HR, execution time, geographical conditions, transport facilities support, 2 aspect Communications (Transmission, Clarity, Consistency and Coordination strongly supports the implementation of the program GBIB is 3 aspects of attitude (attitude implementer, Support Leader, Incentives for implementing and Transparency, relatively supportive in this program, and 4 Structural Aspects of Bureaucracy (SOP and Fragmentation still do not support the implementation of the Program snapping Sexual arousal and this Artificial Insemination.

Savannah River Site (SRS) implementation program plan for DNFSB Recommendation 90-2

International Nuclear Information System (INIS)

Talukdar, B.K.; Loceff, F.

1993-01-01

The Defense Nuclear Facilities Safety Board (DNFSB) based on its review and evaluation of the content and implementation of standards relating to design, construction, operation, and decommissioning of Defense Nuclear Facilities has made the recommendations (90-2) which when implemented would assure comparable or equivalent levels of safety to the environment, public and workers as required for the commercial nuclear facilities. DOE has accepted the DNFSB 90-2 recommendations and have directed SRS and other M ampersand Os to implement them. This report discusses implementation program which commits to developing Requirement Identification Documents (RID's) for all defense nuclear facilities in the DOE complex

The implementation of a discovery-oriented science education program in a rural elementary school

Science.gov (United States)

Liddell, Martha Sue

2000-10-01

This study focused on the implementation of a discovery-oriented science education program at a rural elementary school in Mississippi. The instructional leadership role of the principal was examined in the study through identification and documentation of processes undertaken by the principal to implement a discovery-oriented science education program school. The goal of the study was to develop a suggested approach for implementing a discovery-oriented science education program for principals who wish to become instructional leaders in the area of science education at their schools. Mixed methods were used to collect, analyze, and interpret data. Subjects for the study consisted of teachers, students, and parents. Data were collected through field observation; observations of science education being taught by classroom teachers; examination of the principal's log describing actions taken to implement a discovery-oriented science education program; conducting semi-structured interviews with teachers as the key informants; and examining attitudinal data collected by the Carolina Biological Supply Company for the purpose of measuring attitudes of teachers, students, and parents toward the proposed science education program and the Science and Technology for Children (STC) program piloted at the school. To develop a suggested approach for implementing a discovery-oriented science education program, data collected from field notes, classroom observations, the principal's log of activities, and key informant interviews were analyzed and group into themes pertinent to the study. In addition to descriptive measures, chi-square goodness-of-fit tests were used to determine whether the frequency distribution showed a specific pattern within the attitudinal data collected by the Carolina Biological Supply Company. The pertinent question asked in analyzing data was: Are the differences significant or are they due to chance? An alpha level of .01 was selected to determine

A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus

Science.gov (United States)

Ulfsdotter, Malin

2015-01-01

Objective There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs) as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC). The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness. Methods A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data. Results The cost was €326.3 per parent, of which €53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and €272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of €47 290 per gained QALY. The sensitivity analyses resulted in ratios from €41 739 to €55 072. With the common Swedish threshold value of €55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent. Conclusion Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation. PMID:26681349

A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus.

Directory of Open Access Journals (Sweden)

Malin Ulfsdotter

Full Text Available There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC. The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness.A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data.The cost was € 326.3 per parent, of which € 53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and € 272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of € 47 290 per gained QALY. The sensitivity analyses resulted in ratios from € 41 739 to € 55 072. With the common Swedish threshold value of € 55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent.Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation.

A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus.

Science.gov (United States)

Ulfsdotter, Malin; Lindberg, Lene; Månsdotter, Anna

2015-01-01

There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs) as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC). The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness. A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data. The cost was € 326.3 per parent, of which € 53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and € 272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of € 47 290 per gained QALY. The sensitivity analyses resulted in ratios from € 41 739 to € 55 072. With the common Swedish threshold value of € 55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent. Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation.

Elementary School-Wide Implementation of a Blended Learning Program for Reading Intervention

Science.gov (United States)

Prescott, Jen Elise; Bundschuh, Kristine; Kazakoff, Elizabeth R.; Macaruso, Paul

2018-01-01

The authors examined the implementation of a blended learning program for literacy instruction across kindergarten through Grade 5 in a Title I urban elementary school, including a population of students (18%) who are English learners. Student progress in the online component of the blended learning program was a significant predictor of growth in…

Organizational Wellness Program Implementation and Evaluation: A Holistic Approach to Improve the Wellbeing of Middle Managers.

Science.gov (United States)

Medina, Maria Del Consuelo; Calderon, Angelica; Blunk, Dan I; Mills, Brandy W; Leiner, Marie

2018-06-01

: Employee wellness programs can provide benefits to institutions as well as employees and their families. Despite the attempts of some organizations to implement programs that take a holistic approach to improve physical, mental, and social wellness, the most common programs are exclusively comprised of physical and nutritional components. In this study, we implemented a wellness program intervention, including training using a holistic approach to improve the wellbeing of middle managers in several multinational organizations. We included control and experimental groups to measure wellness and teamwork with two repeated measures. Our results indicated that employees receiving the intervention had improved measures of wellness and teamwork. A positive relationship was found between wellness and teamwork in the experimental group when compared with the control group. Taken together, the data suggest that implementation of these programs would provide valuable outcomes for both employees and organizations.

Implementation of an integrity management program in a crude oil pipeline system

Energy Technology Data Exchange (ETDEWEB)

Martinez, Maria; Tomasella, Marcelo [Oleoductos del Valle, General Roca (Argentina); Rossi, Juan; Pellicano, Adolfo [SINTEC S.A. , Mar del Plata, Buenos Aires (Argentina)

2005-07-01

The implementation of an Integrity Management Program (IMP) in a crude oil pipeline system is focused on the accomplishment of two primary corporative objectives: to increase safety operation margins and to optimize available resources. A proactive work philosophy ensures the safe and reliable operation of the pipeline in accordance with current legislation. The Integrity Management Program is accomplished by means of an interdisciplinary team that defines the strategic objectives that complement and are compatible with the corporative strategic business plan. The implementation of the program is based on the analysis of the risks due to external corrosion, third party damage, design and operations, and the definition of appropriate mitigation, inspection and monitoring actions, which will ensure long-term integrity of the assets. By means of a statistical propagation model of the external defects, reported by high-resolution magnetic inspection tool (MFL), together with the information provided by corrosion sensors, field repair interventions, close internal surveys and operation data, projected defect depth; remaining strength and failure probability distributions were obtained. From the analysis, feasible courses of action were established, including the inspection and repair plan, the internal inspection program and both corrosion monitoring and mitigation programs. (author)

Barriers to Implementing the ACGME Outcome Project: A Systematic Review of Program Director Surveys.

Science.gov (United States)

Malik, Mohammad U; Diaz Voss Varela, David A; Stewart, Charles M; Laeeq, Kulsoom; Yenokyan, Gayane; Francis, Howard W; Bhatti, Nasir I

2012-12-01

The Accreditation Council for Graduate Medical Education (ACGME) introduced the Outcome Project in July 2001 to improve the quality of resident education through competency-based learning. The purpose of this systematic review is to determine and explore the perceptions of program directors regarding challenges to implementing the ACGME Outcome Project. We used the PubMed and Web of Science databases and bibliographies for English-language articles published between January 1, 2001, and February 17, 2012. Studies were included if they described program directors' opinions on (1) barriers encountered when attempting to implement ACGME competency-based education, and (2) assessment methods that each residency program was using to implement competency-based education. Articles meeting the inclusion criteria were screened by 2 researchers. The grading criterion was created by the authors and used to assess the quality of each study. The survey-based data reported the opinions of 1076 program directors. Barriers that were encountered include: (1) lack of time; (2) lack of faculty support; (3) resistance of residents to the Outcome Project; (4) insufficient funding; (5) perceived low priority for the Outcome Project; (6) inadequate salary incentive; and (7) inadequate knowledge of the competencies. Of the 6 competencies, those pertaining to patient care and medical knowledge received the most responses from program directors and were given highest priority. The reviewed literature revealed that time and financial constraints were the most important barriers encountered when implementing the ACGME Outcome Project.

Design and implementation of a programming circuit in radiation-hardened FPGA

International Nuclear Information System (INIS)

Wu Lihua; Han Xiaowei; Zhao Yan; Liu Zhongli; Yu Fang; Chen, Stanley L.

2011-01-01

We present a novel programming circuit used in our radiation-hardened field programmable gate array (FPGA) chip. This circuit provides the ability to write user-defined configuration data into an FPGA and then read it back. The proposed circuit adopts the direct-access programming point scheme instead of the typical long token shift register chain. It not only saves area but also provides more flexible configuration operations. By configuring the proposed partial configuration control register, our smallest configuration section can be conveniently configured as a single data and a flexible partial configuration can be easily implemented. The hierarchical simulation scheme, optimization of the critical path and the elaborate layout plan make this circuit work well. Also, the radiation hardened by design programming point is introduced. This circuit has been implemented in a static random access memory (SRAM)-based FPGA fabricated by a 0.5 μm partial-depletion silicon-on-insulator CMOS process. The function test results of the fabricated chip indicate that this programming circuit successfully realizes the desired functions in the configuration and read-back. Moreover, the radiation test results indicate that the programming circuit has total dose tolerance of 1 x 10 5 rad(Si), dose rate survivability of 1.5 x 10 11 rad(Si)/s and neutron fluence immunity of 1 x 10 14 n/cm 2 .

Design and implementation of a programming circuit in radiation-hardened FPGA

Science.gov (United States)

Lihua, Wu; Xiaowei, Han; Yan, Zhao; Zhongli, Liu; Fang, Yu; Chen, Stanley L.

2011-08-01

We present a novel programming circuit used in our radiation-hardened field programmable gate array (FPGA) chip. This circuit provides the ability to write user-defined configuration data into an FPGA and then read it back. The proposed circuit adopts the direct-access programming point scheme instead of the typical long token shift register chain. It not only saves area but also provides more flexible configuration operations. By configuring the proposed partial configuration control register, our smallest configuration section can be conveniently configured as a single data and a flexible partial configuration can be easily implemented. The hierarchical simulation scheme, optimization of the critical path and the elaborate layout plan make this circuit work well. Also, the radiation hardened by design programming point is introduced. This circuit has been implemented in a static random access memory (SRAM)-based FPGA fabricated by a 0.5 μm partial-depletion silicon-on-insulator CMOS process. The function test results of the fabricated chip indicate that this programming circuit successfully realizes the desired functions in the configuration and read-back. Moreover, the radiation test results indicate that the programming circuit has total dose tolerance of 1 × 105 rad(Si), dose rate survivability of 1.5 × 1011 rad(Si)/s and neutron fluence immunity of 1 × 1014 n/cm2.

Planning and Implementing a Public Health Professional Distance Learning Program

Science.gov (United States)

Escoffery, Cam; Leppke, Allison M.; Robinson, Kara B.; Mettler, Erik P.; Miner, Kathleen R.; Smith, Iris

2005-01-01

Training of public health professionals through web-based technology is rapidly increasing. This article describes one school of public health's effort to establish an online Master's program that serves students nationally and internationally. It examines the critical components in the design and implementation of distance education, including…

The Effect of the Family Physician Program Implementation on the Monitoring of the Performance of Health and Treatment Centers and the Producing and Distribution of Healthy Water, Food and Cosmetics

Directory of Open Access Journals (Sweden)

Hossein Jabari Beyrami

2015-07-01

Full Text Available Background and Objectives : Family physician as the leader of health team is responsible for monitoring water quality, food and cosmetic preparation settings.  This study was carried out to determine the effect of family physician program on the performance of health centers in the mentioned processes in urban areas of East Azerbaijan, Iran. Materials and Methods : In this cross-sectional descriptive study, three health centers of the East Azerbaijan province were selected as samples and data were extracted from environmental health records files for water and sampling was used for food and cosmetic distributors for two periods of time: before and after implementing family physician plan. Data were analyzed using SPSS 16 software. Results : The results showed that monitoring of chlorine in drinking water was doubled and microbial sampling of water was increased one and a half time. Furthermore, the monitoring processes of health regulations in food and cosmetic preparation settings after implementing family physician program were improved. Conclusion : In spite of improvements in drinking water monitoring process after family physician program implementation, it is necessary to revise the family physician responsibilities and performance evaluation checklists in this section.

Peer education programs in corrections: curriculum, implementation, and nursing interventions.

Science.gov (United States)

Dubik-Unruh, S

1999-01-01

Despite the prevalence of HIV and other infectious diseases in U.S. prisons, and the mix of infected and high-risk prisoners in crowded and volatile living conditions, federal and state prisons have reduced or eliminated prevention education programs addressing HIV and other infectious diseases for incarcerated populations. Nurses' knowledge, education, and licensure place them in a position to influence prison policy in developing and implementing educational programs for inmates and staff. Their role as advocates for patients in prison and their separation from the more punitive aspects of corrections also enable nurses to earn the trust of inmate populations. These factors identify nurses as the staff best suited within corrections to implement inmate prevention education. Training inmate educators to provide peer prevention and strategies for risk reduction have potential to modify inmate behaviors both within the facility and following release. Selection criteria for peer educator recruitment, prison-sensitive issues, and suggested training activities are discussed.

Maintenance implementation plan for fuel supply shutdown

International Nuclear Information System (INIS)

Stephenson, R.L.

1995-06-01

This Maintenance Implementation Plan is written to satisfy the requirements of DOE Order 4330.4B, ''MAINTENANCE MANAGEMENT PROGRAM'', that specifies the general policy and objectives for the establishment of DOE controlled maintenance programs. These Programs provide for the management and performance of cost-effective maintenance and repair of Department of Energy (DOE) property, which includes facilities. A review of DOE Order 4330.4B, particularly Chapter II the nuclear portion, against existing WHC site programs and policies has provided assurance that most requirements of this order have already been implemented by existing WHC programs. Applicable requirements and guidelines of 4330.4B that are deficient or not implemented are presently being developed and implemented through WHC site policies and programs. Where no program is presently identified or being developed for 4330.4B requirements, responsibility for implementation has been assigned within this plan

Disseminating contingency management: Impacts of staff training and implementation at an opiate treatment program

OpenAIRE

Hartzler, Bryan; Jackson, T. Ron; Jones, Brinn E.; Beadnell, Blair; Calsyn, Donald A.

2013-01-01

Guided by a comprehensive implementation model, this study examined training/implementation processes for a tailored contingency management (CM) intervention instituted at a Clinical Trials Network-affiliate opioid treatment program (OTP). Staff-level training outcomes (intervention delivery skill, knowledge, and adoption readiness) were assessed before and after a 16-hour training, and again following a 90-day trial implementation period. Management-level implementation outcomes (interventio...

Implementing Intervention Movement Programs for Kindergarten Children

Science.gov (United States)

Deli, Eleni; Bakle, Iliana; Zachopoulou, Evridiki

2006-01-01

The reported study aimed to identify the effects of two 10-week intervention programs on fundamental locomotor skill performance in kindergarten children. Seventy-five children with mean age 5.4 plus or minus 0.5 years participated. Experimental Group A followed a movement program, experimental Group B followed a music and movement program, and…

Cost-Effectiveness of a Family Planning Voucher Program in Rural Pakistan

Directory of Open Access Journals (Sweden)

Edward Ivor Broughton

2017-09-01

Full Text Available IntroductionThis study reports on the effectiveness and efficiency from the program funder’s perspective of the Suraj Social Franchise (SSF voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016.MethodA decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program.ResultsA total of 168,206 married women of reproductive age (MWRA received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient. The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62–5.31.ConclusionThe result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.

Implementing preventive chemotherapy through an integrated National Neglected Tropical Disease Control Program in Mali.

Directory of Open Access Journals (Sweden)

Massitan Dembélé

Full Text Available BACKGROUND: Mali is endemic for all five targeted major neglected tropical diseases (NTDs. As one of the five 'fast-track' countries supported with the United States Agency for International Development (USAID funds, Mali started to integrate the activities of existing disease-specific national control programs on these diseases in 2007. The ultimate objectives are to eliminate lymphatic filariasis, onchocerciasis and trachoma as public health problems and to reduce morbidity caused by schistosomiasis and soil-transmitted helminthiasis through regular treatment to eligible populations, and the specific objectives were to achieve 80% program coverage and 100% geographical coverage yearly. The paper reports on the implementation of the integrated mass drug administration and the lessons learned. METHODOLOGY/PRINCIPAL FINDINGS: The integrated control program was led by the Ministry of Health and coordinated by the national NTD Control Program. The drug packages were designed according to the disease endemicity in each district and delivered through various platforms to eligible populations involving the primary health care system. Treatment data were recorded and reported by the community drug distributors. After a pilot implementation of integrated drug delivery in three regions in 2007, the treatment for all five targeted NTDs was steadily scaled up to 100% geographical coverage by 2009, and program coverage has since been maintained at a high level: over 85% for lymphatic filariasis, over 90% for onchocerciasis and soil-transmitted helminthiasis, around 90% in school-age children for schistosomiasis, and 76-97% for trachoma. Around 10 million people have received one or more drug packages each year since 2009. No severe cases of adverse effects were reported. CONCLUSIONS/SIGNIFICANCE: Mali has scaled up the drug treatment to national coverage through integrated drug delivery involving the primary health care system. The successes and lessons

The Effects of a Developmentally Appropriate Music and Movement Program on Motor Performance

Science.gov (United States)

Zachopoulou, E.; Tsapakidou, A.; Derri, V.

2004-01-01

Basic motor skills development is achieved through the implementation of different types of physical education programs. The purpose of this study was to investigate and to compare the effect of a developmentally appropriate music and movement program and of a developmentally appropriate physical education program on the development of jumping and…

Training of Teachers and Teaching Services Specialists for the Design and Implementation of the "School Psychology Master Program

Directory of Open Access Journals (Sweden)

Maksimova L.A.

2015-11-01

Full Text Available The article presents the experience of organizing the training courses for teachers and teaching services specialists for design and implementation of the basic professional educational pedagogical master program in a psycho-pedagogical training direction (educational psychologist with enhanced internship for students in a context of networking. The authors submit a modular design of training program. The first module includes methodological bases of the design and implementation of the basic professional educational master program. The second module includes legal coverage of the design and implementation of the basic professional educational master program. The third module consists of design and implementation of the basic professional educational master program in a psycho-pedagogical training direction (educational psychologist. The program involves a variety of active and interactive educational technology, providing the development of professional activities: remote technology, expert seminars, design stations, panels and plenary discussions, business games, round-table discussions.

Improving MC and A Oversight in Russia by Implementing Measurement and Training Programs

International Nuclear Information System (INIS)

Bokov, Dmitry; Byers, Kenneth R.

2004-01-01

As the Russian State regulatory agency responsible for oversight of nuclear material control and accounting (MC and A), Gosatomnadzor of Russia (GAN) determines the status of the MC and A programs at Russian facilities. Last year, GAN developed and implemented their Nuclear Material Measurement Program Plan which documents current non-destructive assay (NDA) measurement capability in all regions of GAN; provides justification for upgrades to equipment, procedures and training; and defines the inspector-facility operator interface as it relates to NDA measurement equipment use. This Program Plan has helped to give the GAN inspection measurements more legal and official status as an oversight tool, and has also helped to improve other GAN MC and A oversight activities. These improvements include developing a tamper-indicating device program, conducting NDA workshops at specific Russian nuclear facilities to better train MC and A inspectors, and developing training evaluation programs. The Program is an important tool to address the GAN role in oversight of the Russian Federal Information System nuclear material database. This paper describes the feedback received from the GAN regional offices on the implementation of the Program Plan during its first year in operation and how the Program Plan has affected other GAN inspection activities to improve MC and A oversight.

Effects of a Mathematics Cognitive Acceleration Program on Student Achievement and Motivation

Science.gov (United States)

Finau, Teukava; Treagust, David F.; Won, Mihye; Chandrasegaran, A. L.

2018-01-01

This paper presents the effects of a cognitive acceleration program in mathematics classes on Tongan students' achievements, motivation and self-regulation. Cognitive Acceleration in Mathematics Education (CAME) is a program developed at King's College and implemented worldwide with the aim of improving students' thinking skills, mathematics…

On the implementation of the Biological Threat Reduction Program in the Republic of Uzbekistan

OpenAIRE

Tuychiev, Laziz; Madaminov, Marifjon

2013-01-01

Objective To review the implementation of the Biological Threat Reduction Program (BTRP) of the U.S. Defense Threat Reduction Agency in the Republic of Uzbekistan since 2004. Introduction The Biological Threat Reduction Program (BTRP) has been being implemented in the Republic of Uzbekistan since 2004 within the framework of the Agreement between the Government of the Republic of Uzbekistan and the Government of the United States of America Concerning Cooperation in the Area of the Promotion ...

A theory-based implementation program for alcohol screening and brief intervention (ASBI) in general practices: Planned development and study protocol of a cluster randomised controlled trial.

Science.gov (United States)

Abidi, L; Oenema, A; Candel, M J J M; van de Mheen, D

2016-11-01

Previous studies have shown that alcohol screening and brief intervention (ASBI) in general practices can lead to significant reductions in alcohol consumption among patients, yet ASBI is rarely implemented into routine clinical practice. The aim of this paper is to describe the development and evaluation of an ASBI implementation program aimed at increasing ASBI delivery rates of general practitioners (GPs) and decreasing patients' alcohol consumption. This study protocol describes the step-wise development and evaluation of an ASBI implementation program. A four-step method is used to identify relevant determinants of change and intervention components based on the Behaviour Change Wheel and the Theoretical Domains Framework. The program will be evaluated in general practices in The Netherlands in a two-arm cluster randomised controlled trial which investigates the effect of the program on GPs' ASBI delivery behaviour as well as on patients' alcohol consumption. Effective theory- and practice-based strategies to implement ASBI in general practices are highly needed. Using a stepwise method we described the development of a program consisting of an e-learning module, a tailored feedback module and environmental support and materials. We hypothesize that this program will result in an increase of GPs' ASBI delivery behaviour. Secondly, we expect an overall decrease in percentage of patients with excessive or problematic alcohol use and a higher proportion of patients from GPs receiving the ASBI implementation program decreasing their alcohol consumption, compared to patients from GPs in the control group. NTR5539. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of Medicaid disease management programs on emergency admissions and inpatient costs.

Science.gov (United States)

Conti, Matthew S

2013-08-01

To determine the impact of state Medicaid diabetes disease management programs on emergency admissions and inpatient costs. National InPatient Sample sponsored by the Agency for Healthcare Research and Quality Project for the years from 2000 to 2008 using 18 states. A difference-in-difference methodology compares costs and number of emergency admissions for Washington, Texas, and Georgia, which implemented disease management programs between 2000 and 2008, to states that did not undergo the transition to managed care (N = 103). Costs and emergency admissions were extracted for diabetic Medicaid enrollees diagnosed in the reform and non-reform states and collapsed into state and year cells. In the three treatment states, the implementation of disease management programs did not have statistically significant impacts on the outcome variables when compared to the control states. States that implemented disease management programs did not achieve improvements in costs or the number of emergency of admissions; thus, these programs do not appear to be an effective way to reduce the burden of this chronic disease. © Health Research and Educational Trust.

Understanding an improved cookstove program in rural Mexico: An analysis from the implementers' perspective

International Nuclear Information System (INIS)

Troncoso, Karin; Castillo, Alicia; Merino, Leticia; Lazos, Elena; Masera, Omar R.

2011-01-01

The adoption of innovations in rural areas depends, among many different factors, on the way development workers approach a community. Through a qualitative research methodology this study documented the adoption of a new technology, by following an improved cookstove implementation program carried out by a Mexican NGO. This technology reduces fuel consumption and addresses health impacts of indoor air pollution caused by the widespread use of traditional biomass fuels in open fires in developing countries. Different demographic and socio-economic factors have been analyzed to explain the low success rates implementation projects have faced worldwide, but there are almost no studies that examine the problem from the perspective of implementers. The aim of this study was to understand how the different visions of the individuals involved in an implementation program affect its outcome. Findings showed that the NGO work was constrained by the need to meet the commitment with sponsors. The adoption rates did not change between the first and the second stage of the project, even though the approach towards users was very different. A lack of a shared vision among the work team towards the project was found and the existence of two main perspectives among program workers—broadly described as people-centered and technology-centered—, gave place to differences in attitudes towards the program. - Highlights: ► This study assesses a Mexican NGO ICS implementation program that followed three distinct approaches. ► The first two had similar adoption rates despite their different approaches towards the users. ► An improvement in the technology proved to be more important in raising the adoption rates. ► Two visions were observed among stakeholders: people-centered and technology-centered. ► The NGO work was constrained by the need to meet the commitments with sponsors.

Experience in the design, implementation and use of PL-11, a programming language for the PDP-11

CERN Document Server

Russell, R D

1976-01-01

PL-11 is a programming language for the PDP-11 family of computers designed and implemented as part of the OMEGA Project at CERN (the European Organization for Nuclear Research). Its purpose is to provide an effective tool for both physicists and systems programmers to use in building real time data acquisition systems that are online to high-energy physics experiments. It is a fairly typical member of the PL-class of programming languages which are based on the initial design of PL360. (44 refs).

Cost-Benefit Analysis of the Implementation of an Enhanced Recovery Program in Liver Surgery.

Science.gov (United States)

Joliat, Gaëtan-Romain; Labgaa, Ismaïl; Hübner, Martin; Blanc, Catherine; Griesser, Anne-Claude; Schäfer, Markus; Demartines, Nicolas

2016-10-01

Enhanced recovery after surgery (ERAS) programs have been shown to ease the postoperative recovery and improve clinical outcomes for various surgery types. ERAS cost-effectiveness was demonstrated for colorectal surgery but not for liver surgery. The present study aim was to analyze the implementation costs and benefits of a specific ERAS program in liver surgery. A dedicated ERAS protocol for liver surgery was implemented in our department in July 2013. The subsequent year all consecutive patients undergoing liver surgery were treated according to this protocol (ERAS group). They were compared in terms of real in-hospital costs with a patient series before ERAS implementation (pre-ERAS group). Mean costs per patient were compared with a bootstrap T test. A cost-minimization analysis was performed. Seventy-four ERAS patients were compared with 100 pre-ERAS patients. There were no significant pre- and intraoperative differences between the two groups, except for the laparoscopy number (n = 18 ERAS, n = 9 pre-ERAS, p = 0.010). Overall postoperative complications were observed in 36 (49 %) and 64 patients (64 %) in the ERAS and pre-ERAS groups, respectively (p = 0.046). The median length of stay was significantly shorter for the ERAS group (8 vs. 10 days, p = 0.006). The total mean costs per patient were €38,726 and €42,356 for ERAS and pre-ERAS (p = 0.467). The cost-minimization analysis showed a total mean cost reduction of €3080 per patient after ERAS implementation. ERAS implementation for liver surgery induced a non-significant decrease in cost compared to standard care. Significant decreased complication rate and hospital stay were observed in the ERAS group.

Exploring Barriers to Implementing a School-Wide Positive Behavioral Intervention and Support Program

Science.gov (United States)

Gay, Ronald Lynn

2016-01-01

This study examined factors related to the implementation of a School Wide Positive Behavioral Intervention and Support (SWPBIS) program at a large middle school in the United States. Parent Teacher Student Association volunteers at the school reported that teacher fidelity to implementation of SWPBIS activities was inconsistent, threatening the…

Federal Programs Supporting Educational Change, Vol. VII: Factors Affecting Implementation and Continuation.

Science.gov (United States)

Berman, Paul; And Others

This report is one of three volumes that describe the second phase of a study that examined the implementation of four federal change agent programs related to education. Phase 2 of the study focused on what happens to local projects in the two largest change agent programs--ESEA Title III and ESEA Title VII--when federal funding stops. This…

Conservation Reserve Program effects on floodplain land cover management.

Science.gov (United States)

Jobe, Addison; Kalra, Ajay; Ibendahl, Elise

2018-05-15

Growing populations and industrialized agriculture practices have eradicated much of the United States wetlands along river floodplains. One program available for the restoration of floodplains is the Conservation Reserve Program (CRP). The current research explores the effects CRP land change has on flooding zones, utilizing Flood Modeller and HEC-RAS. Flood Modeller is proven a viable tool for flood modeling within the United States when compared to HEC-RAS. Application of the software is used in the Nodaway River system located in the western halves of Iowa and Missouri to model effects of introducing new forest areas within the region. Flood stage during the conversion first decreases in the early years, before rising to produce greater heights. Flow velocities where CRP land is present are reduced for long-term scopes. Velocity reduction occurs as the Manning's roughness increases due to tree diameter and brush density. Flood zones become more widespread with the implementation of CRP. Future model implementations are recommended to witness the effects of smaller flood recurrence intervals. Copyright © 2018 Elsevier Ltd. All rights reserved.

Factors associated with the implementation of community-based peer-led health promotion programs: A scoping review.

Science.gov (United States)

Lorthios-Guilledroit, Agathe; Richard, Lucie; Filiatrault, Johanne

2018-06-01

Peer education is growing in popularity as a useful health promotion strategy. However, optimal conditions for implementing peer-led health promotion programs (HPPs) remain unclear. This scoping review aimed to describe factors that can influence implementation of peer-led HPPs targeting adult populations. Five databases were searched using the keywords "health promotion/prevention", "implementation", "peers", and related terms. Studies were included if they reported at least one factor associated with the implementation of community-based peer-led HPPs. Fifty-five studies were selected for the analysis. The method known as "best fit framework synthesis" was used to analyze the factors identified in the selected papers. Many factors included in existing implementation conceptual frameworks were deemed applicable to peer-led HPPs. However, other factors related to individuals, programs, and implementation context also emerged from the analysis. Based on this synthesis, an adapted theoretical framework was elaborated, grounded in a complex adaptive system perspective and specifying potential mechanisms through which factors may influence implementation of community-based peer-led HPPs. Further research is needed to test the theoretical framework against empirical data. Findings from this scoping review increase our knowledge of the optimal conditions for implementing peer-led HPPs and thereby maximizing the benefits of such programs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Enhanced Recovery After Surgery Program Implementation in 2 Surgical Populations in an Integrated Health Care Delivery System.

Science.gov (United States)

Liu, Vincent X; Rosas, Efren; Hwang, Judith; Cain, Eric; Foss-Durant, Anne; Clopp, Molly; Huang, Mengfei; Lee, Derrick C; Mustille, Alex; Kipnis, Patricia; Parodi, Stephen

2017-07-19

undergoing colorectal resection and 0.67 (95% CI, 0.45-0.99, P = .05) for patients with hip fracture. Among patients undergoing colorectal resection, ERAS implementation was associated with decreased rates of hospital mortality (0.17; 95% CI, 0.03-0.86; P = .03), whereas among patients with hip fracture, implementation was associated with increased rates of home discharge (1.24; 95% CI, 1.06-1.44; P = .007). Multicenter implementation of an ERAS program among patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair successfully altered processes of care and was associated with significant absolute and relative decreases in hospital length of stay and postoperative complication rates. Rapid, large-scale implementation of a multidisciplinary ERAS program is feasible and effective in improving surgical outcomes.

Reductions in employee productivity impairment observed after implementation of web-based worksite health promotion programs.

Science.gov (United States)

Silberman, Jordan; Schwartz, Steven; Giuseffi, Danielle L; Wang, Chun; Nevedal, Dana; Bedrosian, Richard

2011-12-01

To assess changes in employee productivity impairment observed after the implementation of several Web-based health promotion programs. Health risk assessments and self-report measures of productivity impairment were administered on-line to more than 43,000 participants of Web-based health promotion programs. Reductions in productivity impairment were observed after 1 month of program utilization. Productivity impairment at 90- and 180-day follow-ups also decreased relative to baseline. Improvements in employee health were associated with reductions in employee productivity impairment. The use of Web-based health promotion programs was associated with reductions in productivity impairment and improvements in employee health. After the implementation of Web-based health promotion programs, reductions in productivity impairment may be observed before reductions in direct health care costs.

Regulatory approach of the monitoring the effectiveness of maintenance at nuclear power plants program

International Nuclear Information System (INIS)

Vajgel, Stefan

2009-03-01

The electrical power generation using nuclear power plants requires this installation being safety, reliable and available for the working periods. For this purpose, an adequate, effective and well conducted maintenance program makes an essential and useful tool to the owner of the plant. However, it is necessary to follow the regulatory requirements for this program implementation which monitories this maintenance effectiveness. There are Brazilian norms requirements which must be followed. The international regulatory guides establish these requirements in good details but it is necessary to verify if this methodology for implementing can be totally applied here in Brazil. Then, the american guide NUMARC 93-01 which details how can be implemented a program for this monitoring, shows some methods for using. In this thesis, the Delphi and Probabilistic Safety Analysis were briefly included because they were preferred for implementing this monitoring.in a Brazilian plant. The results which are being obtained show that, looking the regulatory aspects, the NUMARC 93-01 follows our regulations and gives good results for the plant management. (author)

Measuring learning, student engagement, and program effectiveness: a strategic process.

Science.gov (United States)

Jantzi, Julie; Austin, Connie

2005-01-01

What if there was an effective way to address the age-old question from students, "Why do we have to do this assignment?" And from faculty, "How do we know our students are really learning?" And from administrators, "How will we demonstrate to our peers, our accrediting agencies, and other program stakeholders that our programs are educationally effective?" As it undertook a curriculum redesign, faculty in a baccalaureate school of nursing developed a 9-step process for curriculum implementation. The authors discuss how they applied the 9 steps strategically, positioning the program for 2 successful accreditation self-studies and concurrently addressing, with greater confidence, some of these age-old questions.

Interprofessional development and implementation of a pharmacist professional advancement and recognition program.

Science.gov (United States)

Hager, David; Chmielewski, Eric; Porter, Andrea L; Brzozowski, Sarah; Rough, Steve S; Trapskin, Philip J

2017-11-15

The interprofessional development, implementation, and outcomes of a pharmacist professional advancement and recognition program (PARP) at an academic medical center are described. Limitations of the legacy advancement program, in combination with low rates of employee engagement in peer recognition and professional development, at the UW Health department of pharmacy led to the creation of a task force comprising pharmacists from all practice areas to develop a new pharmacist PARP. Senior leadership within the organization expanded the scope of the project to include an interprofessional work group tasked to develop guidelines and core principles that other professional staff could use to reduce variation across advancement and recognition programs. Key program design elements included a triennial review of performance against advancement standards and the use of peer review to supplement advancement decisions. The primary objective was to meaningfully improve pharmacists' engagement as measured through employee engagement surveys. Secondary outcomes of interest included the results of pharmacist and management satisfaction surveys and the program's impact on the volume and mix of pharmacist professional development activities. Of the 126 eligible pharmacists, 93 participated in the new program. The majority of pharmacists was satisfied with the program. For pharmacists who were advanced as part of the program, meaningful increases in employee engagement scores were observed, and a mean of 95 hours of professional development and quality-improvement activities was documented. Implementation of a PARP helped increase pharmacist engagement through participation in quality-improvement and professional development activities. The program also led to the creation of organizationwide interprofessional guidelines for advancement programs within various healthcare disciplines. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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

Science.gov (United States)

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

2016-01-01

The burden of chronic, non-communicable diseases such as diabetes is growing rapidly in low- and middle-income countries. Implementing management programs for diabetes and other chronic diseases for underserved populations is thus a critical global health priority. However, there is a notable dearth of shared programmatic and outcomes data from diabetes treatment programs in these settings. We describe our experiences as a non-governmental organization designing and implementing a type 2 diabetes program serving Maya indigenous people in rural Guatemala. We detail the practical challenges and solutions we have developed to build and sustain diabetes programming in this setting. We conduct a retrospective chart review from our electronic medical record to evaluate our program's performance. We generate a cohort profile, assess cross-sectional indicators using a framework adapted from the literature, and report on clinical longitudinal outcomes. A total of 142 patients were identified for the chart review. The cohort showed a decrease in hemoglobin A1C from a mean of 9.2% to 8.1% over an average of 2.1 years of follow-up (p Guatemala.

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

Science.gov (United States)

Bobitt, Julie; Schwingel, Andiara

2017-01-01

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

EFFECTIVENESS OF THE PROGRAM OF EMPOWERMENT OF THE WOMEN RESIDING AT THE COASTAL AREA OF AMPENAN DISTRICT, MATARAM CITY, LOMBOK IMPLEMENTED IN THE FORM OF LIFE SKILLS

Directory of Open Access Journals (Sweden)

Ni Putu Listiawati

2012-11-01

Full Text Available The program of the empowerment of the women living in Mataram City implemented inthe form of life skills including vocational skill, social skill, and personal skill has been carriedout since 2001. In reality, the attempts already made could not improve the well-being of thewomen in Mataram City in general and the women living along the coastal area of Ampenan,South Ampenan District and Banjar District in particular. Based on the background mentionedabove, the researcher was interested in exploring the effectiveness of the program of theempowerment provided in the form life skills. Three problems are formulated in this research.They are (1 how effective the implementation of the empowerment program of the womenresiding at the coastal area of Ampenan District was?; (2 what factors contributed to theeffectiveness of the empowerment program of the women residing at the coastal area?; (3 whatwere the effects and meanings of the effectiveness of the empowerment program of the womenresiding at the coastal area? The theories employed to answer the problems formulated above arethe theory of post feminism by Ann Brooks, the theory of social practice by Bourdieu and thetheory of power/knowledge by Foucault. The theories were eclectically applied. The qualitativemethod was employed in this study and the data needed were collected by the techniques ofobservation, in-depth interview, Focus Group Discussion (hereon abbreviated to FGD,documentation and library research.The results of the study show that (1 the program of the empowerment of the womenliving in the coastal area was ineffective; (2 the factors which contributed to the effectivenessof the empowerment of the women living along the coastal area are economic capital, culturalcapital, socio culture and symbolic culture; (3 the effects of the effectiveness of theempowerment program were on the skills acquired, the income earned, the independenceacquired, the environment where they live and their pattern

Energy 2000: effects of the program and conclusions from its evaluation

International Nuclear Information System (INIS)

Balthasar, A.

2000-01-01

The action program Energy 2000 has been continually reviewed by independent experts in view of its effects. This resulted in around 50 scientific studies between 1991 and 1999, dealing with different aspects of the program. In the book 'Energy 2000: effects of the program and conclusions from its evaluation', the results of these evaluations are summarised, and conclusions for the design of the follow-up program are drawn. The organisational frame of the program is presented and the question answered whether the determining principles of the program proved practical. Besides, the effects of state intervention, of the conflict solving groups and the voluntary actions of Energy 2000 are appraised. A separate chapter is dedicated to the evaluation strategy of the program, its implementation and the benefits of the evaluations. Propositions for the evaluation of the follow-up program are formulated as well. Dr. Andreas Balthasar is President of the Swiss Evaluation Society. (author)

Implementation of an RHR/LPSI pump coupling retrofit program

International Nuclear Information System (INIS)

Dudiak, J.G.; Koch, R.P.; Orewyler, R.; Tipton, J.W.

1994-01-01

Nuclear plant operating experience has shown the RHR and LPSI services to be very demanding on pumps. The systems handle borated water at high temperatures and pressures with frequent step changes in both temperature and pressure. Additionally, the industry trend towards reduced flow rates during plant mid-loop (reduced inventory) conditions has resulted in extended pump operation at flow rates significantly below the pump best efficiency point flow. Operation at these low flow fates is known to cause high thrust loads and large shaft deflections. The combination of these and other factors have resulted in short mechanical seal life and short motor bearing life, thus requiring frequent pump and motor maintenance. For many nuclear plants, including Southern California Edison's (SCE) San Onofre Units 2 and 3, these pumps have represented a major operations and maintenance (O ampersand M) expenditure and a significant source of radiation exposure to plant personnel. SCE management determined that a pump upgrade was justified to reduce the O ampersand M costs and to improve plant availability. SCE decided to proceed with a pump retrofit program to improve the pump maintainability, reliability and availability. Installation was completed for four LPSI pumps at San Onofre Units 2 and 3 during the Cycle 7 refueling outages in 1993. A key to the program's success was the removal of many traditional supplier and customer barriers and revision of supplier and customer roles to create a unified team. This paper traces the RHR/LPSI retrofit program for San Onofre from problem identification to project implementation. The team approach used for this program and the lessons learned may be useful to other utilities and vendors when evaluating or implementing system and equipment upgrades

Effectiveness of a Formal Mentorship Program in Family Medicine Residency: The Residents’ Perspective

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Marie Andrades

2013-01-01

Full Text Available Introduction. Mentoring is a recognized form of teaching learning strategy in postgraduate medical education. This paper describes the effectiveness of a formal mentorship program from the residents’ perspective after a year of implementation. Methods. The Aga Khan University Family Medicine Residency Program is the first program in Pakistan to our knowledge to implement formal mentorship for all four years of residency. A mentorship program was developed, implemented, and evaluated a year later using a rating scale. The 10-point Likert scale consisted of questions on academics, clinical work, research, administrative issues, and personal/social issues. Results. The response rate was 95% (. Eighty percent ( were women. Satisfaction level in seeking help was the highest for academics (75%. Residents scored mentorship as low in helping to tackle their personal problems (20%. Barriers reported in rapport building with mentor were time constraints and gender difference. The most useful attributes of the mentor which helped rapport building were accessibility, active listening, support for emotional needs, and trustworthiness. Conclusion. Mentoring has a role in trainees’ personal and professional growth especially when their needs are addressed. The effectiveness of the mentorship program in residency can improve if the residents are allowed to choose their own mentors.

I and C security program for nuclear facilities: implementation guide - TAFICS/IG/2

International Nuclear Information System (INIS)

2016-04-01

This is the second in a series of documents being developed by TAFICS for protecting computer-based I and C systems of Indian nuclear facilities from cyber attacks. The document provides guidance to nuclear facility management to establish, implement and maintain a robust I and C security program - consisting of security plan and a set of security controls. In order to provide a firm basis for the security program, the document also identifies the fundamental security principles and foundational security requirements related to computer-based I and C systems of nuclear facilities. It is recommended that all applicable Indian nuclear facilities should implement the security program - with required adaptation - so as to provide the necessary assurance that the I and C systems are adequately protected against cyber attacks. (author)

Guide for monitoring effectiveness of utility Reliability Centered Maintenance (RCM) programs

International Nuclear Information System (INIS)

Midgett, W.D.; Wilson, J.F.; Krochmal, D.F.; Owsenek, L.W.

1991-02-01

Reliability centered maintenance (RCM) programs help utilities optimize preventive maintenance efforts while improving plant safety and economy through increased dependability of plant components. The project team developed this guide and accompanying methodology based on status updates from the Ginna and San Onofre demonstration projects. These updates addressed areas ranging from system selection to the effectiveness of RCM program implementation. In addition, the team incorporated information from a 12-utility survey soliciting opinions on the need for a methodology to monitor RCM cost-effectiveness. An analysis of the 12-utility survey showed that no techniques had been developed to measure RCM program cost-effectiveness. Thus, this guide addresses two key areas: Pros and cons of various monitoring techniques available to assess the overall effectiveness of RCM and a methodology for specifically evaluating the cost-effectiveness of RCM programs. 1 fig

Implementation and outcomes of a zero tolerance of bullying and harassment program.

Science.gov (United States)

Meloni, Marion; Austin, Michelle

2011-02-01

This case study describes the implementation of a zero tolerance of bullying and harassment program and its outcomes in an ACT hospital. The significance of bullying and harassment within this hospital workplace and its impact became apparent in the 2005 employee satisfaction survey. The results showed low staff satisfaction, a relatively high occurrence of perceived bullying and harassment in the workplace, and a low level of trust by staff in the management of bullying and harassment issues in comparison to the health sector norms. A bullying and harassment program was therefore put in place led by the hospital's Organisational Development Unit and a zero-tolerance approach towards bullying and harassment was adopted and embraced by the leadership group. After nearly 3 years the program has had a positive impact, including contributing to an overall increase in staff satisfaction and improvements in the bullying and harassment section of the latest employee satisfaction survey. Additional initiatives have been implemented and improved employee satisfaction results are expected in 2010-11.

A systematic exploration of differences in contextual factors related to implementing the MOVE! weight management program in VA: A mixed methods study

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Fletcher Carol E

2011-09-01

Full Text Available Abstract Background In January 2006, Veterans Affairs (VA disseminated the MOVE!® Weight Management Program to VA medical centers to address the high prevalence of overweight/obesity. In its second year, MOVE! implementation varied widely across facilities. The objective of this study was to understand contextual factors that facilitated or impeded implementation of MOVE! in VA medical centers in the second year after its dissemination. Methods We used an embedded mixed methods cross-sectional study design. Qualitative and quantitative data were collected simultaneously with the primary purpose to explore contextual factors most likely to influence MOVE! implementation effectiveness at five purposively selected facilities. Facilities were selected to maximize variation with respect to participation in MOVE! by candidate Veterans. Semi-structured phone interviews were conducted with 24 staff across the five facilities. Quantitative responses were elicited followed by open-ended questions. The quantitative measures were adapted from a published implementation model. Qualitative analysis was conducted using rigorous content analysis methods. Results Qualitative and quantitative data converged to strengthen findings that point to several recommendations. Management support can help increase visibility of the program, commit needed resources, and communicate the importance of implementation efforts. Establishing a receptive implementation climate can be accomplished by emphasizing the important role that weight management may have in reducing incidence and severity of obesity-related chronic conditions. Coalescing highly functioning multi-disciplinary teams was an essential step for more effective implementation of MOVE!. In some situations, local champions can overcome challenging barriers in facilities that lack sufficient management support. Conclusions Key organizational factors at local VA medical centers were strongly associated with MOVE