Assessing the link between implementation fidelity and health outcomes for a trial of intensive case management by community health workers: a mixed methods study protocol.

Science.gov (United States)

Schmidt, Barbara; Watt, Kerrianne; McDermott, Robyn; Mills, Jane

2017-07-17

Better systems of care are required to address chronic disease in Indigenous people to ensure they can access all their care needs. Health research has produced evidence about effective models of care and chronic disease strategies to address Indigenous health, however the transfer of research findings into routine clinical practice has proven challenging. Complex interventions, such as those related to chronic disease, have many components that are often poorly implemented and hence rarely achieve implementation fidelity. Implementation fidelity is "the degree to which programs are implemented as intended by the program developer". Knowing if an intervention was implemented as planned is fundamental to knowing what has contributed to the success of an intervention. The aim of this study is to adapt the implementation fidelity framework developed by Keith et al. and apply it to the intervention implemented in phase 1 of the Getting Better at Chronic Care in North Queensland study. The objectives are to quantify the level of implementation fidelity achieved during phase 1 of the study, measure the association between implementation fidelity and health outcomes and to explore the features of the primary health care system that contributed to improved health outcomes. A convergent parallel mixed methods study design will be used to develop a process for assessing implementation fidelity. Information collected via a questionnaire and routine data generated during phase 1 of the study will be used to explain the context for the intervention in each site and develop an implementation fidelity score for each component of the intervention. A weighting will be applied to each component of the intervention to calculate the overall implementation score for each participating community. Statistical analysis will assess the level of association between implementation fidelity scores and health outcomes. Health services research seeks to find solutions to social and technical

Implementation of the Leaching Environmental Assessment ...

Science.gov (United States)

LEAF provides a uniform and integrated approach for evaluating leaching from solid materials (e.g., waste, treated wastes such as by solidification/stabilization, secondary materials such as blast furnace slags, energy residuals such as coal fly ash, soil, sediments, mining and mineral processing wastes). Assessment using LEAF applies a stepwise approach that considers the leaching behavior of COPCs in response to chemical and physical factors that control and material properties across a range of plausible field conditions (US EPA, 2010). The framework provides the flexibility to tailor testing to site conditions and select the extent of testing based on assessment objectives and the level of detailed information needed to support decision-making. The main focus will be to discuss the implementation of LEAF in the US and the How to Guide that has recently been completed. To present the How To Guide for the implementation of the leaching environmental assessment framework to an international audience already familiar with comparable leaching tests in use in Europe. Will be meeting with European colleagues on their interest in expanding methods to include organics.

Implementing Strategic Environmental Assessment of spatial planning tools

International Nuclear Information System (INIS)

De Montis, Andrea

2013-01-01

After more than a decade from the publication of the European Directive 2001/42/CE (Directive) on Strategic Environmental Assessment (SEA), the design and construction of the interested spatial planning instruments has gone through a variety of changes and integrations in European and in world states. This inhomogeneous panorama can be explained with a pattern of institutional structures that have so far affected the implementation of the Directive. The aim of this paper is to investigate the level of implementation of the Directive in Italy by developing a comparative analysis of the quality of integration of SEA within the design of the spatial coordination plan of a set of Italian provinces. Italian practice is analyzed in the framework of a comparative study of worldwide SEA implementation within spatial and land use planning. The results reveal strengths and weaknesses in SEA implementation at the provincial level and, in particular, the emergence of critical areas of research concerning institutional context, public participation, monitoring, and observatory of the spatial transformations. -- Highlights: • This is a comparative analysis of SEA in strategic spatial planning in Italy. • The adhesion of Provinces to the study is remarkable. • SEA implementation and integration into spatial planning is still moderate. • Participation via consultations should be more widespread. • Monitoring and institution of observatories are still in an infancy stage

Rockfall Hazard Process Assessment : Implementation Report

Science.gov (United States)

2017-10-01

The Montana Department of Transportation (MDT) commissioned a new research program to improve assessment and management of its rock slope assets. The Department implemented a Rockfall Hazard Rating System (RHRS) program in 2005 and wished to add valu...

Implementing Curriculum-Embedded Formative Assessment in Primary School Science Classrooms

Science.gov (United States)

Hondrich, Annika Lena; Hertel, Silke; Adl-Amini, Katja; Klieme, Eckhard

2016-01-01

The implementation of formative assessment strategies is challenging for teachers. We evaluated teachers' implementation fidelity of a curriculum-embedded formative assessment programme for primary school science education, investigating both material-supported, direct application and subsequent transfer. Furthermore, the relationship between…

Cultural challenges to implementation of formative assessment in Saudi Arabia: an exploratory study.

Science.gov (United States)

Al-Wassia, Rolina; Hamed, Omayma; Al-Wassia, Heidi; Alafari, Reem; Jamjoom, Reda

2015-04-01

This study investigates challenges that students and faculty face to implement assessment for learning; and the activities, capabilities, enablers, and indicators which could impact performance. The study is a mixed methods research, cross-sectional, exploratory study. The study was organized through two phases of data collection and analysis (QUAL → quan). Based on qualitative focus group discussions (FGD), we first gathered data through field notes. Later, we engaged in analysis using techniques drawn from qualitative data including categorization, theme identification, and connection to existing literature. Based on this analysis, we developed a questionnaire that could provide quantitative measures based on the qualitative FGD. We then administered the questionnaire, and the quantitative data were analyzed to quantitatively test the qualitative findings. Twenty-four faculty and 142 students from the 4th and 5th clinical years participated voluntarily. Their perception of FA and the cultural challenges that hinder its adoption were evaluated through a FGD and a questionnaire. The mean score of understanding FA concept was equal in faculty and students (p = 0.08). The general challenge that scored highest was the need to balance work and academic load in faculty and the need to balance study load and training and mental anxiety in students. There was no difference between faculty and students in perceiving "learning is teacher-centered" (p = 0.481); and "past learning and assessment experience" (p = 0.322). There was a significant difference between them regarding interaction with opposite gender (p discrimination by same faculty gender". The authors suggested a "Framework of Innovation in Endorsing Assessment for Learning". It emphasizes a holisitic approach through all levels of the System: Government, Accreditation Bodies, Policy makers; Institution, and Classroom levels.

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.

Assessment of the implementation of environmental management ...

African Journals Online (AJOL)

Assessment of the implementation of environmental management system in the construction ... Journal of Fundamental and Applied Sciences ... The Environmental Management System (EMS) illustrates a possible solution to reduce the ...

Effects of a strategy to improve offender assessment practices: Staff perceptions of implementation outcomes.

Science.gov (United States)

Welsh, Wayne N; Lin, Hsiu-Ju; Peters, Roger H; Stahler, Gerald J; Lehman, Wayne E K; Stein, Lynda A R; Monico, Laura; Eggers, Michele; Abdel-Salam, Sami; Pierce, Joshua C; Hunt, Elizabeth; Gallagher, Colleen; Frisman, Linda K

2015-07-01

This implementation study examined the impact of an organizational process improvement intervention (OPII) on a continuum of evidence based practices related to assessment and community reentry of drug-involved offenders: Measurement/Instrumentation, Case Plan Integration, Conveyance/Utility, and Service Activation/Delivery. To assess implementation outcomes (staff perceptions of evidence-based assessment practices), a survey was administered to correctional and treatment staff (n=1509) at 21 sites randomly assigned to an Early- or Delayed-Start condition. Hierarchical linear models with repeated measures were used to examine changes in evidence-based assessment practices over time, and organizational characteristics were examined as covariates to control for differences across the 21 research sites. Results demonstrated significant intervention and sustainability effects for three of the four assessment domains examined, although stronger effects were obtained for intra- than inter-agency outcomes. No significant effects were found for Conveyance/Utility. Implementation interventions such as the OPII represent an important tool to enhance the use of evidence-based assessment practices in large and diverse correctional systems. Intra-agency assessment activities that were more directly under the control of correctional agencies were implemented most effectively. Activities in domains that required cross-systems collaboration were not as successfully implemented, although longer follow-up periods might afford detection of stronger effects. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion

Directory of Open Access Journals (Sweden)

Lawrence A. Palinkas

2018-05-01

Full Text Available Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP.Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents.Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission.Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion.

Science.gov (United States)

Palinkas, Lawrence A; Campbell, Mark; Saldana, Lisa

2018-01-01

Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.

IMPLEMENTING A VALUE ASSESSMENT TOOL FOR SERVICE INNOVATION IDEAS

OpenAIRE

TOR HELGE AAS

2010-01-01

There has not been much discussion of how firms may assess the value of service innovation projects ex-ante in the extant research literature. This paper theoretically derives a value assessment tool for service innovation ideas called QSI (tool for pre-Qualification of Service Innovation projects). Thereafter QSI is implemented in three firms and it is explored to what degree the implementation improved managerial decision making on service innovation projects and investments. The findings i...

The information protection level assessment system implementation

Science.gov (United States)

Trapeznikov, E. V.

2018-04-01

Currently, the threat of various attacks increases significantly as automated systems become more widespread. On the basis of the conducted analysis the information protection level assessment system establishing objective was identified. The paper presents the information protection level assessment software implementation in the information system by applying the programming language C #. In conclusions the software features are identified and experimental results are represented.

Assessing organizational readiness for depression care quality improvement: relative commitment and implementation capability.

Science.gov (United States)

Rubenstein, Lisa V; Danz, Marjorie S; Crain, A Lauren; Glasgow, Russell E; Whitebird, Robin R; Solberg, Leif I

2014-12-02

Depression is a major cause of morbidity and cost in primary care patient populations. Successful depression improvement models, however, are complex. Based on organizational readiness theory, a practice's commitment to change and its capability to carry out the change are both important predictors of initiating improvement. We empirically explored the links between relative commitment (i.e., the intention to move forward within the following year) and implementation capability. The DIAMOND initiative administered organizational surveys to medical and quality improvement leaders from each of 83 primary care practices in Minnesota. Surveys preceded initiation of activities directed at implementation of a collaborative care model for improving depression care. To assess implementation capability, we developed composites of survey items for five types of organizational factors postulated to be collaborative care barriers and facilitators. To assess relative commitment for each practice, we averaged leader ratings on an identical survey question assessing practice priorities. We used multivariable regression analyses to assess the extent to which implementation capability predicted relative commitment. We explored whether relative commitment or implementation capability measures were associated with earlier initiation of DIAMOND improvements. All five implementation capability measures independently predicted practice leaders' relative commitment to improving depression care in the following year. These included the following: quality improvement culture and attitudes (p = 0.003), depression culture and attitudes (p commitment (p = 0.002) and prior depression quality improvement activities appeared to be associated with earlier participation in the DIAMOND initiative. The study supports the concept of organizational readiness to improve quality of care and the use of practice leader surveys to assess it. Practice leaders' relative commitment to depression care

Process evaluation of the implementation of scorecard-based antenatal risk assessment, care pathways and interdisciplinary consultation: the Healthy Pregnancy 4 All study.

Science.gov (United States)

Vos, A A; van Voorst, S F; Posthumus, A G; Waelput, A J M; Denktaş, S; Steegers, E A P

2017-09-01

To evaluate the implementation of a complex intervention in the antenatal healthcare field in 14 Dutch municipalities. The intervention consisted of the implementation of a systematic scorecard-based risk assessment in pregnancy, subsequent patient-tailored care pathways, and consultations of professionals from different medical and social disciplines. Saunders's seven-step method was used for the development of a programme implementation monitoring plan, with specific attention to the setting and context of the programme. Data were triangulated from multiple sources, and prespecified criteria were applied to examine the evidence for implementation. Six out of 11 municipalities (54%) met the implementation criteria for the entire risk assessment programme, whereas three municipalities (27%) met the criteria if the three components of implementation were analysed separately. A process evaluation of implementation of a complex intervention is possible. The results can be used to improve understanding of the associations between specific programme elements and programme outcomes on effectiveness of the intervention. Additionally, the results are important for formative purposes to assess how future implementation of antenatal risk assessment can be improved in comparable contexts. Copyright © 2017. Published by Elsevier Ltd.

Advancing implementation science through measure development and evaluation: a study protocol.

Science.gov (United States)

Lewis, Cara C; Weiner, Bryan J; Stanick, Cameo; Fischer, Sarah M

2015-07-22

Significant gaps related to measurement issues are among the most critical barriers to advancing implementation science. Three issues motivated the study aims: (a) the lack of stakeholder involvement in defining pragmatic measure qualities; (b) the dearth of measures, particularly for implementation outcomes; and (c) unknown psychometric and pragmatic strength of existing measures. Aim 1: Establish a stakeholder-driven operationalization of pragmatic measures and develop reliable, valid rating criteria for assessing the construct. Aim 2: Develop reliable, valid, and pragmatic measures of three critical implementation outcomes, acceptability, appropriateness, and feasibility. Aim 3: Identify Consolidated Framework for Implementation Research and Implementation Outcome Framework-linked measures that demonstrate both psychometric and pragmatic strength. For Aim 1, we will conduct (a) interviews with stakeholder panelists (N = 7) and complete a literature review to populate pragmatic measure construct criteria, (b) Q-sort activities (N = 20) to clarify the internal structure of the definition, (c) Delphi activities (N = 20) to achieve consensus on the dimension priorities, (d) test-retest and inter-rater reliability assessments of the emergent rating system, and (e) known-groups validity testing of the top three prioritized pragmatic criteria. For Aim 2, our systematic development process involves domain delineation, item generation, substantive validity assessment, structural validity assessment, reliability assessment, and predictive validity assessment. We will also assess discriminant validity, known-groups validity, structural invariance, sensitivity to change, and other pragmatic features. For Aim 3, we will refine our established evidence-based assessment (EBA) criteria, extract the relevant data from the literature, rate each measure using the EBA criteria, and summarize the data. The study outputs of each aim are expected to have a positive impact

Implementing an Online Writing Assessment Strategy for Gerontology

Science.gov (United States)

Brown, Pamela S.; Hanks, Roma S.

2008-01-01

Assessment of student learning is a growing concern for programs in gerontology. This report focuses on the conception, design, funding, and implementation of an innovative online workshop to assess and improve writing skills of students enrolled in distance-learning gerontology classes. The approach is multidisciplinary and involves a…

The influence of street level bureaucracy on the implementation of Strategic Environmental Assessment

DEFF Research Database (Denmark)

Kørnøv, Lone; Zhang, Jasmine; Christensen, Per

2015-01-01

A number of factors are critical to the implementation of measures identified through Strategic Environmental Assessment (SEA) processes. This paper addresses the challenge of implementation from a street level perspective and studies the role of planners and their use of discretion in the SEA...... implementation process: in which way might planners hinder or facilitate the implementation of SEA? Which coping mechanisms and discretions are deliberately or unconsciously developed and used by the planners? The paper reviews the literature on street level bureaucracy (SLB) in order to identify both factors...... influencing the implementation behaviour of street level bureaucrats and their coping mechanism when confronted with these factors. Based upon the SLB theory, a case study explores the SLB behaviour involved in the implementation of the SEA of the Copenhagen spatial plan. The analysis shows a surprisingly...

Overview of the OGAP Formative Assessment Project and CPRE's Large-Scale Experimental Study of Implementation and Impacts

Science.gov (United States)

Supovitz, Jonathan

2016-01-01

In this presentation discussed in this brief abstracted report, the author presents about an ongoing partnership with the Philadelphia School District (PSD) to implement and research the Ongoing Assessment Project (OGAP). OGAP is a systematic, intentional and iterative formative assessment system grounded in the research on how students learn…

Intentional research design in implementation science: implications for the use of nomothetic and idiographic assessment.

Science.gov (United States)

Lyon, Aaron R; Connors, Elizabeth; Jensen-Doss, Amanda; Landes, Sara J; Lewis, Cara C; McLeod, Bryce D; Rutt, Christopher; Stanick, Cameo; Weiner, Bryan J

2017-09-01

The advancement of implementation science is dependent on identifying assessment strategies that can address implementation and clinical outcome variables in ways that are valid, relevant to stakeholders, and scalable. This paper presents a measurement agenda for implementation science that integrates the previously disparate assessment traditions of idiographic and nomothetic approaches. Although idiographic and nomothetic approaches are both used in implementation science, a review of the literature on this topic suggests that their selection can be indiscriminate, driven by convenience, and not explicitly tied to research study design. As a result, they are not typically combined deliberately or effectively. Thoughtful integration may simultaneously enhance both the rigor and relevance of assessments across multiple levels within health service systems. Background on nomothetic and idiographic assessment is provided as well as their potential to support research in implementation science. Drawing from an existing framework, seven structures (of various sequencing and weighting options) and five functions (Convergence, Complementarity, Expansion, Development, Sampling) for integrating conceptually distinct research methods are articulated as they apply to the deliberate, design-driven integration of nomothetic and idiographic assessment approaches. Specific examples and practical guidance are provided to inform research consistent with this framework. Selection and integration of idiographic and nomothetic assessments for implementation science research designs can be improved. The current paper argues for the deliberate application of a clear framework to improve the rigor and relevance of contemporary assessment strategies.

Training Staff to Implement Brief Stimulus Preference Assessments

Science.gov (United States)

Weldy, Christina R.; Rapp, John T.; Capocasa, Kelli

2014-01-01

We trained 9 behavioral staff members to conduct 2 brief preference assessments using 30-min video presentations that contained instructions and modeling. After training, we evaluated each staff member's implementation of the assessments in situ. Results indicated that 1 or 2 training sessions for each method were sufficient for teaching each…

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…

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.

Getting Real: Implementing Assessment Alternatives in Mathematics.

Science.gov (United States)

Hopkins, Martha H.

1997-01-01

Recounts experiences of a university professor who returned to the elementary classroom and attempted to implement the National Council of Teachers of Mathematics Standards and appropriate assessment methods, including nontraditional paper-and-pencil tasks, journal-like writing assignments, focused observations, and performance-based assessments…

Assessment and development of implementation models of health ...

International Development Research Centre (IDRC) Digital Library (Canada)

Assessment and development of implementation models of health-related ... The Contribution of Civil Society Organizations in Achieving Health for All ... Health Information for Maternal and Child Health Planning in Urban Bangladesh.

Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers

Directory of Open Access Journals (Sweden)

Murtomaa Heikki

2011-05-01

Full Text Available Abstract Background Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. Methods A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73 and dental hygienists (n = 22 in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%. We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Results Internal consistency values for theoretical domains varied from 0.50 ('emotion' to 0.71 ('environmental context and resources'. The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4 and was identified as a potential implementation difficulty. The domain emotion

Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers.

Science.gov (United States)

Amemori, Masamitsu; Michie, Susan; Korhonen, Tellervo; Murtomaa, Heikki; Kinnunen, Taru H

2011-05-26

Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC) counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73) and dental hygienists (n = 22) in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%). We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Internal consistency values for theoretical domains varied from 0.50 ('emotion') to 0.71 ('environmental context and resources'). The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4) and was identified as a potential implementation difficulty. The domain emotion provided the highest mean score (60%; 95% CI, 55

Assessing the Implementation of Ghana's Patient Charter

Science.gov (United States)

Abekah-Nkrumah, Gordon; Manu, Abubakar; Atinga, Roger Ayimbillah

2010-01-01

Purpose: This paper seeks to assess the implementation of Ghana's Patients' Charter by investigating the level of awareness and knowledge of the Charter's content, some socio-demographic factors that may influence awareness and knowledge of the Charter and how providers have discharged their responsibilities under the Charter.…

Implementing Trauma-Informed Partner Violence Assessment in Family Planning Clinics.

Science.gov (United States)

Decker, Michele R; Flessa, Sarah; Pillai, Ruchita V; Dick, Rebecca N; Quam, Jamie; Cheng, Diana; McDonald-Mosley, Raegan; Alexander, Kamila A; Holliday, Charvonne N; Miller, Elizabeth

2017-09-01

Intimate partner violence (IPV) and reproductive coercion (RC) are associated with poor reproductive health. Little is known about how family planning clinics implement brief IPV/RC assessment interventions in practice. We describe the uptake and impact of a brief, trauma-informed, universal IPV/RC assessment and education intervention. Intervention implementation was evaluated via a mixed methods study among women ages 18 and up receiving care at one of two family planning clinics in greater Baltimore, MD. This mixed methods study entailed a quasi-experimental, single group pretest-posttest study with family planning clinic patients (baseline and exit survey n = 132; 3-month retention n = 68; retention rate = 52%), coupled with qualitative interviews with providers and patients (total n = 35). Two thirds (65%) of women reported receiving at least one element of the intervention on their exit survey immediately following the clinic-visit. Patients reported that clinic-based IPV assessment is helpful, irrespective of IPV history. Relative to those who reported neither, participants who received either intervention element reported greater perceived caring from providers, confidence in provider response to abusive relationships, and knowledge of IPV-related resources at follow-up. Providers and patients alike described the educational card as a valuable tool. Participants described trade-offs of paper versus in-person, electronic medical record-facilitated screening, and patient reluctance to disclose current situations of abuse. In real-world family planning clinic settings, a brief assessment and support intervention was successful in communicating provider caring and increasing knowledge of violence-related resources, endpoints previously deemed valuable by IPV survivors. Results emphasize the merit of universal education in IPV/RC clinical interventions over seeking IPV disclosure.

Implementation outcome assessment instruments used in physical healthcare settings and their measurement properties: a systematic review protocol.

Science.gov (United States)

Khadjesari, Zarnie; Vitoratou, Silia; Sevdalis, Nick; Hull, Louise

2017-10-08

Over the past 10 years, research into methods that promote the uptake, implementation and sustainability of evidence-based interventions has gathered pace. However, implementation outcomes are defined in different ways and assessed by different measures; the extent to which these measures are valid and reliable is unknown. The aim of this systematic review is to identify and appraise studies that assess the measurement properties of quantitative implementation outcome instruments used in physical healthcare settings, to advance the use of precise and accurate measures. The following databases will be searched from inception to March 2017: MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Library. Grey literature will be sought via HMIC, OpenGrey, ProQuest for theses and Web of Science Conference Proceedings Citation Index-Science. Reference lists of included studies and relevant reviews will be hand searched. Three search strings will be combined to identify eligible studies: (1) implementation literature, (2) implementation outcomes and (3) measurement properties. Screening of titles, abstracts and full papers will be assessed for eligibility by two reviewers independently and any discrepancies resolved via consensus with the wider team. The methodological quality of the studies will be assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. A set of bespoke criteria to determine the quality of the instruments will be used, and the relationship between instrument usability and quality will be explored. Ethical approval is not necessary for systematic review protocols. Researchers and healthcare professionals can use the findings of this systematic review to guide the selection of implementation outcomes instruments, based on their psychometric quality, to assess the impact of their implementation efforts. The findings will also provide a useful guide for reviewers of papers and grants to determine the

Implementation outcome assessment instruments used in physical healthcare settings and their measurement properties: a systematic review protocol

Science.gov (United States)

Vitoratou, Silia; Sevdalis, Nick; Hull, Louise

2017-01-01

Introduction Over the past 10 years, research into methods that promote the uptake, implementation and sustainability of evidence-based interventions has gathered pace. However, implementation outcomes are defined in different ways and assessed by different measures; the extent to which these measures are valid and reliable is unknown. The aim of this systematic review is to identify and appraise studies that assess the measurement properties of quantitative implementation outcome instruments used in physical healthcare settings, to advance the use of precise and accurate measures. Methods and analysis The following databases will be searched from inception to March 2017: MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Library. Grey literature will be sought via HMIC, OpenGrey, ProQuest for theses and Web of Science Conference Proceedings Citation Index-Science. Reference lists of included studies and relevant reviews will be hand searched. Three search strings will be combined to identify eligible studies: (1) implementation literature, (2) implementation outcomes and (3) measurement properties. Screening of titles, abstracts and full papers will be assessed for eligibility by two reviewers independently and any discrepancies resolved via consensus with the wider team. The methodological quality of the studies will be assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. A set of bespoke criteria to determine the quality of the instruments will be used, and the relationship between instrument usability and quality will be explored. Ethics and dissemination Ethical approval is not necessary for systematic review protocols. Researchers and healthcare professionals can use the findings of this systematic review to guide the selection of implementation outcomes instruments, based on their psychometric quality, to assess the impact of their implementation efforts. The findings will also provide a useful guide for

Measuring the food service environment: development and implementation of assessment tools.

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Minaker, Leia M; Raine, Kim D; Cash, Sean B

2009-01-01

The food environment is increasingly being implicated in the obesity epidemic, though few reported measures of it exist. In order to assess the impact of the food environment on food intake, valid measures must be developed and tested. The current study describes the development of a food service environment assessment tool and its implementation in a community setting. A descriptive study with mixed qualitative and quantitative methods at a large, North American university campus was undertaken. Measures were developed on the basis of a conceptual model of nutrition environments. Measures of community nutrition environment were the number, type and hours of operation of each food service outlet on campus. Measures of consumer nutrition environment were food availability, food affordability, food promotion and nutrition information availability. Seventy-five food service outlets within the geographic boundaries were assessed. Assessment tools could be implemented in a reasonable amount of time and showed good face and content validity. The food environments were described and measures were grouped so that food service outlet types could be compared in terms of purchasing convenience, cost/value, healthy food promotion and health. Food service outlet types that scored higher in purchasing convenience and cost/value tended to score lower in healthy food promotion and health. This study adds evidence that food service outlet types that are convenient to consumers and supply high value (in terms of calories per dollar) tend to be less health-promoting. Results from this study also suggest the possibility of characterizing the food environment according to the type of food service outlet observed.

Implementing an Assessment Clinic in a Residential PTSD Program

Directory of Open Access Journals (Sweden)

Joan McDowell

2014-08-01

Full Text Available Creating useful treatment plans can help improve services to consumers of mental health services. As more evidence-based practices are implemented, deciding what treatment, at what time, for whom becomes an important factor in facilitating positive outcomes. Readiness for trauma-focused treatments for Posttraumatic Stress Disorder (PTSD such as Cognitive Processing Therapy or Prolonged Exposure Therapy may influence whether an individual can successfully complete either protocol. In addition, components of adjunctive therapies such as Acceptance and Commitment Therapy or Dialectical Behavior Therapy may be useful in moving a particular patient toward readiness and successful completion of treatment. Psychological assessment adds valuable data to inform these types of treatment decisions. This paper describes the implementation of a psychological assessment clinic in a residential PTSD treatment setting. Barriers to implementation, use of the data, and Veterans’ reactions to the feedback provided to them are included.

Predicting Pre-Service Teachers' Intention of Implementing Peer Assessment for Low-Achieving Students

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Yim, Su Yon; Cho, Young Hoan

2016-01-01

Despite the benefits of peer assessment, many teachers are not willing to implement it, particularly for low-achieving students. This study used the theory of planned behaviour to predict pre-service teachers' intention to use peer assessment for low-achieving students. A total of 229 pre-service teachers in Singapore participated in the survey…

Optimal Pain Assessment in Pediatric Rehabilitation: Implementation of a Nursing Guideline.

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Kingsnorth, Shauna; Joachimides, Nick; Krog, Kim; Davies, Barbara; Higuchi, Kathryn Smith

2015-12-01

In Ontario, Canada, the Registered Nurses' Association promotes a Best Practice Spotlight Organization initiative to enhance evidence-based practice. Qualifying organizations are required to implement strategies, evaluate outcomes, and sustain practices aligned with nursing clinical practice guidelines. This study reports on the development and evaluation of a multifaceted implementation strategy to support adoption of a nursing clinical practice guideline on the assessment and management of acute pain in a pediatric rehabilitation and complex continuing care hospital. Multiple approaches were employed to influence behavior, attitudes, and awareness around optimal pain practice (e.g., instructional resources, electronic reminders, audits, and feedback). Four measures were introduced to assess pain in communicating and noncommunicating children as part of a campaign to treat pain as the fifth vital sign. A prospective repeated measures design examined survey and audit data to assess practice aligned with the guideline. The Knowledge and Attitudes Survey (KNAS) was adapted to ensure relevance to the local practice setting and was assessed before and after nurses' participation in three education modules. Audit data included client demographics and pain scores assessed annually over a 3-year window. A final sample of 69 nurses (78% response rate) provided pre-/post-survey data. A total of 108 pediatric surgical clients (younger than 19 years) contributed audit data across the three collection cycles. Significant improvements in nurses' knowledge, attitudes, and behaviors related to optimal pain care for children with disabilities were noted following adoption of the pain clinical practice guideline. Targeted guideline implementation strategies are central to supporting optimal pain practice. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Commitment to Change and Challenges to Implementing Changes After Workplace-Based Assessment Rater Training.

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Kogan, Jennifer R; Conforti, Lisa N; Yamazaki, Kenji; Iobst, William; Holmboe, Eric S

2017-03-01

Faculty development for clinical faculty who assess trainees is necessary to improve assessment quality and impor tant for competency-based education. Little is known about what faculty plan to do differently after training. This study explored the changes faculty intended to make after workplace-based assessment rater training, their ability to implement change, predictors of change, and barriers encountered. In 2012, 45 outpatient internal medicine faculty preceptors (who supervised residents) from 26 institutions participated in rater training. They completed a commitment to change form listing up to five commitments and ranked (on a 1-5 scale) their motivation for and anticipated difficulty implementing each change. Three months later, participants were interviewed about their ability to implement change and barriers encountered. The authors used logistic regression to examine predictors of change. Of 191 total commitments, the most common commitments focused on what faculty would change about their own teaching (57%) and increasing direct observation (31%). Of the 183 commitments for which follow-up data were available, 39% were fully implemented, 40% were partially implemented, and 20% were not implemented. Lack of time/competing priorities was the most commonly cited barrier. Higher initial motivation (odds ratio [OR] 2.02; 95% confidence interval [CI] 1.14, 3.57) predicted change. As anticipated difficulty increased, implementation became less likely (OR 0.67; 95% CI 0.49, 0.93). While higher baseline motivation predicted change, multiple system-level barriers undermined ability to implement change. Rater-training faculty development programs should address how faculty motivation and organizational barriers interact and influence ability to change.

A framework for risk assessment on lean production implementation

Directory of Open Access Journals (Sweden)

Giuliano Almeida Marodin

2014-02-01

Full Text Available The organizational and technical complexity of implementing the lean principles and practices can become an extensively time consuming journey with few benefits. We argue that risk assessment can aid on the understanding and management of the major difficulties on the Lean production implementation (LPI. Thus, this paper proposes a framework for risk assessment on the LPI process. The literature review permitted to adapt the risk assessment steps to the characteristics of the LPI and develop data collection and analysis procedures for each step. The Sociotechnical systems (STS theory was brought in to improve the understanding of the context’s characteristics on the proposed framework because it has a major influence on the LPI. The framework was has five steps: (a defining the unit of analysis; (b describing the context; (c risk identification; (d risk analysis; and (e risk relationships modeling.

Implementation. Improving caries detection, assessment, diagnosis and monitoring.

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Pitts, N B

2009-01-01

This chapter deals with improving the detection, assessment, diagnosis and monitoring of caries to ensure optimal personalized caries management. This can be achieved by delivering what we have (synthesized evidence and international consensus) better and more consistently, as well as driving research and innovation in the areas where we need them. There is a need to better understand the interrelated pieces of the jigsaw that makes up evidence-based dentistry, i.e. the linkages between (a) research and synthesis, (b) dissemination of research results and (c) the implementation of research findings which should ensure that research findings change practice at the clinician-patient level. The current situation is outlined; it is at the implementation step where preventive caries control seems to have failed in some countries but not others. Opportunities for implementation include: capitalizing on the World Health Organization's global policy for improvement of oral health, which sets out an action plan for health promotion and integrated disease prevention; utilizing the developments around the International Caries Detection and Assessment System wardrobe of options and e-learning; building on initiatives from the International Dental Federation and the American Dental Association and linking these to patients' preferences, the wider moves to wellbeing and health maintenance. Challenges for implementation include the slow pace of evolution around dental remuneration systems and some groups of dentists failing to embrace clinical prevention. In the future, implementation of current and developing evidence should be accompanied by research into getting research findings into routine practice, with impacts on the behaviour of patients, professionals and policy makers. Copyright 2009 S. Karger AG, Basel

Formative assessment in undergraduate medical education: concept, implementation and hurdles.

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Rauf, Ayesha; Shamim, Muhammad Shahid; Aly, Syed Moyn; Chundrigar, Tariq; Alam, Shams Nadeem

2014-01-01

Formative assessment, described as "the process of appraising, judging or evaluating students' work or performance and using this to shape and improve students' competence", is generally missing from medical schools of Pakistan. Progressive institutions conduct "formative assessment" as a fleeting part of the curriculum by using various methods that may or may not include feedback to learners. The most important factor in the success of formative assessment is the quality of feedback, shown to have the maximum impact on student accomplishment. Inclusion of formative assessment into the curriculum and its implementation will require the following: Enabling Environment, Faculty and student Training, Role of Department of Medical Education (DME). Many issues can be predicted that may jeopardize the effectiveness of formative assessment including faculty resistance, lack of motivation from students and faculty and paucity of commitment from the top administration. For improvement in medical education in Pakistan, we need to develop a system considered worthy by national and international standards. This paper will give an overview of formative assessment, its implications and recommendations for implementation in medical institutes of Pakistan.

Assessment on the impact of plasma television implementation on ...

African Journals Online (AJOL)

Assessment on the impact of plasma television implementation on the teaching learning process of mathematics class: the case on selected practicum sites (high schools) for education faculty of Jimma University.

Development and Implementation of an Electronic Clinical Formative Assessment: Dental Faculty and Student Perspectives.

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Kirkup, Michele L; Adams, Brooke N; Meadows, Melinda L; Jackson, Richard

2016-06-01

A traditional summative grading structure, used at Indiana University School of Dentistry (IUSD) for more than 30 years, was identified by faculty as outdated for assessing students' clinical performance. In an effort to change the status quo, a feedback-driven assessment was implemented in 2012 to provide a constructive assessment tool acceptable to both faculty and students. Building on the successful non-graded clinical evaluation employed at Baylor College of Dentistry, IUSD implemented a streamlined electronic formative feedback model (FFM) to assess students' daily clinical performance. An important addition to this evaluation tool was the inclusion of routine student self-assessment opportunities. The aim of this study was to determine faculty and student response to the new assessment instrument. Following training sessions, anonymous satisfaction surveys were examined for the three user groups: clinical faculty (60% response rate), third-year (D3) students (72% response rate), and fourth-year (D4) students (57% response rate). In the results, 70% of the responding faculty members preferred the FFM over the summative model; however, 61.8% of the D4 respondents preferred the summative model, reporting insufficient assessment time and low faculty participation. The two groups of students had different responses to the self-assessment component: 70.2% of the D4 respondents appreciated clinical self-assessment compared to 46% of the D3 respondents. Overall, while some components of the FFM assessment were well received, a phased approach to implementation may have facilitated a transition more acceptable to both faculty and students. Improvements are being made in an attempt to increase overall satisfaction.

Implementation of stress assessments by occupational health nurses working in occupational health agencies and their confidence in conducting such assessments.

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Ikeda, Chiseko; Saeki, Kazuko; Hirano, Michiyo

2016-06-21

Stress assessments are due to be conducted in December 2015. It is expected that there will be an increase in the number of private health agencies that provide stress assessment services and mental health care. This study aimed to clarify the current situation of and the factors related to stress assessments conducted by nurses in occupational health agencies. Nurses working full time were randomly selected from 60 organizations that were members of the National Federation of Industrial Health Organization. Self-administered questionnaires were sent out between November 2013 and January 2014. The questionnaire included the personal attributes of the participants, training programs, job contents, and how practical mental health care, including stress assessment, is. The study was approved by the ethics committees in the respective organizations. Out of the 162 questionnaires that were distributed, 89 (54.9%) were returned and 85 (53.1%) were valid for analysis. Stress assessments were conducted by 38.8% of the participants. With reference to their confidence in conducting stress assessments, "confidence and" 70.6%, respectively. The groups that conducted and did not conduct the stress assessments did not show any differences in the findings or other attributes. Further, the implementation of stress assessment was not associated with occupational health nurse (OHN) training, education, position, age, years of experience, attendance of lectures on mental health, etc. However, the confidence in conducting the assessment was related to age when dealing with cases on confidence stress assessment consultation in follow-up to the implementation of screening, such as stress, persons at high risk, and so on. Approximately 40% of the nurses were already conducting stress assessments, but most of them conducted such assessments about once a year and were not deeply involved in them. Approximately 70% of the nurses were confident in implementing stress assessments. Further

Assessing Culture and Climate of Federally Qualified Health Centers: A Plan for Implementing Behavioral Health Interventions.

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Kramer, Teresa L; Drummond, Karen L; Curran, Geoffrey M; Fortney, John C

2017-01-01

This study examines organizational factors relating to climate and culture that might facilitate or impede the implementation of evidence-based practices (EBP) targeting behavioral health in federally qualified health centers (FQHCs). Employees at six FQHCs participating in an evidence-based quality improvement (EBQI) initiative for mood disorders and alcohol abuse were interviewed (N=32) or surveyed using the Organizational Context Survey (OCS) assessing culture and climate (N=64). The FQHCs scored relatively well on proficiency, a previously established predictor of successful EBP implementation, but also logged high scores on scales assessing rigidity and resistance, which may hinder implementation. Qualitative data contextualized scores on FQHC culture and climate dimensions. Results suggest that the unique culture of FQHCs may influence implementation of evidence-based behavioral health interventions.

Assessing the current implementation of communicative language for English language teachers in Ethiopian Universities

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Anto, A.G.; Coenders, Ferdinand G.M.; Voogt, Joke

2012-01-01

This study has attempted to assess the current implementation of communicative language teaching (CLT) approach in two Ethiopian universities to identify professional development (PD) needs of English language teachers. A cross-sectional study using teachers, students and management as sources of

Implementation fidelity of a self-management course for epilepsy: method and assessment.

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Wojewodka, G; Hurley, S; Taylor, S J C; Noble, A J; Ridsdale, L; Goldstein, L H

2017-07-11

Complex interventions such as self-management courses are difficult to evaluate due to the many interacting components. The way complex interventions are delivered can influence the effect they have for patients, and can impact the interpretation of outcomes of clinical trials. Implementation fidelity evaluates whether complex interventions are delivered according to protocol. Such assessments have been used for one-to-one psychological interventions; however, the science is still developing for group interventions. We developed and tested an instrument to measure implementation fidelity of a two-day self-management course for people with epilepsy, SMILE(UK). Using audio recordings, we looked at adherence and competence of course facilitators. Adherence was assessed by checklists. Competence was measured by scoring group interaction, an overall impression score and facilitator "didacticism". To measure "didacticism", we developed a novel way to calculate facilitator speech using computer software. Using this new instrument, implementation fidelity of SMILE(UK) was assessed on three modules of the course, for 28% of all courses delivered. Using the instrument for adherence, scores from two independent raters showed substantial agreement with weighted Kappa of 0.67 and high percent agreement of 81.2%. For didacticism, the results from both raters were highly correlated with an intraclass coefficient of 0.97 (p  50% of scored items received the maximum of 2 points) and high competence. Groups were interactive (mean score: 1.9-2.0 out of 2) and the overall impression was on average assessed as "good". Didacticism varied from 42% to 93% of total module time and was not associated with the other competence scores. The instrument devised to measure implementation fidelity was reproducible and easy to use. The courses for the SMILE(UK) study were delivered with a good level of adherence to protocol while not compromising facilitator competence. ISRCTN57937389 .

Implementation of health impact assessment in Danish municipal context

DEFF Research Database (Denmark)

Kraemer, Stella R. J.; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

2014-01-01

. Conclusions: Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.......Aims: Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health...... policy. Methods: Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used...

Implementing the IA stage and developing an instrument to assess the fidelity of critical time interventional: task shifting

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Tatiana Fernandes Carpinteiro Silva

2014-10-01

Full Text Available One strategy that has been used for treat patients with mental health disorder is the implementation of psychosocial interventions. Like the development of a new drug, which requires safety studies before efficacy assessment, the psychosocial interventions should be implemented following defined stages, with the objective of increase the validity and reliability of such interventions. These stages are IA (pre-pilot, IB (pilot study, II (randomized clinical trial and III (additional studies. This study proposes a description of all activities carried out in implementation of the pre-pilot (IA Critical Time Intervention – Task Shifting (CTI-TS, including the development of manuals and the development of an instrument to assess fidelity to the original protocol. As a result, were performed the adaptation of instruments to be used in the pilot study, the adaptation of CTI-TS manual to Brazilian context, the adaptation of the agents CTI-TS training manual, as well the development of the CTI-TS assessment scale fidelity and its instruction manual. This allows multicentric studies conducted in different contexts could be performed avoiding biases. Considering that Brazil is a country that lacks resources allocated to mental care, it is expected that more psychosocial interventions can be implemented, since it was possible to develop the implementation process according to the methods recommended by the international scientific literature.

Development and implementation of Strategic Environmental Assessment in Taiwan

International Nuclear Information System (INIS)

Liou, M.-L.; Yu, Y.-H.

2004-01-01

Taiwan is one of the few Asian countries to have officially adopted Strategic Environmental Assessment (SEA) as one important means towards the achievement of environmental conservation and sustainable development. Despite implementation almost a decade ago, SEA remains premature in its development. This paper analyzes the progress and characteristics of SEA in Taiwan and, through examination of its limited case studies, reveals the positive and apparent influence of SEA on policy making. This paper also identifies the barriers hindering SEA's advancement and concludes with recommendations on strategies to overcome these obstacles

Quality science for all: A qualitative study of professional development and assessment implementation in STEP-uP

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Funk, Christine M.

One of the most important factors in achieving scientific literacy is for science teachers at the local level to develop a greater understanding of science education, including science content, pedagogy, and assessment. This study was designed to examine the connection between teacher learning and practice by studying the relationship between professional development and assessment implementation in the elementary science classroom. The goal was to develop a deeper understanding of the components of the STEP-uP model that served as a catalyst for change and to provide insight into how to best work with teachers in order to develop a more scientifically literate population. Four essential questions guided this research. What kinds of opportunities does STEP-uP provide for elementary school teachers to improve their assessment practices in science? In what ways did STEP-uP training affect assessment practices by teachers? How, if at all, are the assessment practices modified by teachers? What are the most salient features of the STEP-uP professional development model that allow for change and growth in assessment practices in elementary science classrooms and for education at large? The research method for this study was educational connoisseurship and criticism. I developed rich descriptions and interpretations based on observations, interviews, and artifacts from six classroom teachers which were then compared and contrasted to the goals of STEP-uP described in their literature, by the assessment coordinator, and an observation of a STEP-uP training. Key findings include: (1) collaboration and collegial support must be integral to sustain change; (2) clearly articulated goals form one, cohesive vision for professional development that must be integral to all components of the program; (3) multiple entry points help encourage participation and honor differences between teachers' personal and professional needs; and, (4) classroom structures such as time, classroom

An examination of cross-cultural systems implementing evidence-based assessment and intervention approaches

Directory of Open Access Journals (Sweden)

Murray Laura K

2006-01-01

Full Text Available Implementation of evidence-based assessment and intervention approaches for youth with behavioral and/or emotional problems is rising to recognition worldwide. Feasibility research is critical to examine what characteristics of systems allow for success or barriers to the implementation of evidence-based practices into real-world settings, especially when working cross-culturally. This paper briefly reviews the experience of 4 international sites to understand how the overall structure and specific site variables directed the implementation of the World Health Organization and the World Psychiatry Association project. Discussion includes a thematic summary of the successes and challenges experienced by the sites, and future directions of feasibility studies.

76 FR 37119 - Development of Best Practices for Community Health Needs Assessment and Implementation Strategy...

Science.gov (United States)

2011-06-24

... Best Practices for Community Health Needs Assessment and Implementation Strategy; Public Forum AGENCY... processes relating to community health needs assessment (CHNA) and implementation strategy/plan development... practices in CHNA and implementation strategy development and execution for improved community health...

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

Organizational readiness for implementing change: a psychometric assessment of a new measure.

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Shea, Christopher M; Jacobs, Sara R; Esserman, Denise A; Bruce, Kerry; Weiner, Bryan J

2014-01-10

Organizational readiness for change in healthcare settings is an important factor in successful implementation of new policies, programs, and practices. However, research on the topic is hindered by the absence of a brief, reliable, and valid measure. Until such a measure is developed, we cannot advance scientific knowledge about readiness or provide evidence-based guidance to organizational leaders about how to increase readiness. This article presents results of a psychometric assessment of a new measure called Organizational Readiness for Implementing Change (ORIC), which we developed based on Weiner's theory of organizational readiness for change. We conducted four studies to assess the psychometric properties of ORIC. In study one, we assessed the content adequacy of the new measure using quantitative methods. In study two, we examined the measure's factor structure and reliability in a laboratory simulation. In study three, we assessed the reliability and validity of an organization-level measure of readiness based on aggregated individual-level data from study two. In study four, we conducted a small field study utilizing the same analytic methods as in study three. Content adequacy assessment indicated that the items developed to measure change commitment and change efficacy reflected the theoretical content of these two facets of organizational readiness and distinguished the facets from hypothesized determinants of readiness. Exploratory and confirmatory factor analysis in the lab and field studies revealed two correlated factors, as expected, with good model fit and high item loadings. Reliability analysis in the lab and field studies showed high inter-item consistency for the resulting individual-level scales for change commitment and change efficacy. Inter-rater reliability and inter-rater agreement statistics supported the aggregation of individual level readiness perceptions to the organizational level of analysis. This article provides evidence in

Developing evaluation instrument based on CIPP models on the implementation of portfolio assessment

Science.gov (United States)

Kurnia, Feni; Rosana, Dadan; Supahar

2017-08-01

This study aimed to develop an evaluation instrument constructed by CIPP model on the implementation of portfolio assessment in science learning. This study used research and development (R & D) method; adapting 4-D by the development of non-test instrument, and the evaluation instrument constructed by CIPP model. CIPP is the abbreviation of Context, Input, Process, and Product. The techniques of data collection were interviews, questionnaires, and observations. Data collection instruments were: 1) the interview guidelines for the analysis of the problems and the needs, 2) questionnaire to see level of accomplishment of portfolio assessment instrument, and 3) observation sheets for teacher and student to dig up responses to the portfolio assessment instrument. The data obtained was quantitative data obtained from several validators. The validators consist of two lecturers as the evaluation experts, two practitioners (science teachers), and three colleagues. This paper shows the results of content validity obtained from the validators and the analysis result of the data obtained by using Aikens' V formula. The results of this study shows that the evaluation instrument based on CIPP models is proper to evaluate the implementation of portfolio assessment instruments. Based on the experts' judgments, practitioners, and colleagues, the Aikens' V coefficient was between 0.86-1,00 which means that it is valid and can be used in the limited trial and operational field trial.

Challenges of implementation and implementation research: Learning from an intervention study designed to improve tumor registry reporting

Directory of Open Access Journals (Sweden)

Ann Scheck McAlearney

2016-08-01

Full Text Available Objectives: Implementation of interventions designed to improve the quality of medical care often proceeds differently from what is planned. Improving existing conceptual models to better understand the sources of these differences can help future projects avoid these pitfalls and achieve desired effectiveness. To inform an adaptation of an existing theoretical model, we examined unanticipated changes that occurred in an intervention designed to improve reporting of adjuvant therapies for breast cancer patients at a large, urban academic medical center. Methods: Guided by the complex innovation implementation conceptual framework, our study team observed and evaluated the implementation of an intervention designed to improve reporting to a tumor registry. Findings were assessed against the conceptual framework to identify boundary conditions and modifications that could improve implementation effectiveness. Results: The intervention successfully increased identification of the managing medical oncologist and treatment reporting. During implementation, however, unexpected external challenges including hospital acquisitions of community practices and practices’ responses to government incentives to purchase electronic medical record systems led to unanticipated changes and associated threats to implementation. We present a revised conceptual model that incorporates the sources of these unanticipated challenges. Conclusion: This report of our experience highlights the importance of monitoring implementation over time and accounting for changes that affect both implementation and measurement of intervention impact. In this article, we use our study to examine the challenges of implementation research in health care, and our experience can help future implementation efforts.

Designing systematic conservation assessments that promote effective implementation: best practice from South Africa.

Science.gov (United States)

Knight, Andrew T; Driver, Amanda; Cowling, Richard M; Maze, Kristal; Desmet, Philip G; Lombard, Amanda T; Rouget, Mathieu; Botha, Mark A; Boshoff, Andre F; Castley, J Guy; Goodman, Peter S; Mackinnon, Kathy; Pierce, Shirley M; Sims-Castley, Rebecca; Stewart, Warrick I; von Hase, Amrei

2006-06-01

Systematic conservation assessment and conservation planning are two distinct fields of conservation science often confused as one and the same. Systematic conservation assessment is the technical, often computer-based, identification of priority areas for conservation. Conservation planning is composed of a systematic conservation assessment coupled with processes for development of an implementation strategy and stakeholder collaboration. The peer-reviewed conservation biology literature abounds with studies analyzing the performance of assessments (e.g., area-selection techniques). This information alone, however can never deliver effective conservation action; it informs conservation planning. Examples of how to translate systematic assessment outputs into knowledge and then use them for "doing" conservation are rare. South Africa has received generous international and domestic funding for regional conservation planning since the mid-1990s. We reviewed eight South African conservation planning processes and identified key ingredients of best practice for undertaking systematic conservation assessments in a way that facilitates implementing conservation action. These key ingredients include the design of conservation planning processes, skills for conservation assessment teams, collaboration with stakeholders, and interpretation and mainstreaming of products (e.g., maps) for stakeholders. Social learning institutions are critical to the successful operationalization of assessments within broader conservation planning processes and should include not only conservation planners but also diverse interest groups, including rural landowners, politicians, and government employees.

Implementation and assessment of an early home-based intervention on infant attachment organisation: the CAPEDP attachment study in France.

Science.gov (United States)

Tereno, Susana; Guedeney, Nicole; Dugravier, Romain; Greacen, Tim; Saïas, Thomas; Tubach, Florence; Guédeney, Antoine

2013-06-01

Attachment is a long-term emotional link between infants and their mothers. Attachment quality influences subsequent psychosocial relationships, the ability to manage stress and, consequently, later mental health. Home intervention programmes targeting infant attachment have been implemented in several contexts with varying degrees of efficacy. Within the CAPEDP study (Parental Skills and Attachment in Early Childhood: reduction of risks linked to mental health problems and promotion of resilience), a subsample of 120 families were recruited with the objective of assessing the impact of this home-visiting programme on infant attachment organisation using the Strange Situation Procedure. The present paper describes the methodology used in this ancillary study.

A systematic review of instruments that assess the implementation of hospital quality management systems.

NARCIS (Netherlands)

Groene, O.; Botje, D.; Suñol, R.; Lopez, M.A.; Wagner, C.

2013-01-01

Purpose: Health-care providers invest substantial resources to establish and implement hospital quality management systems. Nevertheless, few tools are available to assess implementation efforts and their effect on quality and safety outcomes. This review aims to (i) identify instruments to assess

IMPLEMENTATION OF HEALTH TECHNOLOGY ASSESSMENT WORK IN A HOSPITAL IN KAZAKHSTAN.

Science.gov (United States)

Kosherbayeva, Lyazzat; Hailey, David; Kurakbaev, Kural; Tsoy, Aleksey; Zhuzzhanov, Ormanbek; Donbay, Abilay; Kumar, Ainur; Nadyrov, Kamalzhan

2016-01-01

The aim of this study was to implement health technology assessment (HA) in the First General City Hospital in Astana, Kazakhstan. We organized trainings to familiarize hospital staff with the purpose and details of HTA. An HTA committee was established, with representation from hospital physicians and managers, and criteria for prioritization of health technologies determined. Clinical departments of the hospital were asked to prepare applications for new technologies for their services. The HTA committee reviewed five applications and selected a technology from one of these, on single incision laparoscopic surgery (SILS), for assessment. A short HTA report on SILS was prepared, covering its safety, clinical effectiveness, and cost effectiveness. The report was used to support a request to the Department of Health for additional funding to implement this technology within the hospital. This funding was approved and SILS was established in several hospital departments. This successful initial experience with HTA has paved the way for its routine use by the hospital for informing decisions on the procurement and use of new health technologies.

An assessment of implementation and evaluation phases of strategic plans in Iranian hospitals.

Science.gov (United States)

Sadeghifar, Jamil; Tofighi, Shahram; Roshani, Mohamad; Toulideh, Zahra; Mohsenpour, Seyedramezan; Jafari, Mehdi

2017-01-01

To assess the implementation and evaluation phases of strategic plans in selected hospitals. We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital's priorities was the most important advantage of a strategic plan. There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning.

Identifying Barriers in Implementing Outcomes-Based Assessment Program Review: A Grounded Theory Analysis

Science.gov (United States)

Bresciani, Marilee J.

2011-01-01

The purpose of this grounded theory study was to identify the typical barriers encountered by faculty and administrators when implementing outcomes-based assessment program review. An analysis of interviews with faculty and administrators at nine institutions revealed a theory that faculty and administrators' promotion, tenure (if applicable),…

Implementation fidelity of a self-management course for epilepsy: method and assessment

Directory of Open Access Journals (Sweden)

G. Wojewodka

2017-07-01

Full Text Available Abstract Background Complex interventions such as self-management courses are difficult to evaluate due to the many interacting components. The way complex interventions are delivered can influence the effect they have for patients, and can impact the interpretation of outcomes of clinical trials. Implementation fidelity evaluates whether complex interventions are delivered according to protocol. Such assessments have been used for one-to-one psychological interventions; however, the science is still developing for group interventions. Methods We developed and tested an instrument to measure implementation fidelity of a two-day self-management course for people with epilepsy, SMILE(UK. Using audio recordings, we looked at adherence and competence of course facilitators. Adherence was assessed by checklists. Competence was measured by scoring group interaction, an overall impression score and facilitator “didacticism”. To measure “didacticism”, we developed a novel way to calculate facilitator speech using computer software. Using this new instrument, implementation fidelity of SMILE(UK was assessed on three modules of the course, for 28% of all courses delivered. Results Using the instrument for adherence, scores from two independent raters showed substantial agreement with weighted Kappa of 0.67 and high percent agreement of 81.2%. For didacticism, the results from both raters were highly correlated with an intraclass coefficient of 0.97 (p  50% of scored items received the maximum of 2 points and high competence. Groups were interactive (mean score: 1.9–2.0 out of 2 and the overall impression was on average assessed as “good”. Didacticism varied from 42% to 93% of total module time and was not associated with the other competence scores. Conclusion The instrument devised to measure implementation fidelity was reproducible and easy to use. The courses for the SMILE(UK study were delivered with a good level of adherence to

The implementation of assessment model based on character building to improve students’ discipline and achievement

Science.gov (United States)

Rusijono; Khotimah, K.

2018-01-01

The purpose of this research was to investigate the effect of implementing the assessment model based on character building to improve discipline and student’s achievement. Assessment model based on character building includes three components, which are the behaviour of students, the efforts, and student’s achievement. This assessment model based on the character building is implemented in science philosophy and educational assessment courses, in Graduate Program of Educational Technology Department, Educational Faculty, Universitas Negeri Surabaya. This research used control group pre-test and post-test design. Data collection method used in this research were observation and test. The observation was used to collect the data about the disciplines of the student in the instructional process, while the test was used to collect the data about student’s achievement. Moreover, the study applied t-test to the analysis of data. The result of this research showed that assessment model based on character building improved discipline and student’s achievement.

Nutritional screening, assessment and implementation strategies for adults in an Australian acute tertiary hospital: a best practice implementation report.

Science.gov (United States)

Smith, Louise; Chapman, Amanda; Flowers, Kelli; Wright, Kylie; Chen, Tanghua; O'Connor, Charmaine; Astorga, Cecilia; Francis, Nevenka; Vigh, Gia; Wainwright, Craig

2018-01-01

The project aimed to improve the effectiveness of nutritional screening and assessment practices through clinical audits and the implementation of evidence-based practice recommendations. In the absence of optimal nutrition, health may decline and potentially manifest as adverse health outcomes. In a hospitalized person, poor nutrition may adversely impact on the person's outcome. If the nutritional status can be ascertained, nutritional needs can be addressed and potential risks minimized.The overall purpose of this project was to review and monitor staff compliance with nutritional screening and assessment best practice recommendations ensuring there is timely, relevant and structured nutritional therapeutic practices that support safe, compassionate and person-centered care in adults in a tertiary hospital in South Western Sydney, Australia, in the acute care setting. A baseline retrospective chart audit was conducted and measured against 10 best practice criteria in relation to nutritional screening and assessment practices. This was followed by a facilitated multidisciplinary focus group to identify targeted strategies, implementation of targeted strategies, and a post strategy implementation chart audit.The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRIP) tool, including evidence from other available supporting literature, for promoting change in healthcare practice. The baseline audit revealed deficits between current practice and best practice across the 10 criteria. Barriers for implementation of nutritional screening and assessment best practice criteria were identified by the focus group and an education strategy was implemented. There were improved outcomes across all best practice criteria in the follow-up audit. The baseline audit revealed gaps between current practice and best practice. Through the implementation of a targeted education program and

Assessing organizational implementation context in the education sector: confirmatory factor analysis of measures of implementation leadership, climate, and citizenship.

Science.gov (United States)

Lyon, Aaron R; Cook, Clayton R; Brown, Eric C; Locke, Jill; Davis, Chayna; Ehrhart, Mark; Aarons, Gregory A

2018-01-08

A substantial literature has established the role of the inner organizational setting on the implementation of evidence-based practices in community contexts, but very little of this research has been extended to the education sector, one of the most common settings for the delivery of mental and behavioral health services to children and adolescents. The current study examined the factor structure, psychometric properties, and interrelations of an adapted set of pragmatic organizational instruments measuring key aspects of the organizational implementation context in schools: (1) strategic implementation leadership, (2) strategic implementation climate, and (3) implementation citizenship behavior. The Implementation Leadership Scale (ILS), Implementation Climate Scale (ICS), and Implementation Citizenship Behavior Scale (ICBS) were adapted by a research team that included the original scale authors and experts in the implementation of evidence-based practices in schools. These instruments were then administered to a geographically representative sample (n = 196) of school-based mental/behavioral health consultants to assess the reliability and structural validity via a series of confirmatory factor analyses. Overall, the original factor structures for the ILS, ICS, and ICBS were confirmed in the current sample. The one exception was poor functioning of the Rewards subscale of the ICS, which was removed in the final ICS model. Correlations among the revised measures, evaluated as part of an overarching model of the organizational implementation context, indicated both unique and shared variance. The current analyses suggest strong applicability of the revised instruments to implementation of evidence-based mental and behavioral practices in the education sector. The one poorly functioning subscale (Rewards on the ICS) was attributed to typical educational policies that do not allow for individual financial incentives to personnel. Potential directions for

A systematic review of instruments that assess the implementation of hospital quality management systems.

Science.gov (United States)

Groene, Oliver; Botje, Daan; Suñol, Rosa; Lopez, Maria Andrée; Wagner, Cordula

2013-10-01

Health-care providers invest substantial resources to establish and implement hospital quality management systems. Nevertheless, few tools are available to assess implementation efforts and their effect on quality and safety outcomes. This review aims to (i) identify instruments to assess the implementation of hospital quality management systems, (ii) describe their measurement properties and (iii) assess the effects of quality management on quality improvement and quality of care outcomes. We performed a systematic literature search from 1990 to 2011 in PubMed, CINAHL, EMBASE, Cochrane Library and Web of Science. In addition, we used snowball strategies, screened the reference lists of eligible papers, reviewed grey literature and contacted experts in the field. and data extraction Two reviewers screened eligible papers based on pre-defined inclusion and exclusion criteria and all authors extracted data. Eligible papers are described in terms of general characteristics (settings, type and level of respondents, mode of data collection), methodological properties (sampling strategy, item derivation, conceptualization of quality management, assessment of reliability and validity, scoring) and application/implementation (accounting for context, organizational adaptations, sensitivity to change, deployment and effect size). Eighteen papers were deemed eligible for inclusion. While some common domains emerged in measurement conceptualization, substantial differences in scope persist. The instruments' measurement properties were insufficiently described and only few instruments assessed links between the implementation of quality management systems (QMS) and improvement strategies or outcomes. There is currently no well-established measure to assess the implementation and effectiveness of quality management systems. Future research should address this gap.

Factors influencing a problem-based learning implementation: A case study of IT courses

Science.gov (United States)

Darus, Norida Muhd; Mohd, Haslina; Baharom, Fauziah; Saip, Mohamed Ali; Puteh, Nurnasran; Marzuki @ Matt, Zaharin; Husain, Mohd Zabidin; Yasin, Azman

2016-08-01

IT students must be trained to work efficiently as teamwork. One of the techniques that can be used to train them is through Problem-Based Learning (PBL) approach. The PBL implementation can be influenced by various factors depending on the ultimate goal of the study. This study is focusing on the IT students' perception of the PBL implementation. The student's perception is important to ensure the successfulness of the PBL implementation. Therefore, it is important to identify the factors that might influence the implementation of PBL of IT courses. This study aims to identify some catalyst factors that may influence the PBL implementation of IT courses. The study involved three (3) main phases: identifying PBL implementation factors, constructing a PBL model, and PBL model validation using statistical analysis. Four main factors are identified: PBL Characteristics, PBL Course Assessment, PBL Practices, and PBL Perception. Based on these four factors, a PBL model is constructed. Then, based on the proposed PBL model, four hypotheses are formulated and analyzed to validate the model. All hypotheses are significantly acceptable. The result shows that the PBL Characteristics and PBL Course Assessment factors are significantly influenced the PBL Practices and indirectly influenced the Students' Perception of the PBL Implementation for IT courses. This PBL model can assist decision makers in enhancing the PBL teaching and learning strategy for IT courses. It is also can be tested to other courses in the future.

Reflecting on a decade of religion studies implementation in the FET ...

African Journals Online (AJOL)

A decade later while Religion Studies has found a familiar footing among students nationally (i.e. with an increase in student participation in the National Senior Certificate ... Keywords: Religion Studies, curriculum transformation, implementation challenges, pedagogy skills, assessment and moderation, religious literacy ...

The implementation of skill assessment by the educators on the mathematics learning process in senior high school

Science.gov (United States)

Lestariani, I.; Sujadi, I.; Pramudya, I.

2018-03-01

The purpose of research to describe and know the implementation of skill assessment on the mathematics learning process with the high school mathematics teacher as the subject because it is less fully implemented. This research is the type of the descriptive qualitative method. The data was collecting observation method, interview and documentation. The result showed that on the planning stage of the implementation of skill assessment, there were many teachers who had not prepared all the completeness with various assessment techniques through performance, project and portfolio. The teacher was prepared the list of questions. On the implementation stage, there were many teachers who had not understand the stage of completing the assessment with the appropriate instrument method and development. On the reporting stage, discovered that teachers faced the difficulty on preparing scoring report with the range value. Aside from that, the teachers had not prepared the assessment instrument very well on the planning stage. It can be concluded that the implementation of skill assessment has been implemented but not maximally because educators don’t understand about the skill assessment and the number of instrument that must be prepared before the assessment.

Learning Evaluation: blending quality improvement and implementation research methods to study healthcare innovations.

Science.gov (United States)

Balasubramanian, Bijal A; Cohen, Deborah J; Davis, Melinda M; Gunn, Rose; Dickinson, L Miriam; Miller, William L; Crabtree, Benjamin F; Stange, Kurt C

2015-03-10

In healthcare change interventions, on-the-ground learning about the implementation process is often lost because of a primary focus on outcome improvements. This paper describes the Learning Evaluation, a methodological approach that blends quality improvement and implementation research methods to study healthcare innovations. Learning Evaluation is an approach to multi-organization assessment. Qualitative and quantitative data are collected to conduct real-time assessment of implementation processes while also assessing changes in context, facilitating quality improvement using run charts and audit and feedback, and generating transportable lessons. Five principles are the foundation of this approach: (1) gather data to describe changes made by healthcare organizations and how changes are implemented; (2) collect process and outcome data relevant to healthcare organizations and to the research team; (3) assess multi-level contextual factors that affect implementation, process, outcome, and transportability; (4) assist healthcare organizations in using data for continuous quality improvement; and (5) operationalize common measurement strategies to generate transportable results. Learning Evaluation principles are applied across organizations by the following: (1) establishing a detailed understanding of the baseline implementation plan; (2) identifying target populations and tracking relevant process measures; (3) collecting and analyzing real-time quantitative and qualitative data on important contextual factors; (4) synthesizing data and emerging findings and sharing with stakeholders on an ongoing basis; and (5) harmonizing and fostering learning from process and outcome data. Application to a multi-site program focused on primary care and behavioral health integration shows the feasibility and utility of Learning Evaluation for generating real-time insights into evolving implementation processes. Learning Evaluation generates systematic and rigorous cross

Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational study.

Science.gov (United States)

Barker, Anna Lucia; Kamar, Jeannette; Tyndall, Tamara Jane; White, Lyn; Hutchinson, Anastasia; Klopfer, Nicole; Weller, Carolina

2013-06-01

Pressure ulcers are a common but preventable problem in hospitals. Implementation of best practice guideline recommendations can prevent ulcers from occurring. This 9-year cohort study reports prevalence data from point prevalence surveys during the observation period, and three practice metrics to assess implementation of best practice guideline recommendations: (i) nurse compliance with use of a validated pressure ulcer risk assessment and intervention checklist; (ii) accuracy of risk assessment scoring in usual-care nurses and experienced injury prevention nurses; and (iii) use of pressure ulcer prevention strategies. The prevalence of hospital-acquired pressure ulcers decreased following implementation of an evidence-based prevention programme from 12·6% (2 years preprogramme implementation) to 2·6% (6 years postprogramme implementation) (P pressure ulcer prevention documentation according to best practice guidelines was high (>84%). A sample of 270 patients formed the sample for the study of risk assessment scoring accuracy and use of prevention strategies. It was found usual-care nurses under-estimated patients' risk of pressure ulcer development and under-utilised prevention strategies compared with experienced injury prevention nurses. Despite a significant reduction in prevalence of hospital-acquired pressure ulcers and high documentation compliance, use of prevention strategies could further be improved to achieve better patient outcomes. Barriers to the use of prevention strategies by nurses in the acute hospital setting require further examination. This study provides important insights into the knowledge translation of pressure ulcer prevention best practice guideline recommendations at The Northern Hospital. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Participatory redesign of work organisation in hospital nursing: A study of the implementation process.

Science.gov (United States)

Stab, Nicole; Hacker, Winfried

2018-05-01

The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation. Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process. © 2018 John Wiley & Sons Ltd.

Bangladesh Model/Survey Note : Assessment of Implementation of Public Procurement Regulations

OpenAIRE

World Bank

2009-01-01

The report provides an assessment of the status of implementation of public procurement regulations 2003. The objective was to assess the performance of the system using a two-way approach. The report summarizes the major findings of the assessment carried out through a Bank-Government joint collaboration survey with sample data of two financial years (FY2006 and FY2007) from the key secto...

Implementation of a formal in-training assessment programme in anaesthesiology and preliminary results of acceptability

DEFF Research Database (Denmark)

Ringsted, C; Østergaard, D; van der Vleuten, C P M

2003-01-01

BACKGROUND: A new reform on postgraduate education in Denmark requires a formal in-training assessment in all specialties. The aim of this study was to survey the implementation and acceptability of the first example of a nation-wide in-training assessment programme for first-year trainees...... in anaesthesiology developed by a working group under the Danish Society of Anaesthesiology and Intensive Care Medicine. METHODS: A questionnaire about the implementation of the programme in practice and the characteristics of the trainees was sent to the educational responsible consultant (ERC) in each of the 26...... anaesthetic departments in the country with first-year trainees in anaesthesiology. Standard evaluations of the assessment programme were regularly collected from trainees. RESULTS: Twenty-five (96%) departments returned the questionnaire. In total the departments reported on 100 trainees and 83 of these had...

Implementation of health impact assessment in Danish municipal context.

Science.gov (United States)

Kraemer, Stella Rebecca Johnsdatter; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

2014-12-01

Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health policy. Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used for implementation of HIA. No significant differences were found among analyzed municipalities by status of HIA inclusion into health policy. Among barriers; a lack of tools with general validity, a lack of intersectoral working culture, balance between centralized versus participatory way of working and organizational structure of a municipality, and a lack of capacities were enlisted as most relevant. The last one is a crucial factor of an internal social system of a municipality. With regards to communication channels, reporting and presentation skills of implementers and doers are of key importance. Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.

A modified theoretical framework to assess implementation fidelity of adaptive public health interventions.

Science.gov (United States)

Pérez, Dennis; Van der Stuyft, Patrick; Zabala, Maríadel Carmen; Castro, Marta; Lefèvre, Pierre

2016-07-08

One of the major debates in implementation research turns around fidelity and adaptation. Fidelity is the degree to which an intervention is implemented as intended by its developers. It is meant to ensure that the intervention maintains its intended effects. Adaptation is the process of implementers or users bringing changes to the original design of an intervention. Depending on the nature of the modifications brought, adaptation could either be potentially positive or could carry the risk of threatening the theoretical basis of the intervention, resulting in a negative effect on expected outcomes. Adaptive interventions are those for which adaptation is allowed or even encouraged. Classical fidelity dimensions and conceptual frameworks do not address the issue of how to adapt an intervention while still maintaining its effectiveness. We support the idea that fidelity and adaptation co-exist and that adaptations can impact either positively or negatively on the intervention's effectiveness. For adaptive interventions, research should answer the question how an adequate fidelity-adaptation balance can be reached. One way to address this issue is by looking systematically at the aspects of an intervention that are being adapted. We conducted fidelity research on the implementation of an empowerment strategy for dengue prevention in Cuba. In view of the adaptive nature of the strategy, we anticipated that the classical fidelity dimensions would be of limited use for assessing adaptations. The typology we used in the assessment-implemented, not-implemented, modified, or added components of the strategy-also had limitations. It did not allow us to answer the question which of the modifications introduced in the strategy contributed to or distracted from outcomes. We confronted our empirical research with existing literature on fidelity, and as a result, considered that the framework for implementation fidelity proposed by Carroll et al. in 2007 could potentially meet

What do stakeholders need to implement shared decision making in routine cancer care? A qualitative needs assessment.

Science.gov (United States)

Müller, Evamaria; Hahlweg, Pola; Scholl, Isabelle

2016-12-01

Shared decision making (SDM) is particularly relevant in oncology, where complex treatment options with varying side effects may lead to meaningful changes in the patient's quality of life. For several years, health policies have called for the implementation of SDM, but SDM remains poorly implemented in routine clinical practice. Implementation science has highlighted the importance of assessing stakeholders' needs to inform the development of implementation programs. Thus, the aim of the present study was to assess different stakeholders' needs regarding the implementation of SDM in routine care. A qualitative study using focus groups and interviews was conducted. Focus groups were carried out with junior physicians, senior physicians, nurses and other healthcare providers (HPCs) (e.g. psycho-oncologists, physiotherapists), patients and family members. Head physicians as well as other HPCs in management positions were interviewed. Audiotapes of focus groups and interviews were transcribed verbatim and analyzed using content analysis. Six focus groups with a total of n = 42 stakeholders as well as n = 17 interviews were conducted. Focus groups and interviews revealed five main categories of needs to be fulfilled in order to achieve a better implementation of SDM in routine cancer care: 1) changes in communication, 2) involvement of other parties, 3) a trustful patient-physician relationship, 4) culture change and 5) structural changes. Stakeholders discussed four clusters of intervention strategies that could foster the implementation of SDM in routine cancer care: 1) clinician-mediated interventions, 2) patient-mediated interventions, 3) provision of patient information material and 4) the establishment of a patient advocate. Study results show that stakeholders voiced a diversity of needs to foster implementation of SDM in routine cancer care, of which some can be directly addressed by intervention strategies. Present results can be used to develop an

Implementation and assessment of high-resolution numerical methods in TRACE

Energy Technology Data Exchange (ETDEWEB)

Wang, Dean, E-mail: wangda@ornl.gov [Oak Ridge National Laboratory, 1 Bethel Valley RD 6167, Oak Ridge, TN 37831 (United States); Mahaffy, John H.; Staudenmeier, Joseph; Thurston, Carl G. [U.S. Nuclear Regulatory Commission, Washington, DC 20555 (United States)

2013-10-15

Highlights: • Study and implement high-resolution numerical methods for two-phase flow. • They can achieve better numerical accuracy than the 1st-order upwind scheme. • They are of great numerical robustness and efficiency. • Great application for BWR stability analysis and boron injection. -- Abstract: The 1st-order upwind differencing numerical scheme is widely employed to discretize the convective terms of the two-phase flow transport equations in reactor systems analysis codes such as TRACE and RELAP. While very robust and efficient, 1st-order upwinding leads to excessive numerical diffusion. Standard 2nd-order numerical methods (e.g., Lax–Wendroff and Beam–Warming) can effectively reduce numerical diffusion but often produce spurious oscillations for steep gradients. To overcome the difficulties with the standard higher-order schemes, high-resolution schemes such as nonlinear flux limiters have been developed and successfully applied in numerical simulation of fluid-flow problems in recent years. The present work contains a detailed study on the implementation and assessment of six nonlinear flux limiters in TRACE. These flux limiters selected are MUSCL, Van Leer (VL), OSPRE, Van Albada (VA), ENO, and Van Albada 2 (VA2). The assessment is focused on numerical stability, convergence, and accuracy of the flux limiters and their applicability for boiling water reactor (BWR) stability analysis. It is found that VA and MUSCL work best among of the six flux limiters. Both of them not only have better numerical accuracy than the 1st-order upwind scheme but also preserve great robustness and efficiency.

Implementation and assessment of high-resolution numerical methods in TRACE

International Nuclear Information System (INIS)

Wang, Dean; Mahaffy, John H.; Staudenmeier, Joseph; Thurston, Carl G.

2013-01-01

Highlights: • Study and implement high-resolution numerical methods for two-phase flow. • They can achieve better numerical accuracy than the 1st-order upwind scheme. • They are of great numerical robustness and efficiency. • Great application for BWR stability analysis and boron injection. -- Abstract: The 1st-order upwind differencing numerical scheme is widely employed to discretize the convective terms of the two-phase flow transport equations in reactor systems analysis codes such as TRACE and RELAP. While very robust and efficient, 1st-order upwinding leads to excessive numerical diffusion. Standard 2nd-order numerical methods (e.g., Lax–Wendroff and Beam–Warming) can effectively reduce numerical diffusion but often produce spurious oscillations for steep gradients. To overcome the difficulties with the standard higher-order schemes, high-resolution schemes such as nonlinear flux limiters have been developed and successfully applied in numerical simulation of fluid-flow problems in recent years. The present work contains a detailed study on the implementation and assessment of six nonlinear flux limiters in TRACE. These flux limiters selected are MUSCL, Van Leer (VL), OSPRE, Van Albada (VA), ENO, and Van Albada 2 (VA2). The assessment is focused on numerical stability, convergence, and accuracy of the flux limiters and their applicability for boiling water reactor (BWR) stability analysis. It is found that VA and MUSCL work best among of the six flux limiters. Both of them not only have better numerical accuracy than the 1st-order upwind scheme but also preserve great robustness and efficiency

Identification and assessment of site treatment plan implementation opportunities for emerging technologies

International Nuclear Information System (INIS)

Bernard, E.A.

1995-01-01

The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumes that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOX sm , Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE's mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM's Office of Technology Development, has funded this work

EMERGENCE OF "DRIVERS" FOR THE IMPLEMENTATION OF HEALTH TECHNOLOGY ASSESSMENT.

Science.gov (United States)

Castro Jaramillo, Hector Eduardo; Moreno-Mattar, Ornella; Osorio-Cuevas, Diana

2016-01-01

Health technology assessment (HTA) examines the consequences of the application of health technologies and is aimed at better informing decision-makers. Over the past 30 years, different countries have implemented HTA organizations. Colombia established by law its own HTA agency (IETS) in 2011 which started operations in November 2012. The aim of this study was to assess the feasibility of conducting and using HTA to inform decision-making in this context. Through a qualitative approach, ten "drivers" emerged with the ability to help or hinder HTA development in this context: availability and quality of data, implementation strategy, cultural aspects, local capacity, financial support, policy/political support, globalization, stakeholder pressure, health system context, and usefulness perception. Semi-structured interviews were conducted with key HTA researchers, after following rigorous transcription, and thematic content analysis, those aspects that may be barriers or facilitator for HTA development and use in Colombia were identified. Although HTA has become a tool to inform decision-making around the world, its use may vary according to setting. Determining those aspects which may enable or interfere with HTA development and use in Colombia may be useful for other countries when considering the establishment of HTA systems. The conceptual transferability of concepts like "drivers" with caveats may be of interest for similar settings trying to incorporate HTA processes and institutions into systematic decision-making.

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

Design and implementation of a risk assessment module in a spatial decision support system

Science.gov (United States)

Zhang, Kaixi; van Westen, Cees; Bakker, Wim

2014-05-01

The spatial decision support system named 'Changes SDSS' is currently under development. The goal of this system is to analyze changing hydro-meteorological hazards and the effect of risk reduction alternatives to support decision makers in choosing the best alternatives. The risk assessment module within the system is to assess the current risk, analyze the risk after implementations of risk reduction alternatives, and analyze the risk in different future years when considering scenarios such as climate change, land use change and population growth. The objective of this work is to present the detailed design and implementation plan of the risk assessment module. The main challenges faced consist of how to shift the risk assessment from traditional desktop software to an open source web-based platform, the availability of input data and the inclusion of uncertainties in the risk analysis. The risk assessment module is developed using Ext JS library for the implementation of user interface on the client side, using Python for scripting, as well as PostGIS spatial functions for complex computations on the server side. The comprehensive consideration of the underlying uncertainties in input data can lead to a better quantification of risk assessment and a more reliable Changes SDSS, since the outputs of risk assessment module are the basis for decision making module within the system. The implementation of this module will contribute to the development of open source web-based modules for multi-hazard risk assessment in the future. This work is part of the "CHANGES SDSS" project, funded by the European Community's 7th Framework Program.

Designing Conservation Corridors in Production Landscapes: Assessment Methods, Implementation Issues, and Lessons Learned

Directory of Open Access Journals (Sweden)

Amanda T. Lombard

2010-09-01

Full Text Available Designing broad-scale conservation corridors has become increasingly common as a way of conducting an assessment for achieving targets for the representation and persistence of nature. However, since many of these corridors must traverse agricultural and other production landscapes, planning and implementation are not trivial tasks. Most approaches to conservation assessments in the dynamic world of production landscapes are data-intensive and analytically complex. However, in the real world, donor and other external requirements impose time and budget constraints, and dictate strong stakeholder involvement in the entire planning process. In order to accommodate this, assessments must be rapid, cheap, and the approach and products must be comprehensible and acceptable to stakeholders. Here we describe such an assessment aimed at identifying and implementing a network of conservation corridors in the Gouritz Initiative project domain of South Africa's Cape Floristic Region hotspot. We used empirical data and expert knowledge to identify a corridor network hypothesized to sustain key ecological and evolutionary processes. We also consulted experts to provide a spatially explicit assessment of the opportunity costs of conservation associated with agriculture, the predominant land use in the region. We used these products to identify categories of land requiring different actions and instruments to achieve conservation goals, thereby moving from the "where" to the "how" of conservation. This information was then fed into the collaborative strategy development process for the Gouritz Initiative. Our discussion emphasizes the lessons that we learnt from undertaking this assessment, particularly lessons regarding the implementation of the planning products. We conclude that at the outset of any planning project, a consensus on the vision must be achieved, a detailed social assessment of appropriate institutions must be undertaken, and a learning

To Assess Prerequisites Before an Implementation Strategy in an Orthopaedic Department in Sweden.

Science.gov (United States)

Bahtsevani, Christel; Idvall, Ewa

2016-01-01

Promoting Action on Research Implementation in Health Services (PARiHS) asserts that the success of knowledge implementation relates to multiple factors in a complex and dynamic way, and therefore the effects of implementation strategies vary by method and context. An instrument based on the PARiHS framework was developed to help assess critical factors influencing implementation strategies so that strategies can be tailored to promote implementation.The purpose of this study was to use the Evaluation Before Implementation Questionnaire (EBIQ), to describe staff perceptions in one orthopaedic department, and to investigate differences between wards.Staff members in four different wards at one orthopaedic department at a university hospital in Sweden were invited to complete a questionnaire related to planning for the implementation of a clinical practice guideline. The 23 items in the EBIQ were expected to capture staff perceptions about the evidence, context, and facilitation factors that influence the implementation process. Descriptive statistics and differences between wards were analyzed. Although the overall response rate was low (n = 49), two of the four wards accounted for most of the completed questionnaires (n = 25 and n = 12, respectively), enabling a comparison of these wards. We found significant differences between respondents' perceptions at the two wards in six items regarding context and facilitation in terms of receptiveness to change, forms of leadership, and evaluation and presence of feedback and facilitators.The EBIQ instrument requires further testing, but there appears to be initial support for pre-implementation use of the EBIQ as a means to enhance planning for implementation.

Students’ Perception toward the Implementation of Peer-Assessment in Writing; Before and After Revision

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Husni Mubarok

2017-10-01

Full Text Available This study was aimed at elaborating students’ perception toward the implementation of peer assessment in writing class either before or after revision. Writing becomes one of skills which should be mastered by students in order to get higher level of literacy. Writing is a productive skill which asks students to arrange words and organize them into good writing which could be understood by readers. The success of writing is determined by the writing process itself starting from planning, first draft writing, revising, and editing. One of the strategies used in teaching writing is by implementing peer assessment. Peer assessment strategy becomes one of important parts in the process of writing because there will be feedback or suggestion from peers in doing a review. The number of the subject of this research was students in second semester of the English Education Department of UNISNU Jepara. This research was conducted on even semester. The total number of the students, which became respondents, was 37 students of English Education Department. The research design used was qualitative research which measured students’ perceptions of the implementation of peer assessment in writing: before and after revision. The result showed that before revision, students had negative perception toward their own writing. After revision, they had positive perceptions toward peer assessment strategy. Those included usefulness and meaningfulness, nature of feedback, reality of feedback, precision, validity, fairness, and personal goal-setting. Besides that, the score after revision (7.9 was higher than the score before revision (6.62. It meant that the result showed the increasing of students’ score after revision.

Balancing Tensions in Educational Policy Reforms: Large-Scale Implementation of Assessment for Learning in Norway

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Hopfenbeck, Therese N.; Flórez Petour, María Teresa; Tolo, Astrid

2015-01-01

This study investigates how different stakeholders in Norway experienced a government-initiated, large-scale policy implementation programme on "Assessment for Learning" ("AfL"). Data were collected through 58 interviews with stakeholders in charge of the policy; Ministers of Education and members of the Directorate of…

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

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Thomas Hadjistavropoulos

2016-01-01

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

Implementing DOE guidance for hazards assessments at Rocky Flats Plant

International Nuclear Information System (INIS)

Zimmerman, G.A.

1993-01-01

Hazards Assessments are performed for a variety of activities and facilities at Rocky Flats Plant. Prior to 1991, there was no guidance for performing Hazards Assessments. Each organization that performed Hazards Assessments used its own methodology with no attempt at standardization. In 1991, DOE published guidelines for the performance of Hazards Assessments for Emergency Planning (DOE-EPG-5500.1, ''Guidance for a Hazards Assessment Methodology''). Subsequently, in 1992, DOE published a standard for the performance of Hazards Assessments (DOE-STD-1027-92, ''Hazard Categorization and Accident Analysis, Techniques for Compliance with DOE Order 5480.23, Nuclear Safety Analysis Reports''). Although these documents are a step in the direction of standardization, there remains a great deal of interpretation and subjective implementation in the performance of Hazards Assessments. Rocky Flats Plant has initiated efforts to develop a uniform and standard process to be used for Hazards Assessments

Identification and assessment of site treatment plan implementation opportunities for emerging technologies

Energy Technology Data Exchange (ETDEWEB)

Bernard, E.A. [Sandia National Labs., Germantown, MD (United States)

1995-12-31

The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumes that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOX{sup sm}, Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE`s mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM`s Office of Technology Development, has funded this work.

Implementation of the natural resource damage assessment rule

International Nuclear Information System (INIS)

1991-11-01

Regulations have been promulgated by the Department of Interior (DOI) which provide an administrative process whereby natural resource trustees may establish the type and extent of injury and evaluate the damages to natural resources. These regulations provide an optional mechanism for Natural Resource Damage Assessments (NRDAs), with four major components. A workshop was held to develop recommendations for DOE-OR regarding implementation of the DOI NRDA regulations at the Oak Ridge Reservation (ORR). The attendants were divided into three working groups to consider (1) administrative/legal requirements, (2) ecological assessments, and (3) the NRDA/economic evaluation process. This report supplies an overview of the DOI NRDA regulations as well as summaries of the consensus of each of the three working groups

Ontology for assessment studies of human-computer-interaction in surgery.

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Machno, Andrej; Jannin, Pierre; Dameron, Olivier; Korb, Werner; Scheuermann, Gerik; Meixensberger, Jürgen

2015-02-01

New technologies improve modern medicine, but may result in unwanted consequences. Some occur due to inadequate human-computer-interactions (HCI). To assess these consequences, an investigation model was developed to facilitate the planning, implementation and documentation of studies for HCI in surgery. The investigation model was formalized in Unified Modeling Language and implemented as an ontology. Four different top-level ontologies were compared: Object-Centered High-level Reference, Basic Formal Ontology, General Formal Ontology (GFO) and Descriptive Ontology for Linguistic and Cognitive Engineering, according to the three major requirements of the investigation model: the domain-specific view, the experimental scenario and the representation of fundamental relations. Furthermore, this article emphasizes the distinction of "information model" and "model of meaning" and shows the advantages of implementing the model in an ontology rather than in a database. The results of the comparison show that GFO fits the defined requirements adequately: the domain-specific view and the fundamental relations can be implemented directly, only the representation of the experimental scenario requires minor extensions. The other candidates require wide-ranging extensions, concerning at least one of the major implementation requirements. Therefore, the GFO was selected to realize an appropriate implementation of the developed investigation model. The ensuing development considered the concrete implementation of further model aspects and entities: sub-domains, space and time, processes, properties, relations and functions. The investigation model and its ontological implementation provide a modular guideline for study planning, implementation and documentation within the area of HCI research in surgery. This guideline helps to navigate through the whole study process in the form of a kind of standard or good clinical practice, based on the involved foundational frameworks

FIRE (facilitating implementation of research evidence: a study protocol

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Seers Kate

2012-03-01

Full Text Available Abstract Background Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids. Objectives This study aims to advance understanding about the contribution facilitation can make to implementing research findings into practice via: extending current knowledge of facilitation as a process for translating research evidence into practice; evaluating the feasibility, effectiveness, and cost-effectiveness of two different models of facilitation in promoting the uptake of research evidence on continence management; assessing the impact of contextual factors on the processes and outcomes of implementation; and implementing a pro-active knowledge transfer and dissemination strategy to diffuse study findings to a wide policy and practice community. Setting and sample Four European countries, each with six long-term nursing care sites (total 24 sites for people aged 60 years and over with documented urinary incontinence Methods and design Pragmatic randomised controlled trial with three arms (standard dissemination and two different programmes of facilitation, with embedded process and economic evaluation. The primary outcome is compliance with the continence recommendations. Secondary outcomes include proportion of residents with incontinence, incidence of incontinence-related dermatitis, urinary tract infections, and quality of life. Outcomes are assessed at baseline

Developing and Implementing an Assessment Technique to Measure Linked Concepts

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Ye, Li; Oueini, Razanne; Lewis, Scott E.

2015-01-01

The links students make among chemistry content is considered essential for a robust, enduring understanding in multiple learning theories. This article describes the development and implementation of an assessment technique, termed a Measure of Linked Concepts, designed to inform instructors on students' understanding of linking content…

Best Implementation Practices: Disseminating New Assessment Technologies in a Juvenile Justice Agency

Science.gov (United States)

Young, Douglas; Moline, Karl; Farrell, Jill; Bierie, David

2006-01-01

Much has been written in recent years about advances in assessment technologies designed to aid decision making in the juvenile justice system. Adoption and implementation of this latest generation of actuarial tools, however, have lagged behind their development. Assessment in juvenile justice exemplifies the "science-practice gap" that…

The multidisciplinary depression guideline for children and adolescents: an implementation study.

Science.gov (United States)

Hermens, Marleen L M; Oud, Matthijs; Sinnema, Henny; Nauta, Maaike H; Stikkelbroek, Yvonne; van Duin, Daniëlle; Wensing, Michel

2015-10-01

It is important that depressed patients receive adequate and safe care as described in clinical guidelines. The aim of this study was to evaluate the implementation of the Dutch depression guideline for children and adolescents, and to identify factors that were associated with the uptake of the guideline recommendations. The study took place in specialised child and adolescent mental healthcare. An implementation project was initiated to enhance the implementation of the guideline. An evaluation study was performed alongside the implementation project, using structured registration forms and interviews with healthcare professionals. Six multidisciplinary teams participated in the implementation study. The records of 655 patients were analysed. After 1 year, 72% of all eligible patients had been screened for depression and 38% were diagnosed with the use of a diagnostic instrument. The severity of the depression was assessed in 77% of the patients during the diagnostic process, and 41% of the patients received the recommended intervention based on the depression severity. Of the patients that received antidepressants, 25% received weekly checks for suicidal thoughts in the first 6 weeks. Monitoring of the patients' response was recorded in 32% of the patients. A wide range of factors were perceived to influence the uptake of guideline recommendations, e.g. the availability of capable professionals, available time, electronic tools and reminders, and the professionals' skills and attitudes. With the involvement of the teams, recommendations were provided for nationwide implementation of the guideline. In conclusion, a systematic implementation programme using stepped care principles for the allocation of depression interventions seems successful, but there remains room for further improvement.

Adapting Certified Safe Farm to North Carolina Agriculture: An Implementation Study.

Science.gov (United States)

Storm, Julia F; LePrevost, Catherine E; Tutor-Marcom, Robin; Cope, W Gregory

2016-01-01

Certified Safe Farm (CSF) is a multimodal safety and health program developed and assessed through multiple controlled intervention studies in Iowa. Although developed with the intent to be broadly applicable to agriculture, CSF has not been widely implemented outside the midwestern United States. This article describes the CSF implementation process in North Carolina (NC), as piloted on a large-scale in three agriculturally diverse and productive counties of NC, and reports its effectiveness using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Implementation involved (1) capacity building through safety and health training, (2) adaptation of components of Iowa's CSF model to NC agriculture, (3) marketing and recruitment, and (4) formative evaluation, including an online survey and focus group discussion. From 2009 to 2012, 113 farms participated in at least one component of the CSF intervention, representing a NC farm participation rate of 3.1% in the study area. A major adaptation of NC implementation was the utilization of NC Cooperative Extension as the local driver of implementation in contrast to local AgriSafe clinics in Iowa. The most innovative adaptation to CSF components was the development of a defined economic incentive in the form of a cost-share program. The RE-AIM framework was found to be useful and relevant to the field of agricultural health and safety translational research. This study provides effectiveness measures and implementation alternatives useful for those considering implementing CSF. It informs current efforts to move CSF from research to practice through the National Sustainable Model CSF Program initiative.

An Analysis of Campus Violence Threat Assessment Policy Implementation at Michigan Community Colleges

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Panico, Russell T., Jr.

2016-01-01

This dissertation evaluated campus violence threat assessment policy and procedure implementation at the community college level of higher education. The importance of this topic was to provide a manageable and collaborative initiative for leadership at institutions of higher learning to identify, develop, implement, and evaluate a policy that can…

An assessment of maternal, newborn and child health implementation studies in Nigeria: implications for evidence informed policymaking and practice

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Chigozie Jesse Uneke

2016-08-01

Full Text Available Background: The introduction of implementation science into maternal, newborn and child health (MNCH research has facilitated better methods to improve uptake of research findings into practices. With increase in implementation research related to MNCH world-wide, stronger scientific evidence are now available and have improved MNCH policies in many countries including Nigeria. The purpose of this study was to review MNCH implementation studies undertaken in Nigeria in order to understand the extent the evidence generated informed better policy. Methods: This study was a systematic review. A MEDLINE Entrez PubMed search was performed in August 2015 and implementation studies that investigated MNCH in Nigeria from 1966 to 2015 in relation to health policy were sought. Search key words included Nigeria, health policy,maternal, newborn, and child health. Only policy relevant studies that were implementation or intervention research which generated evidence to improve MNCH in Nigeria were eligible and were selected. Results: A total of 18 relevant studies that fulfilled the study inclusion criteria were identified out of 471 studies found. These studies generated high quality policy relevance evidence relating to task shifting, breastfeeding practices, maternal nutrition, childhood immunization, kangaroo mother care (KMC, prevention of maternal to child transmission of HIV, etc. These indicated significant improvements in maternal health outcomes in localities and health facilities where the studies were undertaken. Conclusion: There is a dire need for more implementation research related to MNCH in low income settings because the priority for improved MNCH outcome is not so much the development of new technologies but solving implementation issues, such as how to scale up and evaluate interventions within complex health systems.

Analyzing the Issues in the Implementation of Authentic Assessment in the 2013 Curriculum

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Abna Hidayati

2017-02-01

Full Text Available The  implemention of authentic assessment  in the   2013 Ccurriculum  has been encountered by various challenges. Teacher have to use numerious instruments, which made them quite which are regarded more complicated. this study focused on the analysis of issues experienced by teachers in implementingng theauthentic assessment within the 2013 curriculum. This study used quantitatif method in which questionnaire was  distributed to the teachers. Population included all teachers in Padang whose schools are applying the 2013 curriculum. 120 teacher were randomly taken as the sample.  The results show that in terms of the affective aspect, the teachers had not yet been optimal in conducting self- and peer assessment for the students, thus the further improvement is seriously recomended. In light of the the cognitive aspect, the teachers had done a very good assessment. They had made a variety of assessment types, especially in the essay and oral tests. However, the assessment of psychomotor aspect was not also optimally done need some improvement. From these results, it is hoped that the teachers can further enhance the assessment procedures of the three criteria for better learning outcomes. The school principals should be able to create opportunities for the teachers to take training in the Applying authentic assessment.

Implementation of computerized physician order entry in National Guard Hospitals: assessment of critical success factors.

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Altuwaijri, Majid M; Bahanshal, Abdullah; Almehaid, Mona

2011-09-01

The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE) system in a leading healthcare organization in Saudi Arabia. The National Guard Health Affairs (NGHA) deployed the CPOE in a pilot department, which was the intensive care unit (ICU) in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs) that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The "before go-live training", the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at risk and to learn from mistakes before expanding the system to other

Implementation of computerized physician order entry in National Guard hospitals: Assessment of critical success factors

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Majid M Altuwaijri

2011-01-01

Full Text Available Objective: The purpose of this study is to describe the needs, process and experience of implementing a computerized physician order entry (CPOE system in a leading healthcare organization in Saudi Arabia. Materials and Methods: The National Guard Health Affairs (NGHA deployed the CPOE in a pilot department, which was the intensive care unit (ICU in order to assess its benefits and risks and to test the system. After the CPOE was implemented in the ICU area, a survey was sent to the ICU clinicians to assess their perception on the importance of 32 critical success factors (CSFs that was acquired from the literature. The project team also had several meetings to gather lessons learned from the pilot project in order to utilize them for the expansion of the project to other NGHA clinics and hospitals. Results: The results of the survey indicated that the selected CSFs, even though they were developed with regard to international settings, are very much applicable for the pilot area. The top three CSFs rated by the survey respondents were: The "before go-live" training, the adequate clinical resources during implementation, and the ordering time. After the assessment of the survey and the lessons learned from the pilot project, NGHA decided that the potential benefits of the CPOE are expected to be greater the risks expected. The project was then expanded to cover all NGHA clinics and hospitals in a phased approach. Currently, the project is in its final stages and expected to be completed by the end of 2011. Conclusion: The role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care. In spite of their great benefits, many studies suggest that a high percentage of these projects fail. In order to increase the chances of success and due to the fact that CPOE is a clinical system, NGHA implemented the system first in a pilot area in order to test the system without putting patients at

An Approach for the Development and Implementation of an Assessment Tool for Interprofessional Education Learning Activities

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Lisa Salvati

2017-10-01

Full Text Available The Accreditation Council for Pharmacy Education Standards 2016 state that colleges of pharmacy must assess student achievement and readiness to contribute as a member of an interprofessional collaborative patient care team. There are a limited number of assessment tools available to achieve this part of the Standards. The purpose of this Case Study Report is to describe the process that one college of pharmacy took to develop an interprofessional education (IPE assessment tool to be used for their longitudinal assessment approach for IPE in the didactic portion of the curriculum. Strategies for the development of an assessment tool are provided through three themes: continuous refinement, collaboration and streamlining. Next steps for the implementation of the assessment tool, as well as evaluating its validity and reliability, are discussed.   Type: Case Study

An assessment of option B implementation for the prevention of ...

African Journals Online (AJOL)

An assessment of option B implementation for the prevention of mother to child transmission in Dschang, Cameroon: results from the DREAM (Drug Resource ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader).

Development, validation and implementation of a quantitative food frequency questionnaire to assess habitual vitamin D intake

DEFF Research Database (Denmark)

Kiely, M.; Collins, A.; Lucey, A. J.

2016-01-01

Background A well-designed, validated quantitative food frequency questionnaire (FFQ) could offer an efficient and cost-effective method for assessing habitual vitamin D intake. The present study aimed to describe the development, validation and implementation of a vitamin D FFQ. Methods National...

Safety assessment in plant layout design using indexing approach: Implementing inherent safety perspective

International Nuclear Information System (INIS)

Tugnoli, Alessandro; Khan, Faisal; Amyotte, Paul; Cozzani, Valerio

2008-01-01

Layout planning plays a key role in the inherent safety performance of process plants since this design feature controls the possibility of accidental chain-events and the magnitude of possible consequences. A lack of suitable methods to promote the effective implementation of inherent safety in layout design calls for the development of new techniques and methods. In the present paper, a safety assessment approach suitable for layout design in the critical early phase is proposed. The concept of inherent safety is implemented within this safety assessment; the approach is based on an integrated assessment of inherent safety guideword applicability within the constraints typically present in layout design. Application of these guidewords is evaluated along with unit hazards and control devices to quantitatively map the safety performance of different layout options. Moreover, the economic aspects related to safety and inherent safety are evaluated by the method. Specific sub-indices are developed within the integrated safety assessment system to analyze and quantify the hazard related to domino effects. The proposed approach is quick in application, auditable and shares a common framework applicable in other phases of the design lifecycle (e.g. process design). The present work is divided in two parts: Part 1 (current paper) presents the application of inherent safety guidelines in layout design and the index method for safety assessment; Part 2 (accompanying paper) describes the domino hazard sub-index and demonstrates the proposed approach with a case study, thus evidencing the introduction of inherent safety features in layout design

Do implementation strategies increase adherence to pain assessment in hospitals? A systematic review

NARCIS (Netherlands)

Ista, E.; Dijk, M. van; Achterberg, T. van

2013-01-01

OBJECTIVES: Pain assessment and reassessment is an essential part of the treatment of hospitalised patients and must be integrated in pain management protocols. Yet nurses' adherence to pain assessment recommendations is problematic. We sought to review the comparative evidence for implementation

Teacher Preparedness in the Implementation of the Integrated Business Studies Curriculum in Public Secondary Schools in Kenya

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Jerotich, Florah; Kurgat, Susan J.; Kimutai, Chris K.

2017-01-01

The main purpose of this paper was to assess teacher preparedness in the implementation of the integrated Business Studies curriculum in public secondary schools in Kenya. Specifically, the study sought to: find out the level of preservice training of the Business Studies teachers implementing the integrated Business Studies curriculum and to find…

The Implementation of Pain Management and Assessment in Neonatal Intensive Care Units of Teaching Hospitals Affiliated to Tehran University of Medical Sciences

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O Rahimi

2017-06-01

Full Text Available BACKGROUND AND OBJECTIVE: Neonatal pain causes changes in the structure and function of brain in addition to acute physiologic symptoms and is followed by delayed development of infants. This study aims to determine the implementation of pain management and assessment in neonatal intensive care units. METHODS: This cross-sectional study was conducted among 138 nurses working in neonatal intensive care units through census. The data were collected using researcher – made questionnaire including two parts: pain management and assessment and demographic information. The minimum and maximum scores were 0 and 552, respectively, shown in the form of percentage. FINDINGS: At a response rate of 80.23%, the mean age of participants was 31.76±5.41 years and the mean experience of nurses working in a neonatal intensive care unit was 4.36 ± 3.58 years. The cases of implementation of pain management and assessment were as follows: care management for pain reduction (72.8%, allow parents to relieve pain (68.5%, swaddling (66.7%, pain assessment while implementing therapeutic and caring measures (62.9%, the use of sucrose solution (61.6%, teaching parents about observing pain symptoms in the infant’s face (58.7%, recording infant’s pain behaviors and the method for relieving the pain (52.4%, pain assessment at least every 4 hours (52.2% and the use of valid tools for pain assessment (36.8%. CONCLUSION: According to the results of this study, pain management and assessment was implemented in more than half of the cases.

ASSESSMENT OF GUESTS’ PERCEPTION IN IMPLEMENTATION OF GREEN HOTEL IN SUPPORTING SUSTAINABLE TOURISM

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I Gusti Ayu Oka - Suryawardani

2016-03-01

Full Text Available Tourism industry faced by threats in implementing sustainable tourism development. UNEP (United Nation Environmental Programme designs the concept to gain sustainable development through the program called the greening of industry which includes minimization of energy used, reducing green house emission, water consumption efficiency, waste management, reducing loss of biological diversity, and preserving cultural heritage. Dependency of tourism industry in using energy will impact in global warming and climate change which will lead to sustainability of the future of tourism development. The research was designed to assess guests’ perception on implementation of green hotel in supporting sustainable tourism in Bali. Research was undertaken in DKP hotel which is located in Kuta, Bali in the periods of April-June 2011. The hotel was choosen because DKP hotel is one of the hotels in Bali that has implemented the concept of green hotel in the hotel operational and was awarded as Green Hotel Award in the year of 2010. Sample was designed based on the minimum criteria on using Structural Equation Modelling (SEM. Respondents were guests who stay in the hotel and were willing to be interviewed and fill-in the questionnaires. The number of respondents were 121. Assessing guests’ perception was undertaken based on five-point Likert rating scale and relationship between variables which express level of concern of hotel management on the environment conservation, social-culture preservation and economic development were analyzed by using Software AMOS Version 23. The results show that assessment of guests’ perception in implementation of green hotel in the hotel operational through conservation of environment and preserving social and culture and its impact on economis development was positip and has resulted in supporting sustainable tourism. Environmental conservation awarenesss has been implemented through energy and water efficiency, waste

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

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Hagedorn Hildi J

2010-06-01

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

Assessing the Organizational Characteristics Influencing Quality Improvement Implementation in Saudi Hospitals.

Science.gov (United States)

Shamsuddin Alaraki, Mohammad

The health care system in Saudi Arabia has serious problems with quality and safety that can be reduced through systematic quality improvement (QI) activities. Despite the use of different QI models to improve health care in Saudi hospitals during the last 2 decades, consistent improvements have not yet been achieved and the results are still far below expectations. This may reflect a problem in introducing and implementing the QI models in the local contexts. The objective of this study is to assess the extent of QI implementation in Saudi hospitals and to identify the organizational characteristics that make Saudi hospitals particularly challenging for QI. Understanding these characteristics can inform efforts to improve them and may lead to more successful implementation. A mixed-methods approach was conducted using 2 data collection tools: questionnaires and interviews. The quantitative phase (questionnaires) aimed to uncover the current level of QI implementation in Saudi hospital as measured by 7 critical dimensions adapted from the literature. The qualitative phase (interviews) aimed to understand the organizational characteristics that impede or underpin QI in Saudi hospitals. The QI implementation was found to be significantly poor across the 7 dimensions with average score ranging between 22.80 ± 0.57 and 2.11 ± 0.69 on a 5-point Likert scale and with P value of less than .05. We also found that the current level of QI implementation helped Saudi hospitals neither to improve "customer satisfaction" nor to achieve measurable improvements in "quality results" scoring significantly low at 2.11 ± 0.69 with P value of .000 and 2.47 ± 0.57 with P value of .000, respectively. Our study confirms the presence of a multitude of organizational barriers that impede QI in Saudi hospitals. These are related to organizational culture, human resources management, processes and systems, and structure. These 4 were found to have the strongest impact on QI in Saudi

An assessment of option B implementation for the prevention of ...

African Journals Online (AJOL)

An assessment of option B implementation for the prevention of mother to child transmission in Dschang, Cameroon: results from the DREAM (Drug Resource Enhancement against AIDS and ... Those with a CD4 count <350 cells/mm3 during pregnancy had the highest mortality risk (RR 2.53; 95% CL= 1.86-3.44). The HIV ...

Assessing Server Fault Tolerance and Disaster Recovery Implementation in Thin Client Architectures

National Research Council Canada - National Science Library

Slaydon, Samuel L

2007-01-01

This thesis will focus on assessing server fault tolerance and disaster recovery procedures for thin-clients being implemented in smart classrooms and computer laboratories aboard the Naval Postgraduate School campus...

SUPPORTING TEACHERS IN IMPLEMENTING FORMATIVE ASSESSMENT PRACTICES IN EARTH SYSTEMS SCIENCE

Science.gov (United States)

Harris, C. J.; Penuel, W. R.; Haydel Debarger, A.; Blank, J. G.

2009-12-01

An important purpose of formative assessment is to elicit student thinking to use in instruction to help all students learn and inform next steps in teaching. However, formative assessment practices are difficult to implement and thus present a formidable challenge for many science teachers. A critical need in geoscience education is a framework for providing teachers with real-time assessment tools as well as professional development to learn how to use formative assessment to improve instruction. Here, we describe a comprehensive support system, developed for our NSF-funded Contingent Pedagogies project, for addressing the challenge of helping teachers to use formative assessment to enhance student learning in middle school Earth Systems science. Our support system is designed to improve student understanding about the geosphere by integrating classroom network technology, interactive formative assessments, and contingent curricular activities to guide teachers from formative assessment to instructional decision-making and improved student learning. To accomplish this, we are using a new classroom network technology, Group Scribbles, in the context of an innovative middle-grades Earth Science curriculum called Investigating Earth Systems (IES). Group Scribbles, developed at SRI International, is a collaborative software tool that allows individual students to compose “scribbles” (i.e., drawings and notes), on “post-it” notes in a private workspace (a notebook computer) in response to a public task. They can post these notes anonymously to a shared, public workspace (a teacher-controlled large screen monitor) that becomes the centerpiece of group and class discussion. To help teachers implement formative assessment practices, we have introduced a key resource, called a teaching routine, to help teachers take advantage of Group Scribbles for more interactive assessments. Routine refers to a sequence of repeatable interactions that, over time, become

Reporting on the Strategies Needed to Implement Proven Interventions: An Example From a "Real-World" Cross-Setting Implementation Study.

Science.gov (United States)

Gold, Rachel; Bunce, Arwen E; Cohen, Deborah J; Hollombe, Celine; Nelson, Christine A; Proctor, Enola K; Pope, Jill A; DeVoe, Jennifer E

2016-08-01

The objective of this study was to empirically demonstrate the use of a new framework for describing the strategies used to implement quality improvement interventions and provide an example that others may follow. Implementation strategies are the specific approaches, methods, structures, and resources used to introduce and encourage uptake of a given intervention's components. Such strategies have not been regularly reported in descriptions of interventions' effectiveness, or in assessments of how proven interventions are implemented in new settings. This lack of reporting may hinder efforts to successfully translate effective interventions into "real-world" practice. A recently published framework was designed to standardize reporting on implementation strategies in the implementation science literature. We applied this framework to describe the strategies used to implement a single intervention in its original commercial care setting, and when implemented in community health centers from September 2010 through May 2015. Per this framework, the target (clinic staff) and outcome (prescribing rates) remained the same across settings; the actor, action, temporality, and dose were adapted to fit local context. The framework proved helpful in articulating which of the implementation strategies were kept constant and which were tailored to fit diverse settings, and simplified our reporting of their effects. Researchers should consider consistently reporting this information, which could be crucial to the success or failure of implementing proven interventions effectively across diverse care settings. clinicaltrials.gov Identifier: NCT02299791. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Adapting the Quebecois method for assessing implementation to the French National Alzheimer Plan 2008–2012: lessons for gerontological services integration

Directory of Open Access Journals (Sweden)

Dominique Somme

2014-06-01

Full Text Available Introduction: Many countries face ageing-related demographic and epidemiological challenges, notably neurodegenerative disorders, due to the multiple care services they require, thereby pleading for a more integrated system of care. The integrated Quebecois method issued from the Programme of Research to Integrate Services for the Maintenance of Autonomy inspired a French pilot experiment and the National Alzheimer Plan 2008–2012. Programme of Research to Integrate Services for the Maintenance of Autonomy method implementation was rated with an evaluation grid adapted to assess its successive degrees of completion.Discussion: The approaching end of the president's term led to the method's institutionalization (2011–2012, before the implementation study ended. When the government changed, the study was interrupted. The results extracted from that ‘lost’ study (presented herein have, nonetheless, ‘found’ some key lessons.Key lessons/conclusion: It was possible to implement a Quebecois integrated-care method in France. We describe the lessons and pitfalls encountered in adapting this evaluation tool. This process is necessarily multidisciplinary and requires a test phase. A simple tool for quantitative assessment of integration was obtained. The first assessment of the tool was unsatisfactory but requires further studies. In the meantime, we recommend using mixed methodologies to assess the services integration level.

Adapting the Quebecois method for assessing implementation to the French National Alzheimer Plan 2008–2012: lessons for gerontological services integration

Directory of Open Access Journals (Sweden)

Dominique Somme

2014-06-01

Full Text Available Introduction: Many countries face ageing-related demographic and epidemiological challenges, notably neurodegenerative disorders, due to the multiple care services they require, thereby pleading for a more integrated system of care. The integrated Quebecois method issued from the Programme of Research to Integrate Services for the Maintenance of Autonomy inspired a French pilot experiment and the National Alzheimer Plan 2008–2012. Programme of Research to Integrate Services for the Maintenance of Autonomy method implementation was rated with an evaluation grid adapted to assess its successive degrees of completion. Discussion: The approaching end of the president's term led to the method's institutionalization (2011–2012, before the implementation study ended. When the government changed, the study was interrupted. The results extracted from that ‘lost’ study (presented herein have, nonetheless, ‘found’ some key lessons. Key lessons/conclusion: It was possible to implement a Quebecois integrated-care method in France. We describe the lessons and pitfalls encountered in adapting this evaluation tool. This process is necessarily multidisciplinary and requires a test phase. A simple tool for quantitative assessment of integration was obtained. The first assessment of the tool was unsatisfactory but requires further studies. In the meantime, we recommend using mixed methodologies to assess the services integration level.

Implementation and assessment of improved models and options in TRAC-BF1

International Nuclear Information System (INIS)

Analytis, G.Th.

1996-07-01

A summary of modifications and options introduced in TRAC-BF1 is presented and it is shown that the predicting capabilities of the modified version of the core are greatly improved. These changes include the introduction of a different heat transfer package during reflooding, the implementation of a simple single-phase limit procedure for forcing the two phases to acquire the same velocity if one phase disappears, a close assessment of the annular flow interfacial shear correlation, implementation of a simple radiation model which seems to alleviate some numerical-oscillations problems induced by the existing highly complex model. Furthermore, different options were introduced and tested like upwinding some terms of the momentum equations (which seems to solve a number of problems reported in the past), the second upwind scheme for the convective terms of the phasic momentum equations and the implementation and assessment of a completely different annular flow interfacial shear correlation. The modified TRAC-BF1 is assessed against some bottom-flooding separate-effect experiments, a 'benchmark' top flooding simulation as well as against the TLTA test Nr. 6423. In the process of this task, the different options are assessed and discussed and is shown that the predictions of the modified code are physically sound and close to the measurements, while almost all the predicted variables are free of unphysical spurious oscillations. The modifications introduced solve a number of problems associated with the frozen version of the code and result in a version which can be confidently used for LB-LOCA analyses. (author) 19 figs., 16 refs

A framework for assessing cost management system changes: the case of activity-based costing implementation at food industry

Directory of Open Access Journals (Sweden)

Tayebeh Faraji

2015-04-01

Full Text Available An opportunity to investigate the technical and organizational effect of management accounting system changes has appeared with companies' adoption of activity-based costing (ABC. This paper presents an empirical investigation to study the effects of ABC system for case study from food industry in Iran. From this case, the paper develops a framework for assessing ABC implementation and hypotheses about factors that influence implementation. The study detects five cost centers and for each cost center, it determines different cost drivers. The results of our survey has detected that implementation of ABC system not only helps precise allocation of overhead costs but also helps internal management companies for better planning and control of production, making better decisions for company's profits.

Design and Implementation of the Automatic Assessment System for the Command and Control Specialty in Ships

Directory of Open Access Journals (Sweden)

Zhang Hao

2017-01-01

Full Text Available On the basis of analyzing the actual demand of automated assessment system for the command and control specialty in ships, the thought of the overall design of automated assessment system for the command and control specialty in ships is given, and the concrete realization methods of the user login module, test paper operation module and system maintenance module are studied and demonstrated. The proposed design idea and implementation method of automated assessment system for the command and control specialty in ships is scientific, efficient and practical, and provides reference for the exploitation of automated assessment system for the command and control specialty in ships.

The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study.

Science.gov (United States)

van der Krieke, Lian; Bird, Victoria; Leamy, Mary; Bacon, Faye; Dunn, Rebecca; Pesola, Francesca; Janosik, Monika; Le Boutillier, Clair; Williams, Julie; Slade, Mike

2015-05-23

Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility (SAFE) measure is a standardised assessment of implementation blocks and enablers. The aim of this study was to characterise and compare the implementation blocks and enablers for recommended psychosis interventions. SAFE was used to evaluate and compare three groups of interventions recommended in the 2014 NICE psychosis guideline: pharmacological (43 trials testing 5 interventions), psychosocial (65 trials testing 5 interventions), and recovery (19 trials testing 5 interventions). The 127 trial reports rated with SAFE were supplemented by published intervention manuals, research protocols, trial registrations and design papers. Differences in the number of blocks and enablers across the three interventions were tested statistically, and feasibility profiles were generated. There was no difference between psychosocial and recovery interventions in the number of blocks or enablers to implementation. Pharmacological interventions (a) had fewer blocks than both psychosocial interventions (χ (2)(3) = 133.77, p Feasibility profiles show that pharmacological interventions are relatively easy to implement but can sometimes involve risks. Psychosocial and recovery interventions are relatively complex but tend to be more flexible and more often manualised. SAFE ratings can contribute to tackling the current implementation challenges in mental health services, by providing a reporting guideline structure for researchers to maximise the potential for implementation and by informing prioritisation decisions by clinical guideline developers and service managers.

A Critical Assessment on SPC Implementation in the UK Food Industry

Directory of Open Access Journals (Sweden)

Sarina Abdul Halim Lim

2016-02-01

Full Text Available Statistical process control (SPC is one of the most widely applied techniques to control and improve processes in manufacturing industry, but very few studies have reported on the successful application of SPC in the food industry. This paper aims to critically assess the status of SPC in the UK food manufacturing industry and suggests avenues for future research. By surveying the UK food-manufacturing companies, forty-five percent of them were identified implemented SPC, with x-R and x-S charts found to be the most commonly applied SPC charts in this industry. Top management commitment was identified as the most critical factor, while lack of SPC training is the most significant challenge and lack of awareness of SPC as the main reason for food manufacturing companies not implementing SPC. The paper provides information to food companies in the UK on most common practiced and useful quality tools, SPC charts and critical success factors in the food industry. Furthermore, based on the process performance parameters, SPC companies were observed to achieving better results compared to non-SPC companies.

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…

Effects of Coaching on the Implementation of Functional Assessment-Based Parent Intervention in Reducing Challenging Behaviors

Science.gov (United States)

Fettig, Angel; Schultz, Tia R.; Sreckovic, Melissa A.

2015-01-01

This study examined the effects of coaching on the implementation of functional assessment--based parent intervention in reducing children's challenging behaviors. A multiple baseline across participants design was used with three parent-child dyads with children between the ages of 2 and 5 years. The intervention consisted of training and delayed…

Strategic environmental assessment implementation in China - Five-year review and prospects

International Nuclear Information System (INIS)

Wu Jing; Chang, I-Shin; Bina, Olivia; Lam, Kin-Che; Xu He

2011-01-01

Through literature review and questionnaire survey, the purpose of this study is to understand current status and major fields of SEA implementation in China, and then to provide advice for future improvement of SEA system, according to objective evaluation of the effectiveness of SEA implementation. Major types and fields of SEA implementation were firstly studied to conclude that the attitude of decision-makers and competent authority of SEA implementation does generate direct impacts on SEA implementation. Current status of SEA implementation were then studied, in terms of timing, techniques and methodologies, public participation, information disclosure, alternative, and review organization, to conclude that SEA implementation in China is 'impact-based SEA' and the major problems of SEA implementation are resulted from deficient and defective management of SEA system, such as laws, regulations, and means of management. In order to have objective evaluation on the effectiveness of SEA implementation, to understand good practice of SEA implementation, and to provide advice for future improvement of SEA system, it is necessary to establish reasonable and feasible evaluation criteria for the effectiveness of SEA implementation, based upon foreign experience and political, legislative, administrative and cultural characteristics of China. Various types and stages of SEA should be carefully considered to be included into the evaluation criteria for the effectiveness of SEA implementation.

Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS).

Science.gov (United States)

Ehrhart, Mark G; Aarons, Gregory A; Farahnak, Lauren R

2014-10-23

Although the importance of the organizational environment for implementing evidence-based practices (EBP) has been widely recognized, there are limited options for measuring implementation climate in public sector health settings. The goal of this research was to develop and test a measure of EBP implementation climate that would both capture a broad range of issues important for effective EBP implementation and be of practical use to researchers and managers seeking to understand and improve the implementation of EBPs. Participants were 630 clinicians working in 128 work groups in 32 US-based mental health agencies. Items to measure climate for EBP implementation were developed based on past literature on implementation climate and other strategic climates and in consultation with experts on the implementation of EBPs in mental health settings. The sample was randomly split at the work group level of analysis; half of the sample was used for exploratory factor analysis (EFA), and the other half was used for confirmatory factor analysis (CFA). The entire sample was utilized for additional analyses assessing the reliability, support for level of aggregation, and construct-based evidence of validity. The EFA resulted in a final factor structure of six dimensions for the Implementation Climate Scale (ICS): 1) focus on EBP, 2) educational support for EBP, 3) recognition for EBP, 4) rewards for EBP, 5) selection for EBP, and 6) selection for openness. This structure was supported in the other half of the sample using CFA. Additional analyses supported the reliability and construct-based evidence of validity for the ICS, as well as the aggregation of the measure to the work group level. The ICS is a very brief (18 item) and pragmatic measure of a strategic climate for EBP implementation. It captures six dimensions of the organizational context that indicate to employees the extent to which their organization prioritizes and values the successful implementation of EBPs

Implementing the Stochastic Model of Safety Assessment for the T.D.P. Plume Model

International Nuclear Information System (INIS)

Hurtado, A.; Eguilior, S.; Recreo, F.

2015-01-01

In this paper, it is continued with the first phase of the implementation of the ABACO2G methodology (Application of Bayes to CO2 Geological Storage ) which is a new methodological approach to solving the problem related with the determination of probabilistic component of CO2 geological storage risk assessment, through the application of Bayesian networks and MonteCarlo probability. This in itself is a fundalmental but complex task, inasmuch as the risk assessment requires the identification of those system performance influence variables and the probability distribution of occurrence of defined events, which is highly difficult when there is no significant casuistry and/or fully developed events. On this, at this stage it has been studied the CO2 plume stochastic evolution implementation during the injection period. This is an essential task because the CO2 geologic storage risks will rely primarily on the convolution of the CO2 plume wavefront probability function with the probability functions of system risk elements, such as wells or faults, that define the event space to estimate the CO2 geologic storage risks.

IMPLEMENTING HEALTH TECHNOLOGY ASSESSMENT-BASED RECOMMENDATIONS IN FINLAND

DEFF Research Database (Denmark)

Sihvo, Sinikka; Ikonen, Tuija; Mäkelä, Marjukka

2017-01-01

Objectives: The Managed Uptake of Medical Methods Program (MUMM) started 10 years ago as a joint venture of the Finnish Office for Health Technology Assessment (Finohta) and the twenty hospital districts in Finland. The aim is to offer information on the effectiveness, safety, organizational...... in decision making. Conclusions: HTA-based MUMM recommendations were well received by physicians but in practice they are less used than clinical practice guidelines. Short-form electronic surveys were a useful way of gathering information about awareness and implementation. The surveys also functioned...... as another method of informing key physicians about the recommendations....

Assessment of the implementation risks for ALFRED demonstrator

International Nuclear Information System (INIS)

Constantin, M.; Diaconu, D.

2016-01-01

The risks related to the implementation of ALFRED demonstrator in Romania are discussed. The assessment is based on the risk matrix approach. Two groups of experts were used in the investigation: participants in FP7 ARCADIA projects and members of the FALCON consortium. The results consist of the hierarchy of the risks obtained based on the appreciations of the two groups. They are comparatively presented and discussed in terms of the identified critical risks and possible measures for prevention and mitigation. Additionally, some elements derived from the experience of similar project such as SUSEN and ELI-NP are discussed. (authors)

Impact of the implementation of electronic guidelines for cardiovascular prevention in primary care: study protocol

Directory of Open Access Journals (Sweden)

Eva Comin

2013-03-01

Full Text Available Background The electronic medical records software of the Catalan Institute of Health has recently incorporated an electronic version of clinical practice guidelines (e-CPGs. This study aims to assess the impact of the implementation of e-CPGs on the diagnosis, treatment, control and management of hypercholesterolaemia, diabetes mellitus type 2 and hypertension.Methods Eligible study participants are those aged 35–74 years assigned to family practitioners (FPs of the Catalan Institute of Health. Routinely collected data from electronic primary care registries covering 80% of the Catalan population will be analysed using two approaches: (1 a cross-sectional study to describe the characteristics of the sample before e-CPG implementation; (2 a controlled before-and-after study with 1-year follow-up to ascertain the effect of e-CPG implementation. Patients of FPs who regularly use the e-CPGs will constitute the intervention group; the control group will comprise patients assigned to FPs not regularly using the e-CPG. The outcomes are: (1 suspected and confirmed diagnoses, (2 control of clinical variables, (3 requests for tests and (4 proportions of patients with adequate drug prescriptions.Results This protocol should represent a reproducible process to assess the impact of the implementation of e-CPGs. We anticipate reporting results in late 2013.Conclusion This project will assess the effectiveness of e-CPGs to improve clinical decisions and healthcare procedures in the three disorders analysed. The results will shed light on the use of evidence-based medicine to improve clinical practice of FPs.

Evaluation of an Efficient Method for Training Staff to Implement Stimulus Preference Assessments

Science.gov (United States)

Roscoe, Eileen M.; Fisher, Wayne W.

2008-01-01

We used a brief training procedure that incorporated feedback and role-play practice to train staff members to conduct stimulus preference assessments, and we used group-comparison methods to evaluate the effects of training. Staff members were trained to implement the multiple-stimulus-without-replacement assessment in a single session and the…

Joint implementation: a pioneer mechanism within the limits of emissions - Climate study nr 33

International Nuclear Information System (INIS)

Shishlov, Igor; Bellassen, Valentin; Leguet, Benoit

2012-02-01

The authors first notice that much has been written about the Clean Development mechanism defined in the Kyoto protocol, but also that the Joint Implementation mechanism has an always increasing importance. Provided that always more countries would adopt greenhouse gas emissions thresholds and the Joint Implementation after the Durban conference, they analyse the Joint Implementation mechanism operation in comparison with the Clean Development mechanism. They address the economic and environmental background of the Joint Implementation. Then, they analyse quantitative aspects of this mechanism, develop a model for the assessment of the potential offer in carbon credits. They discuss the qualitative aspects of the Joint Implementation mechanism: environmental integrity, double accounting, perceived concurrence of national climate policies. Case studies are presented (Russia, Ukraine, France, EU, etc.)

Research lessons from implementing a national nursing workforce study.

Science.gov (United States)

Brzostek, T; Brzyski, P; Kózka, M; Squires, A; Przewoźniak, L; Cisek, M; Gajda, K; Gabryś, T; Ogarek, M

2015-09-01

National nursing workforce studies are important for evidence-based policymaking to improve nursing human resources globally. Survey instrument translation and contextual adaptation along with level of experience of the research team are key factors that will influence study implementation and results in countries new to health workforce studies. This study's aim was to describe the pre-data collection instrument adaptation challenges when designing the first national nursing workforce study in Poland while participating in the Nurse Forecasting: Human Resources Planning in Nursing project. A descriptive analysis of the pre-data collection phase of the study. Instrument adaptation was conducted through a two-phase content validity indexing process and pilot testing from 2009 to September 2010 in preparation for primary study implementation in December 2010. Means of both content validation phases were compared with pilot study results to assess for significant patterns in the data. The initial review demonstrated that the instrument had poor level of cross-cultural relevance and multiple translation issues. After revising the translation and re-evaluating using the same process, instrument scores improved significantly. Pilot study results showed floor and ceiling effects on relevance score correlations in each phase of the study. The cross-cultural adaptation process was developed specifically for this study and is, therefore, new. It may require additional replication to further enhance the method. The approach used by the Polish team helped identify potential problems early in the study. The critical step improved the rigour of the results and improved comparability for between countries analyses, conserving both money and resources. This approach is advised for cross-cultural adaptation of instruments to be used in national nursing workforce studies. Countries seeking to conduct national nursing workforce surveys to improve nursing human resources policies may

Case Study Report about Gender Impact Assessment

DEFF Research Database (Denmark)

Faber, Stine Thidemann; Agustin, Lise Rolandsen

2013-01-01

The aim of this national case study report is to take a closer look at the use of Gender Impact Assessments in Denmark in order to describe the Danish implementation of this specific Gender Mainstreaming method. By way of analyzing two selected cases (two law proposals put forward by The Danish...... Ministry of Employment and the Danish Ministry of Transport, respectively) the aim is to assess the transformative potential of GIA as it is performed in Denmark....

Experience in the implementation of quality assurance program and safety culture assessment of research reactor operation and maintenance

International Nuclear Information System (INIS)

Syarip; Suryopratomo, K.

2001-01-01

The implementation of quality assurance program and safety culture for research reactor operation are of importance to assure its safety status. It comprises an assessment of the quality of both technical and organizational aspects involved in safety. The method for the assessment is based on judging the quality of fulfillment of a number of essential issues for safety i.e. through audit, interview and/or discussions with personnel and management in plant. However, special consideration should be given to the data processing regarding the fuzzy nature of the data i.e. in answering the questionnaire. To accommodate this situation, the SCAP, a computer program based on fuzzy logic for assessing plant safety status, has been developed. As a case study, the experience in the assessment of Kartini research reactor safety status shows that it is strongly related to the implementation of quality assurance program in reactor operation and awareness of reactor operation staffs to safety culture practice. It is also shown that the application of the fuzzy rule in assessing reactor safety status gives a more realistic result than the traditional approach. (author)

Developing and implementing an oral care policy and assessment tool.

LENUS (Irish Health Repository)

Stout, Michelle

2012-01-09

Oral hygiene is an essential aspect of nursing care. Poor oral care results in patients experiencing pain and discomfort, puts individuals at risk of nutritional deficiency and infection, and has an adverse effect on quality of life. This article describes how an oral care policy and assessment tool were updated to ensure the implementation of evidence-based practice at one hospital in the Republic of Ireland.

Risk assessment for enterprise resource planning (ERP) system implementations: a fault tree analysis approach

Science.gov (United States)

Zeng, Yajun; Skibniewski, Miroslaw J.

2013-08-01

Enterprise resource planning (ERP) system implementations are often characterised with large capital outlay, long implementation duration, and high risk of failure. In order to avoid ERP implementation failure and realise the benefits of the system, sound risk management is the key. This paper proposes a probabilistic risk assessment approach for ERP system implementation projects based on fault tree analysis, which models the relationship between ERP system components and specific risk factors. Unlike traditional risk management approaches that have been mostly focused on meeting project budget and schedule objectives, the proposed approach intends to address the risks that may cause ERP system usage failure. The approach can be used to identify the root causes of ERP system implementation usage failure and quantify the impact of critical component failures or critical risk events in the implementation process.

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.

[Design and implementation of the ELSA-Brasil biobank: a prospective study in a Brazilian population].

Science.gov (United States)

Pereira, Alexandre C; Bensenor, Isabela M; Fedeli, Ligia M; Castilhos, Cristina; Vidigal, Pedro G; Maniero, Viviane; Leite, Claudia M; Pimentel, Robercia A; Duncan, Bruce B; Mill, Jose Geraldo; Lotufo, Paulo A

2013-06-01

The Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) is a multicenter prospective cohort of civil servants designed to assess the determinants of chronic diseases, especially cardiovascular diseases and type 2 diabetes. The present article describes the main design and implementation points of the ELSA-Brasil biobank project. Economic, political, logistical and technological aspects of this study are characterized. Additionally, it discusses the final biorepository protocol and the facilities implemented to achieve this objective. The design and implementation process of the ELSA-Brasil biobank took three years to be performed. Both the central and local biobanks were built according to the best biorepository techniques, using different technological solutions for the distinct needs expected in this study.

Human Resource Information System implementation readiness in the Ethiopian health sector: a cross-sectional study.

Science.gov (United States)

Dilu, Eyilachew; Gebreslassie, Measho; Kebede, Mihiretu

2017-12-20

Health workforce information systems in low-income countries tend to be defective with poor relationship to information sources. Human Resource Information System (HRIS) is currently in a pilot implementation phase in the Federal Ministry of Health and Regional Health Bureaus of Ethiopia. Before scaling up the implementation, it is important to understand the implementation readiness of hospitals and health departments. The aims of this study were to assess the readiness for HRIS implementation, identify associated factors, and explore the implementation challenges in public hospitals and health departments of the Amhara National Regional State, Ethiopia. An institution-based cross-sectional study supplemented with a qualitative study was conducted from the 15th of February to the 30th of March 2016 in 19 public hospitals and health departments of the Amhara National Regional State, Ethiopia. A self-administered questionnaire was used to collect the data. The questionnaire includes items on socio-demographic characteristics and questions measuring technical, personal, and organizational factors adapted from the 32-item questionnaire of the Management Science for Health (MSH) HRIS readiness assessment tool. The data were entered and analyzed with statistical software. Descriptive statistics and bivariate and multivariable logistic regression analyses were performed. Odds ratios with 95% confidence interval were computed to identify the factors statistically associated with readiness of HRIS implementation. In-depth interviews and observation checklists were used to collect qualitative data. Thematic content analysis was used to analyze the qualitative data. A total of 246 human resource (HR) employees and 16 key informants have been included in the study. The HR employee's level of readiness for HRIS implementation in this study was 35.8%. Employee's Internet access (AOR = 2.59, 95%CI = 1.19, 5.62), availability of separate HR section (AOR = 8.08, 95%CI�

Implementation of the Welfare Quality broiler assessment protocol – final report : overview of outcome-based measurement of broiler welfare and a general discussion on the Welfare Quality broiler assessment protocol

NARCIS (Netherlands)

Jong, de I.C.; Gunnink, H.; Hindle, V.A.

2015-01-01

In the current report, two topics related to our study on the implementation of the Welfare Quality® broiler assessment protocol are discussed. First, animal-based measures for broiler welfare, currently included in the Welfare Quality® broiler assessment protocol, are discussed with respect to

[Implementation of good quality and safety practices. Descriptive study in a occupational mutual health centre].

Science.gov (United States)

Manzanera, R; Plana, M; Moya, D; Ortner, J; Mira, J J

2016-01-01

To describe the level of implementation of quality and safety good practice elements in a Mutual Society health centre. A Cross-sectional study was conducted to assess the level of implementation of good practices using a questionnaire. Some quality dimensions were also assessed (scale 0 to 10) by a set of 87 quality coordinators of health centres and a random sample of 54 healthcare professionals working in small centres. Seventy quality coordinators and 27 professionals replied (response rates 80% and 50%, respectively. There were no differences in the assessment of quality attributes between both groups. They identified as areas for improvement: use of practice guidelines (7.6/10), scientific and technical skills (7.5/10), and patient satisfaction (7.7/10). Availability and accessibility to clinical reports, informed consent, availability of hydro-alcoholic solution, and to record allergies, were considered of high importance to be implemented, with training and research, improvements in equipment and technology plans, adherence to clinical practice guidelines and the preparation of risk maps, being of less importance. The good practices related to equipment and resources have a higher likelihood to be implemented, meanwhile those related to quality and safety attitudes have more barriers before being implemented. The mutual has a similar behaviour than other healthcare institutions. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Development and implementation of a Bayesian-based aquifer vulnerability assessment in Florida

Science.gov (United States)

Arthur, J.D.; Wood, H.A.R.; Baker, A.E.; Cichon, J.R.; Raines, G.L.

2007-01-01

The Florida Aquifer Vulnerability Assessment (FAVA) was designed to provide a tool for environmental, regulatory, resource management, and planning professionals to facilitate protection of groundwater resources from surface sources of contamination. The FAVA project implements weights-of-evidence (WofE), a data-driven, Bayesian-probabilistic model to generate a series of maps reflecting relative aquifer vulnerability of Florida's principal aquifer systems. The vulnerability assessment process, from project design to map implementation is described herein in reference to the Floridan aquifer system (FAS). The WofE model calculates weighted relationships between hydrogeologic data layers that influence aquifer vulnerability and ambient groundwater parameters in wells that reflect relative degrees of vulnerability. Statewide model input data layers (evidential themes) include soil hydraulic conductivity, density of karst features, thickness of aquifer confinement, and hydraulic head difference between the FAS and the watertable. Wells with median dissolved nitrogen concentrations exceeding statistically established thresholds serve as training points in the WofE model. The resulting vulnerability map (response theme) reflects classified posterior probabilities based on spatial relationships between the evidential themes and training points. The response theme is subjected to extensive sensitivity and validation testing. Among the model validation techniques is calculation of a response theme based on a different water-quality indicator of relative recharge or vulnerability: dissolved oxygen. Successful implementation of the FAVA maps was facilitated by the overall project design, which included a needs assessment and iterative technical advisory committee input and review. Ongoing programs to protect Florida's springsheds have led to development of larger-scale WofE-based vulnerability assessments. Additional applications of the maps include land-use planning

The implementation of portfolio assessment by the educators on the mathematics learning process in senior high school

Science.gov (United States)

Lestariani, Ida; Sujadi, Imam; Pramudya, Ikrar

2018-05-01

Portfolio assessment can shows the development of the ability of learners in a period through the work so that can be seen progress monitored learning of each learner. The purpose of research to describe and know the implementation of portfolio assessment on the mathematics learning process with the Senior High school math teacher class X as the subject because of the importance of applying the assessment for the progress of learning outcomes of learners. This research includes descriptive qualitative research type. Techniques of data collecting is done by observation method, interview and documentation. Data collection then validated using triangulation technique that is observation technique, interview and documentation. Data analysis technique is done by data reduction, data presentation and conclusion. The results showed that the steps taken by teachers in applying portfolio assessment obtained focused on learning outcomes. Student learning outcomes include homework and daily tests. Based on the results of research can be concluded that the implementation of portfolio assessment is the form of learning results are scored. Teachers have not yet implemented other portfolio assessment techniques such as student work.

Guidance for Large-scale Implementation of Alternate Wetting and Drying: A Biophysical Suitability Assessment

Science.gov (United States)

Sander, B. O.; Wassmann, R.; Nelson, A.; Palao, L.; Wollenberg, E.; Ishitani, M.

2014-12-01

The alternate wetting and drying (AWD) technology for rice production does not only save 15-30% of irrigation water, it also reduces methane emissions by up to 70%. AWD is defined by periodic drying and re-flooding of a rice field. Due to its high mitigation potential and its simplicity to execute this practice AWD has gained a lot of attention in recent years. The Climate and Clean Air Coalition (CCAC) has put AWD high on its agenda and funds a project to guide implementation of this technology in Vietnam, Bangladesh and Colombia. One crucial activity is a biophysical suitability assessment for AWD in the three countries. For this, we analyzed rainfall and soil data as well as potential evapotranspiration to assess if the water balance allows practicing AWD or if precipitation is too high for rice fields to fall dry. In my talk I will outline key factors for a successful large-scale implementation of AWD with a focus on the biophysical suitability assessment. The seasonal suitability maps that we generated highlight priority areas for AWD implementation and guide policy makers to informed decisions about meaningful investments in infrastructure and extension work.

An innovative implementation of LCA within the EIA procedure: Lessons learned from two Wastewater Treatment Plant case studies

Energy Technology Data Exchange (ETDEWEB)

Larrey-Lassalle, Pyrène, E-mail: pyrene.larrey-lassalle@irstea.fr [Irstea, UMR ITAP, ELSA Research Group & ELSA-PACT Industrial Chair for Environmental and Social Sustainability Assessment, 361 rue Jean François Breton, F-34196 Montpellier (France); LGEI, Ecole des mines d' Alès, 6 avenue de Clavières, 30319 Alès Cedex (France); Catel, Laureline; Roux, Philippe; Rosenbaum, Ralph K. [Irstea, UMR ITAP, ELSA Research Group & ELSA-PACT Industrial Chair for Environmental and Social Sustainability Assessment, 361 rue Jean François Breton, F-34196 Montpellier (France); Lopez-Ferber, Miguel; Junqua, Guillaume [LGEI, Ecole des mines d' Alès, 6 avenue de Clavières, 30319 Alès Cedex (France); Loiseau, Eléonore [Irstea, UMR ITAP, ELSA Research Group & ELSA-PACT Industrial Chair for Environmental and Social Sustainability Assessment, 361 rue Jean François Breton, F-34196 Montpellier (France)

2017-03-15

Life Cycle Assessment (LCA) has been identified in the literature as a promising tool to increase the performance of environmental assessments at different steps in the Environmental Impact Assessment (EIA) procedure. However, few publications have proposed a methodology for an extensive integration, and none have compared the results with existing EIA conclusions without LCA. This paper proposes a comprehensive operational methodology for implementing an LCA within an EIA. Based on a literature review, we identified four EIA steps that could theoretically benefit from LCA implementation, i.e., (a) the environmental comparison of alternatives, (b) the identification of key impacts, (c) the impact assessment, and (d) the impact of mitigation measures. For each of these steps, an LCA was implemented with specific goal and scope definitions that resulted in a specific set of indicators. This approach has been implemented in two contrasting Wastewater Treatment Plant (WWTP) projects and compared to existing EIA studies. The results showed that the two procedures, i.e., EIAs with or without inputs from LCA, led to different conclusions. The environmental assessments of alternatives and mitigation measures were not carried out in the original studies and showed that other less polluting technologies could have been chosen. Regarding the scoping step, the selected environmental concerns were essentially different. Global impacts such as climate change or natural resource depletion were not taken into account in the original EIA studies. Impacts other than those occurring on the project site (off-site impacts) were not assessed, either. All these impacts can be significant compared to those initially considered. On the other hand, unlike current LCA applications, EIAs usually address natural and technological risks and neighbourhood disturbances such as noises or odours, which are very important for the public acceptability of projects. Regarding the impact assessment

An innovative implementation of LCA within the EIA procedure: Lessons learned from two Wastewater Treatment Plant case studies

International Nuclear Information System (INIS)

Larrey-Lassalle, Pyrène; Catel, Laureline; Roux, Philippe; Rosenbaum, Ralph K.; Lopez-Ferber, Miguel; Junqua, Guillaume; Loiseau, Eléonore

2017-01-01

Life Cycle Assessment (LCA) has been identified in the literature as a promising tool to increase the performance of environmental assessments at different steps in the Environmental Impact Assessment (EIA) procedure. However, few publications have proposed a methodology for an extensive integration, and none have compared the results with existing EIA conclusions without LCA. This paper proposes a comprehensive operational methodology for implementing an LCA within an EIA. Based on a literature review, we identified four EIA steps that could theoretically benefit from LCA implementation, i.e., (a) the environmental comparison of alternatives, (b) the identification of key impacts, (c) the impact assessment, and (d) the impact of mitigation measures. For each of these steps, an LCA was implemented with specific goal and scope definitions that resulted in a specific set of indicators. This approach has been implemented in two contrasting Wastewater Treatment Plant (WWTP) projects and compared to existing EIA studies. The results showed that the two procedures, i.e., EIAs with or without inputs from LCA, led to different conclusions. The environmental assessments of alternatives and mitigation measures were not carried out in the original studies and showed that other less polluting technologies could have been chosen. Regarding the scoping step, the selected environmental concerns were essentially different. Global impacts such as climate change or natural resource depletion were not taken into account in the original EIA studies. Impacts other than those occurring on the project site (off-site impacts) were not assessed, either. All these impacts can be significant compared to those initially considered. On the other hand, unlike current LCA applications, EIAs usually address natural and technological risks and neighbourhood disturbances such as noises or odours, which are very important for the public acceptability of projects. Regarding the impact assessment

Nigeria; Publication of Financial Sector Assessment Program Documentation––Detailed Assessment of Implementation of IOSCO Objectives and Principles of Securities Regulation

OpenAIRE

International Monetary Fund

2013-01-01

An assessment of the level of implementation of the International Organization of Securities Commissions (IOSCO) Principles in Nigeria was conducted as part of the International Monetary Fund (IMF)-World Bank Financial Sector Assessment Program (FSAP). The ongoing global financial crisis has reinforced the need for assessors to make a judgment about supervisory practices and to determine whether they are sufficiently effective. The assessment methodology provides a set of assessment criteria ...

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study.

Science.gov (United States)

Dutra, Danette K

2013-07-04

The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

Assessment of Understanding: Student Teachers' Preparation, Implementation and Reflection of a Lesson Plan for Science

Science.gov (United States)

Juhler, Martin Vogt

2017-05-01

Research finds that student teachers often fail to make observable instructional goals, without which a secure bridge between instruction and assessment is precluded. This is one reason that recent reports state that teacher education needs to become better at helping student teachers to develop their thinking about and skills in assessing pupils' learning. Currently in Europe, the Lesson Study method and the Content Representation tool, which both have a specific focus on assessment, have started to address this problem. This article describes and discusses an intervention in which Lesson Study was used in combination with Content Representation in student teachers' field practice. Empirical materials from one group of student teachers were analyzed to illustrate how the student teachers worked with assessment during the planning of a lesson, how they implemented it in a research lesson, and how they used the gathered observations to make claims about assessment aims. The findings suggest that the student teachers placed greater emphasis on assessment through the intervention. However, it is also found that more attention should have been dedicated to the planning phase and that the group did not manage to keep a research focus throughout the Lesson Study process. This suggests that it properly would be beneficial with several planning sessions prior to the research lesson, as well as having an expert teacher leading the Lesson Study.

Introduction to the special issue: toward implementing physiological measures in clinical child and adolescent assessments.

Science.gov (United States)

De Los Reyes, Andres; Aldao, Amelia

2015-01-01

The National Institute of Mental Health recently launched the Research Domain Criteria (RDoC). The RDoC is an initiative to improve classification of mental health concerns by promoting research on the brain mechanisms underlying these concerns, with the ultimate goal of developing interventions that target these brain mechanisms. A key focus of RDoC involves opening new lines of research examining patients' responses on biological measures. The RDoC presents unique challenges to mental health professionals who work with children and adolescents. Indeed, mental health professionals rarely integrate biological measures into clinical assessments. Thus, RDoC's ability to improve patient care rests, in part, on the development of strategies for implementing biological measures within mental health assessments. Further, mental health professionals already carry out comprehensive assessments that frequently yield inconsistent findings. These inconsistencies have historically posed challenges to interpreting research findings as well as assessment outcomes in practice settings. In this introductory article, we review key issues that informed the development of a special issue of articles demonstrating methods for implementing low-cost measures of physiological functioning in clinical child and adolescent assessments. We also outline a conceptual framework, informed by theoretical work on using and interpreting multiple informants' clinical reports (De Los Reyes, Thomas, Goodman, & Kundey, 2013 ), to guide hypothesis testing when using physiological measures within clinical child and adolescent assessments. This special issue and the conceptual model described in this article may open up new lines of research testing paradigms for implementing clinically feasible physiological measures in clinical child and adolescent assessments.

Vending Assessment and Program Implementation in Four Iowa Worksites.

Science.gov (United States)

Lillehoj, Catherine J; Nothwehr, Faryle; Shipley, Kala; Voss, Carol

2015-11-01

The worksite food environment, including vending options, has been explored as an important contributor to dietary decisions made every day. The current study describes the vending environment, and efforts to change it, in four Iowa worksites using a series of case studies. Data were gathered by local coordinators as part of the Iowa Community Transformation Grant project. Data were collected from three sources. First, the Nutrition Environment Measures Survey-Vending was used to assess healthy vending options in worksite machines before and after the intervention. Second, employee vending behavior was evaluated with a pre-, post-intervention survey. Items assessed attitudes and behaviors regarding vending, plus awareness and reaction to intervention activities. Third, program coordinators documented vending machine intervention strategies used, such as social marketing materials and product labels. The Nutrition Environment Measures Survey-Vending documented that the majority of vending options did not meet criteria for healthfulness. The vending survey found that employees were generally satisfied with the healthier items offered. Some differences were noted over time at the four worksites related to employee behavior and attitudes concerning healthy options. There were also differences in intervention implementation and the extent of changes made by vending companies. Overall, findings demonstrate that a large percentage of employees are constrained in their ability to access healthy foods due to limited worksite vending options. There also remain challenges to making changes in this environment. Findings have implications for public health practitioners to consider when designing healthy vending interventions in worksites. © 2015 Society for Public Health Education.

Nuclear Regulatory Commission probabilistic risk assessment implementation program: A status report

International Nuclear Information System (INIS)

Rubin, M.P.; Caruso, M.A.

1996-01-01

The US Nuclear Regulatory Commission (NRC) is undertaking a number of activities intended to increase the consideration of risk significance in its decision processes and the effective use of risk-based technologies in its regulatory activities. Although the NRC is moving toward risk-informed regulation throughout its areas of responsibilities, this paper focuses primarily on those issues associated with reactor regulation. As the NRC completed significant milestones in its development of probabilistic risk assessment (PRA) methodology and gained considerable experience in the limited application of risk assessment to selected regulatory activities, it became evident that a much broader use of risk informed approaches offered advantages to both the NRC and the US commercial nuclear industry. This desire to enhance the use of risk assessment is driven by the clear belief that application of PRA methods will result in direct improvements in nuclear power plant operational safety from the perspective of both the regulator and the plant operator. The NRC believed that an overall policy on the use of PRA methods in nuclear regulatory activities should be established so that the many potential applications of PRA could be implemented in a consistent and predictable manner that would promote regulatory stability and efficiency. This paper describes the key activities that the NRC has undertaken to implement the initial stages of an integrated risk-informed regulatory framework

Designing and Implementing the Model of Public Assessment of Social and Cultural Progress in Universities

Directory of Open Access Journals (Sweden)

Gholamreza Khaje Sarvi

2013-03-01

Full Text Available Implementing Investigations, analyzes and performance measurements in special and qualitative social/cultural arena in our country, needs local and special methodologies. Thus the aim of present article is investigating these issues: the concept of culture, classification of cultural organizations in Islamic Republic of Iran, the Pyramidal structure of cultural hierarchy, the process of development and mutual influences of institutions, reviewing related literature of policy making in cultural issues, compatibility of strategies to existing realities in cultural performance structure, double division in measures and analyzing and elaborating suggested measures in elaborating weighting model and assessment method and investigating progress measures by focusing on Islamic-Iranian pattern of progress and investigating the effects of implementing this pattern plus weighting method and using related measures and studying some university cases which are implemented in three phases in universities and high education centers overall the country. This research has shown a linear model by considering weighting coefficients.

Independent assessment to continue improvement: Implementing statistical process control at the Hanford Site

International Nuclear Information System (INIS)

Hu, T.A.; Lo, J.C.

1994-11-01

A Quality Assurance independent assessment has brought about continued improvement in the PUREX Plant surveillance program at the Department of Energy's Hanford Site. After the independent assessment, Quality Assurance personnel were closely involved in improving the surveillance program, specifically regarding storage tank monitoring. The independent assessment activities included reviewing procedures, analyzing surveillance data, conducting personnel interviews, and communicating with management. Process improvement efforts included: (1) designing data collection methods; (2) gaining concurrence between engineering and management, (3) revising procedures; and (4) interfacing with shift surveillance crews. Through this process, Statistical Process Control (SPC) was successfully implemented and surveillance management was improved. The independent assessment identified several deficiencies within the surveillance system. These deficiencies can be grouped into two areas: (1) data recording and analysis and (2) handling off-normal conditions. By using several independent assessment techniques, Quality Assurance was able to point out program weakness to senior management and present suggestions for improvements. SPC charting, as implemented by Quality Assurance, is an excellent tool for diagnosing the process, improving communication between the team members, and providing a scientific database for management decisions. In addition, the surveillance procedure was substantially revised. The goals of this revision were to (1) strengthen the role of surveillance management, engineering and operators and (2) emphasize the importance of teamwork for each individual who performs a task. In this instance we believe that the value independent assessment adds to the system is the continuous improvement activities that follow the independent assessment. Excellence in teamwork between the independent assessment organization and the auditee is the key to continuing improvement

Key factors influencing adoption of an innovation in primary health care: a qualitative study based on implementation theory

Directory of Open Access Journals (Sweden)

Carlfjord Siw

2010-08-01

Full Text Available Abstract Background Bridging the knowledge-to-practice gap in health care is an important issue that has gained interest in recent years. Implementing new methods, guidelines or tools into routine care, however, is a slow and unpredictable process, and the factors that play a role in the change process are not yet fully understood. There is a number of theories concerned with factors predicting successful implementation in various settings, however, this issue is insufficiently studied in primary health care (PHC. The objective of this article was to apply implementation theory to identify key factors influencing the adoption of an innovation being introduced in PHC in Sweden. Methods A qualitative study was carried out with staff at six PHC units in Sweden where a computer-based test for lifestyle intervention had been implemented. Two different implementation strategies, implicit or explicit, were used. Sixteen focus group interviews and two individual interviews were performed. In the analysis a theoretical framework based on studies of implementation in health service organizations, was applied to identify key factors influencing adoption. Results The theoretical framework proved to be relevant for studies in PHC. Adoption was positively influenced by positive expectations at the unit, perceptions of the innovation being compatible with existing routines and perceived advantages. An explicit implementation strategy and positive opinions on change and innovation were also associated with adoption. Organizational changes and staff shortages coinciding with implementation seemed to be obstacles for the adoption process. Conclusion When implementation theory obtained from studies in other areas was applied in PHC it proved to be relevant for this particular setting. Based on our results, factors to be taken into account in the planning of the implementation of a new tool in PHC should include assessment of staff expectations, assessment of the

Framework and operational procedure for implementing Strategic Environmental Assessment in China

International Nuclear Information System (INIS)

Bao Cunkuan; Lu Yongsen; Shang Jincheng

2004-01-01

Over the last 20 years, Environmental Impact Assessment (EIA) has been implemented and become an important instrument for decision-making in development projects in China. The Environmental Impact Assessment Law of the P.R. China was promulgated on 28 October 2002 and will be put into effect on 1 September of 2003. The law provides that Strategic Environmental Assessment (SEA) is required in regional and sector plans and programs. This paper introduces the research achievements and practice of SEA in China, discusses the relationship of SEA and 'integrating of environment and development in decision-making (IEDD)', and relevant political and legal basis of SEA. The framework and operational procedures of SEA administration and enforcement are presented. Nine cases are analyzed and some proposals are given

Improvements in the quality of co-ordination of nursing care following implementation of the Resident Assessment Instrument in Dutch nursing homes.

NARCIS (Netherlands)

Achterberg, W.P.; Holtkamp, C.C.M.; Kerkstra, A.; Pot, A.M.; Ooms, M.E.; Ribbe, M.W.

2001-01-01

Aim: To study the effect of implementation of the Resident Assessment Instrument (RAI) on the quality of co-ordination of nursing care in Dutch nursing homes. Background: The Resident Assessment Instrument (RAI) was designed to improve the quality of care and quality of life in nursing homes. Until

Self-assessment as an approach to improvement of efficient implementation of Ukrainian NPP operational experience

International Nuclear Information System (INIS)

Pecheritsya, L.M.; Lyigots'kij, O.Yi.; Pecheritsya, O.V.; Tarasenko, V.M.

2012-01-01

the paper contains a brief description of the procedure for implementation of operational experience, focuses on the role of self -assessment in efficient use of operational experience, presents a review of international and national practices of self-assessment and review of the main features, issues and ways to improve self-assessment of efficient use of operational experience in Ukraine

Assessment of hygiene standards and Hazard Analysis Critical Control Points implementation on passenger ships.

Science.gov (United States)

Mouchtouri, Varavara; Malissiova, Eleni; Zisis, Panagiotis; Paparizou, Evina; Hadjichristodoulou, Christos

2013-01-01

The level of hygiene on ferries can have impact on travellers' health. The aim of this study was to assess the hygiene standards of ferries in Greece and to investigate whether Hazard Analysis Critical Control Points (HACCP) implementation contributes to the hygiene status and particularly food safety aboard passenger ships. Hygiene inspections on 17 ferries in Greece were performed using a standardized inspection form, with a 135-point scale. Thirty-four water and 17 food samples were collected and analysed. About 65% (11/17) of ferries were scored with >100 points. Ferries with HACCP received higher scores during inspection compared to those without HACCP (p value food samples, only one was found positive for Salmonella spp. Implementation of management systems including HACCP principles can help to raise the level of hygiene aboard passenger ships.

Assessing Leading ERP-SAP Implementation in Leading Firms in Indonesia

Science.gov (United States)

Syaiful, B.; Gunawan, W.

2017-01-01

Enterprise resource planning (ERP) enables to bring critical capabilities to an organisation, however, the implementation of such capabilities is often surrounded with problems. The implementing ERP-SAP in Indonesian enterprises are still facing tremendous challenges with the failure rate can reach more than 80% of the cases. The article examines the common problems faced by the consultants whenever they deal with their clients, from the practical perspectives. The article takes the multiple case studies of the leading enterprises in Indonesia, such as: KS (largest steel producer), GEM (large mining producer), and HS (large retailer), with the aim to identify the root of problems of SAP implementation. The outcome of the study is expected to provide the consultants with the guideline to understand the ERP implementation process in their clients and effective solutions to cope with it.

Predicting implementation from organizational readiness for change: a study protocol

Directory of Open Access Journals (Sweden)

Kelly P Adam

2011-07-01

Full Text Available Abstract Background There is widespread interest in measuring organizational readiness to implement evidence-based practices in clinical care. However, there are a number of challenges to validating organizational measures, including inferential bias arising from the halo effect and method bias - two threats to validity that, while well-documented by organizational scholars, are often ignored in health services research. We describe a protocol to comprehensively assess the psychometric properties of a previously developed survey, the Organizational Readiness to Change Assessment. Objectives Our objective is to conduct a comprehensive assessment of the psychometric properties of the Organizational Readiness to Change Assessment incorporating methods specifically to address threats from halo effect and method bias. Methods and Design We will conduct three sets of analyses using longitudinal, secondary data from four partner projects, each testing interventions to improve the implementation of an evidence-based clinical practice. Partner projects field the Organizational Readiness to Change Assessment at baseline (n = 208 respondents; 53 facilities, and prospectively assesses the degree to which the evidence-based practice is implemented. We will conduct predictive and concurrent validities using hierarchical linear modeling and multivariate regression, respectively. For predictive validity, the outcome is the change from baseline to follow-up in the use of the evidence-based practice. We will use intra-class correlations derived from hierarchical linear models to assess inter-rater reliability. Two partner projects will also field measures of job satisfaction for convergent and discriminant validity analyses, and will field Organizational Readiness to Change Assessment measures at follow-up for concurrent validity (n = 158 respondents; 33 facilities. Convergent and discriminant validities will test associations between organizational readiness and

developing and implementing assessment moderation procedures

African Journals Online (AJOL)

Temechegn

Written laboratory reports are among the different types of assessment tasks. ... Carefully designed assessment tasks allow students to demonstrate achievement of clearly .... efficient and have a better understanding of how the lab connects to theory ... the mean values of the various marks students received in this study.

Assessment Strategies for Implementing Ngss in K12 Earth System Science Classrooms

Science.gov (United States)

McAuliffe, C.

2016-12-01

Several science education researchers have led assessment efforts that provide strategies particularly useful for evaluating the threedimensional learning that is central to NGSS (DeBarger, A. H., Penuel, W. R., Harris, C. J., Kennedy, C. K., 2016; Knight, A. M. & McNeill, K. L., 2015; McNeill, K. L., KatshSinger, R. & Pelletier, P., 2015; McNeill K.L., et.al., 2015; McNeill, K.L., & Krajcik, J.S., 2011; Penuel, W., 2016). One of the basic premises of these researchers is that, "Assessment is a practice of argument from evidence based on what students say, do, and write" and that "the classroom is the richest place to gather evidence of what students know (Penuel, W., 2016). The implementation of the NGSS in Earth System Science provides a unique opportunity for geoscience education researchers to study student learning and contribute to the development of this research as well as for geoscience educators to apply these approaches and strategies in their own work with K12 inservice and preservice educators. DeBarger, A. H., Penuel, W. R., Harris, C. J., Kennedy, C. K. (2016). Building an Assessment Argument to Design and Use Next Generation Science Assessments in Efficacy Studies of Curriculum Interventions. American†Journal†of†Evaluation†37(2) 174192Æ Knight, A. M. & McNeill, K. L. (2015). Comparing students' individual written and collaborative oral socioscientific arguments. International Journal of Environmental and Science Education.10(5), 23647. McNeill, K. L., KatshSinger, R. & Pelletier, P. (2015). Assessing science practices-Moving your class along a continuum. Science Scope. McNeill, K.L., & Krajcik, J.S. (2011). Supporting Grade 5-8 Students in Constructing Explanations in Science: The Claim, Evidence, and Reasoning Framework for Talk and Writing. Upper Saddle River, New Jersey: Pearson. Penuel, W. (2016). Classroom Assessment Strategies for NGSS Earth and Space Sciences. Implementing†the†NGSS†Webinar†Series, February 11, 2016.

Thrombocalc: implementation and uptake of personalized postpartum venous thromboembolism risk assessment in a high-throughput obstetric environment.

Science.gov (United States)

O'Shaughnessy, Fergal; Donnelly, Jennifer C; Cooley, Sharon M; Deering, Mary; Raman, Ajita; Gannon, Geraldine; Hickey, Jane; Holland, Alan; Hayes, Niamh; Bennett, Kathleen; Ní Áinle, Fionnuala; Cleary, Brian J

2017-11-01

Venous thromboembolism risk assessment (VTERA) is recommended in all pregnant and postpartum women. Our objective was to develop, pilot and implement a user-friendly electronic VTERA tool. We developed "Thrombocalc", an electronic VTERA tool using Microsoft EXCEL ™ . Thrombocalc was designed as a score-based tool to facilitate rapid assessment of all women after childbirth. Calculation of a total score estimated risk of venous thromboembolism in line with consensus guidelines. Recommendations for thromboprophylaxis were included in the VTERA output. Implementation was phased. Uptake of the VTERA tool was assessed prospectively by monitoring the proportion of women who gave birth in our institution and had a completed risk assessment. Factors affecting completion and accuracy of risk assessments were also assessed. Thrombocalc was used prospectively to risk-assess 8380 women between September 2014 and December 2015. Compliance with this tool increased dramatically throughout the study period; over 92% of women were risk-assessed in the last quarter of data collection. Compliance was not adversely affected if delivery took place out of working hours [adjusted odds ratio (aOR) 1.03, 95% confidence interval (CI) 0.93-1.14]. Risk assessment was less likely in the case of cesarean deliveries (aOR 0.66, 95% CI 0.60-0.73) and stillborn infants (aOR 0.48, 95% CI 0.29-0.79). Misclassification of risk factors led to approximately 207 (2.5%) inaccurate thromboprophylaxis recommendations. Our electronic, score-based VTERA tool provides a highly effective mechanism for rapid assessment of individual postpartum venous thromboembolism risk in a high-throughput environment. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Implementation of a risk assessment tool based on a probabilistic safety assessment developed for radiotherapy practices

International Nuclear Information System (INIS)

Paz, A.; Godinez, V.; Lopez, R.

2010-10-01

The present work describes the implementation process and main results of the risk assessment to the radiotherapy practices with Linear Accelerators (Linac), with cobalt 60, and with brachytherapy. These evaluations were made throughout the risk assessment tool for radiotherapy practices SEVRRA (risk evaluation system for radiotherapy), developed at the Mexican National Commission in Nuclear Safety and Safeguards derived from the outcome obtained with the Probabilistic Safety Analysis developed at the Ibero-American Regulators Forum for these radiotherapy facilities. The methodology used is supported by risk matrices method, a mathematical tool that estimates the risk to the patient, radiation workers and public from mechanical failures, mis calibration of the devices, human mistakes, and so. The initiating events are defined as those undesirable events that, together with other failures, can produce a delivery of an over-dose or an under-dose of the medical prescribed dose, to the planned target volume, or a significant dose to non prescribed human organs. Initiating events frequency and reducer of its frequency (actions intended to avoid the accident) are estimated as well as robustness of barriers to those actions, such as mechanical switches, which detect and prevent the accident from occurring. The spectrum of the consequences is parameterized, and the actions performed to reduce the consequences are identified. Based on this analysis, a software tool was developed in order to simplify the evaluations to radiotherapy installations and it has been applied as a first step forward to some Mexican installations, as part of a national implementation process, the final goal is evaluation of all Mexican facilities in the near future. The main target and benefits of the SEVRRA implementation are presented in this paper. (Author)

Implementation of a risk assessment tool based on a probabilistic safety assessment developed for radiotherapy practices

Energy Technology Data Exchange (ETDEWEB)

Paz, A.; Godinez, V.; Lopez, R., E-mail: abpaz@cnsns.gob.m [Comision Nacional de Seguridad Nuclear y Salvaguardias, Dr. Barragan No. 779, Col. Narvarte, 03020 Mexico D. F. (Mexico)

2010-10-15

The present work describes the implementation process and main results of the risk assessment to the radiotherapy practices with Linear Accelerators (Linac), with cobalt 60, and with brachytherapy. These evaluations were made throughout the risk assessment tool for radiotherapy practices SEVRRA (risk evaluation system for radiotherapy), developed at the Mexican National Commission in Nuclear Safety and Safeguards derived from the outcome obtained with the Probabilistic Safety Analysis developed at the Ibero-American Regulators Forum for these radiotherapy facilities. The methodology used is supported by risk matrices method, a mathematical tool that estimates the risk to the patient, radiation workers and public from mechanical failures, mis calibration of the devices, human mistakes, and so. The initiating events are defined as those undesirable events that, together with other failures, can produce a delivery of an over-dose or an under-dose of the medical prescribed dose, to the planned target volume, or a significant dose to non prescribed human organs. Initiating events frequency and reducer of its frequency (actions intended to avoid the accident) are estimated as well as robustness of barriers to those actions, such as mechanical switches, which detect and prevent the accident from occurring. The spectrum of the consequences is parameterized, and the actions performed to reduce the consequences are identified. Based on this analysis, a software tool was developed in order to simplify the evaluations to radiotherapy installations and it has been applied as a first step forward to some Mexican installations, as part of a national implementation process, the final goal is evaluation of all Mexican facilities in the near future. The main target and benefits of the SEVRRA implementation are presented in this paper. (Author)

A systematic review of implementation strategies for assessment, prevention, and management of ICU delirium and their effect on clinical outcomes.

Science.gov (United States)

Trogrlić, Zoran; van der Jagt, Mathieu; Bakker, Jan; Balas, Michele C; Ely, E Wesley; van der Voort, Peter H J; Ista, Erwin

2015-04-09

Despite recommendations from professional societies and patient safety organizations, the majority of ICU patients worldwide are not routinely monitored for delirium, thus preventing timely prevention and management. The purpose of this systematic review is to summarize what types of implementation strategies have been tested to improve ICU clinicians' ability to effectively assess, prevent and treat delirium and to evaluate the effect of these strategies on clinical outcomes. We searched PubMed, Embase, PsychINFO, Cochrane and CINAHL (January 2000 and April 2014) for studies on implementation strategies that included delirium-oriented interventions in adult ICU patients. Studies were suitable for inclusion if implementation strategies' efficacy, in terms of a clinical outcome, or process outcome was described. We included 21 studies, all including process measures, while 9 reported both process measures and clinical outcomes. Some individual strategies such as "audit and feedback" and "tailored interventions" may be important to establish clinical outcome improvements, but otherwise robust data on effectiveness of specific implementation strategies were scarce. Successful implementation interventions were frequently reported to change process measures, such as improvements in adherence to delirium screening with up to 92%, but relating process measures to outcome changes was generally not possible. In meta-analyses, reduced mortality and ICU length of stay reduction were statistically more likely with implementation programs that employed more (six or more) rather than less implementation strategies and when a framework was used that either integrated current evidence on pain, agitation and delirium management (PAD) or when a strategy of early awakening, breathing, delirium screening and early exercise (ABCDE bundle) was employed. Using implementation strategies aimed at organizational change, next to behavioral change, was also associated with reduced mortality

Safety assessment to support NUE fuel full core implementation in CANDU reactors

Energy Technology Data Exchange (ETDEWEB)

Fan, H.Z.; Laurie, T.; Siddiqi, A.; Li, Z.P.; Rouben, D.; Zhu, W.; Lau, V.; Cottrell, C.M. [CANDU Energy Inc., Mississauga, Ontario (Canada)

2013-07-01

The Natural Uranium Equivalent (NUE) fuel contains a combination of recycled uranium and depleted uranium, in such a manner that the resulting mixture is similar to the natural uranium currently used in CANDU® reactors. Based on successful preliminary results of 24 bundles of NUE fuel demonstration irradiation in Qinshan CANDU 6 Unit 1, the NUE full core implementation program has been developed in cooperation with the Third Qinshan Nuclear Power Company and Candu Energy Inc, which has recently received Chinese government policy and funding support from their National-Level Energy Innovation program. This paper presents the safety assessment results to technically support NUE fuel full core implementation in CANDU reactors. (author)

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.

Grade Point Average System of Assessment: the Implementation Peculiarities in Russia

Directory of Open Access Journals (Sweden)

B. A. Sazonov

2012-01-01

Full Text Available The paper analyzes the specificity, as well as flaws and faults of implementing the Grade Point Average (GPA system of students’ personal assessment in Russian higher schools. Nowadays, the above system is regarded as the basic functional element of educational process organization at the world’s leading universities. The author summarizes the foreign experience and demonstrates the advantages of the GPA system in comparison with the traditional domestic scale of assessment: full records of student’s assessment, objectivity, activation of responsibility for the results achieved, and self-control motivation. The standard GPA model is demonstrated, its application systemizing both the Russian and European requirements to the higher school graduates. The author suggests his own version of the assessment scale estimating and comparing the quality of education in Russian universities and worldwide. The research findings can be of interest to the specialists in the sphere of quality measurement and educational management. 

Issues in Assessment: Implementation.

Science.gov (United States)

Malinowski, Patricia A., Ed.

This collection of articles is the third in a series on assessment produced by Finger Lakes Community College (New York). It deals with classroom assessment as an ongoing process that can be of significant value to teachers as well as to students. Assessment at the college and assessment in the classroom in general are explored. Articles include:…

Assessment of the implementation regulations for smart meters; Beoordeling uitvoeringsregelingen Slimme Meter

Energy Technology Data Exchange (ETDEWEB)

Boekema, J.

2011-03-15

TNO (Netherlands) assessed whether the smart meter is reliable and future proof. By request of the Dutch Ministry of Economic Affairs, Agriculture and Innovation (ELI) an assessment was conducted of the requirements for smart meters and, as formulated in the Order in Council 'Decree on remotely readable metering devices', based on 48 tests regarding security, privacy and future stability. Taking into account a number of described recommendations, TNO deems the legislation and implementation schemes sufficient to allow for safe, reliable and future proof implementation of smart meters in the Netherlands. [Dutch] TNO heeft beoordeeld of de slimme meter betrouwbaar en toekomstvast is. Ten behoeve van het ministerie van Economische Zaken, Landbouw en Innovatie (ELI) zijn de eisen die aan slimme meters worden gesteld, en zoals verwoord in de AmvB 'Besluit op afstand uitleesbare meetinrichtingen', beoordeeld aan de hand van 48 toetsen over zekerheid (security), persoonlijke levenssfeer (privacy) en toekomstvastheid. Met inachtneming van een aantal omschreven aanbevelingen, vindt TNO wetgeving en uitvoeringsregelingen zodanig dat daarmee een veilige, betrouwbare en toekomstvaste slimme meter geimplementeerd kan worden in Nederland.

BNSF San Bernardino case study : positive train control risk assessment.

Science.gov (United States)

2014-09-01

The Federal Railroad Administration funded the BNSF San Bernardino Case Study to verify its Generalized Train Movement : Simulator (GTMS) risk assessment capabilities on a planned implementation of the I-ETMS PTC system. The analysis explicitly : sim...

Organizational Readiness for Change (ORC) test used in the implementation of assessment instruments and treatment methods in a Swedish National study.

Science.gov (United States)

Billsten, Johan; Fridell, Mats; Holmberg, Robert; Ivarsson, Andréas

2018-01-01

Organizational climate and related factors are associated with outcome and are as such of vital interest for healthcare organizations. Organizational Readiness for Change (ORC) is the questionnaire used in the present study to assess the influence of organizational factors on implementation success. The respondents were employed in one of 203 Swedish municipalities within social work and psychiatric substance/abuse treatment services. They took part in a nationwide implementation project organized by the Swedish Association of Local Authorities and Regions (SALAR), commissioned by the Swedish National Board of Health and Welfare. The aims were: (a) to identify classes (clusters) of employees with different ORC profiles on the basis of data collected in 2011 and (b) to investigate ORC profiles which predicted the use of assessment instruments, therapy methods and collaborative activities in 2011 and 2013. The evaluation study applied a naturalistic design with registration of outcome at consecutive assessments. The participants were contacted via official e-mail addresses in their respective healthcare units and were encouraged by their officials to participate on a voluntary basis. Descriptive statistics were obtained using SPSS version 23. A latent profile analysis (LPA) using Mplus 7.3 was performed with a robust maximum likelihood estimator (MLR) to identify subgroups (clusters) based on the 18 ORC indexes. A total of 2402 employees responded to the survey, of whom 1794 (74.7%) completed the ORC scores. Descriptive analysis indicated that the respondents were a homogenous group of employees, where women (72.0%) formed the majority. Cronbach's alpha for the 18 ORC indexes ranged from α=0.67 to α=0.78. A principal component analysis yielded a four-factor solution explaining 62% of the variance in total ORC scores. The factors were: motivational readiness (α=0.64), institutional resources (α=0.52), staff attributes (α=0.76), and organizational climate (α=0

Benefit-cost assessment programs: Costa Rica case study

International Nuclear Information System (INIS)

Clark, A.L.; Trocki, L.K.

1991-01-01

An assessment of mineral potential, in terms of types and numbers of deposits, approximate location and associated tonnage and grades, is a valuable input to a nation's economic planning and mineral policy development. This study provides a methodology for applying benefit-cost analysis to mineral resource assessment programs, both to determine the cost effectiveness of resource assessments and to ascertain future benefits to the nation. In a case study of Costa Rica, the benefit-cost ratio of a resource assessment program was computed to be a minimum of 4:1 ($10.6 million to $2.5 million), not including the economic benefits accuring from the creation of 800 mining sector and 1,200 support services jobs. The benefit-cost ratio would be considerably higher if presently proposed revisions of mineral policy were implemented and benefits could be defined for Costa Rica

Integrating addiction treatment into primary care using mobile health technology: protocol for an implementation research study.

Science.gov (United States)

Quanbeck, Andrew R; Gustafson, David H; Marsch, Lisa A; McTavish, Fiona; Brown, Randall T; Mares, Marie-Louise; Johnson, Roberta; Glass, Joseph E; Atwood, Amy K; McDowell, Helene

2014-05-29

Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers's diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods - pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance - with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixed-methods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation protocol) methods, and assessment of

An Evaluation of Video Modeling with Embedded Instructions to Teach Implementation of Stimulus Preference Assessments

Science.gov (United States)

Rosales, Rocío; Gongola, Leah; Homlitas, Christa

2015-01-01

A multiple baseline design across participants was used to evaluate the effects of video modeling with embedded instructions on training teachers to implement 3 preference assessments. Each assessment was conducted with a confederate learner or a child with autism during generalization probes. All teachers met the predetermined mastery criterion,…

Assessment of human resources for health programme implementation in 15 Latin American and Caribbean countries.

Science.gov (United States)

Dal Poz, Mario Roberto; Sepulveda, Hernan Rodrigo; Costa Couto, Maria Helena; Godue, Charles; Padilla, Monica; Cameron, Rick; Vidaurre Franco, Thais de Andrade

2015-04-28

The health systems in the Americas region are characterized by fragmentation and segmentation, which constitute an important barrier to expanding coverage, achieving integrated primary health care, and reducing inefficiency and discontinuity of care. An assessment of the human resources for health (HRH) programmes that have been implemented at the country level was developed as part of the measurement of the 20 HRH regional goals for 2007-2015, adopted in 2007 by the Pan American Sanitary Conference (CSPA). The exercise was a combination of academic research and the development/application of an advocacy tool involving policy makers and stakeholders to influence the decision-making in the development, implementation, or change of HRH programmes while building evidence through a structured approach based on qualitative and quantitative information and the exchange and dissemination of best practices. This paper covers the methodological challenges, as well as a summary of the main findings of the study, which included 15 countries: Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama in the Central America, Dominican Republic in the Caribbean, Chile, Colombia, Ecuador and Peru in the Andean sub region, and Argentina, Paraguay, and Uruguay in the South Cone. Despite the different contexts, the results showed that the programmes evaluated faced common challenges, such as lack of political support and financial unsustainability. The evaluation process allowed the exchange and dissemination of practices, interventions, and programmes currently running in the region. A shared lesson was the importance of careful planning of the implementation of programmes and interventions. The similarities in the problems and challenges of HRH among the participating countries highlighted the need for a cooperation programme on the evaluation and assessment of implementation strategies in the Americas region.

An Internet Resource for Self-Assessment of Mental Health and Health Behavior: Development and Implementation of the Self-Assessment Kiosk.

Science.gov (United States)

Maunder, Robert G; Hunter, Jonathan J

2018-05-16

Standardized measurement of physical and mental health is useful for identification of health problems. Personalized feedback of the results can influence health behavior, and treatment outcomes can be improved by monitoring feedback over time. However, few resources are available that are free for users, provide feedback from validated measurement instruments, and measure a wide range of health domains. This study aimed to develop an internet self-assessment resource that fills the identified gap and collects data to generate and test hypotheses about health, to test its feasibility, and to describe the characteristics of its users. The Self-Assessment Kiosk was built using validated health measurement instruments and implemented on a commercial internet survey platform. Data regarding usage and the characteristics of users were collected over 54 weeks. The rate of accrual of new users, popularity of measurement domains, frequency with which multiple domains were selected for measurement, and characteristics of users who chose particular questionnaires were assessed. Of the 1435 visits, 441 (30.73%) were visiting for the first time, completed at least 1 measure, indicated that their responses were truthful, and consented to research. Growth in the number of users over time was approximately linear. Users were skewed toward old age and higher income and education. Most (53.9%, 234/434) reported at least 1 medical condition. The median number of questionnaires completed was 5. Internal reliability of most measures was good (Cronbach alpha>.70), with lower reliability for some subscales of coping (self-distraction alpha=.35, venting alpha=.50, acceptance alpha=.51) and personality (agreeableness alpha=.46, openness alpha=.45). The popular questionnaires measured depression (61.0%, 269/441), anxiety (60.5%, 267/441), attachment insecurity (54.2%, 239/441), and coping (46.0%, 203/441). Demographic characteristics somewhat influenced choice of instruments, accounting

Development of weighting value for ecodrainage implementation assessment criteria

Science.gov (United States)

Andajani, S.; Hidayat, D. P. A.; Yuwono, B. E.

2018-01-01

This research aim to generate weighting value for each factor and find out the most influential factor for identify implementation of ecodrain concept using loading factor and Cronbach Alpha. The drainage problem especially in urban areas are getting more complex and need to be handled as soon as possible. Flood and drought problem can’t be solved by the conventional paradigm of drainage (to drain runoff flow as faster as possible to the nearest drainage area). The new paradigm of drainage that based on environmental approach called “ecodrain” can solve both of flood and drought problems. For getting the optimal result, ecodrain should be applied in smallest scale (domestic scale), until the biggest scale (city areas). It is necessary to identify drainage condition based on environmental approach. This research implement ecodrain concept by a guidelines that consist of parameters and assessment criteria. It was generating the 2 variables, 7 indicators and 63 key factors from previous research and related regulations. the conclusion of the research is the most influential indicator on technical management variable is storage system, while on non-technical management variable is government role.

DEVELOPMENT AND IMPROVEMENT OF BUSINESS HIGHER EDUCATION THROUGH IMPLEMENTATION OF STUDENTS LEARNING OUTCOMES ASSESSMENT PLAN (SLOAP

Directory of Open Access Journals (Sweden)

Zoran Ivanovski

2013-03-01

Full Text Available This study presents new vision how to upgrade business higher education at the Faculty of Economics at University of Tourism and Management in Skopje (UTMS. This paper is result of analyses of best practices of leading higher education institutions as well authors experience in higher education and business education and practice. The UTMS is orientated to introduce best practices and objective standards in order to offer high-quality business education for its students. UTMS has mission for permanent implementation of quality improvement measures as a way to achieve high professional and academic standards and become part of prosperous and respective Universities. In order to achieve this goal, UTMS plan to use additional measures, outcomes assessment as a way to measure institutional effectiveness, as well as effective technique for identifying where changes and improvements are necessary. UTMS has developed Students Learning Outcomes Assessment Plan (SLOAP as a way to reach this goal.Based on permanent analysis of students needs as well as business sector suggestions about desirable level of knowledge, skills and competence of the students from Faculty of Economics, gained from conducted evaluations, UTMS decide to make additional improvement and development of business education. This process have 4 phases: 1 evaluation of students attitude towards curricula and the instructors efficiency, 2preparation of the SLOAP (Student Learning Outcomes Assessment Plan document, 3 implementation of two direct measures from the SLOAP through assessment analysis and action planning, and 4 monitoring changes and improvements made as a result of action planning.The first phase was completed in spring semester 2012, as well as second one with development of Comprehensive Exam and Capstone Course as direct measures. Complete SLOAP also has indirect measures like student satisfaction inventory, course evaluations, alumni, and employers’ surveys, and a

Rhett Talks: The development, implementation, and assessment of a faculty-in-residence program.

Science.gov (United States)

Healea, C Daryl; Ribera, Robert

2015-01-01

Student-faculty interactions outside the classroom have long been touted as beneficial to students' success at an institution of higher education. However, obstacles to realizing these interactions have also been well-documented. This case study profiles how student affairs administrators and faculty-in-residence overcame these obstacles to develop, implement, and assess an award-winning program for facilitating student-faculty interactions outside the classroom. Named after the Boston University (BU) mascot (Rhett the Boston terrier) and inspired by the popular online lecture series (TED Talks), Rhett Talks has met BU's unique campus needs, facilitated potent student-faculty interactions, and demonstrated effective partnering between student affairs and academic affairs.

Assessing Implementation Fidelity and Adaptation in a Community-Based Childhood Obesity Prevention Intervention

Science.gov (United States)

Richards, Zoe; Kostadinov, Iordan; Jones, Michelle; Richard, Lucie; Cargo, Margaret

2014-01-01

Little research has assessed the fidelity, adaptation or integrity of activities implemented within community-based obesity prevention initiatives. To address this gap, a mixed-method process evaluation was undertaken in the context of the South Australian Obesity Prevention and Lifestyle (OPAL) initiative. An ecological coding procedure assessed…

A pilot study on implementation of an e-learning course for clinical education in oral medicine

Directory of Open Access Journals (Sweden)

Vlaho Brailo

2015-09-01

Full Text Available This study presents the process of implementing an e-learning course for clinical education in oral medicine and examines its impact on students’ knowledge and satisfaction. Thirty six (39.6% fifth-year undergraduate students participated in the study. Every week before their clinical practice, students studied relevant e-learning materials and completed an assessment test. At the end of the semester, students’ knowledge and attitudes towards e-learning were assessed by the knowledge test and anonymous questionnaire. Students who had access to the e-learning course had significantly better knowledge than students who did not have access to the e-learning course. Exposure to the e-learning course contributed to a better understanding of oral medicine curriculum, increased confidence with oral medicine patients and easier participation in oral medicine clinical practice. This study provided evidence that the e-learning can be implemented as a valuable adjunct to clinical education in oral medicine.

Feasibility of implementing a practice guideline for fall prevention on geriatric wards: a multicentre study.

Science.gov (United States)

Milisen, Koen; Coussement, Joke; Arnout, Hanne; Vanlerberghe, Virginie; De Paepe, Leen; Schoevaerdts, Didier; Lambert, Margareta; Van Den Noortgate, Nele; Delbaere, Kim; Boonen, Steven; Dejaeger, Eddy

2013-04-01

About 40% of all adverse events in hospital are falls, but only about one in three Belgian hospitals have a fall prevention policy in place. The implementation of a national practice guideline is urgently needed. This multicentre study aimed to determine the feasibility of a previously developed guideline. SETTING, PARTICIPANTS AND METHOD: Seventeen geriatric wards, selected at random out of 40 Belgian hospitals who agreed to take part in the study, evaluated the fall prevention guideline. After the one-month test period, 49 healthcare workers completed a questionnaire on the feasibility of the guideline. At the end of the study, 512 geriatric patients had been assessed using the practice guideline. The average time spent per patient on case finding, multifactorial assessment and initiating a treatment plan was 5.1, 76.1 and 30.6 min, respectively. For most risk assessments and risk modifications, several disciplines considered themselves as being responsible and capable. The majority (more than 69%) of the respondents judged the practice guideline as useful, but only a small majority (62.3%) believed that the guideline could be successfully integrated into their daily practice over a longer period of time. Barriers for implementation included a large time investment (81.1%), lack of communication between the different disciplines (35.8%), lack of motivation of the patient (34.0%), lack of multidisciplinary teamwork (28.3%), and lack of interest from the hospital management (15.4%). Overall, the guideline was found useful, and for each risk factor (except for visual impairment), at least one discipline felt responsible and capable. Towards future implementation of the guideline, following steps should be considered: division of the risk-factor assessment duties and interventions among different healthcare workers; patient education; appointment of a fall prevention coordinator; development of a fall prevention policy with support from the management of the hospital

Researching implementation of formative assessment in different educational cultures in order to change educational policy

DEFF Research Database (Denmark)

Dolin, Jens

2015-01-01

This paper reports from a four year international research project, Assess Inquiry in Science, Technology and Mathematics Education (ASSIST-ME) involving 10 partners in 8 European countries (http://assistme.ku.dk/), running 2012-2016. The project combines research on implementation of innovative ...... assessment methods with a policy aspect in order to influence educational policy....

An implementation study of two evidence-based exercise and health education programmes for older adults with osteoarthritis of the knee and hip

NARCIS (Netherlands)

Jong, O.R.W de; Hopman-Rock, M.; Tak, E.C.M.P.; Klazinga, N.S.

2004-01-01

Implementation studies are recommended to assess the feasibility and effectiveness in real-life of programmes which have been tested in randomized controlled trials (RCTs). We report on an implementation study of two evidence-based exercise and health education programmes for older adults with

Implementing Cognitive Behavioral Therapy in the real world: A case study of two mental health centers

Directory of Open Access Journals (Sweden)

Burns Barbara J

2008-02-01

Full Text Available Abstract Background Behavioral health services for children and adolescents in the U.S. are lacking in accessibility, availability and quality. Evidence-based interventions for emotional and behavioral disorders can improve quality, yet few studies have systematically examined their implementation in routine care settings. Methods Using quantitative and qualitative data, we evaluated a multi-faceted implementation strategy to implement cognitive-behavioral therapy (CBT for depressed adolescents into two publicly-funded mental healthcare centers. Extent of implementation during the study's duration and variables influencing implementation were explored. Results Of the 35 clinicians eligible to participate, 25 (71% were randomized into intervention (n = 11 or usual care (n = 14. Nine intervention clinicians completed the CBT training. Sixteen adolescents were enrolled in CBT with six of the intervention clinicians; half of these received at least six CBT manually-based sessions. Multiple barriers to CBT adoption and sustained use were identified by clinicians in qualitative interviews. Conclusion Strategies to implement evidence-based interventions into routine clinical settings should include multi-method, pre-implementation assessments of the clinical environment and address multiple barriers to initial uptake as well as long-term sustainability.

A Study on improvement of environmental assessment system in social, economic, and environmental sectors

Energy Technology Data Exchange (ETDEWEB)

Nam, Young Sook; Koo, Doh Wan; Keum, Kee Yong [Korea Environment Institute, Seoul (Korea)

1998-12-01

The environmental assessment system is assessed as a mechanism that can achieve the goal for environmental policy in 21st century. As it can evaluate social and economic feasibility of large-scale development program, this system can achieve a sustainable society by mitigating social conflicts arising from environmental problems. For making the environmental assessment system substantial, this study was implemented by the need of improvement of the system, by analyzing problems of social, economic, and environmental evaluation, which is implemented under the present system. 44 refs., 1 fig., 25 tabs.

Organizational capacities for health promotion implementation: results from an international hospital study.

Science.gov (United States)

Röthlin, Florian; Schmied, Hermann; Dietscher, Christina

2015-06-01

In this article, organizational structures in hospitals are discussed as possible capacities for hospital health promotion (HP) implementation, based on data from the PRICES-HPH study. PRICES-HPH is a cross-sectional evaluation study of the International Network of Health Promoting Hospitals & Health Services (HPH-Network) and was conducted in 2008-2012. Data from 159 acute care hospitals were used in the analysis. Twelve organizational structures, which were denoted as possible organizational health promotion capacities in previous literature, were tested for their association with certain strategic HP implementation approaches. Four organizational structures were significantly (p = 0.05) associated with one or more elaborate and comprehensive strategic HP implementation approaches: (1) a health promotion specific quality assessment routine; (2) an official hospital health promotion team; (3) a fulltime hospital health promotion coordinator; and (4) officially documented health promotion policies, strategies or standards. The results add further evidence to the importance of organizational capacity structures for hospital health promotion and identify four tangible structures as likely candidates for organizational HP capacities in hospitals. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A systematic and transparent approach for assessing the methodological quality of intervention effectiveness research: the Study Design and Implementation Assessment Device (Study DIAD).

Science.gov (United States)

Valentine, Jeffrey C; Cooper, Harris

2008-06-01

Assessments of studies meant to evaluate the effectiveness of interventions, programs, and policies can serve an important role in the interpretation of research results. However, evidence suggests that available quality assessment tools have poor measurement characteristics and can lead to opposing conclusions when applied to the same body of studies. These tools tend to (a) be insufficiently operational, (b) rely on arbitrary post-hoc decision rules, and (c) result in a single number to represent a multidimensional construct. In response to these limitations, a multilevel and hierarchical instrument was developed in consultation with a wide range of methodological and statistical experts. The instrument focuses on the operational details of studies and results in a profile of scores instead of a single score to represent study quality. A pilot test suggested that satisfactory between-judge agreement can be obtained using well-trained raters working in naturalistic conditions. Limitations of the instrument are discussed, but these are inherent in making decisions about study quality given incomplete reporting and in the absence of strong, contextually based information about the effects of design flaws on study outcomes. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

Justification of RFID Implementation. A Case Study of White Goods Manufacturer

Directory of Open Access Journals (Sweden)

Gladysz Bartlomiej

2017-12-01

Full Text Available Radio Frequency Identification (RFID is a rapidly emerging technology with a wide range of impact and still not fully exploited potential applications. The impact of RFID is not limited to the area of its direct application. There are many possible benefits to be gained from RFID application, but it must be preceded with careful analysis as its implementation is not always reasonable. A new method for an assessment of RFID technology was presented and explained on the case of a white goods manufacturer. There was a lack of such a method allowing for relatively quick and flexible assessment, which is important for decision makers, who do not want to become involved in very sophisticated and time-consuming analysis at the early stage of decision making. The method supports early phases of decision making related to RFID implementation. Conclusions derived from the analysis of the case study confirmed that the method applied allows for rationalizing decision making and answers whether RFID could generate strategic advantage, in which area RFID should be applied, how RFID-supported processes will be executed and what benefits would be expected. previous papers focused only on answering specific questions from the above list, without showing a holistic approach. the approach to answer questions about execution of processes and benefits was not considered earlier at all. The paper illustrates details of using a new method of an assessment of RFID technology (ART using a real industrial example.

Production Leveling (Heijunka) Implementation in a Batch Production System: A Case Study

OpenAIRE

Araujo , Luciano Fonseca; Queiroz , Abelardo Alves

2009-01-01

International audience; This paper presents a case study of an implementation of a new method for Production Leveling designed for batch production. It includes prioritizing criteria of products and level production plan. Moreover, it was applied on a subsidiary of a multinational enterprise located on Brazil, which manufacturing processes comprise batch production in a make-to-stock policy. Regarding a qualitative assessment, evidences show that the company had deficient practices related to...

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.

The assessment of the readiness of five countries to implement child maltreatment prevention programs on a large scale.

Science.gov (United States)

Mikton, Christopher; Power, Mick; Raleva, Marija; Makoae, Mokhantso; Al Eissa, Majid; Cheah, Irene; Cardia, Nancy; Choo, Claire; Almuneef, Maha

2013-12-01

This study aimed to systematically assess the readiness of five countries - Brazil, the Former Yugoslav Republic of Macedonia, Malaysia, Saudi Arabia, and South Africa - to implement evidence-based child maltreatment prevention programs on a large scale. To this end, it applied a recently developed method called Readiness Assessment for the Prevention of Child Maltreatment based on two parallel 100-item instruments. The first measures the knowledge, attitudes, and beliefs concerning child maltreatment prevention of key informants; the second, completed by child maltreatment prevention experts using all available data in the country, produces a more objective assessment readiness. The instruments cover all of the main aspects of readiness including, for instance, availability of scientific data on the problem, legislation and policies, will to address the problem, and material resources. Key informant scores ranged from 31.2 (Brazil) to 45.8/100 (the Former Yugoslav Republic of Macedonia) and expert scores, from 35.2 (Brazil) to 56/100 (Malaysia). Major gaps identified in almost all countries included a lack of professionals with the skills, knowledge, and expertise to implement evidence-based child maltreatment programs and of institutions to train them; inadequate funding, infrastructure, and equipment; extreme rarity of outcome evaluations of prevention programs; and lack of national prevalence surveys of child maltreatment. In sum, the five countries are in a low to moderate state of readiness to implement evidence-based child maltreatment prevention programs on a large scale. Such an assessment of readiness - the first of its kind - allows gaps to be identified and then addressed to increase the likelihood of program success. Copyright © 2013 Elsevier Ltd. All rights reserved.

Assessing Cultural Readiness of Organization For Successful Implementation of Knowledge Managment, Appling FMCDM Approach: Case of Central Bank of Iran

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Shaban Elahi

2012-02-01

Full Text Available Supportive organizational culture for knowledge management can vouch for successful implementation of knowledge management. In the case of lacking this kind of supportive culture, the organizational culture is one of the obstacles which can lead the implementation of knowledge management to full failure and waste of organizational assets. In this research, a framework based on FMCDM was utilized to assess the cultural readiness of organization as the knowledge management implementation prerequisite. This framework has been utilized to assess Central Bank of Iran’s cultural readiness. The methodology of research was descriptive and research data were gathered by questionnaire and were answered by experts and CBI executives. In this term, the cultural readiness of CBI was assessed and in accordance with this assessment, embarking on corrective action was proposed.

Implementing structured functional assessments in general practice for persons with long-term sick leave: a cluster randomised controlled trial

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Benth Jūratė

2009-05-01

Full Text Available Abstract Background The increasing attention on functional assessments in medical and vocational rehabilitation requires a focus change for the general practitioners (GP into paying attention to patient resources, possibilities and coping instead of symptoms, problems and limitations. The GPs report difficulties in performing the requested explicit functional assessments. The purpose of this study was to implement a structured method in general practice for assessing functional ability in persons with long-term sick leave. The study aim was to evaluate intervention effects on important GP parameters; knowledge, attitudes, self-efficacy towards functional assessments and knowledge about patient work factors. Methods Fifty-seven GPs were randomly assigned to an intervention or a control group. The intervention group GPs attended an introductory one-day work-shop and implemented structured functional assessments during an eight months intervention period. GP knowledge, GP attitudes, and GP self-efficacy towards functional assessments, as well as GP knowledge of patient work factors, were collected before, after and six months after the intervention period started. Evaluation score-sheets were filled in by both the intervention GPs and their patients immediately after the consultation to evaluate the GPs' knowledge of patient work factors. Results The intervention GPs reported increased knowledge (B: 0.56, 95% CI (0.19, 0.91 and self-efficacy (B: 0.90, 95% CI (0.53, 1.26 towards functional assessments, and increased knowledge about their patients' workplace (B: 0.75, 95% CI (0.35, 1.15 and perceived stressors (B: 0.55, 95% CI (0.23, 0.88 with lasting effects at the second follow-up. No intervention effect was seen in relation to GP attitudes. Both before and after the intervention, the GPs were most informed about physical stressors, and less about mental and work organisational stressors (Guttman's reproducibility coefficient: 0.95 and 1.00. After

Implementing structured functional assessments in general practice for persons with long-term sick leave: a cluster randomised controlled trial.

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Østerås, Nina; Gulbrandsen, Pål; Benth, Jūrate Saltyte; Hofoss, Dag; Brage, Søren

2009-05-06

The increasing attention on functional assessments in medical and vocational rehabilitation requires a focus change for the general practitioners (GP) into paying attention to patient resources, possibilities and coping instead of symptoms, problems and limitations. The GPs report difficulties in performing the requested explicit functional assessments. The purpose of this study was to implement a structured method in general practice for assessing functional ability in persons with long-term sick leave. The study aim was to evaluate intervention effects on important GP parameters; knowledge, attitudes, self-efficacy towards functional assessments and knowledge about patient work factors. Fifty-seven GPs were randomly assigned to an intervention or a control group. The intervention group GPs attended an introductory one-day work-shop and implemented structured functional assessments during an eight months intervention period. GP knowledge, GP attitudes, and GP self-efficacy towards functional assessments, as well as GP knowledge of patient work factors, were collected before, after and six months after the intervention period started. Evaluation score-sheets were filled in by both the intervention GPs and their patients immediately after the consultation to evaluate the GPs' knowledge of patient work factors. The intervention GPs reported increased knowledge (B: 0.56, 95% CI (0.19, 0.91)) and self-efficacy (B: 0.90, 95% CI (0.53, 1.26)) towards functional assessments, and increased knowledge about their patients' workplace (B: 0.75, 95% CI (0.35, 1.15)) and perceived stressors (B: 0.55, 95% CI (0.23, 0.88)) with lasting effects at the second follow-up. No intervention effect was seen in relation to GP attitudes. Both before and after the intervention, the GPs were most informed about physical stressors, and less about mental and work organisational stressors (Guttman's reproducibility coefficient: 0.95 and 1.00). After the consultation, both the intervention GPs

Software Tool Implementing the Fuzzy AHP Method in Ecological Risk Assessment

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Radionovs Andrejs

2017-12-01

Full Text Available Due to the increased spread of invasive animals and plants in the territory of Latvia, the necessity of ecological risk assessment related to such kind of spread has grown lately. In cases with sufficient statistical data, the risk assessment may be successfully performed on the basis of statistical methods. The amount of statistical data in the context of spread of invasive animals and plants is pretty poor; therefore, the only method of ecological risk assessment remains subjective judgements of experts. The present paper proposes using a programming tool for ecological risk analysis elaborated by the authors. With the help of this programming tool the method of Fuzzy Analytical Hierarchical Process is implemented. The elements of the pairwise comparison matrix are allowed to be expressed by triangular and trapezoidal fuzzy sets. The presented tool makes it possible to design the fuzzy pair-wise comparison matrix and process the results in a user-friendly way.

Assessment of school wellness policies implementation by benchmarking against diffusion of innovation framework.

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Harriger, Dinah; Lu, Wenhua; McKyer, E Lisako J; Pruitt, Buzz E; Goodson, Patricia

2014-04-01

The School Wellness Policy (SWP) mandate marks one of the first innovative and extensive efforts of the US government to address the child obesity epidemic and the influence of the school environment on child health. However, no systematic review has been conducted to examine the implementation of the mandate. The study examines the literature on SWP implementation by using the Diffusion of Innovations Theory as a framework. Empirically based literature on SWP was systematically searched and analyzed. A theory-driven approach was used to categorize the articles by 4 diffusion stages: restructuring/redefining, clarifying, routinizing, and multiple stages. Twenty-one studies were identified, and 3 key characteristics of the reviewed literature were captured: (1) uniformity in methodology, (2) role of context in analyzing policy implementation, and (3) lack of information related to policy clarification. Over half of the studies were published by duplicate set of authors, and only 1 study employed a pure qualitative methodology. Only 2 articles include an explicit theoretical framework to study theory-driven constructs related to SWP implementation. Policy implementation research can inform the policy process. Therefore, it is essential that policy implementation is measured accurately. Failing to clearly define implementation constructs may result in misguided conclusion. © 2014, American School Health Association.

Investigation into promotion/disincentive factors and proposal of support policy in implementation of risk assessment

International Nuclear Information System (INIS)

Nagasaka, Akihiko; Tomizawa, Norio

2012-01-01

The implementation of risk assessment (RA) has been mandated effort in business place of the type of industry that must elect a safe hygiene manager by the enforcement of the revised Occupational Safety and Health Act of April, 2006. However, it is guessed that some problems are still left unfinished in many business places to promote RA effectively. In this study, at first the authors investigated promotion factors and disincentive factors when implementing RA by literature survey. As the result, factors to show as follows were classified in some categories such as participation of the top, the organization which promotes RA, the use of the existing safety activity, matching of RA technique and work, etc. unlike conventional safety activity to learn from a disaster, infiltrating significance of RA to prevent a risk enough, letting a worker engaged in work participate in RA. Next, the authors performed the visit investigation for 8 business places and extracted a new promotion factors to show as follows. incorporating RA in usual duties, utilizing results of RA effectively. In reference to above promotion factors, the authors examined a policy to implement RA smoothly. (author)

Analyzing the Implementation of an ERP System by Self-Assessment in Higher Education

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Máté, Domicián; Bács, Zoltán; Takács, Viktor László

2017-01-01

Over the last few decades, not only organizations but also Higher Education Institutions should be more responsive to the demands of the changed global business environment and improve their effectiveness. Our motivation to write this paper is to assess the implementation of an Enterprise Resource Planning (ERP) system in higher education and…

Operational research on implementation of tuberculosis guidelines in Mozambique

NARCIS (Netherlands)

Brouwer, M.A.

2015-01-01

The overall objective of this thesis is to assess how guideline implementation and evaluation contribute to health care decision-making and to assess what critical factors contribute to successful or unsuccessful implementation of TB control guidelines through case studies mainly conducted in

ASSESSMENT OF THE INQUIRY-BASED PROJECT IMPLEMENTATION PROCESS IN SCIENCE EDUCATION UPON STUDENTS’ POINTS OF VIEWS

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Orhan AKINOGLU

2008-01-01

Full Text Available Aim of the study is to assess how students in 6th, 7th and 8th grades of primary education see the project works made in science education and their implementation processes. The study was fulfilled upon the descriptive survey model to collect data. Participants of the research were 100 students who had project implementation experiences in science education, and they were from 24 primary schools in 7 districts randomly chosen in the city of Istanbul in Turkey. Data of the study were collected by using a semi-constructed interview form offered to students during the 2005-2006 teaching year. In the research, following items were examined: The extent to which students are inspired from the previously made projects during their own project selection process, the level of scientific document survey and the effects of contemporary events, science and technology class topics and students’ interest areas. It was seen that internet is the mostly used source to obtain information. For students, one of the most problematic issues faced during the project implementation is the time limits set out by teacher. It was found that the most obvious benefit obtained by students from the project works is their increasing interest towards science and technology class. The most significant change seen by students regarding project preparation is their increasing grades in exams during and following the project works.

Implementing and Assessing Inquiry-Based Learning through the CAREER Award

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Brudzinski, M. R.

2011-12-01

In order to fully attain the benefits of inquiry-based learning, instructors who typically employ the traditional lecture format need to make many adjustments to their approach. This change in styles can be intimidating and logistically difficult to overcome, both for instructors and students, such that a stepwise approach to this transformation is likely to be more manageable. In this session, I will describe a series of tools to promote inquiry-based learning that I am helping to implement and assess in classroom courses and student research projects. I will demonstrate the importance of integrating with existing institutional initiatives as well as recognizing how student development plays a key role in student engagement. Some of the features I will highlight include: defining both student learning outcomes and student development outcomes, converting content training to be self-directed and asynchronous, utilizing conceptests to help students practice thinking like scientists, and employing both objective pre/post assessment and student self-reflective assessment. Lastly, I will reflect on how the well-defined goal of teaching and research integration in the CAREER award solicitation resonated with me even as an undergraduate and helped inspire my early career.

The implementation of national and European environmental legislation in Germany: three case studies

Energy Technology Data Exchange (ETDEWEB)

Bueltmann, A.; Waetzold, F. [UFZ - Umweltforschungszentrum Leipzig-Halle GmbH, Leipzig (Germany). Sektion Oekonomie, Soziologie und Recht

2000-07-01

This report traces the implementation of the EMAS Regulation in Germany, i.e. it describes what kind of an institutional setting was chosen, in what way it was established and how it is working in practice. Moreover, the outcome of the implementation process is analysed in terms of efficiency and environmental effectiveness. To gain the relevant data and information we conducted expert interviews, reviewed the relevant literature and carried out a questionnaire survey. Chapter 2 provides some background information about EMAS, including the main contents of the EMAS Regulation and the political process that preceded the adoption of the EMAS Regulation and the implementation requirements imposed on the Member States. Chapter 3 describes the implementation of the EMAS Regulation and companies' motives to participate in the scheme. In chapter 4 the outcome of the implementation process is assessed in terms of the attainment of the Regulation's environmental goals and efficiency. To this end the criteria of efficiency (allocative, productive and administrative efficiency) and environmental effectiveness are adapted to the case of EMAS and indicators are developed for their assessment. Finally, data for the indicators are provided for Germany. Chapter 5 develops some hypotheses on how goal attainment and efficiency have been influenced by specific features of the implementation process. (orig.)

Assessment of the Implementation of the Erasmus Programme in Turkey through the Experiences of Foreign Students Visiting Turkish HEI's

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Burçer, Sibel

2015-01-01

The aim of this paper is to study the implementation of the ERASMUS programme in Turkey from the perspective of the foreign exchange students. The author conducted a survey which included 112 respondents from 8 Turkish universities. In the survey, the respondents assessed the level of language competence, the existence or the lack of sufficient…

Implementing trials of complex interventions in community settings: the USC-Rancho Los Amigos pressure ulcer prevention study (PUPS).

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Clark, Florence; Pyatak, Elizabeth A; Carlson, Mike; Blanche, Erna Imperatore; Vigen, Cheryl; Hay, Joel; Mallinson, Trudy; Blanchard, Jeanine; Unger, Jennifer B; Garber, Susan L; Diaz, Jesus; Florindez, Lucia I; Atkins, Michal; Rubayi, Salah; Azen, Stanley Paul

2014-04-01

Randomized trials of complex, non-pharmacologic interventions implemented in home and community settings, such as the University of Southern California (USC)-Rancho Los Amigos National Rehabilitation Center (RLANRC) Pressure Ulcer Prevention Study (PUPS), present unique challenges with respect to (1) participant recruitment and retention, (2) intervention delivery and fidelity, (3) randomization and assessment, and (4) potential inadvertent treatment effects. We describe the methods employed to address the challenges confronted in implementing PUPS. In this randomized controlled trial, we are assessing the efficacy of a complex, preventive intervention in reducing the incidence of, and costs associated with, the development of medically serious pressure ulcers in people with spinal cord injury. Individuals with spinal cord injury recruited from RLANRC were assigned to either a 12-month preventive intervention group or a standard care control group. The primary outcome is the incidence of serious pressure ulcers with secondary endpoints including ulcer-related surgeries, medical treatment costs, and quality of life. These outcomes are assessed at 12 and 24 months after randomization. Additionally, we are studying the mediating mechanisms that account for intervention outcomes. PUPS has been successfully implemented, including recruitment of the target sample size of 170 participants, assurance of the integrity of intervention protocol delivery with an average 90% treatment adherence rate, and enactment of the assessment plan. However, implementation has been replete with challenges. To meet recruitment goals, we instituted a five-pronged approach customized for an underserved, ethnically diverse population. In intervention delivery, we increased staff time to overcome economic and cultural barriers to retention and adherence. To ensure treatment fidelity and replicability, we monitored intervention protocol delivery in accordance with a rigorous plan. Finally, we

Do regulators pay attention? An assessment of IT governance implementation in systemically important banks

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Mehrdad Sepahvand

2017-03-01

Full Text Available The large size and complexity of Information Technology systems in systematically important banks raise the need for creating an IT governance architecture that could make IT strategy aligned with business strategy and delivers value while it effectively identifies and manages IT risk. This study traces the links between IT governance and two more applied risk management frameworks, COSO and BCBS’s principles for managing IT risk. Then it argues due to the magnitude of potential losses caused by any weakness in IT governance in D-SIBs, the assessment of IT governance in these banks should be one of the main concerns of local regulators and supervisors. As a case study, it assesses the relative rank of D-SIBs in Iranian banking system to see where these banks would stand in an ordered list of the banks including both private and public banks in terms of IT governance implementation. The application of the Fuzzy AHP technique shows that IT governance practice in Iranian D-SIBs is not as good as the private banks while it outperforms some state-owned banks.

The development and implementation of a decision-making capacity assessment model.

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Parmar, Jasneet; Brémault-Phillips, Suzette; Charles, Lesley

2015-03-01

Decision-making capacity assessment (DMCA) is an issue of increasing importance for older adults. Current challenges need to be explored, and potential processes and strategies considered in order to address issues of DMCA in a more coordinated manner. An iterative process was used to address issues related to DMCA. This began with recognition of challenges associated with capacity assessments (CAs) by staff at Covenant Health (CH). Review of the literature, as well as discussions with and a survey of staff at three CH sites, resulted in determination of issues related to DMCA. Development of a DMCA Model and demonstration of its feasibility followed. A process was proposed with front-end screening/problem- solving, a well-defined standard assessment, and definition of team member roles. A Capacity Assessment Care Map was formulated based on the process. Documentation was developed consisting of a Capacity Assessment Process Worksheet, Capacity Interview Worksheet, and a brochure. Interactive workshops were delivered to familiarize staff with the DMCA Model. A successful demonstration project led to implementation across all sites in the Capital Health region, and eventual provincial endorsement. Concerns identified in the survey and in the literature regarding CA were addressed through the holistic interdisciplinary approach offered by the DMCA Model.

Using the Consolidated Framework for Implementation Research to Identify Barriers and Facilitators for the Implementation of an Internet-Based Patient-Provider Communication Service in Five Settings: A Qualitative Study.

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Varsi, Cecilie; Ekstedt, Mirjam; Gammon, Deede; Ruland, Cornelia M

2015-11-18

Although there is growing evidence of the positive effects of Internet-based patient-provider communication (IPPC) services for both patients and health care providers, their implementation into clinical practice continues to be a challenge. The 3 aims of this study were to (1) identify and compare barriers and facilitators influencing the implementation of an IPPC service in 5 hospital units using the Consolidated Framework for Implementation Research (CFIR), (2) assess the ability of the different constructs of CFIR to distinguish between high and low implementation success, and (3) compare our findings with those from other studies that used the CFIR to discriminate between high and low implementation success. This study was based on individual interviews with 10 nurses, 6 physicians, and 1 nutritionist who had used the IPPC to answer messages from patients. Of the 36 CFIR constructs, 28 were addressed in the interviews, of which 12 distinguished between high and low implementation units. Most of the distinguishing constructs were related to the inner setting domain of CFIR, indicating that institutional factors were particularly important for successful implementation. Health care providers' beliefs in the intervention as useful for themselves and their patients as well as the implementation process itself were also important. A comparison of constructs across ours and 2 other studies that also used the CFIR to discriminate between high and low implementation success showed that 24 CFIR constructs distinguished between high and low implementation units in at least 1 study; 11 constructs distinguished in 2 studies. However, only 2 constructs (patient need and resources and available resources) distinguished consistently between high and low implementation units in all 3 studies. The CFIR is a helpful framework for illuminating barriers and facilitators influencing IPPC implementation. However, CFIR's strength of being broad and comprehensive also limits its

A Reliability and Validity of an Instrument to Evaluate the School-Based Assessment System: A Pilot Study

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Ghazali, Nor Hasnida Md

2016-01-01

A valid, reliable and practical instrument is needed to evaluate the implementation of the school-based assessment (SBA) system. The aim of this study is to develop and assess the validity and reliability of an instrument to measure the perception of teachers towards the SBA implementation in schools. The instrument is developed based on a…

Design, Implementation & Assessment of Local Exhaust Ventilation System and dust collectors for crushing unit

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Farshid Ghorbani shahna

2015-09-01

Full Text Available Background & objective: Industrial ventilation systems and dust collectors are effective solutions to reduce particulate emissions in the workplace and environmental in mineral processes. In this study, Local Exhaust Ventilation System and dust collectors for control of emitted silica, coke, silicon carbide dusts from crushing unit was designed and evaluated. Methods: : Local Exhaust ventilation system based on standards and guides was designed and implemented after field study of the processes and sources of air pollutants. A set comprised of the four parallel cyclones (Stairmand model and a new design of the scrubber had been used for dust control. After set-up of systems, its effectiveness in reducing the exposure of workers in the workshops and dust collecting were assessed. Results: Test results were significant differences between the concentration of particles in both on and off the ventilation system revealed (P <0.05. The system has been implemented as means of personal exposure to pollutants and environmental emissions were reduced 93.01% and 64.64%, respectively. Also, alone and integrated collection efficiency of cyclone and scrubber, were 94.2%, 59.05% and 97.4%, respectively. The results show good agreement with the values of the parameters ventilation system was designed. Conclusion: Implementation of integrated dust collectors is a good option in industries that have the financial and technical constraints to improve change processes and devices. This method with attainment to health and environmental standards not only can be resolve of the pollution problems, but also will be economically justified of such projects with reduction of depreciation expense and dust recycling.

Health technology assessment to optimize health technology utilization: using implementation initiatives and monitoring processes.

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Frønsdal, Katrine B; Facey, Karen; Klemp, Marianne; Norderhaug, Inger Natvig; Mørland, Berit; Røttingen, John-Arne

2010-07-01

The way in which a health technology is used in any particular health system depends on the decisions and actions of a variety of stakeholders, the local culture, and context. In 2009, the HTAi Policy Forum considered how health technology assessment (HTA) could be improved to optimize the use of technologies (in terms of uptake, change in use, or disinvestment) in such complex systems. In scoping, it was agreed to focus on initiatives to implement evidence-based guidance and monitoring activities. A review identified systematic reviews of implementation initiatives and monitoring activities. A two-day deliberative workshop was held to discuss key papers, members' experiences, and collectively address key questions. This consensus paper was developed by email and finalized at a postworkshop meeting. Evidence suggests that the impact and use of HTA could be increased by ensuring timely delivery of relevant reports to clearly determined policy receptor (decision-making) points. To achieve this, the breadth of assessment, implementation initiatives such as incentives and targeted, intelligent dissemination of HTA result, needs to be considered. HTA stakeholders undertake a variety of monitoring activities, which could inform optimal use of a technology. However, the quality of these data varies and is often not submitted to an HTA. Monitoring data should be sufficiently robust so that they can be used in HTA to inform optimal use of technology. Evidence-based implementation initiatives should be developed for HTA, to better inform decision makers at all levels in a health system about the optimal use of technology.

Exploring a clinically friendly web-based approach to clinical decision support linked to the electronic health record: design philosophy, prototype implementation, and framework for assessment.

Science.gov (United States)

Miller, Perry; Phipps, Michael; Chatterjee, Sharmila; Rajeevan, Nallakkandi; Levin, Forrest; Frawley, Sandra; Tokuno, Hajime

2014-07-01

Computer-based clinical decision support (CDS) is an important component of the electronic health record (EHR). As an increasing amount of CDS is implemented, it will be important that this be accomplished in a fashion that assists in clinical decision making without imposing unacceptable demands and burdens upon the provider's practice. The objective of our study was to explore an approach that allows CDS to be clinician-friendly from a variety of perspectives, to build a prototype implementation that illustrates features of the approach, and to gain experience with a pilot framework for assessment. The paper first discusses the project's design philosophy and goals. It then describes a prototype implementation (Neuropath/CDS) that explores the approach in the domain of neuropathic pain and in the context of the US Veterans Administration EHR. Finally, the paper discusses a framework for assessing the approach, illustrated by a pilot assessment of Neuropath/CDS. The paper describes the operation and technical design of Neuropath/CDS, as well as the results of the pilot assessment, which emphasize the four areas of focus, scope, content, and presentation. The work to date has allowed us to explore various design and implementation issues relating to the approach illustrated in Neuropath/CDS, as well as the development and pilot application of a framework for assessment.

Implementation of a clinical dementia guideline. A controlled study on the effect of a multifaceted strategy

DEFF Research Database (Denmark)

Waldorff, Frans Boch; Almind, Gert; Mäkelä, Marjukka

2003-01-01

OBJECTIVE: To assess the impact of a multifaceted implementation strategy aiming to improve GP adherence to a clinical guideline on dementia. DESIGN: Controlled before and after study using data records from regional laboratories. The guideline was mailed to all GPs. The multifaceted implementation...... strategy was planned with local GPs, and consisted of seminars, outreach visits, reminders and continuing medical education (CME) small group training. SETTING: Primary health care. SUBJECTS: 535 GP practices with 727 physicians in Denmark. MAIN OUTCOME MEASURES: The diffusion and use of the guideline...... of dementia in general practice. CONCLUSION: Although GPs regarded the guideline applicable in primary care, no change in practice adherence to guideline recommendations was detected after a multifaceted implementation....

Implementation of Water Safety Plans (WSPs): A Case Study in the Coastal Area in Semarang City, Indonesia

Science.gov (United States)

Budiyono; Ginandjar, P.; Saraswati, L. D.; Pangestuti, D. R.; Martini; Jati, S. P.

2018-02-01

An area of 508.28 hectares in North Semarang is flooded by tidal inundation, including Bandarharjo village, which could affect water quality in the area. People in Bandarharjo use safe water from deep groundwater, without disinfection process. More than 90% of water samples in the Bandaharjo village had poor bacteriological quality. The aimed of the research was to describe the implementation of Water Safety Plans (WSPs) program in Bandarharjo village. This was a descriptive study with steps for implementations adopted the guidelines and tools of the World Health Organization. The steps consist of introducing WSPs program, team building, training the team, examination of water safety before risk assessment, risk assessment, minor repair I, examination of water safety risk, minor repair II (after monitoring). Data were analyzed using descriptive methods. WSPs program has been introduced and formed WSPs team, and the training of the team has been conducted. The team was able to conduct risks assessment, planned the activities, examined water quality, conduct minor repair and monitoring at the source, distribution, and households connection. The WSPs program could be implemented in the coastal area in Semarang, however regularly supervision and some adjustment are needed.

Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

Science.gov (United States)

Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

2017-04-01

Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current

Development of the evaluation instrument use CIPP on the implementation of project assessment topic optik

Science.gov (United States)

Asfaroh, Jati Aurum; Rosana, Dadan; Supahar

2017-08-01

This research aims to develop an evaluation instrument models CIPP valid and reliable as well as determine the feasibility and practicality of an evaluation instrument models CIPP. An evaluation instrument models CIPP to evaluate the implementation of the project assessment topic optik to measure problem-solving skills of junior high school class VIII in the Yogyakarta region. This research is a model of development that uses 4-D. Subject of product trials are students in class VIII SMP N 1 Galur and SMP N 1 Sleman. Data collection techniques in this research using non-test techniques include interviews, questionnaires and observations. Validity in this research was analyzed using V'Aikens. Reliability analyzed using ICC. This research uses 7 raters are derived from two lecturers expert (expert judgment), two practitioners (science teacher) and three colleagues. The results of this research is the evaluation's instrument model of CIPP is used to evaluate the implementation of the implementation of the project assessment instruments. The validity result of evaluation instrument have V'Aikens values between 0.86 to 1, which means a valid and 0.836 reliability values into categories so well that it has been worth used as an evaluation instrument.

Algorithms for the extension of precise and imprecise conditional probability assessments: an implementation with maple V

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Veronica Biazzo

2000-05-01

Full Text Available In this paper, we illustrate an implementation with Maple V of some procedures which allow to exactly propagate precise and imprecise probability assessments. The extension of imprecise assessments is based on a suitable generalization of the concept of coherence of de Finetti. The procedures described are supported by some examples and relevant cases.

The Implementation of RSBY in Chhattisgarh, India: A study of the Durg district

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S Nandi

2012-03-01

Full Text Available The Rashtriya Swasthya Bima Yojana (RSBY scheme is a health insurance model currently being implemented by the Indian government. It is a model, however, still in nascent state, subject to tensions and value testing. Very few studies have hitherto assessed the scheme’s implementation and whether the stated objectives of the government initiative are being fulfilled. This short study undertaken in the Durg district of Chhattisgarh reveals that RSBY fails to cover the population living Below the Poverty Line (BPL. Likewise there is discrepancy in the consistency of information and knowledge regarding the scheme among the beneficiaries who are themselves continuing to incur high out-of-pocket expenses. There are thus severe issues in transparency and accountability within the RSBY scheme. Unless the public health delivery system is strengthened and the private sector regulated and indeed monitored, the scheme will not yield the desired results, and the cost of healthcare will further escalate for the poor. In the absence of regulated health services there needs to be more debate, and indeed greater research, on the implementation and the design of RSBY. 

Corporate Governance Scorecards : Assessing and Promoting the Implementation of Codes of Corporate Governance

OpenAIRE

International Finance Corporation

2014-01-01

This is a supplement to second IFC's toolkit: developing Corporate Governance codes of best practice. The focus of second toolkit is the development of codes of corporate governance. This supplement focuses narrowly on how to use scorecards to measure the observance and implementation of such codes. It does not cover the full panoply of governance assessment tools. This supplement provides...

Implementing trials of complex interventions in community settings: The USC – Rancho Los Amigos Pressure Ulcer Prevention Study (PUPS)

Science.gov (United States)

Clark, Florence; Pyatak, Elizabeth A.; Carlson, Mike; Blanche, Erna Imperatore; Vigen, Cheryl; Hay, Joel; Mallinson, Trudy; Blanchard, Jeanine; Unger, Jennifer B.; Garber, Susan L.; Diaz, Jesus; Florindez, Lucia I.; Atkins, Michal; Rubayi, Salah; Azen, Stanley Paul

2014-01-01

Background Randomized trials of complex, non-pharmacologic interventions implemented in home and community settings, such as the University of Southern California (USC)–Rancho Los Amigos National Rehabilitation Center (RLANRC) Pressure Ulcer Prevention Study (PUPS), present unique challenges with respect to: (a) participant recruitment and retention, (b) intervention delivery and fidelity, (c) randomization and assessment, and (d) potential inadvertent treatment effects. Purpose We describe the methods employed to address the challenges confronted in implementing PUPS. In this randomized controlled trial, we are assessing the efficacy of a complex, preventive intervention in reducing the incidence of, and costs associated with, the development of medically serious pressure ulcers in people with spinal cord injury. Method Individuals with spinal cord injury recruited from RLANRC were assigned to either a 12-month preventive intervention group or a standard care control group. The primary outcome is the incidence of serious pressure ulcers with secondary endpoints including ulcer-related surgeries, medical treatment costs, and quality of life. These outcomes are assessed at 12 and 24 months after randomization. Additionally, we are studying the mediating mechanisms that account for intervention outcomes. Results PUPS has been successfully implemented, including recruitment of the target sample size of 170 participants, assurance of the integrity of intervention protocol delivery with an average 90% treatment adherence rate, and enactment of the assessment plan. However, implementation has been replete with challenges. To meet recruitment goals, we instituted a five-pronged approach customized for an underserved, ethnically diverse population. In intervention delivery, we increased staff time to overcome economic and cultural barriers to retention and adherence. To ensure treatment fidelity and replicability, we monitored intervention protocol delivery in accord

Energy climate study. Energy assessment, Greenhouse gas emission assessment, Analysis of vulnerability to climate change, Courses of mitigation and adaptation actions. Full report + Appendices + Restitution of the Energy-Climate Study, September 17, 2012

International Nuclear Information System (INIS)

2012-01-01

After a brief presentation of Le Mans region, a presentation of the study (context, scope, methodology), and a recall of challenges related to energy and to climate, this study reports a situational analysis and a discussion of development perspectives for energy production on the concerned territory, an assessment of energy consumptions and of greenhouse gas emissions by the different sectors, and a study of territory vulnerability to climate change (methodology, territory characteristics, climate scenarios, vulnerability assessment). It discusses lessons learned from energy and greenhouse gas emission assessments (social-economic stakes, territory strengths and weaknesses, perspectives for action). It discusses the implementation of these issues within a territorial planning document, and the perspective of elaboration of a territorial climate energy plan. An appendix reports an assessment of the potential of development of the different renewable energies (hydroelectric, solar photovoltaic and thermal, wind, wood, methanization, and other processes like waste valorisation, geothermal, and heat networks). Another appendix reports the precise assessment of greenhouse gas emissions on the territory. The next appendix proposes detailed descriptions of scenarios for the implementation of the issue of greenhouse gas emissions within the territorial planning document. The last appendix contains Power Point presentations of the study

Successful implementation of the National Environmental Policy Act (NEPA) at a US Department of Energy (DOE) site: Environmental assessment preparation - a case study

International Nuclear Information System (INIS)

Haagenstad, T.; Ladino, A.

1997-01-01

The U.S. Department of Energy (DOE) at Los Alamos National Laboratory (LANL) implements the requirements of the National Environmental Policy Act (NEPA) using a NEPA Compliance Team. The NEPA Compliance Team (Team) is composed of DOE Los Alamos Area Office (LAAO) and LANL employees that combine to create quality improvements in the DOE NEPA compliance process at both LAAO and LANL. A major focus of quality improvement has been in the area of Environmental Assessment (EA) documentation preparation. The NEPA Team within LANL's Ecology Group (ESH-20) is the organization responsible for preparing the EA documentation on behalf of DOE. DOE and LANL team in an interdisciplinary process to prepare review, and complete EAs using the technical expertise of individuals throughout the DOE and LANL. This approach has demonstrated significant time and cost savings as well as EA document quality improvements. The process used to prepare an EA for the Low Energy Demonstration Accelerator (LEDA) is presented as an example of a successful approach to implementing NEPA. The LEDA EA is used as a case study example to demonstrate how an integrated and interdisciplinary approach to conducting a NEPA analysis yields extremely successful results. The LEDA EA was prepared on an extremely aggressive schedule with tight cost constraints. The ESH-20 NEPA Team was successful in providing a critical link between the DOE decision-makers and the LEDA project representatives within LANL. As the technical scope of the LEDA project changed during the preparation of the EA, by emphasizing an interdisciplinary approach, the Team was able to quickly assess the implications and potential impacts through open communications with the various subject matter experts while maintaining a pace consistent with the EA schedule demands

Study protocol for "Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET)": a pragmatic trial comparing implementation strategies.

Science.gov (United States)

Gold, Rachel; Hollombe, Celine; Bunce, Arwen; Nelson, Christine; Davis, James V; Cowburn, Stuart; Perrin, Nancy; DeVoe, Jennifer; Mossman, Ned; Boles, Bruce; Horberg, Michael; Dearing, James W; Jaworski, Victoria; Cohen, Deborah; Smith, David

2015-10-16

Little research has directly compared the effectiveness of implementation strategies in any setting, and we know of no prior trials directly comparing how effectively different combinations of strategies support implementation in community health centers. This paper outlines the protocol of the Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET), a trial designed to compare the effectiveness of several common strategies for supporting implementation of an intervention and explore contextual factors that impact the strategies' effectiveness in the community health center setting. This cluster-randomized trial compares how three increasingly hands-on implementation strategies support adoption of an evidence-based diabetes quality improvement intervention in 29 community health centers, managed by 12 healthcare organizations. The strategies are as follows: (arm 1) a toolkit, presented in paper and electronic form, which includes a training webinar; (arm 2) toolkit plus in-person training with a focus on practice change and change management strategies; and (arm 3) toolkit, in-person training, plus practice facilitation with on-site visits. We use a mixed methods approach to data collection and analysis: (i) baseline surveys on study clinic characteristics, to explore how these characteristics impact the clinics' ability to implement the tools and the effectiveness of each implementation strategy; (ii) quantitative data on change in rates of guideline-concordant prescribing; and (iii) qualitative data on the "how" and "why" underlying the quantitative results. The outcomes of interest are clinic-level results, categorized using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, within an interrupted time-series design with segmented regression models. This pragmatic trial will compare how well each implementation strategy works in "real-world" practices. Having a better understanding of how different

What is needed to implement a computer-assisted health risk assessment tool? An exploratory concept mapping study

Directory of Open Access Journals (Sweden)

Ahmad Farah

2012-12-01

Full Text Available Abstract Background Emerging eHealth tools could facilitate the delivery of comprehensive care in time-constrained clinical settings. One such tool is interactive computer-assisted health-risk assessments (HRA, which may improve provider-patient communication at the point of care, particularly for psychosocial health concerns, which remain under-detected in clinical encounters. The research team explored the perspectives of healthcare providers representing a variety of disciplines (physicians, nurses, social workers, allied staff regarding the factors required for implementation of an interactive HRA on psychosocial health. Methods The research team employed a semi-qualitative participatory method known as Concept Mapping, which involved three distinct phases. First, in face-to-face and online brainstorming sessions, participants responded to an open-ended central question: “What factors should be in place within your clinical setting to support an effective computer-assisted screening tool for psychosocial risks?” The brainstormed items were consolidated by the research team. Then, in face-to-face and online sorting sessions, participants grouped the items thematically as ‘it made sense to them’. Participants also rated each item on a 5-point scale for its ‘importance’ and ‘action feasibility’ over the ensuing six month period. The sorted and rated data was analyzed using multidimensional scaling and hierarchical cluster analyses which produced visual maps. In the third and final phase, the face-to-face Interpretation sessions, the concept maps were discussed and illuminated by participants collectively. Results Overall, 54 providers participated (emergency care 48%; primary care 52%. Participants brainstormed 196 items thought to be necessary for the implementation of an interactive HRA emphasizing psychosocial health. These were consolidated by the research team into 85 items. After sorting and rating, cluster analysis

Systematic Assessment of Neutron and Gamma Backgrounds Relevant to Operational Modeling and Detection Technology Implementation

Energy Technology Data Exchange (ETDEWEB)

Archer, Daniel E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hornback, Donald Eric [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Johnson, Jeffrey O. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Nicholson, Andrew D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Patton, Bruce W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Peplow, Douglas E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Miller, Thomas Martin [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Ayaz-Maierhafer, Birsen [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2015-01-01

This report summarizes the findings of a two year effort to systematically assess neutron and gamma backgrounds relevant to operational modeling and detection technology implementation. The first year effort focused on reviewing the origins of background sources and their impact on measured rates in operational scenarios of interest. The second year has focused on the assessment of detector and algorithm performance as they pertain to operational requirements against the various background sources and background levels.

Teacher Conceptions and Approaches Associated with an Immersive Instructional Implementation of Computer-Based Models and Assessment in a Secondary Chemistry Classroom

Science.gov (United States)

Waight, Noemi; Liu, Xiufeng; Gregorius, Roberto Ma.; Smith, Erica; Park, Mihwa

2014-01-01

This paper reports on a case study of an immersive and integrated multi-instructional approach (namely computer-based model introduction and connection with content; facilitation of individual student exploration guided by exploratory worksheet; use of associated differentiated labs and use of model-based assessments) in the implementation of…

[Guideline implementation study on asthma: Results of a pragmatic implementation approach].

Science.gov (United States)

Redaèlli, Marcus; Vollmar, Horst Christian; Simic, Dusan; Maly-Schürer, Cornelia; Löscher, Susanne; Koneczny, Nikolaus

2015-01-01

Knowledge transfer from theory to practice in healthcare systems poses a challenge worldwide. Typical examples include national disease management guidelines. The present study contributes towards improving implementation strategies for an asthma guideline. A guideline implementation strategy was examined in a four-armed, non-randomised, controlled intervention study with an additional control group. The study participants were general practitioners and paediatricians recruited from primary care quality circles. All study participants attended an interactive seminar on the evidence-based recommendations for patients with asthma. In addition, the participants were asked to choose among the following options: no further intervention, additional e-learning, training of their practice nurses, or e-learning and training of their practice nurses. The success of the intervention was measured by questionnaire (and the success rate expressed as a percentage). About one third of all participants (n=313) opted for the combination of an interactive seminar and a training of practice nurses; two third preferred the classic way of continuing medical education with an interactive seminar without a further intervention. Just 10 % of the physicians participated in e-learning. Independently of their choice for continuing medical education, all participants demonstrated an increase in knowledge about asthma and an improvement in the management of asthma. The physicians exhibited an average increase in both categories of about 10 % of the percentage values, compared to an increase of about 28 % among the practice nurses without continuing medical education. The physicians' free choice of the educative modules might be an integral part of successful implementation strategies. However, this will require a change of focus from general continuing medical education packages to a more individualised culture of continuing professional development in Germany. Copyright © 2015. Published by

How University Teachers Design Assessments: A Cross-Disciplinary Study

Science.gov (United States)

Bearman, Margaret; Dawson, Phillip; Bennett, Sue; Hall, Matt; Molloy, Elizabeth; Boud, David; Joughin, Gordon

2017-01-01

There are dissonances between educators' aspirations for assessment design and actual assessment implementation in higher education. Understanding how assessment is designed "on the ground" can assist in resolving this tension. Thirty-three Australian university educators from a mix of disciplines and institutions were interviewed. A…

Assessing the flexibility of research-based instructional strategies: Implementing tutorials in introductory physics in the lecture environment

Science.gov (United States)

Kryjevskaia, Mila; Boudreaux, Andrew; Heins, Dustin

2014-03-01

Materials from Tutorials in Introductory Physics, originally designed and implemented by the Physics Education Group at the University of Washington, were used in modified form as interactive lectures under conditions significantly different from those suggested by the curriculum developers. Student learning was assessed using tasks drawn from the physics education research literature. Use of tutorials in the interactive lecture format yielded gains in student understanding comparable to those obtained through the canonical tutorial implementation at the University of Washington, suggesting that student engagement with the intellectual steps laid out in the tutorials, rather than the specific strategies used in facilitating such engagement, plays the central role in promoting student learning. We describe the implementation details and assessment of student learning for two different tutorials: one focused on mechanical waves, used at North Dakota State University, and one on Galilean relativity, used at Western Washington University. Also discussed are factors that may limit the generalizability of the results.

[The implementation of the week surgery in an orthopedic and urology ward and assessment of its impact].

Science.gov (United States)

Mulloni, Giovanna; Petrucco, Stefania; De Marc, Raffaella; Nazzi, Cheti; Petri, Roberto; Guarrera, Giovanni Maria

2015-01-01

The implementation of the week surgery in an orthopedic and urology ward and the assessment of its impact. The week surgery (WS) is one of the models organized according the intensity of care that allows the improvement of the appropriateness of the hospital admissions. To describe the implementation and the impact of the WS on costs and levels of care. The WS was gradually implemented in an orthopedic and urology ward. The planning of the surgeries was modified, the wards where patients would have been transferred during the week-end where identified, the nurses were supported by expert nurses to learn new skills and clinical pathways were implemented. The periods January-June 2012 and 2013 were compared identifying a set of indicators according to the health technology assessment method. The nurses were able to take vacations according to schedule; the cost of outsourcing services were reduced (-4.953 Euros) as well as those of consumables. The nursing care could be guaranteed employing less (-5) full-time nurses; the global clinical performance of the ward did not vary. Unfortunately several urology patients could not be discharged during the week-ends. A good planning of the surgeries according to the patients' length of staying, together with interventions to increase the staff-skill mix, and the clinical pathways allowed an effective and efficient implementation of the WS model without jeopardizing patients' safety.

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version.

Science.gov (United States)

Vlemmix, Floortje; Rosman, Ageeth N; Fleuren, Margot A H; Rijnders, Marlies E B; Beuckens, Antje; Haak, Monique C; Akerboom, Bettina M C; Bais, Joke M J; Kuppens, Simone M I; Papatsonis, Dimitri N; Opmeer, Brent C; van der Post, Joris A M; Mol, Ben Willem J; Kok, Marjolein

2010-05-10

Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less.We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV.The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Dutch Trial Register (NTR): 1878.

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version

Directory of Open Access Journals (Sweden)

Papatsonis Dimitri N

2010-05-01

Full Text Available Abstract Background Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV and the Dutch Society for Obstetrics and Gynaecology (NVOG. Implementation of ECV does not exceed 50 to 60% and probably less. We aim to improve the implementation of ECV to decrease maternal and neonatal morbidity and mortality due to breech presentations. This will be done by defining barriers and facilitators of implementation of ECV in the Netherlands. An innovative implementation strategy will be developed based on improved patient counselling and thorough instructions of health care providers for counselling. Method/design The ultimate purpose of this implementation study is to improve counselling of pregnant women and information of clinicians to realize a better implementation of ECV. The first phase of the project is to detect the barriers and facilitators of ECV. The next step is to develop an implementation strategy to inform and counsel pregnant women with a breech presentation, and to inform and educate care providers. In the third phase, the effectiveness of the developed implementation strategy will be evaluated in a randomised trial. The study population is a random selection of midwives and gynaecologists from 60 to 100 hospitals and practices. Primary endpoints are number of counselled women. Secondary endpoints are process indicators, the amount of fetes in cephalic presentation at birth, complications due to ECV, the number of caesarean sections and perinatal condition of mother and child. Cost effectiveness of the implementation strategy will be measured. Discussion This study will provide evidence for the cost effectiveness of a structural implementation of external cephalic versions to reduce the number of breech presentations at term. Trial

User's perspectives of barriers and facilitators to implementing quality colonoscopy services in Canada: a study protocol.

Science.gov (United States)

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

2010-11-02

Colorectal cancer (CRC) represents a serious and growing health problem in Canada. Colonoscopy is used for screening and diagnosis of symptomatic or high CRC risk individuals. Although a number of countries are now implementing quality colonoscopy services, knowledge synthesis of barriers and facilitators perceived by healthcare professionals and patients during implementation has not been carried out. In addition, the perspectives of various stakeholders towards the implementation of quality colonoscopy services and the need of an efficient organisation of such services have been reported in the literature but have not been synthesised yet. The present study aims to produce a comprehensive synthesis of actual knowledge on the barriers and facilitators perceived by all stakeholders to the implementation of quality colonoscopy services in Canada. First, we will conduct a comprehensive review of the scientific literature and other published documentation on the barriers and facilitators to implementing quality colonoscopy services. Standardised literature searches and data extraction methods will be used. The quality of the studies and their relevance to informing decisions on colonoscopy services implementation will be assessed. For each group of users identified, barriers and facilitators will be categorised and compiled using narrative synthesis and meta-analytical techniques. The principle factors identified for each group of users will then be validated for its applicability to various Canadian contexts using the Delphi study method. Following this study, a set of strategies will be identified to inform decision makers involved in the implementation of quality colonoscopy services across Canadian jurisdictions. This study will be the first to systematically summarise the barriers and facilitators to implementation of quality colonoscopy services perceived by different groups and to consider the local contexts in order to ensure the applicability of this

Implementing Domestic Violence Gun Confiscation Policy in Rural and Urban Communities: Assessing the Perceived Risk, Benefits, and Barriers.

Science.gov (United States)

Lynch, Kellie R; Logan, T K

2017-07-01

The purpose of this study was to gain a deeper understanding of why communities differing in culture and resources are willing and able to implement gun confiscation as part of a protective order in the absence of a uniform statewide gun law. Specifically, the perceived risk of intimate partner homicide and gun violence, effectiveness of implementing gun confiscation, and the barriers to implementing gun confiscation were assessed. Interviews were conducted with key community professionals ( N = 133) who worked in victim services and the justice system in one urban community and four rural, under-resourced communities. Analyses revealed that professionals in the rural communities viewed the risk of intimate partner homicide and gun violence as lower, and the process of implementing gun confiscation as less effective than professionals in the urban community. In addition, urban justice system professionals, in comparison with all other professionals, reported fewer barriers to enforcing the gun confiscation police and were more likely to downplay law enforcement limitations in the community. The results have implications for developing more effective regional strategies in states that lack domestic violence gun laws as a means to increase a community's ability to enforce gun policies and initiatives.

Evaluation of a program for routine implementation of shared decision-making in cancer care: study protocol of a stepped wedge cluster randomized trial.

Science.gov (United States)

Scholl, Isabelle; Hahlweg, Pola; Lindig, Anja; Bokemeyer, Carsten; Coym, Anja; Hanken, Henning; Müller, Volkmar; Smeets, Ralf; Witzel, Isabell; Kriston, Levente; Härter, Martin

2018-03-27

Shared decision-making (SDM) has become increasingly important in health care. However, despite scientific evidence, effective implementation strategies, and a prominent position on the health policy agenda, SDM is not widely implemented in routine practice so far. Therefore, we developed a program for routine implementation of SDM in oncology by conducting an analysis of the current state and a needs assessment in a pilot study based on the Consolidated Framework for Implementation Research (CFIR). Based on these results, the main aim of our current study is to evaluate the process and outcome of this theoretically and empirically grounded multicomponent implementation program designed to foster SDM in routine cancer care. We use a stepped wedge design, a variant of the cluster randomized controlled trial. The intervention to be implemented is SDM. Three participating clinics of one comprehensive cancer center will be randomized and receive the multicomponent SDM implementation program in a time-delayed sequence. The program consists of the following strategies: (a) SDM training for health care professionals, (b) individual coaching for physicians, (c) patient activation strategy, (d) provision of patient information material and decision aids, (e) revision of the clinics' quality management documents, and (f) critical reflection of current organization of multidisciplinary team meetings. We will conduct a mixed methods outcome and process evaluation. The outcome evaluation will consist of four measurement points. The primary outcome is adoption of SDM, measured by the 9-item Shared Decision Making Questionnaire. A range of other implementation outcomes will be assessed (i.e., acceptability, readiness for implementing change, appropriateness, penetration). The implementation process will be evaluated using stakeholder interviews and field notes. This will allow adapting interventions if necessary. This study is the first large study on routine implementation of

Assessing the Implementation Fidelity of a School-Based Teaching Personal and Social Responsibility Program in Physical Education and Other Subject Areas

Science.gov (United States)

Escartí, Amparo; Liops-Goig, Ramon; Wright, Paul M.

2018-01-01

Purpose: The Teaching Personal and Social Responsibility (TPSR) model was developed to foster responsibility and teach life skills that transfer to various settings. The purpose of this study was to assess the implementation fidelity of a school-based TPSR program in physical education and other subject areas. Method: Systematic observation was…

Implementation of life cycle impact assessment methods. Data v2.0 (2007). Ecoinvent report No. 3

International Nuclear Information System (INIS)

Frischknecht, R.; Jungbluth, N.; Althaus, H.-J.; Hischier, R.; Doka, G.; Bauer, Ch.; Dones, R.; Nemecek, T.; Hellweg, S.; Humbert, S.; Margni, M.; Koellner, T.; Loerincik, Y.

2007-12-01

The ecoinvent database offers life cycle inventory (LCI) and life cycle impact assessment (LCIA) results. The following LCIA methods are implemented in the ecoinvent data v2.0: CML 2001; Cumulative energy demand; Cumulative exergy demand; Eco-indicator 99; Ecological footprint; Ecological scarcity 1997; Ecosystem damage potential EDP; EDIP'97 and 2003 (Environmental design of industrial products); EPS 2000 (environmental priority strategies in product development (will be provided with ecoinvent data v2.1)); IMPACT 2002+; IPCC 2001 (climate change); TRACI; Selected life cycle inventory indicators. There is a range of methodological problems and questions while linking the LCIA methods with the elementary flows of a database. This lead to different results in the past, even if the same LCIA method was applied on the same inventory results. The aim of this report is to avoid such discrepancies. In the first part of this report the general assumptions for the implementation of impact assessment methods on the ecoinvent life cycle inventory data are described. For that purpose, general and harmonised rules were developed how to deal with a certain problem. The second part of this report contains a detailed description of the implementation of the above mentioned methods. Please refer to the original publications for a general description and the scientific background of the methods. It is strongly recommended to read the original publications before using the LCIA results from the ecoinvent database. It is recommended to follow these implementation guidelines also while using other or new LCIA methods, which are so far not implemented in ecoinvent data. (authors)

Implementation of life cycle impact assessment methods. Data v2.0 (2007). Ecoinvent report No. 3

Energy Technology Data Exchange (ETDEWEB)

Frischknecht, R. (ed.) [Ecoinvent Centre, Swiss Federal Laboratories for Materials Testing and Research (EMPA), Duebendorf (Switzerland); Jungbluth, N. (ed.) [ESU-services Ltd, Uster (Switzerland); Althaus, H.-J.; Hischier, R. [Swiss Federal Laboratories for Materials Testing and Research (EMPA), Duebendorf (Switzerland); Doka, G. [Doka Life Cycle Assessments (LCA), Zuerich (Switzerland); Bauer, Ch.; Dones, R. [Paul Scherrer Institute (PSI), Villigen (Switzerland); Nemecek, T. [Forschungsanstalt Agroscope Reckenholz-Taenikon (ART), Zuerich (Switzerland); Hellweg, S. [Swiss Federal Institute of Technology (ETHZ), Institute for Chemicals and Bioengineering (ICB), Zuerich (Switzerland); Humbert, S.; Margni, M. [Swiss Federal Institute of Technology (EPFL), Lausanne (Switzerland); Koellner, T. [Swiss Federal Institute of Technology (ETHZ), Zuerich (Switzerland); Loerincik, Y. [Ecointesys, Swiss Federal Institute of Technology (EPFL), Lausanne (Switzerland)

2007-12-15

The ecoinvent database offers life cycle inventory (LCI) and life cycle impact assessment (LCIA) results. The following LCIA methods are implemented in the ecoinvent data v2.0: CML 2001; Cumulative energy demand; Cumulative exergy demand; Eco-indicator 99; Ecological footprint; Ecological scarcity 1997; Ecosystem damage potential EDP; EDIP'97 and 2003 (Environmental design of industrial products); EPS 2000 (environmental priority strategies in product development (will be provided with ecoinvent data v2.1)); IMPACT 2002+; IPCC 2001 (climate change); TRACI; Selected life cycle inventory indicators. There is a range of methodological problems and questions while linking the LCIA methods with the elementary flows of a database. This lead to different results in the past, even if the same LCIA method was applied on the same inventory results. The aim of this report is to avoid such discrepancies. In the first part of this report the general assumptions for the implementation of impact assessment methods on the ecoinvent life cycle inventory data are described. For that purpose, general and harmonised rules were developed how to deal with a certain problem. The second part of this report contains a detailed description of the implementation of the above mentioned methods. Please refer to the original publications for a general description and the scientific background of the methods. It is strongly recommended to read the original publications before using the LCIA results from the ecoinvent database. It is recommended to follow these implementation guidelines also while using other or new LCIA methods, which are so far not implemented in ecoinvent data. (authors)

Implementation of Subjective Cognitive Decline criteria in research studies

Science.gov (United States)

Molinuevo, José L; Rabin, Laura A.; Amariglio, Rebecca; Buckley, Rachel; Dubois, Bruno; Ellis, Kathryn A.; Ewers, Michael; Hampel, Harald; Klöppel, Stefan; Rami, Lorena; Reisberg, Barry; Saykin, Andrew J.; Sikkes, Sietske; Smart, Colette M.; Snitz, Beth E.; Sperling, Reisa; van der Flier, Wiesje M.; Wagner, Michael; Jessen, Frank

2017-01-01

INTRODUCTION Subjective Cognitive Decline (SCD) manifesting prior to clinical impairment could serve as a target population for early intervention trials in Alzheimer’s disease (AD). A working group, the Subjective Cognitive Decline Initiative (SCD-I), published SCD research criteria in the context of preclinical AD. To successfully apply them, a number of issues regarding assessment and implementation of SCD needed to be addressed. METHODS Members of the SCD-I met to identify and agree upon topics relevant to SCD criteria operationalization in research settings. Initial ideas and recommendations were discussed with other SCD-I working group members and modified accordingly. RESULTS Topics included SCD inclusion and exclusion criteria, together with the informant’s role in defining SCD presence and the impact of demographic factors. DISCUSSION Recommendations for the operationalization of SCD in differing research settings, with the aim of harmonization of SCD measurement across studies are proposed, to enhance comparability and generalizability across studies. PMID:27825022

Knowledge and Implementation of Tertiary Institutions' Social Health Insurance Programme (TISHIP) in Nigeria: a case study of Nnamdi Azikiwe University, Awka.

Science.gov (United States)

Anetoh, Maureen Ugonwa; Jibuaku, Chiamaka Henrietta; Nduka, Sunday Odunke; Uzodinma, Samuel Uchenna

2017-01-01

Tertiary Institutions' Social Health Insurance Programme (TISHIP) is an arm of the National Health Insurance Scheme (NHIS), which provides quality healthcare to students in Nigerian higher institutions. The success of this scheme depends on the students' knowledge and awareness of its existence as well as the level of its implementation by healthcare providers. This study was therefore designed to assess students' knowledge and attitude towards TISHIP and its implementation level among health workers in Nnamdi Azikiwe University Medical Centre. Using a stratified random sampling technique, 420 undergraduate students of Nnamdi Azikiwe University, Awka were assessed on their level of awareness and general assessment of TISHIP through an adapted and validated questionnaire instrument. The level of implementation of the scheme was then assessed among 50 randomly selected staff of the University Medical Center. Data collected were analyzed using Statistical Package for Social Sciences (SPSS) version 20 software. Whereas the students in general, showed a high level of TISHIP awareness, more than half of them (56.3%) have never benefited from the scheme with 52.8% showing dissatisfaction with the quality of care offered with the scheme. However, an overwhelming number of the students (87.9%) opined that the scheme should continue. On the other hand, the University Medical Centre staff responses showed a satisfactory scheme implementation. The study found satisfactory TISHIP awareness with poor attitude among Nnamdi Azikiwe University students. Furthermore, the University Medical Centre health workers showed a strong commitment to the objectives of the scheme.

Association between organizational climate and perceptions and use of an innovation in Swedish primary health care: a prospective study of an implementation.

Science.gov (United States)

Carlfjord, Siw; Festin, Karin

2015-09-10

There is a need for new knowledge regarding determinants of a successful implementation of new methods in health care. The role of a receptive context for change to support effective diffusion has been underlined, and could be studied by assessing the organizational climate. The aim of this study was to assess the association between organizational climate when a computer-based lifestyle intervention tool (CLT) was introduced in primary health care (PHC) and the implementation outcome in terms of how the tool was perceived and used after 2 years. The CLT was offered to 32 PHC units in Sweden, of which 22 units agreed to participate in the study. Before the introduction of the CLT, the creative climate at each participating unit was assessed. After 24 months, a follow-up questionnaire was distributed to the staff to assess how the CLT was perceived and how it was used. A question on the perceived need for the CLT was also included. The units were divided into three groups according to the creative climate: high, medium and low. The main finding was that the units identified as having a positive creative climate demonstrated more frequent use and more positive perceptions regarding the new tool than those with the least positive creative climate. More positive perceptions were seen at both individual and unit levels. According to the results from this study there is an association between organizational climate at baseline and implementation outcome after 2 years when a tool for lifestyle intervention is introduced in PHC in Sweden. Further studies are needed before measurement of organizational climate at baseline can be recommended in order to predict implementation outcome.

Understanding the context of balanced scorecard implementation: a hospital-based case study in Pakistan.

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Rabbani, Fauziah; Lalji, Sabrina Nh; Abbas, Farhat; Jafri, Sm Wasim; Razzak, Junaid A; Nabi, Naheed; Jahan, Firdous; Ajmal, Agha; Petzold, Max; Brommels, Mats; Tomson, Goran

2011-03-31

As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp's context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation. Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing infrastructures and data

Understanding the context of balanced scorecard implementation: a hospital-based case study in pakistan

Directory of Open Access Journals (Sweden)

Ajmal Agha

2011-03-01

Full Text Available Abstract Background As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp's context (why, process (how and content (what framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire and qualitative approaches including key informant interviews and participant observation. Results Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if

Factors associated with early childhood education and care service implementation of healthy eating and physical activity policies and practices in Australia: a cross-sectional study.

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Wolfenden, Luke; Finch, Meghan; Nathan, Nicole; Weaver, Natasha; Wiggers, John; Yoong, Sze Lin; Jones, Jannah; Dodds, Pennie; Wyse, Rebecca; Sutherland, Rachel; Gillham, Karen

2015-09-01

Many early childhood education and care (ECEC) services fail to implement recommended policies and practices supportive of healthy eating and physical activity. The purpose of this study was to assess whether certain theoretically-based factors are associated with implementation of healthy eating and physical activity policies and practices in a sample of ECEC services. A cross-sectional survey was conducted with Service Managers of ECEC services. The survey assessed the operational characteristics, policy, and practice implementation, and 13 factors were suggested by Damschroder's Consolidated Framework for Implementation Research to impede or promote implementation. Logistic regression analyses found a significant association between implementation factor score and full implementation (OR 1.38; 95% CI 1.18-1.61; p = <0.01), indicating that for every one point increase in implementation score, ECEC services were 38 % more likely to be fully implementing the policies and practices. The findings highlight the opportunities for improving implementation of obesity prevention interventions in this setting by developing interventions that address such factors.

Lower limb spasticity assessment using an inertial sensor: a reliability study

International Nuclear Information System (INIS)

Sterpi, I; Colombo, R; Caroli, A; Meazza, E; Maggioni, G; Pistarini, C

2013-01-01

Spasticity is a common motor impairment in patients with neurological disorders that can prevent functional recovery after rehabilitation. In the clinical setting, its assessment is carried out using standardized clinical scales. The aim of this study was to verify the applicability of inertial sensors for an objective measurement of quadriceps spasticity and evaluate its test–retest and inter-rater reliability during the implementation of the Wartenberg pendulum test. Ten healthy subjects and 11 patients in vegetative state with severe brain damage were enrolled in this study. Subjects were evaluated three times on three consecutive days. The test–retest reliability of measurement was assessed in the first two days. The third day was devoted to inter-rater reliability assessment. In addition, the lower limb muscle tone was bilaterally evaluated at the knee joint by the modified Ashworth scale. The factorial ANOVA analysis showed that the implemented method allowed us to discriminate between healthy and pathological conditions. The fairly low SEM and high ICC values obtained for the pendulum parameters indicated a good test–retest and inter-rater reliability of measurement. This study shows that an inertial sensor can be reliably used to characterize leg kinematics during the Wartenberg pendulum test and provide quantitative evaluation of quadriceps spasticity. (paper)

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

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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…

Lung Ultrasound-Implemented Diagnosis of Acute Decompensated Heart Failure in the ED: A SIMEU Multicenter Study.

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Pivetta, Emanuele; Goffi, Alberto; Lupia, Enrico; Tizzani, Maria; Porrino, Giulio; Ferreri, Enrico; Volpicelli, Giovanni; Balzaretti, Paolo; Banderali, Alessandra; Iacobucci, Antonello; Locatelli, Stefania; Casoli, Giovanna; Stone, Michael B; Maule, Milena M; Baldi, Ileana; Merletti, Franco; Cibinel, Gian Alfonso; Baron, Paolo; Battista, Stefania; Buonafede, Giuseppina; Busso, Valeria; Conterno, Andrea; Del Rizzo, Paola; Ferrera, Patrizia; Pecetto, Paolo Fascio; Moiraghi, Corrado; Morello, Fulvio; Steri, Fabio; Ciccone, Giovannino; Calasso, Cosimo; Caserta, Mimma A; Civita, Marina; Condo', Carmen; D'Alessandro, Vittorio; Del Colle, Sara; Ferrero, Stefania; Griot, Giulietta; Laurita, Emanuela; Lazzero, Alberto; Lo Curto, Francesca; Michelazzo, Marianna; Nicosia, Vincenza; Palmari, Nicola; Ricchiardi, Alberto; Rolfo, Andrea; Rostagno, Roberto; Bar, Fabrizio; Boero, Enrico; Frascisco, Mauro; Micossi, Ilaria; Mussa, Alessandro; Stefanone, Valerio; Agricola, Renzo; Cordero, Gabriele; Corradi, Federica; Runzo, Cristina; Soragna, Aldo; Sciullo, Daniela; Vercillo, Domenico; Allione, Attilio; Artana, Nicoletta; Corsini, Fabrizio; Dutto, Luca; Lauria, Giuseppe; Morgillo, Teresa; Tartaglino, Bruno; Bergandi, Daniela; Cassetta, Ilaria; Masera, Clotilde; Garrone, Mario; Ghiselli, Gianluca; Ausiello, Livia; Barutta, Letizia; Bernardi, Emanuele; Bono, Alessia; Forno, Daniela; Lamorte, Alessandro; Lison, Davide; Lorenzati, Bartolomeo; Maggio, Elena; Masi, Ilaria; Maggiorotto, Matteo; Novelli, Giulia; Panero, Francesco; Perotto, Massimo; Ravazzoli, Marco; Saglio, Elisa; Soardo, Flavia; Tizzani, Alessandra; Tizzani, Pietro; Tullio, Mattia; Ulla, Marco; Romagnoli, Elisa

2015-07-01

Lung ultrasonography (LUS) has emerged as a noninvasive tool for the differential diagnosis of pulmonary diseases. However, its use for the diagnosis of acute decompensated heart failure (ADHF) still raises some concerns. We tested the hypothesis that an integrated approach implementing LUS with clinical assessment would have higher diagnostic accuracy than a standard workup in differentiating ADHF from noncardiogenic dyspnea in the ED. We conducted a multicenter, prospective cohort study in seven Italian EDs. For patients presenting with acute dyspnea, the emergency physician was asked to categorize the diagnosis as ADHF or noncardiogenic dyspnea after (1) the initial clinical assessment and (2) after performing LUS ("LUS-implemented" diagnosis). All patients also underwent chest radiography. After discharge, the cause of each patient's dyspnea was determined by independent review of the entire medical record. The diagnostic accuracy of the different approaches was then compared. The study enrolled 1,005 patients. The LUS-implemented approach had a significantly higher accuracy (sensitivity, 97% [95% CI, 95%-98.3%]; specificity, 97.4% [95% CI, 95.7%-98.6%]) in differentiating ADHF from noncardiac causes of acute dyspnea than the initial clinical workup (sensitivity, 85.3% [95% CI, 81.8%-88.4%]; specificity, 90% [95% CI, 87.2%-92.4%]), chest radiography alone (sensitivity, 69.5% [95% CI, 65.1%-73.7%]; specificity, 82.1% [95% CI, 78.6%-85.2%]), and natriuretic peptides (sensitivity, 85% [95% CI, 80.3%-89%]; specificity, 61.7% [95% CI, 54.6%-68.3%]; n = 486). Net reclassification index of the LUS-implemented approach compared with standard workup was 19.1%. The implementation of LUS with the clinical evaluation may improve accuracy of ADHF diagnosis in patients presenting to the ED. Clinicaltrials.gov; No.: NCT01287429; URL: www.clinicaltrials.gov.

Assessing and comparing the short-term effects of TPB only and TPB plus implementation intentions interventions on snacking behavior in Iranian adolescent girls: a cluster randomized trial.

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Karimi-Shahanjarini, Akram; Rashidian, Arash; Omidvar, Nasrin; Majdzadeh, Reza

2013-01-01

The evidence for the effectiveness of theory of planned behavior (TPB)-based interventions is mixed. There is also mixed evidence on the effectiveness of adding implementation intentions to TPB-based interventions. In this study we assessed and compared the short-term effects of TPB-only intervention and TPB plus implementation intentions intervention on snacking behavior and intention to consume unhealthy snacks in Iranian adolescent girls. Three-arm cluster randomized controlled trial. Ten middle schools in Tehran (Iran). A total of 29 classes included 739 female adolescents (age range: 12-15 years). Intervention. Two brief interventions including TPB-only intervention and TPB plus implementation intentions intervention. Food frequency questionnaire and intentions at baseline, 10 days, and 3 months measuring snacking behavior and cognitions about unhealthy snack consumption, respectively. Hierarchical linear modeling to assess the interventions' effects. Both interventions successfully decreased intention to consume and consumption of unhealthy snacks at postintervention. Calculation of the effect sizes revealed that the TPB plus implementation intentions intervention was more effective than the TPB-only intervention. The effects remained significant at 3-month follow-up in the TPB plus implementation intentions intervention group only, although the effect size decreased. Overall, the study suggests that adding implementation intentions on top of TPB-based persuasive messages improves effectiveness and sustainability of desirable changes.

Self-assessment and students’ study strategies in a community of clinical practice: A qualitative study

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Al-Kadri, Hanan M.; Al-Moamary, Mohamed S.; Al-Takroni, Habib; Roberts, Chris; van der Vleuten, Cees P. M.

2012-01-01

Background Self-assessment is recognized as a necessary skill for lifelong learning. It is widely reported to offer numerous advantages to the learner. The research evaluated the impact of students’ and supervisors’ self-assessment and feedback training on students’ perceptions and practices of self-assessment. Moreover, it evaluated the effect of self-assessment process on students’ study strategies within a community of clinical practice. Methods We conducted a qualitative phenomenological study from May 2008 to December 2009. We held 37 semi-structured individual interviews with three different cohorts of undergraduate medical students until we reached data saturation. The cohorts were exposed to different contexts while experiencing their clinical years’ assessment program. In the interviews, students’ perceptions and interpretations of ‘self-assessment practice’ and ‘supervisor-provided feedback’ within different contexts and the resulting study strategies were explored. Results The analysis of interview data with the three cohorts of students yielded three major themes: strategic practice of self-assessment, self-assessment and study strategies, and feedback and study strategies. It appears that self-assessment is not appropriate within a summative context, and its implementation requires cultural preparation. Despite education and orientation on the two major components of the self-assessment process, feedback was more effective in enhancing deeper study strategies. Conclusion This research suggests that the theoretical advantages linked to the self-assessment process are a result of its feedback component rather than the practice of self-assessment isolated from feedback. Further research exploring the effects of different contextual and personal factors on students’ self-assessment is needed. PMID:22355241

Self-assessment and students' study strategies in a community of clinical practice: a qualitative study.

Science.gov (United States)

Al-Kadri, Hanan M; Al-Moamary, Mohamed S; Al-Takroni, Habib; Roberts, Chris; van der Vleuten, Cees P M

2012-01-01

Self-assessment is recognized as a necessary skill for lifelong learning. It is widely reported to offer numerous advantages to the learner. The research evaluated the impact of students' and supervisors' self-assessment and feedback training on students' perceptions and practices of self-assessment. Moreover, it evaluated the effect of self-assessment process on students' study strategies within a community of clinical practice. We conducted a qualitative phenomenological study from May 2008 to December 2009. We held 37 semi-structured individual interviews with three different cohorts of undergraduate medical students until we reached data saturation. The cohorts were exposed to different contexts while experiencing their clinical years' assessment program. In the interviews, students' perceptions and interpretations of 'self-assessment practice' and 'supervisor-provided feedback' within different contexts and the resulting study strategies were explored. The analysis of interview data with the three cohorts of students yielded three major themes: strategic practice of self-assessment, self-assessment and study strategies, and feedback and study strategies. It appears that self-assessment is not appropriate within a summative context, and its implementation requires cultural preparation. Despite education and orientation on the two major components of the self-assessment process, feedback was more effective in enhancing deeper study strategies. This research suggests that the theoretical advantages linked to the self-assessment process are a result of its feedback component rather than the practice of self-assessment isolated from feedback. Further research exploring the effects of different contextual and personal factors on students' self-assessment is needed.

Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

Science.gov (United States)

Shortell, S M; O'Brien, J L; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

1995-01-01

OBJECTIVE: This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. DATA SOURCES AND STUDY SETTING: Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. STUDY DESIGN: The study involved cross-sectional examination of the named relationships. DATA COLLECTION/EXTRACTION METHODS: Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. PRINCIPAL FINDINGS: A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. CONCLUSIONS: What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult

Implementation of the safety assessment in the practice of industrial radiography

International Nuclear Information System (INIS)

Alfonso Pallarés, C.; Pérez Reyes, Y.

2015-01-01

The CNSN as regulatory authority has regulatory control processes based on regulations, permits, inspections and limitation to ensure the supervision and control of the practice of industrial radiography. On the other hand in the light of the new regulations approved and being implemented such as: Resolution 334/2011 CITMA 'Regulation on Notification and authorization of practices and activities associated with the use of ionizing radiation sources' and Resolution 17 / 2012, Security Guide: Security Assessment Practices and Activities associated with the use of ionizing radiation (recommendatory), it is necessary for compliance with regulatory requirements concerning the safety assessment. Since 2009 it has been applied this experience in different medical practices and industry, providing a systematic and consistent basis, to the safety assessment of all facilities and activities, which has helped increase the confidence that has been achieved an adequate level of security. The work was able to identify that there is a group of barriers operating in the risk reduction in various accident sequences and therefore have a relative importance in risk reduction, recommendations in this regard to improve the program management of safety in the practice of industrial radiography. [es

Predicting Teachers' Intentions to Implement School-Based Assessment Using the Theory of Planned Behaviour

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Yan, Zi

2014-01-01

The theory of planned behaviour (TPB) was used to explore the Hong Kong teachers' intentions to implement school-based assessment (SBA) and the predictors of those intentions. A total of 280 teachers from Hong Kong secondary schools who had been involved in SBA were surveyed. Rasch-calibrated teacher measures were calculated for each of the 6…

Article Commentary: Group Learning Assessments as a Vital Consideration in the Implementation of New Peer Learning Pedagogies in the Basic Science Curriculum of Health Profession Programs

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Charlotte L. Briggs

2016-01-01

Full Text Available Inspired by reports of successful outcomes in health profession education literature, peer learning has progressively grown to become a fundamental characteristic of health profession curricula. Many studies, however, are anecdotal or philosophical in nature, particularly when addressing the effectiveness of assessments in the context of peer learning. This commentary provides an overview of the rationale for using group assessments in the basic sciences curriculum of health profession programs and highlights the challenges associated with implementing group assessments in this context. The dearth of appropriate means for measuring group process suggests that professional collaboration competencies need to be more clearly defined. Peer learning educators are advised to enhance their understanding of social psychological research in order to implement best practices in the development of appropriate group assessments for peer learning.

Implementation of Industrial Emissions Directive in Finland. Impacts assessment; Teollisuuspaeaestoedirektiivin toimeenpanon vaikutukset Suomessa

Energy Technology Data Exchange (ETDEWEB)

Attila, M.; Groenroos, J.; Jantunen, J.

2012-08-15

The report deals with environmental, administrative and social effects of the Industrial Emissions Directive (Iced) implementation in Finland. The scope of industrial activities under the IED was determined and compared with the IPPC-directive and existing national environmental legislation. The sectors specifically looked into were large combustion plants, pulp and paper industry, iron and steel industry, as well as intensive rearing of pigs and poultry. Particularly the application of best available techniques (BAT), emissions and environmental impacts within these sectors in Finland were evaluated. The study included interviews of permit and enforcement authorities about their views of the effects on authority tasks, human resource needs and other aspects including administrative procedures. Interviews and questionnaire surveys were also made for industry representatives. Moreover, impacts on emergence and dissemination of innovations were assessed. According to the IED the environmental permit conditions including the emission limit values are to be based on the BAT conclusions, which are reviewed approximately every 10 years. Public consultation of permit applications, permit decisions and supervision documents through electronic media is strengthened which improves means for participation of citizens in the environmental permit process and enforcement activities. The implementation of the IED brings about significant emission reductions in large combustion plants over the next decade and thereafter. To some extent also emissions from pulp and paper industry as well as metal industry in Finland will be reduced. On European level the IED will produce positive effects through reduced transboundary air pollution. The implementation of the IED requires significant investments in large combustion plants, in particular, but also in many processing industry installations. More human resources also need to be allocated to permit and enforcement authority functions for

A Step Prior to REDD+ Implementation: A Socioeconomic Study

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Anne Bernard

2014-01-01

Full Text Available Phase 2 of the United Nations’ REDD+ climate change mitigation initiative is underway in the Democratic Republic of Congo. Meanwhile, activities are being implemented to assess the reduction of emissions from deforestation and forest degradation. REDD+ projects need to include a social dimension; thus, the aim of this research was to understand how land-use relationships vary across communities in an area where a REDD+ project is planned. Specifically, we aimed to identify the primary income-generating activities, the variation in access to land, the potential for the development of community projects, and the implementation of alternative income-generating activities. In the summer of 2013, we assessed a REDD+ pilot project in and around the Luki Biosphere Reserve, Bas-Congo Province. We used participatory rural appraisal (PRA methods in four communities located both inside and outside the reserve. We found that current subsistence income activities led to the destruction of forest habitat due to population pressure and a lack of alternative income-generating activities. Customary land tenures overlay statutory rights, which can often mean that community rights are threatened. To achieve their targets, REDD+ projects should consider the actual land-use patterns of local communities in order to generate sustainable income from the land.

Implementation and assessment of a training course for residents in neonatology and pediatric emergency medicine.

Science.gov (United States)

Brossier, D; Bellot, A; Villedieu, F; Fazilleau, L; Brouard, J; Guillois, B

2017-05-01

Residents must balance patient care and the ongoing acquisition of medical knowledge. With increasing clinical responsibilities and patient overload, medical training is often left aside. In 2010, we designed and implemented a training course in neonatology and pediatric emergency medicine for residents in pediatrics, in order to improve their medical education. The course was made of didactic sessions and several simulation-based seminars for each year of residency. We conducted this study to assess the impact of our program on residents' satisfaction and self-assessed clinical skills. A survey was conducted at the end of each seminar. The students were asked to complete a form on a five-point rating scale to evaluate the courses and their impact on their satisfaction and self-assessed clinical skills, following the French National Health Institute's adapted Kirkpatrick model. Sixty-four (84%) of the 76 residents who attended the courses completed the form. The mean satisfaction score for the entire course was 4.78±0.42. Over 80% of the students felt that their clinical skills had improved. Medical education is an important part of residency training. Our training course responded to the perceived needs of the students with consistently satisfactory evaluations. Before the evaluation of the impact of the course on patient care, further studies are needed to assess the acquisition of knowledge and skills through objective evaluations. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Comparative study for environmental assessment by program characters

Energy Technology Data Exchange (ETDEWEB)

Kim, Suk Chul; Lee, Young Soo; Park, Young Min; Park, Suk Soon; Chung, Kyung Tae; Cho, Hong Yun; Chae, Jang Won; Lee, Sang Don; Lee, Chan Ho; Choi, Joon Kyu; Kim, Kang Joo; Chung, Won Moo; Jin, Jae Yool [Korea Environment Institute, Seoul (Korea)

1998-12-01

The level of environmental assessment in Korea was diagnosed by examining the situation of its model for the entire environmental assessment implemented. Also, it proposed an improvement scheme for its problems to be able to advance. It is expected to be utilized as developing optimum model for Korea and establishing a systematic and concrete guideline for environmental assessment modeling. 244 refs., 65 figs., 28 tabs.

A case study detailing key considerations for implementing a telehealth approach to office ergonomics.

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Ritchie, Catherine L W; Miller, Linda L; Antle, David M

2017-01-01

Telehealth approaches to delivering ergonomics assessment hold great potential to improve service delivery in rural and remote settings. This case study describes a telehealth-based ergonomics service delivery process, and compares in-person and telehealth-based ergonomics approaches at an Alberta-based non-profit advocacy group. This project demonstrates that telehealth approaches to ergonomics do not lead to significantly different scoring outcomes for assessment of ergonomics issues, when compared to in-person assessments. This project also outlines the importance of live real-time video conferencing to improving communication, attaining key assessment information, and demonstrating ergonomic adjustments. However, some key considerations of bandwidth and hardware capabilities need to be taken into account. Key communication strategies are outlined to improve rapport, maintain employee confidentiality, and reduce client anxiety around telehealth ergonomics assessments. This project provides further support for telehealth approaches to office ergonomics, and outlines some key implementation strategies and barriers that should be considered.

Classroom Implementation. Issues in Assessment.

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Malinowski, Patricia A., Ed.

This booklet, second in a series on issues in assessment, seeks to describe an initiative supported by Finger Lakes Community College (New York) to use classroom assessment techniques (CATs) in different academic areas and to present an overview of some assessment approaches that have been used in the classroom. Papers include: (1) "Enhancing…

Logistics Cost Calculation of Implementation Warehouse Management System: A Case Study

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Kučera Tomáš

2017-01-01

Full Text Available Warehouse management system can take full advantage of the resources and provide efficient warehousing services. The paper aims to show advantages and disadvantages of the warehouse management system in a chosen enterprise, which is focused on logistics services and transportation. The paper can bring new innovative approach for warehousing and presents how logistics enterprise can reduce logistics costs. This approach includes cost reduction of the establishment, operation and savings in the overall assessment of the implementation of the warehouse management system. The innovative warehouse management system will be demonstrated as the case study, which is classified as a qualitative scientific method, in the chosen logistics enterprise. The paper is based on the research of the world literature, analyses of the internal logistics processes, data and finally enterprise documents. The paper discovers costs related to personnel costs, handling equipment costs and costs for material identification. Implementation of the warehouse management system will reduce overall logistics costs of warehousing and extend the warehouse management system to other parts of the logistics chain.

Watershed planning, implementation and assessment: the May River Watershed Action Plan case study

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Kimberly W. Jones; Christopher L. Ellis; Jeremy S. Ritchie

2016-01-01

Prior to exponential growth in the early to mid-2000s, the Town of Bluffton, SC was one square mile; as of 2015, it is approximately 55 square miles. Associated with this growth was a shellfish harvesting closure for nearly onethird of the May River in 2009. The Town and its partners developed and began to implement the May River Watershed Action Plan in 2011. The plan...

Virtual Classrooms in the Workplace: an Implementation Study

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Angela Walsh

2014-06-01

Full Text Available The use of e-learning by corporate organisations as a means to deliver training to employees has grown significantly in recent years. Improvements in technology have meant that corporate Learning and Development (L&D departments now have more options available to them and the use of web 2.0 technologies is increasingly being explored as a method of delivering training to employees both asynchronously and synchronously. Research into elearning in workplaces is limited and tends to consist of anecdotal accounts from organisations with a US focus (Newton & Ellis, 2005. This case study explores the implementation of web conferencing software as a means to deliver training both synchronously and asynchronously within an Irish insurance company. The case study was undertaken during an eight month period prior to the planned launch of the technology and it provides a perspective on the challenges encountered during implementation and how issues affecting the production of high quality e-learning content were overcome. The research was undertaken using an exploratory case study approach. Data was collected through direct observation, participant observation and interviews with trainers and managers who were directly or indirectly involved with the implementation of previous and current e-learning strategies. The research finds that the presence of the championing factors: leadership, learning culture, technology infrastructure and financial support, contributed towards the successful implementation of learning technology within the organisation. In addition the study illustrates that emphasises within the organisation has shifted from producing as much e-learning content as possible to producing high quality e-learning content. Further research is warranted to evaluate the transfer of knowledge and behavioural change achieved as a result of the content generated during the study. The study has relevance for corporate L&D departments considering the

Implementing an early childhood school-based mental health promotion intervention in low-resource Ugandan schools: study protocol for a cluster randomized controlled trial.

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Huang, Keng-Yen; Nakigudde, Janet; Calzada, Esther; Boivin, Michael J; Ogedegbe, Gbenga; Brotman, Laurie Miller

2014-12-01

Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs, but this region has limited access to mental health workers and resources to address these needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions are not available in SSA. This study will investigate the transportability of an evidence-based program from a developed country (United States) to a SSA country (Uganda). The approach includes task-shifting to early childhood teachers and consists of professional development (five days) to introduce strategies for effective behavior management and positive teacher-student interactions, and group-based consultation (14 sessions) to support adoption of effective practices and tailoring to meet the needs of individual students. The design of this study is guided by two implementation frameworks, the Consolidated Framework for Implementation Research and the Teacher Training Implementation Model, that consider multidimensional aspects of intervention fidelity and contextual predictors that may influence implementation and teacher outcomes. Using a cluster randomized design, 10 schools in Uganda will be randomized to either the intervention group (five schools) or the waitlist control group (five schools). A total of 80 to 100 early childhood teachers will be enrolled in the study. Teacher utilization of evidence-based strategies and practices will be assessed at baseline, immediate post-intervention (six months after baseline), and at seven months post-intervention (during a new academic year). Fidelity measures will be assessed throughout the program implementation period (during professional development and consultation sessions). Individual teacher and contextual factors will be assessed at baseline. Data will be collected from multiple sources. Linear mixed-effect modeling, adjusting for school nesting, will be applied to address study questions. The

Structural observation of long-span suspension bridges for safety assessment: implementation of an optical displacement measurement system

International Nuclear Information System (INIS)

Martins, L Lages; Ribeiro, A Silva; Rebordão, J M

2015-01-01

This paper addresses the implementation of an optical displacement measurement system in the observation scenario of a long-span suspension bridge and its contribution for structural safety assessment. The metrological background required for quality assurance of the measurements is described, namely, the system's intrinsic parameterization and integration in the SI dimensional traceability chain by calibration, including its measurement uncertainty assessment

Facilitating the implementation of the American College of Surgeons/Association of Program Directors in Surgery phase III skills curriculum: training faculty in the assessment of team skills.

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Hull, Louise; Arora, Sonal; Stefanidis, Dimitrios; Sevdalis, Nick

2015-11-01

Effective teamwork is critical to safety in the operating room; however, implementation of phase III of the American College of Surgeons (ACS) and Association of Program Directors in Surgery (APDS) Curriculum that focuses on team-based skills remains worryingly low. Training and assessing the complexities of teamwork is challenging. The objective of this study was to establish guidelines and recommendations for training faculty in assessing/debriefing team skills. A multistage survey-based consensus study was completed by 108 experts responsible for training and assessing surgical residents from the ACS Accredited Educational Institutes. Experts agreed that a program to teach faculty to assess team-based skills should include training in the recognition of teamwork skills, practice rating these skills, and training in the provision of feedback/debriefing. Agreement was reached that faculty responsible for conducting team-based skills assessment should be revalidated every 2 years and stringent proficiency criteria should be met. Faculty development is critical to ensure high-quality, standardized training and assessment. Training faculty to assess team-based skills has the potential to facilitate the effective implementation of phase III of the ACS and APDS Curriculum. Copyright © 2015 Elsevier Inc. All rights reserved.

Planning, implementation and analysis of an assessment method of an industrial engineering course grounded on problem based learning

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Camila Pereira Pinto

2015-06-01

Full Text Available In a highly competitive market, companies need increasingly skilled human resources, especially when it comes to engineering. Universities, therefore, play an important role in this scenario, while training future professionals of the country. However, in this task, the institutions are faced with the challenge of attracting and working with young people of Generation Y, which have characteristics and needs that are not met by traditional teaching methods. Problem-Based Learning (PBL is an approach evolved in order to study and develop educational alternatives that meet the needs of businesses as well as the new student profile. In addition, actively teaching is not a simple task and becomes more complex when it refers to assess the knowledge gained through this method. Thus, this paper presents the planning, implementation and the assessment method adopted in a course of Industrial Engineering at the Federal University of Itajubá based on PBL. For this study it was adopted the action research method, in which the authors actively participated in all stages of the course, acting as facilitators in the course planning, implementation and monitoring. As a result, it is highlighted in this article, the benefits achieved by all involved through active learning, as well as the strengths and weaknesses of the method. Moreover, improvements are proposed for future courses.

Knowledge and Implementation of Tertiary Institutions’ Social Health Insurance Programme (TISHIP) in Nigeria: a case study of Nnamdi Azikiwe University, Awka

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Anetoh, Maureen Ugonwa; Jibuaku, Chiamaka Henrietta; Nduka, Sunday Odunke; Uzodinma, Samuel Uchenna

2017-01-01

Introduction Tertiary Institutions’ Social Health Insurance Programme (TISHIP) is an arm of the National Health Insurance Scheme (NHIS), which provides quality healthcare to students in Nigerian higher institutions. The success of this scheme depends on the students’ knowledge and awareness of its existence as well as the level of its implementation by healthcare providers. This study was therefore designed to assess students’ knowledge and attitude towards TISHIP and its implementation level among health workers in Nnamdi Azikiwe University Medical Centre. Methods Using a stratified random sampling technique, 420 undergraduate students of Nnamdi Azikiwe University, Awka were assessed on their level of awareness and general assessment of TISHIP through an adapted and validated questionnaire instrument. The level of implementation of the scheme was then assessed among 50 randomly selected staff of the University Medical Center. Data collected were analyzed using Statistical Package for Social Sciences (SPSS) version 20 software. Results Whereas the students in general, showed a high level of TISHIP awareness, more than half of them (56.3%) have never benefited from the scheme with 52.8% showing dissatisfaction with the quality of care offered with the scheme. However, an overwhelming number of the students (87.9%) opined that the scheme should continue. On the other hand, the University Medical Centre staff responses showed a satisfactory scheme implementation. Conclusion The study found satisfactory TISHIP awareness with poor attitude among Nnamdi Azikiwe University students. Furthermore, the University Medical Centre health workers showed a strong commitment to the objectives of the scheme. PMID:29541317

Association of School Characteristics and Implementation in the X:IT Study--A School-Randomized Smoking Prevention Program

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Bast, Lotus S.; Due, Pernille; Ersbøll, Annette K.; Damsgaard, Mogens T.; Andersen, Anette

2017-01-01

Background: Assessment of implementation is essential for the evaluation of school-based preventive activities. Interventions are more easily implemented in schools if detailed instructional manuals, lesson plans, and materials are provided; however, implementation may also be affected by other factors than the intervention itself--for example,…

The implementation of school-based lesson study at elementary school

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Purnomo Purnomo

2017-07-01

Full Text Available This study aims to describe and interpret the implementation of school-based lesson study in SDN I Kretek. This study uses the qualitative research. The data were collected through in-depth interviews, participant observation, field notes, and documentation. The data validity was determined through sources and techniques triangulation. The data were analyzed using the Interactive Analysis Model from Miles and Huberman. The results show: (1 the planning of school-based lesson study program at SDN 1 Kretek has been implemented from the beginning of the school year 2014/2015 by establishing school-based lesson study team. This team is responsible for planning, managing, and evaluating school-based lesson study program at SDN 1 Kretek, (2 school-based lesson study at SDN 1 Kretek is implemented in three phases, namely planning, implementation, and reflection, and (3 The evaluation of lesson study is conducted by each teacher who has conducted the open class and conducted thoroughly with a meeting by a team of school-based lesson study SDN 1 Kretek at the end of the school year.

Advancing Implementation of Evidence-Based Public Health in China: An Assessment of the Current Situation and Suggestions for Developing Regions.

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Shi, Jianwei; Jiang, Chenghua; Tan, Duxun; Yu, Dehua; Lu, Yuan; Sun, Pengfei; Pan, Ying; Zhang, Hanzhi; Wang, Zhaoxin; Yang, Beilei

2016-01-01

Objective. Existing research shows a serious scarcity of EBPH practice in China and other developing regions; as an exploratory study, this study aimed to assess the current EBPH implementation status in Shanghai of China qualitatively. Methods. Using semistructured key informant interviews, we examined the status of and impediments to the lagging EBPH in China. Data were analyzed based on the Consolidated Framework for Implementation Research (CFIR). Results. Chinese public health practitioners knew more about evidence-based medicine but less about EBPH. The situation was worse in community healthcare centers. Participants perceived that evidence sources were limited and the quality of evidence was low. Concerning the inner setting factors, the structural characteristics, networks and communications, implementation climate, and leadership engagement were confronted with many problems. Among the outer setting factors, external government policies and incentives and low patient compliance were the key problems. Additionally, public health practitioners in Shanghai lacked sufficient awareness of EBPH. Furthermore, the current project-based EBPH lacks a systematic implementation system. Conclusions. Existing practical perspectives on EBPH indicate a lag in the advocacy of this new ideology in China. It would be advisable for healthcare institutions to take the initiative to explore feasible and multiple methods of EBPH promotion.

Assessment of air quality after the implementation of compressed natural gas (CNG) as fuel in public transport in Delhi, India.

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Ravindra, Khaiwal; Wauters, Eric; Tyagi, Sushil K; Mor, Suman; Van Grieken, René

2006-04-01

Public transport in Delhi was amended by the Supreme Court of India to use Compressed Natural Gas (CNG) instead of diesel or petrol. After the implementation of CNG since April 2001, Delhi has the highest fraction of CNG-run public vehicles in the world and most of them were introduced within 20 months. In the present study, the concentrations of various criteria air pollutants (SPM, PM(10), CO, SO(2) and NO(x)) and organic pollutants such as benzene, toluene, xylene (BTX) and polycyclic aromatic hydrocarbons (PAHs) were assessed before and after the implementation of CNG. A decreasing trend was found for PAHs, SO(2) and CO concentrations, while the NO(x) level was increased in comparison to those before the implementation of CNG. Further, SPM, PM(10), and BTX concentrations showed no significant change after the implementation of CNG. However, the BTX concentration demonstrated a clear relation with the benzene content of gasoline. In addition to the impact of the introduction of CNG the daily variation in PAHs levels was also studied and the PAHs concentrations were observed to be relatively high between 10 pm to 6 am, which gives a proof of a relation with the limited day entry and movement of heavy vehicles in Delhi.

Advancing Implementation of Evidence-Based Public Health in China: An Assessment of the Current Situation and Suggestions for Developing Regions

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Jianwei Shi

2016-01-01

Full Text Available Objective. Existing research shows a serious scarcity of EBPH practice in China and other developing regions; as an exploratory study, this study aimed to assess the current EBPH implementation status in Shanghai of China qualitatively. Methods. Using semistructured key informant interviews, we examined the status of and impediments to the lagging EBPH in China. Data were analyzed based on the Consolidated Framework for Implementation Research (CFIR. Results. Chinese public health practitioners knew more about evidence-based medicine but less about EBPH. The situation was worse in community healthcare centers. Participants perceived that evidence sources were limited and the quality of evidence was low. Concerning the inner setting factors, the structural characteristics, networks and communications, implementation climate, and leadership engagement were confronted with many problems. Among the outer setting factors, external government policies and incentives and low patient compliance were the key problems. Additionally, public health practitioners in Shanghai lacked sufficient awareness of EBPH. Furthermore, the current project-based EBPH lacks a systematic implementation system. Conclusions. Existing practical perspectives on EBPH indicate a lag in the advocacy of this new ideology in China. It would be advisable for healthcare institutions to take the initiative to explore feasible and multiple methods of EBPH promotion.

The Common Core State Standards: An Opportunity to Enhance Formative Assessment in History/Social Studies Classrooms

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Ateh, Comfort M.; Wyngowski, Aaron J.

2015-01-01

This article discusses the opportunity that the Common Core State Standards (CCSS) present for enhancing formative assessment (FA) in history and social studies classrooms. There is evidence that FA can enhance learning for students if implemented well. Unfortunately, teachers continue to be challenged in implementing FA in their classrooms. We…

Health information exchange implementation: lessons learned and critical success factors from a case study.

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Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

2014-08-15

statewide HIE were found. The most significant perceived success was accomplishing the implementation, although many interviewees also underscored the value of a project champion with decision-making power. In terms of lessons learned, social reasons were found to be very significant motivators for early implementation, frequently outweighing economic motivations. It was clear that understanding the guides early in the project would have mitigated some of the challenges that emerged, and early communication with the electronic health record vendor so that they have a solid understanding of the undertaking was critical. An HIE implementations evaluation framework was found to be useful for assessing challenges, motivations, value propositions for participating, and success factors to consider for future implementations. This case study illuminates five critical success factors for implementation of a health system onto a statewide HIE. This study also reveals that organizations have varied motivations and value proposition perceptions for engaging in the exchange of health information, few of which, at the early stages, are economically driven.

Implementation of integrated management system

International Nuclear Information System (INIS)

Gaspar Junior, Joao Carlos A.; Fonseca, Victor Zidan da

2007-01-01

In present day exist quality assurance system, environment, occupational health and safety such as ISO9001, ISO14001 and OHSAS18001 and others standards will can create. These standards can be implemented and certified they guarantee one record system, quality assurance, documents control, operational control, responsibility definition, training, preparing and serve to emergency, monitoring, internal audit, corrective action, continual improvement, prevent of pollution, write procedure, reduce costs, impact assessment, risk assessment , standard, decree, legal requirements of municipal, state, federal and local scope. These procedure and systems when isolate applied cause many management systems and bureaucracy. Integration Management System reduce to bureaucracy, excess of documents, documents storage and conflict documents and easy to others standards implementation in future. The Integrated Management System (IMS) will be implemented in 2007. INB created a management group for implementation, this group decides planing, works, policy and advertisement. Legal requirements were surveyed, internal audits, pre-audits and audits were realized. INB is partially in accordance with ISO14001, OSHAS18001 standards. But very soon, it will be totally in accordance with this norms. Many studies and works were contracted to deal with legal requirements. This work have intention of show implementation process of ISO14001, OHSAS18001 and Integrated Management System on INB. (author)

Implementation of building information modeling in Malaysian construction industry

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Memon, Aftab Hameed; Rahman, Ismail Abdul; Harman, Nur Melly Edora

2014-10-01

This study has assessed the implementation level of Building Information Modeling (BIM) in the construction industry of Malaysia. It also investigated several computer software packages facilitating BIM and challenges affecting its implementation. Data collection for this study was carried out using questionnaire survey among the construction practitioners. 95 completed forms of questionnaire received against 150 distributed questionnaire sets from consultant, contractor and client organizations were analyzed statistically. Analysis findings indicated that the level of implementation of BIM in the construction industry of Malaysia is very low. Average index method employed to assess the effectiveness of various software packages of BIM highlighted that Bentley construction, AutoCAD and ArchiCAD are three most popular and effective software packages. Major challenges to BIM implementation are it requires enhanced collaboration, add work to a designer, interoperability and needs enhanced collaboration. For improving the level of implementing BIM in Malaysian industry, it is recommended that a flexible training program of BIM for all practitioners must be created.

Assessing behavioural intention of small and medium enterprises in implementing an HIV/AIDS policy and programme

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A. Parsadh

2005-10-01

Full Text Available Small and Medium Enterprises (SMEs are likely to feel the impact of an HIV/AIDS epidemic through reduced productivity and an increased percentage of absenteeism; staff turnover; recruitment and training costs; cost of employee benefits; and poor staff morale. One of the interventions is to implement an HIV/AIDS policy and programme, yet a literature search showed that psychological studies of SMEs in implementing an HIV/AIDS policy and programme are limited. The present study utilised the model of the theory of planned behaviour (Ajzen, 1988, 1991, which is an extension of the theory of reasoned action (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980. The intention to implement an HIV/AIDS policy and programme was predicted by the theory of planned behaviour constructs such as attitude, subjective norm and perceived behavioural control. The theory of planned behaviour was found to have limited use in assessing behavioural intention of SMEs in implementing an HIV/AIDS policy and programme. Opsomming Die uitwerking van die MIV/VIGS pandemie op Klein en Medium Sake-ondernemings sal tot gevolg hê ’n afname in produktiwiteit; ’n toename in personeelafwesigheid, personeelomset, personeelwerwing en –opleidingskoste, personeelvoordele; en swak personeel moraal tot gevolg hê. Een manier om die probleem aan te spreek is om ’n MIV/VIGS beleid en program te implimenteer. Navorsing toon dat psigologiese studies van klein en medium sakeondernemings om ’n HIV/VIGS beleid en program te implimenteer, beperk is. Hierdie navorsing steun op die teorie van planmatige gedrag (Ajzen, 1988; 1991, wat ’n verlenging is van die teorie van beredeneerde optrede (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980. Die oogmerk met die implimentering van ’n MIV/VIGS beleid en program is bepaal deur die teorie van planmagtige gedrag soos waargeneem in houding, subjektiewe norme en waargenome gedragskontrole. Die resultate toon dat die teorie van planmagtige gedrag

The Implementation of Lesson Study in English Language Learning: A Case Study

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Wakhid Nashruddin

2016-12-01

Full Text Available Lesson Study as a growing interest in the education world has attracted educators, experts, and professionals in the area to make use of it in improving the lessons—it also happens in Indonesia. Originally applied in the teaching of mathematics in Japan, now it turns to be used in other fields, and English is one of them. This paper highlights the guideline on Lesson Study and pictures its application in a private senior high school in Malang, East Java, Indonesia. The adaptation of Lesson Study is interesting since Japan and Indonesia have different cultural background. How Lesson Study is usually implemented in Japan and the US and how it is applied in Indonesia will be seen here. As this is a case study, it will only focus on a school and the result should not be used to generalize Lesson Study applications in Indonesia. Interview and observation were instruments used in this study. The interview was used to gain information on how Lesson Study was normally conducted and observation (and the researchers’ involvements was used to see the real implementation of Lesson Study. What happened during the implementation of Lesson Study and during the teaching and learning process become a great attention here.

The Implementation Leadership Scale (ILS): development of a brief measure of unit level implementation leadership.

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Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R

2014-04-14

In healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation Leadership Scale (ILS). Participants were 459 mental health clinicians working in 93 different outpatient mental health programs in Southern California, USA. Initial item development was supported as part of a two United States National Institutes of Health (NIH) studies focused on developing implementation leadership training and implementation measure development. Clinician work group/team-level data were randomly assigned to be utilized for an exploratory factor analysis (n = 229; k = 46 teams) or for a confirmatory factor analysis (n = 230; k = 47 teams). The confirmatory factor analysis controlled for the multilevel, nested data structure. Reliability and validity analyses were then conducted with the full sample. The exploratory factor analysis resulted in a 12-item scale with four subscales representing proactive leadership, knowledgeable leadership, supportive leadership, and perseverant leadership. Confirmatory factor analysis supported an a priori higher order factor structure with subscales contributing to a single higher order implementation leadership factor. The scale demonstrated excellent internal consistency reliability as well as convergent and discriminant validity. The ILS is a brief and efficient measure of unit level leadership for EBP implementation. The availability of the ILS will allow researchers to assess strategic leadership for implementation in order to advance understanding of leadership as a predictor of organizational context for implementation. The ILS also holds promise as a tool for

The implementation leadership scale (ILS): development of a brief measure of unit level implementation leadership

Science.gov (United States)

2014-01-01

Background In healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation Leadership Scale (ILS). Methods Participants were 459 mental health clinicians working in 93 different outpatient mental health programs in Southern California, USA. Initial item development was supported as part of a two United States National Institutes of Health (NIH) studies focused on developing implementation leadership training and implementation measure development. Clinician work group/team-level data were randomly assigned to be utilized for an exploratory factor analysis (n = 229; k = 46 teams) or for a confirmatory factor analysis (n = 230; k = 47 teams). The confirmatory factor analysis controlled for the multilevel, nested data structure. Reliability and validity analyses were then conducted with the full sample. Results The exploratory factor analysis resulted in a 12-item scale with four subscales representing proactive leadership, knowledgeable leadership, supportive leadership, and perseverant leadership. Confirmatory factor analysis supported an a priori higher order factor structure with subscales contributing to a single higher order implementation leadership factor. The scale demonstrated excellent internal consistency reliability as well as convergent and discriminant validity. Conclusions The ILS is a brief and efficient measure of unit level leadership for EBP implementation. The availability of the ILS will allow researchers to assess strategic leadership for implementation in order to advance understanding of leadership as a predictor of organizational context for implementation

Developing a Tool to Assess the Capacity of Out-of-School Time Program Providers to Implement Policy, Systems, and Environmental Change.

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Leeman, Jennifer; Blitstein, Jonathan L; Goetz, Joshua; Moore, Alexis; Tessman, Nell; Wiecha, Jean L

2016-08-11

Little is known about public health practitioners' capacity to change policies, systems, or environments (PSEs), in part due to the absence of measures. To address this need, we partnered with the Alliance for a Healthier Generation (Alliance) to develop and test a theory-derived measure of the capacity of out-of-school time program providers to improve students' level of nutrition and physical activity through changes in PSEs. The measure was developed and tested through an engaged partnership with staff working on the Alliance's Healthy Out-of-School Time (HOST) Initiative. In total, approximately 2,000 sites nationwide are engaged in the HOST Initiative, which serves predominantly high-need children and youths. We partnered with the Alliance to conduct formative work that would help develop a survey that assessed attitudes/beliefs, social norms, external resources/supports, and self-efficacy. The survey was administered to providers of out-of-school time programs who were implementing the Alliance's HOST Initiative. Survey respondents were 185 out-of-school time program providers (53% response rate). Exploratory factor analysis yielded a 4-factor model that explained 44.7% of the variance. Factors pertained to perceptions of social norms (6 items) and self-efficacy to build support and engage a team (4 items) and create (5 items) and implement (3 items) an action plan. We report initial development and factor analysis of a tool that the Alliance can use to assess the capacity of after-school time program providers, which is critical to targeting capacity-building interventions and assessing their effectiveness. Study findings also will inform the development of measures to assess individual capacity to plan and implement other PSE interventions.

Feasibility and acceptance of electronic quality of life assessment in general practice: an implementation study

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Kochen Michael M

2009-06-01

Full Text Available Abstract Background Patients' health related quality of life (HRQoL has rarely been systematically monitored in general practice. Electronic tools and practice training might facilitate the routine application of HRQoL questionnaires. Thorough piloting of innovative procedures is strongly recommended before the conduction of large-scale studies. Therefore, we aimed to assess i the feasibility and acceptance of HRQoL assessment using tablet computers in general practice, ii the perceived practical utility of HRQoL results and iii to identify possible barriers hindering wider application of this approach. Methods Two HRQoL questionnaires (St. George's Respiratory Questionnaire SGRQ and EORTC QLQ-C30 were electronically presented on portable tablet computers. Wireless network (WLAN integration into practice computer systems of 14 German general practices with varying infrastructure allowed automatic data exchange and the generation of a printout or a PDF file. General practitioners (GPs and practice assistants were trained in a 1-hour course, after which they could invite patients with chronic diseases to fill in the electronic questionnaire during their waiting time. We surveyed patients, practice assistants and GPs regarding their acceptance of this tool in semi-structured telephone interviews. The number of assessments, HRQoL results and interview responses were analysed using quantitative and qualitative methods. Results Over the course of 1 year, 523 patients filled in the electronic questionnaires (1–5 times; 664 total assessments. On average, results showed specific HRQoL impairments, e.g. with respect to fatigue, pain and sleep disturbances. The number of electronic assessments varied substantially between practices. A total of 280 patients, 27 practice assistants and 17 GPs participated in the telephone interviews. Almost all GPs (16/17 = 94%; 95% CI = 73–99%, most practice assistants (19/27 = 70%; 95% CI = 50–86% and the majority of

The implementation of customer profitability analysis: a case study

NARCIS (Netherlands)

van Raaij, E.M.; Vernooij, M.J.A.; Vernooij, Maarten J.A.; van Triest, S.P.

2003-01-01

By using customer profitability analysis (CPA), firms can determine the profit contribution of customer segments and/or individual customers. This article presents an approach for the implementation of CPA. The implementation process is illustrated using a case study of a firm producing and selling

Study design for concurrent development, assessment, and implementation of new diagnostic imaging technology

NARCIS (Netherlands)

M.G.M. Hunink (Myriam); G.P. Krestin (Gabriel)

2002-01-01

textabstractWith current constraints on health care resources and emphasis on value for money, new diagnostic imaging technologies must be assessed and their value demonstrated. The state of the art in the field of diagnostic imaging technology assessment advocates a hierarchical

Longitudinal study of the feasibility of using ecological momentary assessment to study teacher stress: Objective and self-reported measures.

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McIntyre, Teresa M; McIntyre, Scott E; Barr, Christopher D; Woodward, Phillip S; Francis, David J; Durand, Angelia C; Mehta, Paras; Kamarck, Thomas W

2016-10-01

There is a lack of comprehensive research on Ecological Momentary Assessment (EMA) feasibility to study occupational stress, especially its long-term sustainability. EMA application in education contexts has also been sparse. This study investigated the feasibility of using EMA to study teacher stress over 2 years using both objective compliance data and a self-reported feasibility survey. It also examined the influence of individual and school factors on EMA feasibility. Participants were 202 sixth through eighth grade teachers from 22 urban middle schools in the southern United States. EMA was implemented via an iPod-based Teacher Stress Diary (TSD). Teachers recorded demands, stress responses, and resources during 12 days (6 waves) over 2 years. Feasibility was assessed via compliance data generated by the TSD (e.g., entry completion) and an EMA Feasibility Survey of self-reported user-friendliness and EMA interference. The results showed high compliance regarding entry and item completion, and completion time, which was sustained over time. User-friendliness was appraised as very high and EMA interference as low. Initial difficulties regarding timing and length of assessments were addressed via EMA method refinement, resulting in improved feasibility. Teachers' ethnicity, age, marital status, grade/course taught, class size, class load, and daily workload impacted feasibility. The results supported the feasibility of using EMA to study work stress longitudinally and the value of continued feasibility monitoring. They also support EMA use to study teacher stress and inform EMA implementation in schools. Some teacher and school factors need to be taken into consideration when deciding on EMA implementation in education contexts. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Study on Design and Implementation of JAVA Programming Procedural Assessment Standard

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Tingting, Xu; Hua, Ma; Xiujuan, Wang; Jing, Wang

2015-01-01

The traditional JAVA course examination is just a list of questions from which we cannot know students' skills of programming. According to the eight abilities in curriculum objectives, we designed an assessment standard of JAVA programming course that is based on employment orientation and apply it to practical teaching to check the teaching…

Implementation and dissemination of a transition of care program for rural veterans: a controlled before and after study

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Chelsea Leonard

2017-10-01

Full Text Available Abstract Background Adapting promising health care interventions to local settings is a critical component in the dissemination and implementation process. The Veterans Health Administration (VHA rural transitions nurse program (TNP is a nurse-led, Veteran-centered intervention designed to improve transitional care for rural Veterans funded by VA national offices for dissemination to other VA sites serving a predominantly rural Veteran population. Here, we describe our novel approach to the implementation and evaluation = the TNP. Methods This is a controlled before and after study that assesses both implementation and intervention outcomes. During pre-implementation, we assessed site context using a mixed method approach with data from diverse sources including facility-level quantitative data, key informant and Veteran interviews, observations of the discharge process, and a group brainstorming activity. We used the Practical Robust Implementation and Sustainability Model (PRISM to inform our inquiries, to integrate data from all sources, and to identify factors that may affect implementation. In the implementation phase, we will use internal and external facilitation, paired with audit and feedback, to encourage appropriate contextual adaptations. We will use a modified Stirman framework to document adaptations. During the evaluation phase, we will measure intervention and implementation outcomes at each site using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance. We will conduct a difference-in-differences analysis with propensity-matched Veterans and VA facilities as a control. Our primary intervention outcome is 30-day readmission and Emergency Department visit rates. We will use our findings to develop an implementation toolkit that will inform the larger scale-up of the TNP across the VA. Discussion The use of PRISM to inform pre-implementation evaluation and synthesize data from multiple sources

Implementing Self-Assessment in Singapore Primary Schools: Effects on Students' Perceptions of Self-Assessment

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Wong, Hwei Ming

2017-01-01

Student academic self-assessment engages the students in deliberate reflection about what they are learning and how they are learning it. This intervention study investigated the effects of self-assessment training on students' perceptions towards self-assessment in two Singaporean primary schools. The study, which used a pretest-posttest design,…

Implementation and Use of the Pharmacy Curriculum Outcomes Assessment at US Schools of Pharmacy.

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Gortney, Justine Schuller; Bray, Brenda S; Salinitri, Francine D

2015-11-25

To describe how schools and colleges of pharmacy use the Pharmacy Curriculum Outcomes Assessment (PCOA) in relation to student assessment and curricular feedback. A survey was distributed to all programs that have implemented the PCOA. The survey was designed to assess 3 domains regarding the use of the PCOA: rationale for use, logistics of administration, and performance data review and distribution. A 79% response rate (41/52) was obtained. The mix of responses was 93% current PCOA users and 7% past users. The most common reasons for PCOA use were for programmatic assessment and benchmarking. The examination was most frequently administered during the P3 year, with minimal stakes attached to performance. Significant differences in responses based on public vs private institution were seen with respect to length of accreditation of current PCOA users, messaging to students regarding performance, inclusion of results in student advising, and distribution of results to stakeholders. Programs were using the PCOA primarily as an assessment in the P3 year for reasons related to programmatic and curricular assessment. Some differences existed between public and private institutional PCOA use and examination-related processes and results distribution.

Case Study Approaches for Implementing the 2007 NRC Report “Toxicity Testing in the 21st Century: A Vision and A Strategy”

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Andersen, Melvin E.; Clewell, Harvey J.; Carmichael, Paul L.; Boekelheide, Kim

2013-01-01

The 2007 report “Toxicity Testing in the 21st Century: A Vision and A Strategy” argued for a change in toxicity testing for environmental agents and discussed federal funding mechanisms that could be used to support this transformation within the USA. The new approach would test for in vitro perturbations of toxicity pathways using human cells with high throughput testing platforms. The NRC report proposed a deliberate timeline, spanning about 20 years, to implement a wholesale replacement of current in-life toxicity test approaches focused on apical responses with in vitro assays. One approach to accelerating implementation is to focus on well-studied prototype compounds with known toxicity pathway targets. Through a series of carefully executed case studies with four or five pathway prototypes, the various steps required for implementation of an in vitro toxicity pathway approach to risk assessment could be developed and refined. In this article, we discuss alternative approaches for implementation and also outline advantages of a case study approach and the manner in which the cases studies could be pursued using current methodologies. A case study approach would be complementary to recently proposed efforts to map the human toxome, while representing a significant extension toward more formal risk assessment compared to the profiling and prioritization approaches offered by programs such as the EPA’s ToxCast effort. PMID:21993955

An exploration of how guideline developer capacity and guideline implementability influence implementation and adoption: study protocol

Directory of Open Access Journals (Sweden)

Lemieux-Charles Louise

2009-07-01

Full Text Available Abstract Background Practice guidelines can improve health care delivery and outcomes but several issues challenge guideline adoption, including their intrinsic attributes, and whether and how they are implemented. It appears that guideline format may influence accessibility and ease of use, which may overcome attitudinal barriers of guideline adoption, and appear to be important to all stakeholders. Guideline content may facilitate various forms of decision making about guideline adoption relevant to different stakeholders. Knowledge and attitudes about, and incentives and capacity for implementation on the part of guideline sponsors may influence whether and how they develop guidelines containing these features, and undertake implementation. Examination of these issues may yield opportunities to improve guideline adoption. Methods The attributes hypothesized to facilitate adoption will be expanded by thematic analysis, and quantitative and qualitative summary of the content of international guidelines for two primary care (diabetes, hypertension and institutional care (chronic ulcer, chronic heart failure topics. Factors that influence whether and how guidelines are implemented will be explored by qualitative analysis of interviews with individuals affiliated with guideline sponsoring agencies. Discussion Previous research examined guideline implementation by measuring rates of compliance with recommendations or associated outcomes, but this produced little insight on how the products themselves, or their implementation, could be improved. This research will establish a theoretical basis upon which to conduct experimental studies to compare the cost-effectiveness of interventions that enhance guideline development and implementation capacity. Such studies could first examine short-term outcomes predictive of guideline utilization, such as recall, attitude toward, confidence in, and adoption intention. If successful, then long-term objective

Mach-Zehnder interferometer implementation for thermo-optical and Kerr effect study

Science.gov (United States)

Bundulis, Arturs; Nitiss, Edgars; Busenbergs, Janis; Rutkis, Martins

2018-04-01

In this paper, we propose the Mach-Zehnder interferometric method for third-order nonlinear optical and thermo-optical studies. Both effects manifest themselves as refractive index dependence on the incident light intensity and are widely employed for multiple opto-optical and thermo-optical applications. With the implemented method, we have measured the Kerr and thermo-optical coefficients of chloroform under CW, ns and ps laser irradiance. The application of lasers with different light wavelengths, pulse duration and energy allowed us to distinguish the processes responsible for refractive index changes in the investigated solution. Presented setup was also used for demonstration of opto-optical switching. Results from Mach-Zehnder experiment were compared to Z-scan data obtained in our previous studies. Based on this, a quality comparison of both methods was assessed and advantages and disadvantages of each method were analyzed.

Safety assessment in plant layout design using indexing approach: implementing inherent safety perspective. Part 1 - guideword applicability and method description.

Science.gov (United States)

Tugnoli, Alessandro; Khan, Faisal; Amyotte, Paul; Cozzani, Valerio

2008-12-15

Layout planning plays a key role in the inherent safety performance of process plants since this design feature controls the possibility of accidental chain-events and the magnitude of possible consequences. A lack of suitable methods to promote the effective implementation of inherent safety in layout design calls for the development of new techniques and methods. In the present paper, a safety assessment approach suitable for layout design in the critical early phase is proposed. The concept of inherent safety is implemented within this safety assessment; the approach is based on an integrated assessment of inherent safety guideword applicability within the constraints typically present in layout design. Application of these guidewords is evaluated along with unit hazards and control devices to quantitatively map the safety performance of different layout options. Moreover, the economic aspects related to safety and inherent safety are evaluated by the method. Specific sub-indices are developed within the integrated safety assessment system to analyze and quantify the hazard related to domino effects. The proposed approach is quick in application, auditable and shares a common framework applicable in other phases of the design lifecycle (e.g. process design). The present work is divided in two parts: Part 1 (current paper) presents the application of inherent safety guidelines in layout design and the index method for safety assessment; Part 2 (accompanying paper) describes the domino hazard sub-index and demonstrates the proposed approach with a case study, thus evidencing the introduction of inherent safety features in layout design.

Implementing interorganizational cooperation in labour market reintegration: a case study.

Science.gov (United States)

Ståhl, Christian

2012-06-01

To bring people with complex medical, social and vocational needs back to the labour market, interorganizational cooperation is often needed. Yet, studies of processes and strategies for achieving sustainable interorganizational cooperation are sparse. The aim of this study was to analyse the implementation processes of Swedish legislation on financial coordination, with specific focus on different strategies for and perspectives on implementing interorganizational cooperation. A multiple-case study was used, where two local associations for financial coordination were studied in order to elucidate and compare the development of cooperative work in two settings. The material, collected during a 3-year period, consisted of documents, individual interviews with managers, and focus groups with officials. Two different implementation strategies were identified. In case 1, a linear strategy was used to implement cooperative projects, which led to difficulties in maintaining cooperative work forms due to a fragmented and time-limited implementation process. In case 2, an interactive strategy was used, where managers and politicians were continuously involved in developing a central cooperation team that became a central part of a developing structure for interorganizational cooperation. An interactive cooperation strategy with long-term joint financing was here shown to be successful in overcoming organizational barriers to cooperation. It is suggested that a strategy based on adaptation to local conditions, flexibility and constant evaluation is preferred for developing sustainable interorganizational cooperation when implementing policies or legislation affecting interorganizational relationships.

What stage are low-income and middle-income countries (LMICs) at with patient safety curriculum implementation and what are the barriers to implementation? A two-stage cross-sectional study

Science.gov (United States)

Ginsburg, Liane R; Dhingra-Kumar, Neelam; Donaldson, Liam J

2017-01-01

Objectives The improvement of safety in healthcare worldwide depends in part on the knowledge, skills and attitudes of staff providing care. Greater patient safety content in health professional education and training programmes has been advocated internationally. While WHO Patient Safety Curriculum Guides (for Medical Schools and Multi-Professional Curricula) have been widely disseminated in low-income and middle-income countries (LMICs) over the last several years, little is known about patient safety curriculum implementation beyond high-income countries. The present study examines patient safety curriculum implementation in LMICs. Methods Two cross-sectional surveys were carried out. First, 88 technical officers in Ministries of Health and WHO country offices were surveyed to identify the pattern of patient safety curricula at country level. A second survey followed that gathered information from 71 people in a position to provide institution-level perspectives on patient safety curriculum implementation. Results The majority, 69% (30/44), of the countries were either considering whether to implement a patient safety curriculum or actively planning, rather than actually implementing, or embedding one. Most organisations recognised the need for patient safety education and training and felt a safety curriculum was compatible with the values of their organisation; however, important faculty-level barriers to patient safety curriculum implementation were identified. Key structural markers, such as dedicated financial resources and relevant assessment tools to evaluate trainees’ patient safety knowledge and skills, were in place in fewer than half of organisations studied. Conclusions Greater attention to patient safety curriculum implementation is needed. The barriers to patient safety curriculum implementation we identified in LMICs are not unique to these regions. We propose a framework to act as a global standard for patient safety curriculum implementation

Graduate performance of science education department in implementing conservation-based science teaching

Science.gov (United States)

Parmin; Savitri, E. N.; Amalia, A. V.; Pratama, M. R.

2018-04-01

This study aims to measure the performance of graduates in implementing conservation-based science teaching. The study employed a qualitative method by collecting the self-assessment data from alumni and the performance assessment from the headmasters of schools where the graduates are currently teaching. There are nine indicators of conservation insight examined in this study. The study concluded that the 78 alumni, who have become teachers when the study was conducted, perform well in implementing conservative science lessons.

Assessing HITECH Implementation and Lessons: 5 Years Later.

Science.gov (United States)

Gold, Marsha; McLAUGHLIN, Catherine

2016-09-01

The expansive goals of the Health Information Technology for Economic and Clinical Health (HITECH) Act required the simultaneous development of a complex and interdependent infrastructure and a wide range of relationships, generating points of vulnerability. While federal legislation can be a powerful stimulus for change, its effectiveness also depends on its ability to accommodate state and local policies and private health care markets. Ambitious goals require support over a long time horizon, which can be challenging to maintain. The future of health information technology (health IT) support nationally is likely to depend on the ability of the technology to satisfy its users that its functionalities address the interests policymakers and other stakeholders have in using technology to promote better care, improved outcomes, and reduced costs. The Health Information Technology for Economic and Clinical Health (HITECH) Act set ambitious goals for developing electronic health information as one tool to reform health care delivery and improve health outcomes. With HITECH's grant funding now mostly exhausted but statutory authority for standards remaining, this article looks back at HITECH's experience in the first 5 years to assess its implementation, remaining challenges, and lessons learned. This review derives from a global assessment of the HITECH Act. Earlier, we examined the logic of HITECH and identified interdependencies critical to its ultimate success. In this article, we build on that framework to review what has and has not been accomplished in building the infrastructure authorized by HITECH since it was enacted. The review incorporates quantitative and qualitative evidence of progress from the global assessment and from the evaluations funded by the Office of the National Coordinator for Health Information Technology (ONC) of individual programs authorized by the HITECH Act. Our review of the evidence provides a mixed picture. Despite HITECH

Implementing assessments of robot-assisted technical skill in urological education: a systematic review and synthesis of the validity evidence.

Science.gov (United States)

Goldenberg, Mitchell G; Lee, Jason Y; Kwong, Jethro C C; Grantcharov, Teodor P; Costello, Anthony

2018-03-31

To systematically review and synthesise the validity evidence supporting intraoperative and simulation-based assessments of technical skill in urological robot-assisted surgery (RAS), and make evidence-based recommendations for the implementation of these assessments in urological training. A literature search of the Medline, PsycINFO and Embase databases was performed. Articles using technical skill and simulation-based assessments in RAS were abstracted. Only studies involving urology trainees or faculty were included in the final analysis. Multiple tools for the assessment of technical robotic skill have been published, with mixed sources of validity evidence to support their use. These evaluations have been used in both the ex vivo and in vivo settings. Performance evaluations range from global rating scales to psychometrics, and assessments are carried out through automation, expert analysts, and crowdsourcing. There have been rapid expansions in approaches to RAS technical skills assessment, both in simulated and clinical settings. Alternative approaches to assessment in RAS, such as crowdsourcing and psychometrics, remain under investigation. Evidence to support the use of these metrics in high-stakes decisions is likely insufficient at present. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

Knee ultrasound from research to real practice: a systematic literature review of adult knee ultrasound assessment feasibility studies.

Science.gov (United States)

Peltea, Alexandra; Berghea, Florian; Gudu, Tania; Ionescu, Ruxandra

2016-12-05

To identify and analyse existing data regarding knee ultrasound (US) feasibility in clinical practice. Material and methods: A systematic literature review was performed using the terms: ("knee") AND ("ultrasound" OR "ultrasonography") AND ("feasibility" OR "pilot" OR "proof of concept"). Feasibility studies regarding knee US or US aided maneuver involving knee joint, published during 2005-2015, were selected and evaluated against a complex framework constructed around mandatory key areas for feasibility studies: acceptability, demand, implementation, practicality, adaptation, integration and expansion. One hundred and fifty-nine publications were identified, of which 9 were included in the final analysis: 6 dealt with the development and implementation of novel US scores, while the rest focused on implementing MSUS in clinical practice, evaluating the usefulness of articular cartilage US assessment and the feasibility of sonography for intra-articular knee injections, respectively. Six studies quantified feasibility as time spent for the evaluation, with only two addressing areassuch as acceptability, implementation and practicality, although none of these systematically assessed all feasibility domains. Knee US feasibility is still poorly addressed; the time required for US assessment is the main area addressed. This information gap should be properly addressed in future works, in order to ensure the right place for this technique.

Intimate examination teaching with volunteers: implementation and assessment at the University of Antwerp.

Science.gov (United States)

Hendrickx, Kristin; De Winter, Benedicte Y; Wyndaele, Jean-Jacques; Tjalma, Wiebren A A; Debaene, Luc; Selleslags, Bert; Mast, Frieda; Buytaert, Philippe; Bossaert, Leo

2006-10-01

Teaching intimate physical examinations in medical schools generates practical, didactical and ethical problems. At the University of Antwerp, a unique program with intimate examination assistants (IEA) was implemented for fifth year's undergraduate students. They learn gynaecological and urological skills in healthy volunteers. Technical, communicative and attitude aspects are taken into account. Description of the implementation of the project. Assessment of the project by questionnaires, written reflections and round table conferences. The results provide detailed information about the student's perceptions of each component of the program as well as the perceptions of the IEA's and the teachers. The multilevel evaluation of the program supports the surplus value of working with IEA's in medical education. The eye-catcher in this program is the integration of clinical skills with communicative skills and attention for students' attitude. Working with IEA's for intimate examinations represents a benefit in medical education by lowering the student's threshold to perform the intimate physical examination on both men and women during their fulltime clerkships.

Implementing Product Platforms: A Case Study

DEFF Research Database (Denmark)

Nielsen, Ole Fiil; Mortensen, Niels Henrik

2006-01-01

The paper describes a case study dealing with the process of creating and implementing a product platform. The paper espessially deals with the fact that to obtain the benefits of platforms a permanent change in behaviour in product development must be ensured. This change in behaviour requires...... acceptance and approval from the organisation in general and the commitment from management to enforce agreed-upon decisions. The case study itself was performed in the Danish company LEGO Group. The case study had two objectives: To create a technical architecture and align this architecture...

Implementation of project Safe in Amber. Verification study for SFR 1 SAR-08

Energy Technology Data Exchange (ETDEWEB)

Thomson, Gavin; Herben, Martin; Lloyd, Pam; Rose, Danny; Smith, Chris; Barraclough, Ian (Enviros Consulting Ltd (GB))

2008-03-15

This report documents an exercise in which AMBER has been used to represent the models used in Project SAFE, a safety assessment undertaken on SFR 1. (AMBER is a flexible, graphical-user-interface based tool that allows users to build their own dynamic compartmental models to represent the migration, degradation and fate of contaminants in an environmental system. AMBER allows the user to assess routine, accidental and long-term contaminant release.) AMBER has been used to undertake assessment calculations on all of the disposal system, including all disposal tunnels and the Silo, the geosphere and several biosphere modules. The near-field conceptual models were implemented with minimal changes to the approach undertaken previously in Project SAFE. Model complexity varied significantly between individual disposal facilities increasing significantly from the BLA to the BTF and BMA tunnels and Silo. Radionuclide transport through the fractured granite geosphere was approximated using a compartment model approach in AMBER. Several biosphere models were implemented in AMBER including reasonable biosphere development, which considered the evolution of the Forsmark area from coastal to lacustrine to agricultural environments in response to land uplift. Parameters were sampled from distributions and simulations were run for 1,000 realisations. In undertaking the comparison of AMBER with the various codes and calculation tools used in Project SAFE it was necessary to undertake a detailed analysis of the modelling approach previously adopted, with particular focus given to the near-field models. As a result some discrepancies in the implementation of the models and documentation were noted. The exercise demonstrates that AMBER is fully capable of representing the features of the SFR 1 disposal system in a safety assessment suitable for SAR-08

Implementation of project Safe in Amber. Verification study for SFR 1 SAR-08

International Nuclear Information System (INIS)

Thomson, Gavin; Herben, Martin; Lloyd, Pam; Rose, Danny; Smith, Chris; Barra clough, Ian

2008-03-01

This report documents an exercise in which AMBER has been used to represent the models used in Project SAFE, a safety assessment undertaken on SFR 1. (AMBER is a flexible, graphical-user-interface based tool that allows users to build their own dynamic compartmental models to represent the migration, degradation and fate of contaminants in an environmental system. AMBER allows the user to assess routine, accidental and long-term contaminant release.) AMBER has been used to undertake assessment calculations on all of the disposal system, including all disposal tunnels and the Silo, the geosphere and several biosphere modules. The near-field conceptual models were implemented with minimal changes to the approach undertaken previously in Project SAFE. Model complexity varied significantly between individual disposal facilities increasing significantly from the BLA to the BTF and BMA tunnels and Silo. Radionuclide transport through the fractured granite geosphere was approximated using a compartment model approach in AMBER. Several biosphere models were implemented in AMBER including reasonable biosphere development, which considered the evolution of the Forsmark area from coastal to lacustrine to agricultural environments in response to land uplift. Parameters were sampled from distributions and simulations were run for 1,000 realisations. In undertaking the comparison of AMBER with the various codes and calculation tools used in Project SAFE it was necessary to undertake a detailed analysis of the modelling approach previously adopted, with particular focus given to the near-field models. As a result some discrepancies in the implementation of the models and documentation were noted. The exercise demonstrates that AMBER is fully capable of representing the features of the SFR 1 disposal system in a safety assessment suitable for SAR-08

Assessing the ERP-SAP implementation strategy from cultural perspectives

Science.gov (United States)

Wang, Gunawan; Syaiful, Bakhri; Sfenrianto; Nurul, Fajar Ahmad

2017-09-01

Implementing ERP-SAP projects in Indonesian large enterprises frequently create headaches for the consultants, since there are always be a large gap between the outcomes of the SAP with the expected results. Indonesian enterprises have experience with a huge amount of investments and ended up with minor benefits. Despite its unprecedented benefits, the SAP strategy is still considered as a mandatory enterprise system for every enterprise to compete in the marketplaces. The article examines the SAP implementation from cultural perspectives to present new horizon that commonly ignored by major Indonesian enterprises. The article applies the multiple case studies with three large Indonesia enterprises, such as KS, the largest steel producer; GEM, a subsidiary of conglomerate enterprise operates in the mining industry, and HS, a subsidiary of the largest retailer in Asia with more than 700 stores in Indonesia. The outcome of the article is expected to provide a comprehensive analysis from cultural perspectives regarding to common problems faced by SAP consultants.

The management issues of implementing telecommuting: a case study

OpenAIRE

Bane, Chuck Howard, Jr.

1993-01-01

Approved for public release; distribution is unlimited. This thesis is a case study of the implementation of telecommuting by CalComp at the Telecommuting Workcenter of Riverside County and is a real life example of the management issues that surround telecommuting. The issues brought forth in this study will enable those responsible for implementing a telecommuting program to better understand the impact of this change on their organization and how a telecommuting center may be used in th...

Implementation evaluation of the Dutch national heat plan among long-term care institutions in Amsterdam: a cross-sectional study

NARCIS (Netherlands)

Kunst, Anton E.; Britstra, Rieneke

2013-01-01

In 2007, a national heat plan was introduced in the Netherlands to effectively protect vulnerable populations (such as institutionalised elderly people) against heatwaves. The aim of this study was to assess the extent to which the measures recommended in this heat plan had been implemented, and

Implementing community-based provider participation in research: an empirical study

Science.gov (United States)

2012-01-01

Background Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. Methods We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute’s (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. Results The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization

Exploring assessment factors contributing to students' study strategies: literature review.

NARCIS (Netherlands)

Al-Kadri, H.M.; Al-Moamary, M.S.; Roberts, C.; Vleuten, C.P.M. van der

2012-01-01

"Assessment steers students' learning" is a statement that has been used repeatedly without solid evidence in the literature. This manuscript aims to evaluate the published literatures on the effect of teaching learning environment in particular, the implemented assessment on students' learning

Barriers to and facilitators for implementing quality improvements in palliative care - results from a qualitative interview study in Norway.

Science.gov (United States)

Sommerbakk, Ragni; Haugen, Dagny Faksvåg; Tjora, Aksel; Kaasa, Stein; Hjermstad, Marianne Jensen

2016-07-15

Implementation of quality improvements in palliative care (PC) is challenging, and detailed knowledge about factors that may facilitate or hinder implementation is essential for success. One part of the EU-funded IMPACT project (IMplementation of quality indicators in PAlliative Care sTudy) aiming to increase the knowledge base, was to conduct national studies in PC services. This study aims to identify factors perceived as barriers or facilitators for improving PC in cancer and dementia settings in Norway. Individual, dual-participant and focus group interviews were conducted with 20 employees working in different health care services in Norway: two hospitals, one nursing home, and two local medical centers. Thematic analysis with a combined inductive and theoretical approach was applied. Barriers and facilitators were connected to (1) the innovation (e.g. credibility, advantage, accessibility, attractiveness); (2) the individual professional (e.g. motivation, PC expertise, confidence); (3) the patient (e.g. compliance); (4) the social context (e.g. leadership, culture of change, face-to-face contact); (5) the organizational context (e.g. resources, structures/facilities, expertise); (6) the political and economic context (e.g. policy, legislation, financial arrangements) and (7) the implementation strategy (e.g. educational, meetings, reminders). Four barriers that were particular to PC were identified: the poor general condition of patients in need of PC, symptom assessment tools that were not validated in all patient groups, lack of PC expertise and changes perceived to be at odds with staff's philosophy of care. When planning an improvement project in PC, services should pay particular attention to factors associated with their chosen implementation strategy. Leaders should also involve staff early in the improvement process, ensure that they have the necessary training in PC and that the change is consistent with the staff's philosophy of care. An important

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.

Studying Human Resource Information Systems Implementation using Adaptive Structuration Theory: The Case of an HRIS Implementation at Dow Chemical Company

NARCIS (Netherlands)

Ruel, Hubertus Johannes Maria; Chiemeke, Charles C.; Bondarouk, Tatiana; Ruel, Hubertus Johannes Maria; Guiderdoni-Jourdain, Karine; Oiry, Ewan

2009-01-01

Research on Human Resource Information Systems (HRIS) implementation lacks theoretical depth and richness. For that reason this paper applies a theory to HRIS implementation developed by Gerardine DeSanctis and Marshal Scott Poole originally for studying information systems implementation, namely

Do daily fluctuations in inhibitory control predict alcohol consumption? : An ecological momentary assessment study

NARCIS (Netherlands)

Jones, Andrew; Tiplady, Brian; Houben, Katrijn; Nederkoorn, Chantal; Field, Matt

RATIONALE: Deficient inhibitory control is predictive of increased alcohol consumption in the laboratory; however, little is known about this relationship in naturalistic, real-world settings. OBJECTIVES: In the present study, we implemented ecological momentary assessment methods to investigate the

Determination of the potential implementation impact of 2016 ministry of environmental protection generic assessment criteria for potentially contaminated sites in China.

Science.gov (United States)

Cheng, Yuanyuan; Tang, Yu-Ting; Nathanail, C Paul

2017-04-12

The Ministry of Environmental Protection of China issued a 3rd draft edition of risk-based Generic Assessment Criteria (the MEP-GAC) in March 2016. Since these will be the first authoritative GAC in China, their implementation is likely to have a significant impact on China's growing contaminated land management sector. This study aims to determine the potential implementation impact of the MEP-GAC through an in-depth analysis of the management context, land use scenarios, health criteria values adopted and exposure pathways considered. The MEP-GAC have been proposed for two broad categories of land use scenarios for contaminated land risk assessment, and these two categories of land use scenarios need to be further delved, and a MEP-GAC for Chinese cultivated land scenario ought to be developed, to ensure human health protection of Chinese farmers. The MEP-GAC have adopted 10 -6 as the acceptable lifetime cancer risk, given the widespread extent and severe level of land contamination in China, consideration should be given to the decision on excess lifetime cancer risk of 10 -5 . During risk assessment process in practice, it is better to review the 20% TDI against local circumstances to determine their suitability before adopting it. The MEP-GAC are based on a SOM value of 1%, for regions with particularly high SOM, it might be necessary to develop regional GAC, due to SOM's significant impact on the GAC developed. An authoritative risk assessment model developed based on HJ25.3-2014 would help facilitate the DQRA process in practice. The MEP-GAC could better reflect the likely exposures of China's citizens due to vapour inhalation by using characteristics of Chinese exposure scenarios, including China-generic building stock, as inputs into the Johnson and Ettinger model as opposed to adoption of the US EPA parameters. The MEP-GAC once implemented will set the trajectory for the development of the investigation, assessment and remediation of land contamination

Radiation Safety Analysis In The NFEC For Assessing Possible Implementation Of The ICRP-60 Standard

International Nuclear Information System (INIS)

Yowono, I.

1998-01-01

Radiation safety analysis of the 3 facilities in the nuclear fuel element center (NFEC) for assessing possible implementation of the ICRP-60 standard has been done. The analysis has covered the radiation dose received by workers, dose rate in the working area, surface contamination level, air contamination level and the level of radioactive gas release to the environment. The analysis has been based on BATAN regulation and ICRP-60 standard. The result of the analysis has showed that the highest radiation dose received has been found to be only around 15% of the set value in the ICRP-60 standard and only 6% of the set value in the BATAN regulation. Thus the ICRP-60 as radiation safety standard could be implemented without changing the laboratory design

Implementing a low-cost web-based clinical trial management system for community studies: a case study.

Science.gov (United States)

Geyer, John; Myers, Kathleen; Vander Stoep, Ann; McCarty, Carolyn; Palmer, Nancy; DeSalvo, Amy

2011-10-01

Clinical trials with multiple intervention locations and a single research coordinating center can be logistically difficult to implement. Increasingly, web-based systems are used to provide clinical trial support with many commercial, open source, and proprietary systems in use. New web-based tools are available which can be customized without programming expertise to deliver web-based clinical trial management and data collection functions. To demonstrate the feasibility of utilizing low-cost configurable applications to create a customized web-based data collection and study management system for a five intervention site randomized clinical trial establishing the efficacy of providing evidence-based treatment via teleconferencing to children with attention-deficit hyperactivity disorder. The sites are small communities that would not usually be included in traditional randomized trials. A major goal was to develop database that participants could access from computers in their home communities for direct data entry. Discussed is the selection process leading to the identification and utilization of a cost-effective and user-friendly set of tools capable of customization for data collection and study management tasks. An online assessment collection application, template-based web portal creation application, and web-accessible Access 2007 database were selected and customized to provide the following features: schedule appointments, administer and monitor online secure assessments, issue subject incentives, and securely transmit electronic documents between sites. Each tool was configured by users with limited programming expertise. As of June 2011, the system has successfully been used with 125 participants in 5 communities, who have completed 536 sets of assessment questionnaires, 8 community therapists, and 11 research staff at the research coordinating center. Total automation of processes is not possible with the current set of tools as each is loosely

The effectiveness of studying outcome in the assessment of students from the selected faculty

Directory of Open Access Journals (Sweden)

Anna Goliszek

2014-06-01

Full Text Available The problem of this article is to answer the question whether and to what extent the learning outcomes are achieved by students? The problem is illustrated on the basis of own research carried out on one of education university, majoring in Economics. The effectiveness of the implementation of the effects will be studied based on the subjective opinions of students regarding the scope of their assimilation. Survey was realized within pilot program as a part of systematic survey program “ An assessment of Economy study direction by the students” pointed in introducing students opinions concerning both quality and effectiveness of education but practical-implementation aim is to elaborate indications to improve education quality. An author used public opinion research – questionnaires to collect information. Subjective assessment of education effects realization level by students is positive but it is difficult to determine at that survey stage how realistic above mentioned assessment is. In the opinion of students an effectiveness of practical skills and competences gaining depends upon used research methods like: activating and project methods.

A Preliminary Assessment of the SURF Reactive Burn Model Implementation in FLAG

Energy Technology Data Exchange (ETDEWEB)

Johnson, Carl Edward [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); McCombe, Ryan Patrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Carver, Kyle [United States Air Force, Washington, DC (United States)

2017-09-18

Properly validated and calibrated reactive burn models (RBM) can be useful engineering tools for assessing high explosive performance and safety. Experiments with high explosives are expensive. Inexpensive RBM calculations are increasingly relied on for predictive analysis for performance and safety. This report discusses the validation of Menikoff and Shaw’s SURF reactive burn model, which has recently been implemented in the FLAG code. The LANL Gapstick experiment is discussed as is its’ utility in reactive burn model validation. Data obtained from pRad for the LT-63 series is also presented along with FLAG simulations using SURF for both PBX 9501 and PBX 9502. Calibration parameters for both explosives are presented.

Assessment of risk factors for musculoskeletal disorders using the Rapid Office Strain Assessment (ROSA Method and implementing ergonomics intervention programs in Sepah Bank

Directory of Open Access Journals (Sweden)

I. Nasiri

2015-07-01

.Conclusion: Using the ROSA technique was seemed to be beneficialto assess the ergonomic risk factors of office works, and the deficiencies in the workstation can be identified through this method. Moreover,by design and implementation of an educational intervention program along with engineering interventions which comply with the elements of this technique, the defects can be eliminated.

Exploring the Effectiveness of Implementing Seminars as a Teaching and an Assessment Method in a Children's Literature Course

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Al'Adawi, Sharifa Said Ali

2017-01-01

The classroom environment should support students' autonomy through teaching and assessment methods. This article highlights students' perceptions about the value of implementing seminars as a teaching and an assessment method in a children's literature course in a college of applied sciences (XCAS). Additionally, preparation considerations and…

Implementation of a competency assessment tool for agency nurses working in an acute paediatric setting.

LENUS (Irish Health Repository)

Hennerby, Cathy

2012-02-01

AIM: This paper reports on the implementation of a competency assessment tool for registered general agency nurses working in an acute paediatric setting, using a change management framework. BACKGROUND: The increased number of registered general agency nurses working in an acute children\\'s hospital alerted concerns around their competency in working with children. These concerns were initially raised via informal complaints about \\'near misses\\

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.

Assessing the impacts of implementing lean construction Evaluando los impactos de la implementación de lean construction

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Luis F Alarcón

2008-04-01

Full Text Available Over the last 10 years an increasing number of companies have implemented lean construction practices in an attempt to improve performance in construction projects. Most companies, and also some researchers, have reported satisfactory results from their implementation. However, there is still a need to provide more extensive analysis of the empirical evidence available to assess the impact of the implementation of lean construction. The authors have researched the implementation of the Last Planner System and other Lean Construction techniques in over one hundred construction projects over the last five years. They have also developed strategies and support tools for implementation. This paper analyzes some of the main impacts observed in the studied projects, and some of the lessons learned from implementations. The paper discusses difficulties and barriers for implementation, productivity improvements, variability reduction and effectiveness of implementation strategies. The paper also provides recommendations for future implementation and researchEn los últimos 10 años un creciente número de empresas constructoras ha implementado prácticas de Lean Construction para mejorar el desempeño de sus proyectos. La mayor parte de estas empresas, y también algunos investigadores, han informado sobre buenos resultados obtenidos en los proyectos. Sin embargo, todavía es necesario un análisis más completo de la evidencia empírica disponible para evaluar así el impacto de Lean Construction en los proyectos y empresas. Los autores han investigado la implementación del Sistema Ultimo Planificador y otras técnicas de Lean Construction en mas de un centenar de proyectos en los últimos 5 años y han desarrollado estrategias y herramientas de apoyo para su implementación. Este artículo analiza algunos de los principales impactos observados en los proyectos estudiados y las lecciones aprendidas en este proceso. Se discuten dificultades y barreras

Assessing the Implementation and Cost of High Quality Early Care and Education: A Review of the Literature. OPRE Report 2016-31

Science.gov (United States)

Caronongan, Pia; Kirby, Gretchen; Boller, Kimberly; Modlin, Emily; Lyskawa, Julia

2016-01-01

This report summarizes the findings of a literature review conducted as part of the Assessing the Implementation and Cost of High-Quality Early Care and Education (ECE-ICHQ) project. The project's goal is to create a technically sound and feasible instrument that will provide consistent, systematic measures of the implementation and costs of…

Implementation of outpatient schema therapy for borderline personality disorder: study design

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van Asselt Thea

2009-10-01

Full Text Available Abstract Background Schema Therapy (ST is an integrative psychotherapy based upon a cognitive schema model which aims at identifying and changing dysfunctional schemas and modes through cognitive, experiential and behavioral pathways. It is specifically developed for patients with personality disorders. Its effectiveness and efficiency have been demonstrated in a few randomized controlled trials, but ST has not been evaluated in regular mental healthcare settings. This paper describes the study protocol of a multisite randomized 2-group design, aimed at evaluating the implementation of outpatient schema therapy for patients with borderline personality disorder (BPD in regular mental healthcare and at determining the added value of therapist telephone availability outside office hours in case of crisis. Methods/Design Patient outcome measures will be assessed with a semi-structured interview and self-report measures on BPD, therapeutic alliance, quality of life, costs and general psychopathology at baseline, 6, 12, 18 and 36 months. Intention-to-treat analyses will be executed with survival analysis for dichotomous variables, and one-sample t-tests and ANCOVAs for continuous variables with baseline as covariate and condition as between group factor. All tests will be two-tailed with a significance level of 5%. Discussion The study will provide an answer to the question whether ST can be effectively implemented and whether phone support by the therapist has an additional value. Trial Registration The Dutch Cochrane Center, NTR (TC = 1781.

A 4-year sequential assessment of the Families First Edmonton partnership: challenges to synergy in the implementation stage.

Science.gov (United States)

Gray, Erin; Mayan, Maria; Lo, Sanchia; Jhangri, Gian; Wilson, Douglas

2012-03-01

This article assesses the partnership functioning of Families First Edmonton, a multisectored collaborative effort formed to determine the best health and recreation service delivery model for families with low income. Partners' evaluations of the collaborative process are examined across the formation, implementation, and maintenance stages of development. Statistical analyses of questionnaire data reveal a significant decrease in the partnership's capacity to maximize synergy-a main indicator of a successful collaborative process-in the implementation stage of the partnership. Implications for partnership practice are addressed.

Effects of Language of Implementation on Functional Analysis Outcomes

Science.gov (United States)

Rispoli, Mandy; O'Reilly, Mark; Lang, Russell; Sigafoos, Jeff; Mulloy, Austin; Aguilar, Jeannie; Singer, George

2011-01-01

This study evaluated the influence of language of implementation on functional analysis outcomes for a child with a severe intellectual disability from a Spanish-speaking home. Challenging behavior was assessed during 5-min sessions under 4 conditions; attention, play-verbal, play-nonverbal, and demand and across 2 phases; implementation in…

The primary school teachers’ competence in implementing the 2013 curriculum

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Maba Wayan

2018-01-01

Full Text Available This study was conducted to analyze the competence of primary school teachers in implementing the 2013 curriculum. The 2013 curriculum has been implemented in almost all schools and there are still many unsuccessful implementations in several Indonesian schools. Therefore it is important to study the teachers’ competence in implementing the 2013 curriculum. A qualitative research design was carried out in this study by utilizing argumentative descriptive analysis. The data was collected by carrying out in depth interviews to the primary schools teachers who were selected by random sampling techniques. The results of this study indicated that primary school teachers have insufficient competence in implementing the 2013 curriculum especially in designing lesson plan, lesson plan implementation and assessment practices. Consequently, it is recommended that further intensive training and focus group discussion should be held to improve the teachers’ competence in implementing the 2013 curriculum.

PErineal Assessment and Repair Longitudinal Study (PEARLS: protocol for a matched pair cluster trial

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Thomas Peter W

2010-02-01

Full Text Available Abstract Background The Perineal Assessment and Repair Longitudinal Study (PEARLS is a national clinical quality improvement initiative designed to improve the assessment and management of perineal trauma. Perineal trauma affects around 85% of women who have a vaginal birth in the UK each year and millions more world-wide. Continuous suturing techniques compared with traditional interrupted methods are more effective in reducing pain and postnatal morbidity, however they are not widely used by clinicians despite recommendations of evidence based national clinical guidelines. Perineal suturing skills and postnatal management of trauma remain highly variable within and between maternity units in the UK as well as worldwide. Implementation of a standardised training package to support effective perineal management practices could reduce perineal pain and other related postnatal morbidity for a substantial number of women. Methods/Design PEARLS is a matched pair cluster trial, which is being conducted in maternity units across the UK. Units within a matched pair will be randomised to implement the study intervention either early or late in the study period. The intervention will include the cascading of a multi-professional training package to enhance midwifery and obstetric skills in the assessment, repair and postnatal management of perineal trauma. Women who have had an episiotomy or second degree perineal tear will be eligible for recruitment. Prior to developing the intervention and deciding on study outcomes, a Delphi survey and a consensus conference were held to identify what women, who previously suffered perineal trauma during childbirth, considered to be important outcomes for them. Findings from this preliminary work (which will be reported elsewhere and other outcomes including women's experiences of perineal pain and pain on activity, breastfeeding uptake and duration and psychological well-being as assessed using the Edinburgh

From the teachers' eyes: An ethnographic-case study on developing models of Informal Formative Assessments (IFA) and understanding the challenges to effective implementation in science classrooms

Science.gov (United States)

Sezen, Asli

improved through the use of academic literature on IFA and video-cases of their own practice. Teachers also reflected on the challenges for effective implementations of IFA and they emphasized challenges due to the division of labor among the classroom participants and the open nature of scientific knowledge. Through participation in the study, the teachers helped develop an IFA model for middle school science classrooms designed to capture the complex nature of teacher-student interaction. This model can be used for further analysis of IFA activity and professional development activities focused on assessment practices.

A mixed methods pilot study with a cluster randomized control trial to evaluate the impact of a leadership intervention on guideline implementation in home care nursing

Directory of Open Access Journals (Sweden)

Tourangeau Ann

2008-12-01

Full Text Available Abstract Background Foot ulcers are a significant problem for people with diabetes. Comprehensive assessments of risk factors associated with diabetic foot ulcer are recommended in clinical guidelines to decrease complications such as prolonged healing, gangrene and amputations, and to promote effective management. However, the translation of clinical guidelines into nursing practice remains fragmented and inconsistent, and a recent homecare chart audit showed less than half the recommended risk factors for diabetic foot ulcers were assessed, and peripheral neuropathy (the most significant predictor of complications was not assessed at all. Strong leadership is consistently described as significant to successfully transfer guidelines into practice. Limited research exists however regarding which leadership behaviours facilitate and support implementation in nursing. The purpose of this pilot study is to evaluate the impact of a leadership intervention in community nursing on implementing recommendations from a clinical guideline on the nursing assessment and management of diabetic foot ulcers. Methods Two phase mixed methods design is proposed (ISRCTN 12345678. Phase I: Descriptive qualitative to understand barriers to implementing the guideline recommendations, and to inform the intervention. Phase II: Matched pair cluster randomized controlled trial (n = 4 centers will evaluate differences in outcomes between two implementation strategies. Primary outcome: Nursing assessments of client risk factors, a composite score of 8 items based on Diabetes/Foot Ulcer guideline recommendations. Intervention: In addition to the organization's 'usual' implementation strategy, a 12 week leadership strategy will be offered to managerial and clinical leaders consisting of: a printed materials, b one day interactive workshop to develop a leadership action plan tailored to barriers to support implementation; c three post-workshop teleconferences. Discussion This

Implementing school nursing strategies to reduce LGBTQ adolescent suicide: a randomized cluster trial study protocol.

Science.gov (United States)

Willging, Cathleen E; Green, Amy E; Ramos, Mary M

2016-10-22

Reducing youth suicide in the United States (U.S.) is a national public health priority, and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) youth are at elevated risk. The Centers for Disease Control and Prevention (CDC) endorses six evidence-based (EB) strategies that center on meeting the needs of LGBTQ youth in schools; however, fewer than 6 % of U.S. schools implement all of them. The proposed intervention model, "RLAS" (Implementing School Nursing Strategies to Reduce LGBTQ Adolescent Suicide), builds on the Exploration, Preparation, Implementation, and Sustainment (EPIS) conceptual framework and the Dynamic Adaptation Process (DAP) to implement EB strategies in U.S. high schools. The DAP accounts for the multilevel context of school settings and uses Implementation Resource Teams (IRTs) to facilitate appropriate expertise, advise on acceptable adaptations, and provide data feedback to make schools implementation ready and prepared to sustain changes. Mixed methods will be used to examine individual, school, and community factors influencing both implementation process and youth outcomes. A cluster randomized controlled trial will assess whether LGBTQ students and their peers in RLAS intervention schools (n = 20) report reductions in suicidality, depression, substance use, bullying, and truancy related to safety concerns compared to those in usual care schools (n = 20). Implementation progress and fidelity for each EB strategy in RLAS intervention schools will be examined using a modified version of the Stages of Implementation Completion checklist. During the implementation and sustainment phases, annual focus groups will be conducted with the 20 IRTs to document their experiences identifying and advancing adaptation supports to facilitate use of EB strategies and their perceptions of the DAP. The DAP represents a data-informed, collaborative, multiple stakeholder approach to progress from exploration to sustainment and obtain

Implementing school nursing strategies to reduce LGBTQ adolescent suicide: a randomized cluster trial study protocol

Directory of Open Access Journals (Sweden)

Cathleen E. Willging

2016-10-01

Full Text Available Abstract Background Reducing youth suicide in the United States (U.S. is a national public health priority, and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ youth are at elevated risk. The Centers for Disease Control and Prevention (CDC endorses six evidence-based (EB strategies that center on meeting the needs of LGBTQ youth in schools; however, fewer than 6 % of U.S. schools implement all of them. The proposed intervention model, “RLAS” (Implementing School Nursing Strategies to Reduce LGBTQ Adolescent Suicide, builds on the Exploration, Preparation, Implementation, and Sustainment (EPIS conceptual framework and the Dynamic Adaptation Process (DAP to implement EB strategies in U.S. high schools. The DAP accounts for the multilevel context of school settings and uses Implementation Resource Teams (IRTs to facilitate appropriate expertise, advise on acceptable adaptations, and provide data feedback to make schools implementation ready and prepared to sustain changes. Methods/Design Mixed methods will be used to examine individual, school, and community factors influencing both implementation process and youth outcomes. A cluster randomized controlled trial will assess whether LGBTQ students and their peers in RLAS intervention schools (n = 20 report reductions in suicidality, depression, substance use, bullying, and truancy related to safety concerns compared to those in usual care schools (n = 20. Implementation progress and fidelity for each EB strategy in RLAS intervention schools will be examined using a modified version of the Stages of Implementation Completion checklist. During the implementation and sustainment phases, annual focus groups will be conducted with the 20 IRTs to document their experiences identifying and advancing adaptation supports to facilitate use of EB strategies and their perceptions of the DAP. Discussion The DAP represents a data-informed, collaborative, multiple stakeholder

Study on countermeasures for effective assessment of domestic system of physical protection

International Nuclear Information System (INIS)

Lee, Jong Uk; An, J. S.; Min, G. S.; Yoon, W. K.; Kim, K. J.; Kim, J. K.; Lim, J. H.; Choe, K. K.; Park, S. G.

2004-04-01

Since the threat for nuclear facilities has increased due to the collapse of the Soviet Union and the allegations of Iraq and North Korean nuclear programmes, the concern for international regime of physical protection has been a hot issue worldwide. In addition, as the international strengthening trend of physical protection had been speeded up since the September 11th terror, Member States including the IAEA had agreed to revise the CPPNM(INFCIRC/274/rev.1) and prepared a draft amendment of CPPNM to establish their systems of physical protection based on threat assessment. However, Korean government has not yet established the domestic regime of threat assessment as well as national DBT for nuclear facilities, so it is very urgent to prepare the measures for them. As a domestic countermeasure for the international trend, Korean government promulgated a new 'Law for Physical Protection and Radiological Emergency'(LPPRE) on May 2003, which was based on establishing the regime of threat assessment, but it is necessary for us to construct the substantial countermeasures for its implementation as well as to legislate the following regulations of the LPPRE. Therefore, this study suggests the measures for constructing domestic regime of threat assessment in order to establish the legal and institutional framework and provides the efficient countermeasures for its implementation

Pediatric eMental healthcare technologies: a systematic review of implementation foci in research studies, and government and organizational documents.

Science.gov (United States)

Gehring, Nicole D; McGrath, Patrick; Wozney, Lori; Soleimani, Amir; Bennett, Kathryn; Hartling, Lisa; Huguet, Anna; Dyson, Michele P; Newton, Amanda S

2017-06-21

Researchers, healthcare planners, and policymakers convey a sense of urgency in using eMental healthcare technologies to improve pediatric mental healthcare availability and access. Yet, different stakeholders may focus on different aspects of implementation. We conducted a systematic review to identify implementation foci in research studies and government/organizational documents for eMental healthcare technologies for pediatric mental healthcare. A search of eleven electronic databases and grey literature was conducted. We included research studies and documents from organization and government websites if the focus included eMental healthcare technology for children/adolescents (0-18 years), and implementation was studied and reported (research studies) or goals/recommendations regarding implementation were made (documents). We assessed study quality using the Mixed Methods Appraisal Tool and document quality using the Appraisal of Guidelines for Research & Evaluation II. Implementation information was grouped according to Proctor and colleagues' implementation outcomes-acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability-and grouped separately for studies and documents. Twenty research studies and nine government/organizational documents met eligibility criteria. These articles represented implementation of eMental healthcare technologies in the USA (14 studies), United Kingdom (2 documents, 3 studies), Canada (2 documents, 1 study), Australia (4 documents, 1 study), New Zealand (1 study), and the Netherlands (1 document). The quality of research studies was excellent (n = 11), good (n = 6), and poor (n = 1). These eMental health studies focused on the acceptability (70%, n = 14) and appropriateness (50%, n = 10) of eMental healthcare technologies to users and mental healthcare professionals. The quality of government and organizational documents was high (n = 2), medium (n = 6

Implementing Knowledge Translation Strategies in Funded Research in Canada and Australia: A Case Study

Directory of Open Access Journals (Sweden)

Gabriel Moore

2016-09-01

Full Text Available There is an emerging literature describing the use of knowledge translation strategies to increase the relevance and usability of research, yet there are few real-world examples of how this works in practice. This case study reports on the steps taken to embed knowledge translation strategies in the Movember Foundation's Men’s Mental Health Grant Rounds in 2013–14, which were implemented in Australia and Canada, and on the support provided to the applicants in developing their knowledge translation plans. It identifies the challenges faced by the Men’s Mental Health Program Team and how these were resolved. The strategies explored include articulating knowledge translation requirements, ensuring a common understanding of knowledge translation, assessing knowledge translation plans, methods of engaging end users, and building capacity with applicants. An iterative approach to facilitating knowledge translation planning within project development was rolled out in Australia just prior to Canada so that lessons learned were immediately available to refine the second roll out. Implementation included the use of external knowledge translation expertise, the development of knowledge translation plans, and the need for internal infrastructure to support monitoring and reporting. Differences in the Australian and Canadian contexts may point to differential exposure to the concepts and practices of knowledge translation. This case study details an example of designing and implementing an integrated knowledge translation strategy that moves beyond traditional dissemination models. Lessons learned point to the importance of a long lead-up time, the use of knowledge translation expertise for capacity building, the need for flexible implementation, and the need for efficiencies in supporting applicants.

Comparative assessment of PSI air oxidation model implementation in SCDAPSim3.5, MELCOR 1.8.6 and MELCOR 2.1

International Nuclear Information System (INIS)

Fernandez-Moguel, Leticia

2015-01-01

Highlights: • The PSI air oxidation model has been successfully implemented in MELCOR. • The model treats oxygen as an active species and nitrogen as a catalyst. • The implementation has been assessed against the previous post-test analyses for QUENCH-16. • The pre-oxidation and air phase were consistent when similar modelling options were used. • All code versions were in fair agreement with the experimental data. - Abstract: The PSI air oxidation model has been successfully implemented in the lump parameter code MELCOR. The PSI air oxidation model treats oxygen as an active species and nitrogen as a catalyst that accelerates the oxidation kinetics. The essential feature of the model is the transition from parabolic to linear kinetics. The implementation has been assessed against the previous post-test analyses for the air ingress experiment QUENCH-16 performed with a local version of RELAP5/SCDAPSim3.5. This version contains the PSI air oxidation model. The pre-oxidation and air phase were consistent when similar modelling options were used and all code versions were in fair agreement with the experimental data, showing consistency in the implementation of the model. The PSI air oxidation model will be used in the future for analysis of spent fuel pool uncovery sequences where steam/air mixture is the prototypical environment

What stage are low-income and middle-income countries (LMICs) at with patient safety curriculum implementation and what are the barriers to implementation? A two-stage cross-sectional study.

Science.gov (United States)

Ginsburg, Liane R; Dhingra-Kumar, Neelam; Donaldson, Liam J

2017-06-15

The improvement of safety in healthcare worldwide depends in part on the knowledge, skills and attitudes of staff providing care. Greater patient safety content in health professional education and training programmes has been advocated internationally. While WHO Patient Safety Curriculum Guides (for Medical Schools and Multi-Professional Curricula) have been widely disseminated in low-income and middle-income countries (LMICs) over the last several years, little is known about patient safety curriculum implementation beyond high-income countries. The present study examines patient safety curriculum implementation in LMICs. Two cross-sectional surveys were carried out. First, 88 technical officers in Ministries of Health and WHO country offices were surveyed to identify the pattern of patient safety curricula at country level. A second survey followed that gathered information from 71 people in a position to provide institution-level perspectives on patient safety curriculum implementation. The majority, 69% (30/44), of the countries were either considering whether to implement a patient safety curriculum or actively planning, rather than actually implementing, or embedding one. Most organisations recognised the need for patient safety education and training and felt a safety curriculum was compatible with the values of their organisation; however, important faculty-level barriers to patient safety curriculum implementation were identified. Key structural markers, such as dedicated financial resources and relevant assessment tools to evaluate trainees' patient safety knowledge and skills, were in place in fewer than half of organisations studied. Greater attention to patient safety curriculum implementation is needed. The barriers to patient safety curriculum implementation we identified in LMICs are not unique to these regions. We propose a framework to act as a global standard for patient safety curriculum implementation. Educating leaders through the system in

Technology-based functional assessment in early childhood intervention: a pilot study.

Science.gov (United States)

Khetani, Mary A; McManus, Beth M; Arestad, Kristen; Richardson, Zachary; Charlifue-Smith, Renee; Rosenberg, Cordelia; Rigau, Briana

2018-01-01

Electronic patient-reported outcomes (e-PROs) may provide valid and feasible options for obtaining family input on their child's functioning for care planning and outcome monitoring, but they have not been adopted into early intervention (EI). The purpose of this pilot study was to evaluate the feasibility of implementing technology-based functional assessment into EI practice and to examine child, family, service, and environmental correlates of caregiver-reported child functioning in the home. In a cross-sectional design, eight individual EI providers participated in a 90-min technology-based functional assessment training to recruit participants and a 60-min semi-structured focus group post data collection. Participants completed the Young Children's Participation and Environment Measure (YC-PEM) home section online and Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) via iPad. Participants' EI service use data were obtained from administrative records. A total of 37 caregivers of children between 6 and 35 months old (mean age = 19.4, SD = 7.7) enrolled, a rate of 44% (37/84) in 2.5 months. Providers suggested expanding staff training, gathering data during scheduled evaluations, and providing caregivers and providers with access to assessment summaries. Caregivers wanted their child's participation to change in 56% of home activities. Lower caregiver education and higher EI intensity were related to less child involvement in home activities. Implementing technology-based functional assessment is feasible with modifications, and these data can be useful for highlighting child, family, and EI service correlates of caregiver-reported child functioning that merit further study. Feasibility results informed protocol modifications related to EI provider training, timing of data collection, and management of EI service use data extraction, as preparation for a subsequent scale-up study that is underway.

Environmental impact assessment: Process and implementation

International Nuclear Information System (INIS)

Chen, S.Y.; Tsai, S.Y.

1989-01-01

In this paper, the procedures and issues regarding the preparation of an environmental impact assessment in accordance with the National Environmental Policy Act (NEPA) as promulgated by the US Congress in 1969 are discussed. NEPA procedures and requirements are covered in general, while particular attention is given to the preparation of the environmental impact assessment. Also included is a discussion of the social impact assessment. The aim of the social impact assessment is to address the social issues involved in enhancing public understanding of the hazardous risks, thereby mitigating any conflicts that may arise in the NEPA process. 3 refs., 1 fig., 1 tab

Implementing new product development: A study of personal characteristics among managers

DEFF Research Database (Denmark)

Jespersen, Kristina Risom; Bysted, Rune

2016-01-01

Strategy implementation is an important aspect of innovation, as only 30% of planned strategies are matched by realised innovation outcomes. The present study investigates this in a setting of strategic implementation of New Product Development (NPD). In the implementation process, the managers...... strategic intentions create information overload in the NPD process, which decreases the new product novelty. In contrast, realisation of defensive strategic intentions makes experienced NPD managers focus on known NPD competences, thereby decreasing the new product novelty of NPD efforts. The study...

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

Web-Based System for Adaptable Rubrics: Case Study on CAD Assessment

Science.gov (United States)

Company, Pedro; Contero, Manuel; Otey, Jeffrey; Camba, Jorge D.; Agost, María-Jesús; Pérez-López, David

2017-01-01

This paper describes the implementation and testing of our concept of adaptable rubrics, defined as analytical rubrics that arrange assessment criteria at multiple levels that can be expanded on demand. Because of its adaptable nature, these rubrics cannot be implemented in paper formats, neither are they supported by current Learning Management…

Implementation of a competency assessment tool for agency nurses working in an acute paediatric setting.

Science.gov (United States)

Hennerby, Cathy; Joyce, Pauline

2011-03-01

This paper reports on the implementation of a competency assessment tool for registered general agency nurses working in an acute paediatric setting, using a change management framework. The increased number of registered general agency nurses working in an acute children's hospital alerted concerns around their competency in working with children. These concerns were initially raised via informal complaints about 'near misses', parental dissatisfaction, perceived competency weaknesses and rising cost associated with their use. [Young's (2009) Journal of Organisational Change, 22, 524-548] nine-stage change framework was used to guide the implementation of the competency assessment tool within a paediatric acute care setting. The ongoing success of the initiative, from a nurse manager's perspective, relies on structured communication with the agency provider before employing competent agency nurses. Sustainability of the change will depend on nurse managers' persistence in attending the concerns of those resisting the change while simultaneously supporting those championing the change. These key communication and supporting roles highlight the pivotal role held by nurse managers, as gate keepers, in safe-guarding children while in hospital. Leadership qualities of nurse managers will also be challenged in continuing to manage and drive the change where resistance might prevail. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Social Life Cycle Assessment in the Textile Sector: An Italian Case Study

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Paola Lenzo

2017-11-01

Full Text Available This study presents the first application of the Social Life Cycle Assessment (S-LCA to a textile product made in Sicily (Italy, according to the Social Life Cycle Assessment guidelines (UNEP. The main goal is to assess and present the social values of a product manufactured in a particular territorial area where the presence of an industry represents the main source of employment. The first part of the study is a literature review of the current state of the art of the S-LCA and its implementation to textile products. In the implementation, particular attention is paid in identifying the positive impacts and in highlighting the strengths and weaknesses of the method when applied in this specific sector. The functional unit of the study is an order for a garment (consisting of 495 capes in a soft blend of wool and cashmere, produced by a textile company located in Sicily (Italy. The system boundaries of the study include all phases from cradle-to-gate, i.e. from raw material production through fabric/accessory production to the manufacturing process of the product itself at the company. Background and foreground processes are taken into account using specific and generic data. Two stakeholder groups have been considered (workers and local communities as those that can better represent the company’s value in the territory. The analysis carried out on the functional unit of the study allowed assessing social performance related to the specific textile product, but also to outline the general behaviour of the company. Results offer to scholars a perspective on which to focus their future researches in the sector and highlight that S-LCA is a valuable tool to support business decisions, assessing the social impact of the product to improve the social conditions of stakeholders. However, the access to primary and/or good quality local, national and global data is essential to draw credible conclusions; consequently, every effort to promote the

Association of School Characteristics and Implementation in the X:IT Study-A School-Randomized Smoking Prevention Program.

Science.gov (United States)

Bast, Lotus S; Due, Pernille; Ersbøll, Annette K; Damsgaard, Mogens T; Andersen, Anette

2017-05-01

Assessment of implementation is essential for the evaluation of school-based preventive activities. Interventions are more easily implemented in schools if detailed instructional manuals, lesson plans, and materials are provided; however, implementation may also be affected by other factors than the intervention itself-for example, school-level characteristics, such as principal support and organizational capacity. We examined school-level characteristics of schools in groups of high, medium, and low implementation of a smoking prevention intervention. The X:IT study is a school-randomized trial testing a multicomponent intervention to prevent smoking among adolescents. Our data came from electronic questionnaires completed by school coordinators at 96.1% of participating intervention schools (N = 49) at first follow -up. Schools that implemented the X:IT intervention to a medium or high degree had higher levels of administrative leadership (77.3% and 83.3% vs 42.9%), school climate/organizational health (95.5% and 91.7% vs 66.7%), mission-policy alignment (90.9% and 100.0% vs 71.4%), personnel expertise (81.8% and 75.0% vs 46.7%), school culture (77.3% and 91.7% vs 53.3%), positive classroom climate (91.4% and 96.2% vs 82.9%) compared with low implementation schools. Our findings highlight the importance of considering the school context in future health prevention initiatives. © 2017, American School Health Association.

Implementing nurse prescribing: a case study in diabetes.

Science.gov (United States)

Stenner, Karen; Carey, Nicola; Courtenay, Molly

2010-03-01

This paper is a report of a study exploring the views of nurses and team members on the implementation of nurse prescribing in diabetes services. Nurse prescribing is adopted as a means of improving service efficiency, particularly where demand outstretches resources. Although factors that support nurse prescribing have been identified, it is not known how these function within specific contexts. This is important as its uptake and use varies according to mode of prescribing and area of practice. A case study was undertaken in nine practice settings across England where nurses prescribed medicines for patients with diabetes. Thematic analysis was conducted on qualitative data from 31 semi-structured interviews undertaken between 2007 and 2008. Participants were qualified nurse prescribers, administrative staff, physicians and non-nurse prescribers. Nurses prescribed more often following the expansion of nurse independent prescribing rights in 2006. Initial implementation problems had been resolved and few current problems were reported. As nurses' roles were well-established, no major alterations to service provision were required to implement nurse prescribing. Access to formal and informal resources for support and training were available. Participants were accepting and supportive of this initiative to improve the efficiency of diabetes services. The main factors that promoted implementation of nurse prescribing in this setting were the ability to prescribe independently, acceptance of the prescribing role, good working relationships between doctors and nurses, and sound organizational and interpersonal support. The history of established nursing roles in diabetes care, and increasing service demand, meant that these diabetes services were primed to assimilate nurse prescribing.

A comparison of two delivery modalities of a mobile phone-based assessment for serious mental illness: native smartphone application vs text-messaging only implementations.

Science.gov (United States)

Ainsworth, John; Palmier-Claus, Jasper E; Machin, Matthew; Barrowclough, Christine; Dunn, Graham; Rogers, Anne; Buchan, Iain; Barkus, Emma; Kapur, Shitij; Wykes, Til; Hopkins, Richard S; Lewis, Shôn

2013-04-05

Mobile phone-based assessment may represent a cost-effective and clinically effective method of monitoring psychotic symptoms in real-time. There are several software options, including the use of native smartphone applications and text messages (short message service, SMS). Little is known about the strengths and limitations of these two approaches in monitoring symptoms in individuals with serious mental illness. The objective of this study was to compare two different delivery modalities of the same diagnostic assessment for individuals with non-affective psychosis-a native smartphone application employing a graphical, touch user interface against an SMS text-only implementation. The overall hypothesis of the study was that patient participants with sewrious mental illness would find both delivery modalities feasible and acceptable to use, measured by the quantitative post-assessment feedback questionnaire scores, the number of data points completed, and the time taken to complete the assessment. It was also predicted that a native smartphone application would (1) yield a greater number of data points, (2) take less time, and (3) be more positively appraised by patient participant users than the text-based system. A randomized repeated measures crossover design was employed. Participants with currently treated Diagnostic and Statistical Manual (Fourth Edition) schizophrenia or related disorders (n=24) were randomly allocated to completing 6 days of assessment (four sets of questions per day) with a native smartphone application or the SMS text-only implementation. There was then a 1-week break before completing a further 6 days with the alternative delivery modality. Quantitative feedback questionnaires were administered at the end of each period of sampling. A greater proportion of data points were completed with the native smartphone application in comparison to the SMS text-only implementation (β = -.25, SE=.11, P=.02), which also took significantly less

SYMBIOSIS: development, implementation, and assessment of a model curriculum across biology and mathematics at the introductory level.

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Depelteau, Audrey M; Joplin, Karl H; Govett, Aimee; Miller, Hugh A; Seier, Edith

2010-01-01

"It takes a lot of courage to release the familiar and seemingly secure, to embrace the new. But there is no real security in what is no longer meaningful. There is more security in the adventurous and exciting, for in movement there is life, and in change there is power." Alan Cohen (Used by permission. All rights reserved. For more information on Alan Cohen's books and programs, see (www.alancohen.com.) With the support of the East Tennessee State University (ETSU) administration and a grant from Howard Hughes Medical Institute, the departments of Biological Sciences, Mathematics and Statistics, and Curriculum and Instruction have developed a biology-math integrated curriculum. An interdisciplinary faculty team, charged with teaching the 18 curriculum modules, designed this three-semester curriculum, known as SYMBIOSIS. This curriculum was piloted to two student cohorts during the developmental stage. The positive feedback and assessment results of this project have given us the foundation to implement the SYMBIOSIS curriculum as a replacement for the standard biology majors curriculum at the introductory level. This article addresses the history and development of the curriculum, previous assessment results and current assessment protocol, and the future of ETSU's approach to implementing the SYMBIOSIS curriculum.

Implementation of a clinical dementia guideline. A controlled study on the effect of a multifaceted strategy

DEFF Research Database (Denmark)

Waldorff, Frans Boch; Almind, Gert; Mäkelä, Marjukka

2003-01-01

OBJECTIVE: To assess the impact of a multifaceted implementation strategy aiming to improve GP adherence to a clinical guideline on dementia. DESIGN: Controlled before and after study using data records from regional laboratories. The guideline was mailed to all GPs. The multifaceted implementation...... strategy was planned with local GPs, and consisted of seminars, outreach visits, reminders and continuing medical education (CME) small group training. SETTING: Primary health care. SUBJECTS: 535 GP practices with 727 physicians in Denmark. MAIN OUTCOME MEASURES: The diffusion and use of the guideline...... was measured by a mailed survey. Adherence to guideline recommendations was monitored by data on laboratory tests from general practice in patient's > or = 65 years: thyroid stimulating hormone requested with vitamin B12 or methylmalonate. The use of these tests as part of a diagnostic evaluation of dementia...

An integrated web-based mental health intervention of assessment-referral-care to reduce stress, anxiety, and depression in hospitalized pregnant women with medically high-risk pregnancies: a feasibility study protocol of hospital-based implementation.

Science.gov (United States)

Kingston, Dawn; Janes-Kelley, Selikke; Tyrrell, Janie; Clark, Lorna; Hamza, Deena; Holmes, Penny; Parkes, Cheryl; Moyo, Nomagugu; McDonald, Sheila; Austin, Marie-Paule

2015-01-16

At prevalence rates of up to 40%, rates of depression and anxiety among women with medically complex pregnancies are 3 times greater than those in community-based samples of pregnant women. However, mental health care is not a component of routine hospital-based antenatal care for medically high-risk pregnant women. The purpose of this study is to evaluate the effectiveness and feasibility of the hospital-based implementation of a Web-based integrated mental health intervention comprising psychosocial assessment, referral, and cognitive behavioral therapy (CBT) for antenatal inpatients. This study is a quasi-experimental design. Pregnant women are eligible to participate if they are (1) 72 hours, (3) able to speak and read English or be willing to use a translation service to assist with completion of the questionnaires and intervention, (4) able to complete follow-up email questionnaires, (5) >16 years of age, and (6) not actively suicidal. Women admitted to the unit for induction (eg, care hospital. All women will complete a Web-based psychosocial assessment and 6 Web-based CBT modules. Results of the psychosocial assessment will be used by a Web-based clinical decision support system to generate a clinical risk score and clinician prompts to provide recommendations for the best treatment and referral options. The primary outcome is self-reported prenatal depression, anxiety, and stress symptoms at 6-8 weeks postrecruitment. Secondary outcomes are postpartum depression, anxiety, and stress symptoms; self-efficacy; mastery; self-esteem; sleep; relationship quality; coping; resilience; Apgar score; gestational age; birth weight; maternal-infant attachment; infant behavior and development; parenting stress/competence at 3-months postpartum; and intervention cost-effectiveness, efficiency, feasibility, and acceptability. All women will complete email questionnaires at 6-8 weeks postrecruitment and 3-months postpartum. Qualitative interviews with 10-15 health care

The implementation of isoniazid preventive therapy in HIV clinics: the experience from the TB/HIV in Rio (THRio) study.

Science.gov (United States)

Durovni, Betina; Cavalcante, Solange C; Saraceni, Valeria; Vellozo, Vitoria; Israel, Giselle; King, Bonnie S; Cohn, Silvia; Efron, Anne; Pacheco, Antonio G; Moulton, Lawrence H; Chaisson, Richard E; Golub, Jonathan E

2010-11-01

The TB/HIV in Rio (THRio) study was launched in September 2005 to assess the impact of integrated tuberculosis (TB) and HIV treatment strategies in 29 HIV clinics in Rio de Janeiro, Brazil. THRio is a cluster-randomized trial (CRT) to determine whether routine screening for and treatment of latent TB in HIV clinic patients with access to antiretroviral therapy will reduce TB incidence at the clinic level. THRio is part of the Consortium to Respond Effectively to AIDS/TB Epidemic that is implementing research studies to assess the impact of bold, new public health paradigms for controlling the AIDS/TB epidemic. Twenty-nine public primary HIV clinics were randomly assigned a date to begin implementing TB screening procedures and provision of isoniazid preventive therapy (IPT) for TB/HIV coinfected patients. Final analysis of the CRT is expected in 2011. Starting at date of tuberculin skin test (TST)/IPT implementation at each clinic through August 2010, 1670 HIV-infected patients initiated IPT, of which 215 are still receiving treatment. Of the remaining 1455 patients, 1230 (85%) completed therapy and only 20 (1.2%) patients initiating IPT reported adverse reactions leading to discontinuation of therapy. IPT completion was higher among HIV-infected patients receiving HAART (87%) than those not yet receiving HAART (79%, P effort requires a package of activities including training, advocacy and reorganization of services.

Study of hardware implementations of fast tracking algorithms

International Nuclear Information System (INIS)

Song, Z.; Huang, G.; Wang, D.; Lentdecker, G. De; Dong, J.; Léonard, A.; Robert, F.; Yang, Y.

2017-01-01

Real-time track reconstruction at high event rates is a major challenge for future experiments in high energy physics. To perform pattern-recognition and track fitting, artificial retina or Hough transformation methods have been introduced in the field which have to be implemented in FPGA firmware. In this note we report on a case study of a possible FPGA hardware implementation approach of the retina algorithm based on a Floating-Point core. Detailed measurements with this algorithm are investigated. Retina performance and capabilities of the FPGA are discussed along with perspectives for further optimization and applications.

Design, implementation and verification of software code for radiation dose assessment based on simple generic environmental model

International Nuclear Information System (INIS)

I Putu Susila; Arif Yuniarto

2017-01-01

Radiation dose assessment to determine the potential of radiological impacts of various installations within nuclear facility complex is necessary to ensure environmental and public safety. A simple generic model-based method for calculating radiation doses caused by the release of radioactive substances into the environment has been published by the International Atomic Energy Agency (IAEA) as the Safety Report Series No. 19 (SRS-19). In order to assist the application of the assessment method and a basis for the development of more complex assessment methods, an open-source based software code has been designed and implemented. The software comes with maps and is very easy to be used because assessment scenarios can be done through diagrams. Software verification was performed by comparing its result to SRS-19 and CROM software calculation results. Dose estimated by SRS-19 are higher compared to the result of developed software. However, these are still acceptable since dose estimation in SRS-19 is based on conservative approach. On the other hand, compared to CROM software, the same results for three scenarios and a non-significant difference of 2.25 % in another scenario were obtained. These results indicate the correctness of our implementation and implies that the developed software is ready for use in real scenario. In the future, the addition of various features and development of new model need to be done to improve the capability of software that has been developed. (author)

A radiological control implementation guide

International Nuclear Information System (INIS)

Hamley, S.A.

1993-01-01

A manual is being developed to explain to line managers how radiological controls are designed and implemented. The manual also fills a gap in the Health Physics literature between textbooks and on-the-floor procedures. It may be helpful to new Health Physicists with little practical experience and to those wishing to improve self-assessment, audit, and appraisal processes. Many audits, appraisals, and evaluations have indicated a need for cultural change, increased vigor and example, and more effective oversight by line management. Inadequate work controls are a frequent and recurring problem identified in occurrence reports and accident investigations. Closer study frequently indicates that many line managers are willing to change and want to achieve excellence, but no effective guidance exists that will enable them to understand and implement a modern radiological control program. The manual is now in draft form and includes information that will be of use to line managers dealing with improving radiological performance and the practical aspects of radiological controls implementation. The manual is expected to be completed by the fall of 1993 and to be used in conjunction with a performance-based self-assessment training program at the Oak Ridge National Laboratory

Factors influencing practitioner adoption of carer-led assessment in palliative homecare: A qualitative study of the use of the Carer Support Needs Assessment Tool (CSNAT.

Directory of Open Access Journals (Sweden)

Lynn Austin

Full Text Available Informal caregivers play a pivotal role in supporting patients approaching the end of life. The Carer Support Needs Assessment Tool (CSNAT is designed to facilitate person-centred assessment and support through a process that is practitioner-facilitated, but carer-led. This study explored practitioners' experiences of implementing the CSNAT in palliative homecare.We conducted qualitative interviews/focus groups with 20 practitioners in one UK hospice homecare service (18 nurses, two healthcare assistants before and after the implementation of the CSNAT. Thematic analysis of the data was underpinned by framework analysis.Not all practitioners appreciated that using the CSNAT required a shift towards a more person-centred approach to assessment; consequently they tagged the tool onto their existing practitioner-led practice. Practitioners who did use the CSNAT as intended were able to act as role models and support their colleagues in making this transition. Practitioners' comments revealed a number of contradictions: 1 Most felt that they 'already do' identify carer support needs, but feared using the CSNAT could increase their workload; 2 some worried about introducing the CSNAT 'too soon', but recognised that it was 'too late' once patients were close to the end of life; 3 whilst practitioners stated 'they were there for the family as well as the patient', care provision was overtly centred around patients.This study provides vital insights into barriers and facilitators to implementing the CSNAT as part of a person-centred approach to assessment. The findings identified the training and support required to help practitioners make this transition to this new way of working.

Informal caregivers and detection of delirium in postacute care: a correlational study of the confusion assessment method (CAM), confusion assessment method-family assessment method (CAM-FAM) and DSM-IV criteria.

Science.gov (United States)

Flanagan, Nina M; Spencer, Gale

2016-09-01

Delirium is a common, serious and potentially life-threatening syndrome affecting older adults. This syndrome continues to be under-recognised and under treated by healthcare professionals across all care settings. Older adults who develop delirium have poorer outcomes, higher mortality and higher care costs. The purposes of this study were to correlate the confusion assessment method-family assessment method and confusion assessment method in the detection of delirium in postacute care, to correlate the confusion assessment method-family assessment method and diagnostic and statistical manual of mental disorders text revision criteria in detection of delirium in postacute care, to determine the prevalence of delirium in postacute care elders and to describe the relationship of level of cognitive impairment and delirium in the postacute care setting. Implications for Practice Delirium is disturbing for patients and caregivers. Frequently . family members want to provide information about their loved one. The use of the CAM-FAM and CAM can give a more definitive determination of baseline status. Frequent observations using both instruments may lead to better recognition of delirium and implementation of interventions to prevent lasting sequelae. Descriptive studies determined the strengths of relationship between the confusion assessment method, confusion assessment method-family assessment method, Mini-Cog and diagnostic and statistical manual of mental disorders text revision criteria in detection of delirium in the postacute care setting. Prevalence of delirium in this study was 35%. The confusion assessment method-family assessment method highly correlates with the confusion assessment method and diagnostic and statistical manual of mental disorders text revision criteria for detecting delirium in older adults in the postacute care setting. Persons with cognitive impairment are more likely to develop delirium. Family members recognise symptoms of delirium when

Implementation of patient safety strategies in European hospitals.

Science.gov (United States)

Suñol, R; Vallejo, P; Groene, O; Escaramis, G; Thompson, A; Kutryba, B; Garel, P

2009-02-01

This study is part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) research project on cross-border care, investigating quality improvement strategies in healthcare systems across the European Union (EU). To explore to what extent a sample of acute care European hospitals have implemented patient safety strategies and mechanisms and whether the implementation is related to the type of hospital. Data were collected on patient safety structures and mechanisms in 389 acute care hospitals in eight EU countries using a web-based questionnaire. Subsequently, an on-site audit was carried out by independent surveyors in 89 of these hospitals to assess patient safety outputs. This paper presents univariate and bivariate statistics on the implementation and explores the associations between implementation of patient safety strategies and hospital type using the chi(2) test and Fisher exact test. Structures and plans for safety (including responsibilities regarding patient safety management) are well developed in most of the hospitals that participated in this study. The study found greater variation regarding the implementation of mechanisms or activities to promote patient safety, such as electronic drug prescription systems, guidelines for prevention of wrong patient, wrong site and wrong surgical procedure, and adverse events reporting systems. In the sample of hospitals that underwent audit, a considerable proportion do not comply with basic patient safety strategies--for example, using bracelets for adult patient identification and correct labelling of medication.

The guideline implementability research and application network (GIRAnet: an international collaborative to support knowledge exchange: study protocol

Directory of Open Access Journals (Sweden)

Gagliardi Anna R

2012-04-01

Full Text Available Abstract Background Modifying the format and content of guidelines may facilitate their use and lead to improved quality of care. We reviewed the medical literature to identify features desired by different users and associated with guideline use to develop a framework of implementability and found that most guidelines do not contain these elements. Further research is needed to develop and evaluate implementability tools. Methods We are launching the Guideline Implementability Research and Application Network (GIRAnet to enable the development and testing of implementability tools in three domains: Resource Implications, Implementation, and Evaluation. Partners include the Guidelines International Network (G-I-N and its member guideline developers, implementers, and researchers. In phase one, international guidelines will be examined to identify and describe exemplar tools. Indication-specific and generic tools will populate a searchable repository. In phase two, qualitative analysis of cognitive interviews will be used to understand how developers can best integrate implementability tools in guidelines and how health professionals use them for interpreting and applying guidelines. In phase three, a small-scale pilot test will assess the impact of implementability tools based on quantitative analysis of chart-based behavioural outcomes and qualitative analysis of interviews with participants. The findings will be used to plan a more comprehensive future evaluation of implementability tools. Discussion Infrastructure funding to establish GIRAnet will be leveraged with the in-kind contributions of collaborating national and international guideline developers to advance our knowledge of implementation practice and science. Needs assessment and evaluation of GIRAnet will provide a greater understanding of how to develop and sustain such knowledge-exchange networks. Ultimately, by facilitating use of guidelines, this research may lead to improved

Assessing refugee healthcare needs in Europe and implementing educational interventions in primary care: a focus on methods.

Science.gov (United States)

Lionis, Christos; Petelos, Elena; Mechili, Enkeleint-Aggelos; Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Angelaki, Agapi; Rurik, Imre; Pavlic, Danica Rotar; Dowrick, Christopher; Dückers, Michel; Ajdukovic, Dean; Bakic, Helena; Jirovsky, Elena; Mayrhuber, Elisabeth Sophie; van den Muijsenbergh, Maria; Hoffmann, Kathryn

2018-02-08

The current political crisis, conflicts and riots in many Middle Eastern and African countries have led to massive migration waves towards Europe. European countries, receiving these migratory waves as first port of entry (POE) over the past few years, were confronted with several challenges as a result of the sheer volume of newly arriving refugees. This humanitarian refugee crisis represents the biggest displacement crisis of a generation. Although the refugee crisis created significant challenges for all national healthcare systems across Europe, limited attention has been given to the role of primary health care (PHC) to facilitate an integrated delivery of care by enhancing care provision to refugees upon arrival, on transit or even for longer periods. Evidence-based interventions, encompassing elements of patient-centredness, shared decision-making and compassionate care, could contribute to the assessment of refugee healthcare needs and to the development and the implementation of training programmes for rapid capacity-building for the needs of these vulnerable groups and in the context of integrated PHC care. This article reports on methods used for enhancing PHC for refugees through rapid capacity-building actions in the context of a structured European project under the auspices of the European Commission and funded under the 3rd Health Programme by the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA). The methods include the assessment of the health needs of all the people reaching Europe during the study period, and the identification, development, and testing of educational tools. The developed tools were evaluated following implementation in selected European primary care settings.

Examining Barriers to Sustained Implementation of School-Wide Prevention Practices