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Sample records for outcomes framework qof

  1. The quality and outcomes framework: QOF - transforming general practice

    National Research Council Canada - National Science Library

    Gillam, Stephen; Siriwardena, Aloysius Niroshan

    2011-01-01

    ... comprehensive scheme of its kind in the world. Champions claim the QOF advances the quality of primary care; detractors fear the end of general practice as we know it. The introduction of the QOF provides a unique opportunity for research, analysis and re ection. This book is the rst comprehensive analysis of the impact of the QOF, examining the claims and counter-claims ...

  2. Addressing long-term physical healthcare needs in a forensic mental health inpatient population using the UK primary care Quality and Outcomes Framework (QOF): an audit

    OpenAIRE

    Ivbijaro, GO; Kolkiewicz, LA; McGee, LSF; Gikunoo, M

    2008-01-01

    Objectives This audit aims to evaluate the effectiveness of delivering an equivalent primary care service to a long-term forensic psychiatric inpatient population, using the UK primary care national Quality and Outcomes Framework (QOF).

  3. Addressing long-term physical healthcare needs in a forensic mental health inpatient population using the UK primary care Quality and Outcomes Framework (QOF): an audit.

    Science.gov (United States)

    Ivbijaro, Go; Kolkiewicz, LA; McGee, Lsf; Gikunoo, M

    2008-03-01

    Objectives This audit aims to evaluate the effectiveness of delivering an equivalent primary care service to a long-term forensic psychiatric inpatient population, using the UK primary care national Quality and Outcomes Framework (QOF).Method The audit compares the targets met by the general practitioner with special interest (GPwSI) service, using local and national QOF benchmarks (2005-2006), and determines the prevalence of chronic disease in a long-term inpatient forensic psychiatry population.Results The audit results show that the UK national QOF is a useful tool for assessment and evaluation of physical healthcare needs in a non-community based population. It shows an increased prevalence of all QOF-assessed long-term physical conditions when compared to the local East London population and national UK population, confirming previously reported elevated levels of physical healthcare need in psychiatric populations.Conclusions This audit shows that the UK General Practice QOF can be used as a standardised instrument for commissioning and monitoring the delivery of physical health services to in-patient psychiatric populations, and for the evaluation of the effectiveness of clinical interventions in long-term physical conditions. The audit also demonstrates the effectiveness of using a GPwSI in healthcare delivery in non-community based settings. We suggest that the findings may be generalisable to other long-term inpatient psychiatric and prison populations in order to further the objective of delivering an equivalent primary care service to all populations.The QOF is a set of national primary care audit standards and is freely available on the British Medical Association website or the UK Department of Health website. We suggest that primary care workers in health economies who have not yet developed their own national primary care standards can access and adapt these standards in order to improve the clinical standards of care given to the primary care

  4. The relationship between general practice characteristics and quality of care: a national survey of quality indicators used in the UK Quality and Outcomes Framework, 2004–5

    Directory of Open Access Journals (Sweden)

    Armstrong David

    2006-11-01

    Full Text Available Abstract Background The descriptive information now available for primary care in the UK is unique in international terms. Under the 'Quality and Outcomes Framework' (QOF, data for 147 performance indicators are available for each general practice. We aimed to determine the relationship between the quality of primary care, as judged by the total QOF score, social deprivation and practice characteristics. Methods We obtained QOF data for each practice in England and linked these with census derived data (deprivation indices and proportion of patients born in a developing country. Characteristics of practices were also obtained. QOF and census data were available for 8480 practices. Results The median QOF score was 999.7 out of a possible maximum of 1050 points. Three characteristics were independently associated with higher QOF scores: training practices, group practices and practices in less socially deprived areas. In a regression model, these three factors explained 14.6% of the variation in QOF score. Higher list sizes per GP, turnover of registered patients, chronic disease prevalence, proportions of elderly patients or patients born in a developing country did not contribute to lower QOF scores in the final model. Conclusion Socially deprived areas experience a lower quality of primary care, as judged by QOF scores. Social deprivation itself is an independent predictor of lower quality. Training and group practices are independent predictors of higher quality but these types of practices are less well represented in socially deprived areas.

  5. The equity dimension in evaluations of the quality and outcomes framework: a systematic review.

    Science.gov (United States)

    Boeckxstaens, Pauline; Smedt, Delphine De; Maeseneer, Jan De; Annemans, Lieven; Willems, Sara

    2011-08-31

    Pay-for-performance systems raise concerns regarding inequity in health care because providers might select patients for whom targets can easily be reached. This paper aims to describe the evolution of pre-existing (in)equity in health care in the period after the introduction of the Quality and Outcomes Framework (QOF) in the UK and to describe (in)equities in exception reporting. In this evaluation, a theory-based framework conceptualising equity in terms of equal access, equal treatment and equal treatment outcomes for people in equal need is used to guide the work. A systematic MEDLINE and Econlit search identified 317 studies. Of these, 290 were excluded because they were not related to the evaluation of QOF, they lacked an equity dimension in the evaluation, their qualitative research focused on experiences or on the nature of the consultation, or unsuitable methodology was used to pronounce upon equity after the introduction of QOF. None of the publications (n = 27) assessed equity in access to health care. Concerning equity in treatment and (intermediate) treatment outcomes, overall quality scores generally improved. For the majority of the observed indicators, all citizens benefit from this improvement, yet the extent to which different patient groups benefit tends to vary and to be highly dependent on the type and complexity of the indicator(s) under study, the observed patient group(s) and the characteristics of the study. In general, the introduction of QOF was favourable for the aged and for males. Total QOF scores did not seem to vary according to ethnicity. For deprivation, small but significant residual differences were observed after the introduction of QOF favouring less deprived groups. These differences are mainly due to differences at the practice level. The variance in exception reporting according to gender and socio-economic position is low. Although QOF seems not to be socially selective at first glance, this does not mean QOF does not

  6. The equity dimension in evaluations of the quality and outcomes framework: A systematic review

    Directory of Open Access Journals (Sweden)

    Annemans Lieven

    2011-08-01

    Full Text Available Abstract Background Pay-for-performance systems raise concerns regarding inequity in health care because providers might select patients for whom targets can easily be reached. This paper aims to describe the evolution of pre-existing (inequity in health care in the period after the introduction of the Quality and Outcomes Framework (QOF in the UK and to describe (inequities in exception reporting. In this evaluation, a theory-based framework conceptualising equity in terms of equal access, equal treatment and equal treatment outcomes for people in equal need is used to guide the work. Methods A systematic MEDLINE and Econlit search identified 317 studies. Of these, 290 were excluded because they were not related to the evaluation of QOF, they lacked an equity dimension in the evaluation, their qualitative research focused on experiences or on the nature of the consultation, or unsuitable methodology was used to pronounce upon equity after the introduction of QOF. Results None of the publications (n = 27 assessed equity in access to health care. Concerning equity in treatment and (intermediate treatment outcomes, overall quality scores generally improved. For the majority of the observed indicators, all citizens benefit from this improvement, yet the extent to which different patient groups benefit tends to vary and to be highly dependent on the type and complexity of the indicator(s under study, the observed patient group(s and the characteristics of the study. In general, the introduction of QOF was favourable for the aged and for males. Total QOF scores did not seem to vary according to ethnicity. For deprivation, small but significant residual differences were observed after the introduction of QOF favouring less deprived groups. These differences are mainly due to differences at the practice level. The variance in exception reporting according to gender and socio-economic position is low. Conclusions Although QOF seems not to be socially

  7. The impact of the Quality and Outcomes Framework on practice organisation and service delivery: summary of evidence from two qualitative studies.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen

    2010-01-01

    In 2003, the new General Medical Services Contract introduced a pay-for-performance programme know as the Quality and Outcomes Framework (QOF) into UK general practice, with payment for meeting a number of both clinical and organisational quality standards. To investigate in detail the impact of the QOF on practice organisation and service delivery. Two linked qualitative case studies in England and Scotland, using interviews and observation to investigate in depth the impact of the QOF in four general medical practices. A number of significant changes to practice organisation and service delivery were observed, including: changes to practice organisational structures; an increased role for information technology; a move towards a more biomedical form of medical care; and changes to roles and relationships, including the introduction of internal peer-review and surveillance. In spite of this, the practices maintained a narrative of 'no change', arguing that they had 'fitted QOF in' to their routines with little trouble.

  8. Primary care in an era of hospital bed reduction: what can we infer from QOF and PBC?

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen

    2010-12-01

    The Quality and Outcomes Framework (QOF) has been efficiently and effectively incorporated into practice routines. One possible negative effect of this has been a move towards a more biomedical form of practice.There has been patchy but real engagement with practice-based commissioning (PBC), with significant moves in some areas towards GPs acting collectively to improve services across the health economy, including engaging in performance management of each others' practice.Together, responses to QOF and PBC suggest that GPs may be willing and able to act both individually and collectively to try to mitigate the negative impacts of future spending reductions. General practice will be under a great deal of pressure in the next few years. Understanding the impact of past policy changes is essential if we are to ensure that the core values of general practice are maintained.

  9. The use of financial incentives to help improve health outcomes: is the quality and outcomes framework fit for purpose? A systematic review.

    Science.gov (United States)

    Langdown, Carwyn; Peckham, Stephen

    2014-06-01

    The quality and outcomes framework (QOF) is one of the world's largest pay-for-performance schemes, rewarding general practitioners for the quality of care they provide. This review examines the evidence on the efficacy of the scheme for improving health outcomes, its impact on non-incentivized activities and the robustness of the clinical targets adopted in the scheme. The review was conducted using six electronic databases, six sources of grey literature and bibliography searches from relevant publications. Studies were identified using a comprehensive search strategy based on MeSH terms and keyword searches. A total of 21,543 references were identified of which 32 met the eligibility criteria with 11 studies selected for the review. Findings provide strong evidence that the QOF initially improved health outcomes for a limited number of conditions but subsequently fell to the pre-existing trend. There was limited impact on non-incentivized activities with adverse effects for some sub-population groups. The QOF has limited impact on improving health outcomes due to its focus on process-based indicators and the indicators' ceiling thresholds. Further research is required to strengthen the quality of evidence available on the QOF's impact on population health to ensure that the incentive scheme is both clinically and cost-effective. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Impact of the QOF and the NICE guideline in the diagnosis and management of depression: a qualitative study.

    Science.gov (United States)

    Mitchell, Caroline; Dwyer, Rachel; Hagan, Teresa; Mathers, Nigel

    2011-05-01

    The National Institute for Health and clinical Excellence (NICE) depression guideline (2004) and the updated Quality and Outcomes Framework (QOF) (2006) in general practice have introduced the concepts of screening severity assessment, for example using the Patient Health Questionnaire 9 (PHQ-9), and 'stepped care' for depression. To explore primary care practitioner perspectives on the clinical utility of the NICE guideline and the impact of the QOF on diagnosis and management of depression in routine practice. Qualitative study using focus groups from four multidisciplinary practice teams with diverse populations in south Yorkshire. Four focus groups were conducted, using a topic guide and audiotaping. There were 38 participants: GPs, nurses, doctors in training, mental health workers, and a manager. Data analysis was iterative and thematic. The NICE guideline, with its embedded principles of holism and evidence-based practice, was viewed positively but its impact was compromised by resource and practitioner barriers to implementation. The perceived imposition of the screening questions and severity assessments (PHQ-9) with no responsive training had required practitioners to work hard to minimise negative impacts on their work, for example: constantly adapting consultations to tick boxes; avoiding triggering open displays of distress without the time to offer appropriate care; positively managing how their patients were labelled. Further confusion was experienced around the evolving content of psychological interventions for depression. Organisational barriers to the implementation of the NICE guideline and the limited scope of the QOF highlight the need for policy makers to work more effectively with the complex realities of general practice in order to systematically improve the quality and delivery of 'managed' care for depression.

  11. The UK Quality and Outcomes Framework pay-for-performance scheme and spirometry: rewarding quality or just quantity? A cross-sectional study in Rotherham, UK

    Directory of Open Access Journals (Sweden)

    South Gail

    2009-06-01

    Full Text Available Abstract Background Accurate spirometry is important in the management of COPD. The UK Quality and Outcomes Framework pay-for-performance scheme for general practitioners includes spirometry related indicators within its COPD domain. It is not known whether high achievement against QOF spirometry indicators is associated with spirometry to BTS standards. Methods Data were obtained from the records of 3,217 patients randomly sampled from 5,649 patients with COPD in 38 general practices in Rotherham, UK. Severity of airflow obstruction was categorised by FEV1 (% predicted according to NICE guidelines. This was compared with clinician recorded COPD severity. The proportion of patients whose spirometry met BTS standards was calculated in each practice using a random sub-sample of 761 patients. The Spearman rank correlation between practice level QOF spirometry achievement and performance against BTS spirometry standards was calculated. Results Spirometry as assessed by clinical records was to BTS standards in 31% of cases (range at practice level 0% to 74%. The categorisation of airflow obstruction according to the most recent spirometry results did not agree well with the clinical categorisation of COPD recorded in the notes (Cohen's kappa = 0.34, 0.30 – 0.38. 12% of patients on COPD registers had FEV1 (% predicted results recorded that did not support the diagnosis of COPD. There was no association between quality, as measured by adherence to BTS spirometry standards, and either QOF COPD9 achievement (Spearman's rho = -0.11, or QOF COPD10 achievement (rho = 0.01. Conclusion The UK Quality and Outcomes Framework currently assesses the quantity, but not the quality of spirometry.

  12. Creating an outcomes framework.

    Science.gov (United States)

    Doerge, J B

    2000-01-01

    Four constructs used to build a framework for outcomes management for a large midwestern tertiary hospital are described in this article. A system framework outlining a model of clinical integration and population management based in Steven Shortell's work is discussed. This framework includes key definitions of high-risk patients, target groups, populations and community. Roles for each level of population management and how they were implemented in the health care system are described. A point of service framework centered on seven dimensions of care is the next construct applied on each nursing unit. The third construct outlines the framework for role development. Three roles for nursing were created to implement strategies for target groups that are strategic disease categories; two of those roles are described in depth. The philosophy of nursing practice is centered on caring and existential advocacy. The final construct is the modification of the Dartmouth model as a common framework for outcomes. System applications of the scorecard and lessons learned in the 2-year process of implementation are shared

  13. Accounting for multimorbidity in pay for performance: a modelling study using UK Quality and Outcomes Framework data.

    Science.gov (United States)

    Ruscitto, Andrea; Mercer, Stewart W; Morales, Daniel; Guthrie, Bruce

    2016-08-01

    The UK Quality and Outcomes Framework (QOF) offers financial incentives to deliver high-quality care for individual diseases, but the single-disease focus takes no account of multimorbidity. To examine variation in QOF payments for two indicators incentivised in ≥1 disease domain. Modelling study using cross-sectional data from 314 general practices in Scotland. Maximum payments that practices could receive under existing financial incentives were calculated for blood pressure (BP) control and influenza immunisation according to the number of coexisting clinical conditions. Payments were recalculated assuming a single new indicator. Payment varied by condition (£4.71-£11.08 for one BP control and £2.09-£5.78 for one influenza immunisation). Practices earned more for delivering the same action in patients with multimorbidity: in patients with 2, 3, and ≥4 conditions mean payments were £13.95, £21.92, and £29.72 for BP control, and £7.48, £11.21, and £15.14 for influenza immunisation, respectively. Practices in deprived areas had more multiple incentivised patients. When recalculated so that each incentivised action was only paid for once, all practices received less for BP control: affluent practices received more and deprived practices received less for influenza immunisation. For patients with single conditions, existing QOF payment methods have more than twofold variation in payment for delivering the same process. Multiple payments were common in patients with multimorbidity. A payment method is required that ensures fairness of rewards while maintaining adequate funding for practices based on actual workload. © British Journal of General Practice 2016.

  14. Physical health indicators in major mental illness: data from the Quality and Outcome Framework in the UK.

    Science.gov (United States)

    Martin, Julie Langan; Lowrie, Richard; McConnachie, Alex; McLean, Gary; Mair, Frances; Mercer, Stewart; Smith, Daniel

    2015-02-26

    In the UK, the Quality and Outcome Framework (QOF) has specific targets for general practictioners to record body-mass index (BMI) and blood pressure (BP) in major mental illness, diabetes, and chronic kidney disease. Although incentives are given for aspects of major mental illness (schizophrenia, bipolar disorder, and related psychoses), barriers to care can occur. Our aim was to compare recording of specific targets for BP and BMI in individuals with major mental illness relative to diabetes and chronic kidney disease across the UK. Using 2012 and 2013 QOF data from 9731 general practices across all four countries in the UK, we calculated median payment, population achievement, and exception rates for BP indicators in major mental illness and chronic kidney disease and BMI indicators in major mental illness and diabetes. Differences in unweighted rates between practices in the same UK country were tested with a sign test. Differences in population achievement rate between practices in different countries were compared with those in England by use of a quantile regression analysis. UK payment and population achievement rates for BMI recording in major mental illness were significantly lower than were those in diabetes (payment 92·7% vs 95·5% and population achievement 84·0% vs 92·5%, pmental illness than for chronic kidney disease (94·1% vs 97·8% and 87·0% vs 97·1%, pmental illness were significantly lower in Scotland than in England (for BMI -1·5%, 99% CI -2·7 to -0·3, and for BP -1·8%, -2·7 to -0·9; pmental illness than in diabetes and chronic kidney disease throughout the UK. We also found variation in these rates between countries. This finding is probably multifactorial, reflecting a combination of patient, clinician, and wider organisational factors; however, it might also suggest inequality in access to certain aspects of health care for people with major mental illness. None. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Framework and indicator testing protocol for developing and piloting quality indicators for the UK quality and outcomes framework

    Directory of Open Access Journals (Sweden)

    Burke Martyn

    2011-08-01

    Full Text Available Abstract Background Quality measures should be subjected to a testing protocol before being used in practice using key attributes such as acceptability, feasibility and reliability, as well as identifying issues derived from actual implementation and unintended consequences. We describe the methodologies and results of an indicator testing protocol (ITP using data from proposed quality indicators for the United Kingdom Quality and Outcomes Framework (QOF. Methods The indicator testing protocol involved a multi-step and methodological process: 1 The RAND/UCLA Appropriateness Method, to test clarity and necessity, 2 data extraction from patients' medical records, to test technical feasibility and reliability, 3 diaries, to test workload, 4 cost-effectiveness modelling, and 5 semi-structured interviews, to test acceptability, implementation issues and unintended consequences. Testing was conducted in a sample of representative family practices in England. These methods were combined into an overall recommendation for each tested indicator. Results Using an indicator testing protocol as part of piloting was seen as a valuable way of testing potential indicators in 'real world' settings. Pilot 1 (October 2009-March 2010 involved thirteen indicators across six clinical domains and twelve indicators passed the indicator testing protocol. However, the indicator testing protocol identified a number of implementation issues and unintended consequences that can be rectified or removed prior to national roll out. A palliative care indicator is used as an exemplar of the value of piloting using a multiple attribute indicator testing protocol - while technically feasible and reliable, it was unacceptable to practice staff and raised concerns about potentially causing actual patient harm. Conclusions This indicator testing protocol is one example of a protocol that may be useful in assessing potential quality indicators when adapted to specific country health

  16. Advancing the Adverse Outcome Pathway Framework - an ...

    Science.gov (United States)

    The ability of scientists to conduct whole organism toxicity tests to understand chemical safety has been significantly outpaced by the rapid synthesis of new chemicals. Therefore, to increase efficiencies in chemical risk assessment, scientists are turning to mechanistic-based studies, making greater use of in vitro and in silico methods, to screen for potential environmental and human health hazards. A framework that has gained traction for capturing available knowledge describing the linkage between mechanistic data and apical toxicity endpoints, required for regulatory assessments, is the adverse outcome pathway (AOP). A number of international activities have focused on AOP development and plausible applications to regulatory decision-making. These interactions have prompted dialog between research scientists and regulatory communities to consider how best to use the AOP framework in risk assessment. While expert-facilitated discussions have been instrumental in moving the science of AOPs forward, it was recognized that a survey of the broader scientific community would aid in identifying shortcomings and guiding future initiatives for the AOP framework. To that end, a ?‘Horizon Scanning’ exercise was conducted to solicit questions from the global scientific and regulatory communities concerning the challenges or limitations that must be addressed to realize the full potential of the AOP framework in research and regulatory decision making. The m

  17. 76 FR 1440 - Notice of Revised Child Outcomes Framework

    Science.gov (United States)

    2011-01-10

    ... Outcomes Framework, renamed The Head Start Child Development and Learning Framework: Promoting Positive Outcomes in Early Childhood Programs Serving Children 3-5 Years Old. The Framework was revised to give more... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Notice of Revised...

  18. Comparability of outcome frameworks in medical education: Implications for framework development.

    Science.gov (United States)

    Hautz, Stefanie C; Hautz, Wolf E; Feufel, Markus A; Spies, Claudia D

    2015-01-01

    Given the increasing mobility of medical students and practitioners, there is a growing need for harmonization of medical education and qualifications. Although several initiatives have sought to compare national outcome frameworks, this task has proven a challenge. Drawing on an analysis of existing outcome frameworks, we identify factors that hinder comparability and suggest ways of facilitating comparability during framework development and revisions. We searched MedLine, EmBase and the Internet for outcome frameworks in medical education published by national or governmental organizations. We analyzed these frameworks for differences and similarities that influence comparability. Of 1816 search results, 13 outcome frameworks met our inclusion criteria. These frameworks differ in five core features: history and origins, formal structure, medical education system, target audience and key terms. Many frameworks reference other frameworks without acknowledging these differences. Importantly, the level of detail of the outcomes specified differs both within and between frameworks. The differences identified explain some of the challenges involved in comparing outcome frameworks and medical qualifications. We propose a two-level model distinguishing between "core" competencies and culture-specific "secondary" competencies. This approach could strike a balance between local specifics and cross-national comparability of outcome frameworks and medical education.

  19. Outcomes-focused knowledge translation: a framework for knowledge translation and patient outcomes improvement.

    Science.gov (United States)

    Doran, Diane M; Sidani, Souraya

    2007-01-01

    Regularly accessing information that is current and reliable continues to be a challenge for front-line staff nurses. Reconceptualizing how nurses access information and designing appropriate decision support systems to facilitate timely access to information may be important for increasing research utilization. An outcomes-focused knowledge translation framework was developed to guide the continuous improvement of patient care through the uptake of research evidence and feedback data about patient outcomes. The framework operationalizes the three elements of the PARIHS framework at the point of care. Outcomes-focused knowledge translation involves four components: (a) patient outcomes measurement and real-time feedback about outcomes achievement; (b) best-practice guidelines, embedded in decision support tools that deliver key messages in response to patient assessment data; (c) clarification of patients' preferences for care; and (d) facilitation by advanced practice nurses and practice leaders. In this paper the framework is described and evidence is provided to support theorized relationships among the concepts in the framework. The framework guided the design of a knowledge translation intervention aimed at continuous improvement of patient care and evidence-based practice, which are fostered through real-time feedback data about patient outcomes, electronic access to evidence-based resources at the point of care, and facilitation by advanced practice nurses. The propositions in the framework need to be empirically tested through future research.

  20. Framework of outcome measures recommended for use in the evaluation of childhood obesity treatment interventions: the CoOR framework.

    Science.gov (United States)

    Bryant, M; Ashton, L; Nixon, J; Jebb, S; Wright, J; Roberts, K; Brown, J

    2014-12-01

    Consensus is lacking in determining appropriate outcome measures for assessment of childhood obesity treatments. Inconsistency in the use and reporting of such measures impedes comparisons between treatments and limits consideration of effectiveness. This study aimed to produce a framework of recommended outcome measures: the Childhood obesity treatment evaluation Outcomes Review (CoOR) framework. A systematic review including two searches was conducted to identify (1) existing trial outcome measures and (2) manuscripts describing development/evaluation of outcome measures. Outcomes included anthropometry, diet, eating behaviours, physical activity, sedentary time/behaviour, fitness, physiology, environment, psychological well-being and health-related quality of life. Eligible measures were appraised by the internal team using a system developed from international guidelines, followed by appraisal from national external expert collaborators. A total of 25,486 papers were identified through both searches. Eligible search 1 trial papers cited 417 additional papers linked to outcome measures, of which 56 were eligible. A further 297 outcome development/evaluation papers met eligibility criteria from search 2. Combined, these described 191 outcome measures. After internal and external appraisal, 52 measures across 10 outcomes were recommended for inclusion in the CoOR framework. Application of the CoOR framework will ensure greater consistency in choosing robust outcome measures that are appropriate to population characteristics. © 2014 The Authors. Pediatric Obesity © 2014 International Association for the Study of Obesity.

  1. Setting the stage to advance the adverse outcome pathway (AOP) framework through horizon scanning

    Science.gov (United States)

    Recognizing the international interest surrounding the adverse outcome pathway framework, which captures existing information describing causal linkages between a molecular initiating event through levels of biological organization to an adverse outcome of regulatory significance...

  2. Computational framework explains how animals select actions with rewarding outcomes.

    Directory of Open Access Journals (Sweden)

    Janelle Weaver

    2015-01-01

    Full Text Available A new model of how the brain learns beneficial behavior from rewarding outcomes emphasizes the importance of the striatum, replicates experimental data, and raises new questions about neurological disorders. Read the Research Article.

  3. Development of FOCUS-GC: Framework for Outcomes of Clinical Communication Services in Genetic Counseling.

    Science.gov (United States)

    Cragun, Deborah; Zierhut, Heather

    2018-02-01

    Conceptual frameworks bring together existing theories and models in order to identify, consolidate, and fill in gaps between theory, practice, and evidence. Given the vast number of possible outcomes that could be studied in genetic counseling, a framework for organizing outcomes and postulating relationships between communication services and genetic counseling outcomes was sought. Through an iterative approach involving literature review, thematic analysis, and consolidation, outcomes and processes were categorized to create and define components of a conceptual framework. The final product, "Framework for Outcomes of Clinical commUnication Services" (FOCUS) contains the following domains: communication strategy; communication process measures; patient care experience, patient changes, patient health; and family changes. A website was created to allow easier access and ongoing modifications to the framework. In addition, a step-by-step guide and two examples were created to show flexibility in how the framework can be used. FOCUS may help in conceptualizing, organizing and summarizing outcomes research related to risk communication and counseling in genetic service delivery as well as other healthcare settings.

  4. A Framework for Designing a Healthcare Outcome Data Warehouse

    Science.gov (United States)

    Parmanto, Bambang; Scotch, Matthew; Ahmad, Sjarif

    2005-01-01

    Many healthcare processes involve a series of patient visits or a series of outcomes. The modeling of outcomes associated with these types of healthcare processes is different from and not as well understood as the modeling of standard industry environments. For this reason, the typical multidimensional data warehouse designs that are frequently seen in other industries are often not a good match for data obtained from healthcare processes. Dimensional modeling is a data warehouse design technique that uses a data structure similar to the easily understood entity-relationship (ER) model but is sophisticated in that it supports high-performance data access. In the context of rehabilitation services, we implemented a slight variation of the dimensional modeling technique to make a data warehouse more appropriate for healthcare. One of the key aspects of designing a healthcare data warehouse is finding the right grain (scope) for different levels of analysis. We propose three levels of grain that enable the analysis of healthcare outcomes from highly summarized reports on episodes of care to fine-grained studies of progress from one treatment visit to the next. These grains allow the database to support multiple levels of analysis, which is imperative for healthcare decision making. PMID:18066371

  5. A framework for designing a healthcare outcome data warehouse.

    Science.gov (United States)

    Parmanto, Bambang; Scotch, Matthew; Ahmad, Sjarif

    2005-09-06

    Many healthcare processes involve a series of patient visits or a series of outcomes. The modeling of outcomes associated with these types of healthcare processes is different from and not as well understood as the modeling of standard industry environments. For this reason, the typical multidimensional data warehouse designs that are frequently seen in other industries are often not a good match for data obtained from healthcare processes. Dimensional modeling is a data warehouse design technique that uses a data structure similar to the easily understood entity-relationship (ER) model but is sophisticated in that it supports high-performance data access. In the context of rehabilitation services, we implemented a slight variation of the dimensional modeling technique to make a data warehouse more appropriate for healthcare. One of the key aspects of designing a healthcare data warehouse is finding the right grain (scope) for different levels of analysis. We propose three levels of grain that enable the analysis of healthcare outcomes from highly summarized reports on episodes of care to fine-grained studies of progress from one treatment visit to the next. These grains allow the database to support multiple levels of analysis, which is imperative for healthcare decision making.

  6. The Social Outcomes of Older Adult Learning in Taiwan: Evaluation Framework and Indicators

    Science.gov (United States)

    Lin, Li-Hui

    2015-01-01

    The purpose of this study is to explore the social outcomes of older adult learning in Taiwan. In light of our society's aging population structure, the task of establishing evaluation framework and indicators for the social outcomes of learning (SOL) as applied to older adults is urgent. In order to construct evaluation indicators for older adult…

  7. A framework for outcome-level evaluation of in-service training of health care workers.

    Science.gov (United States)

    O'Malley, Gabrielle; Perdue, Thomas; Petracca, Frances

    2013-10-01

    In-service training is a key strategic approach to addressing the severe shortage of health care workers in many countries. However, there is a lack of evidence linking these health care worker trainings to improved health outcomes. In response, the United States President's Emergency Plan for AIDS Relief's Human Resources for Health Technical Working Group initiated a project to develop an outcome-focused training evaluation framework. This paper presents the methods and results of that project. A general inductive methodology was used for the conceptualization and development of the framework. Fifteen key informant interviews were conducted to explore contextual factors, perceived needs, barriers and facilitators affecting the evaluation of training outcomes. In addition, a thematic analysis of 70 published articles reporting health care worker training outcomes identified key themes and categories. These were integrated, synthesized and compared to several existing training evaluation models. This formed an overall typology which was used to draft a new framework. Finally, the framework was refined and validated through an iterative process of feedback, pilot testing and revision. The inductive process resulted in identification of themes and categories, as well as relationships among several levels and types of outcomes. The resulting framework includes nine distinct types of outcomes that can be evaluated, which are organized within three nested levels: individual, organizational and health system/population. The outcome types are: (1) individual knowledge, attitudes and skills; (2) individual performance; (3) individual patient health; (4) organizational systems; (5) organizational performance; (6) organizational-level patient health; (7) health systems; (8) population-level performance; and (9) population-level health. The framework also addresses contextual factors which may influence the outcomes of training, as well as the ability of evaluators to

  8. THE ADVERSE OUTCOME PATHWAY (AOP) FRAMEWORK: A FRAMEWORK FOR ORGANIZING BIOLOGICAL KNOWLEDGE LEADING TO HEALTH RISKS.

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    An Adverse Outcome Pathway (AOP) represents the organization of current and newly acquired knowledge of biological pathways. These pathways contain a series of nodes (Key Events, KEs) that when sufficiently altered influence the next node on the pathway, beginning from an Molecul...

  9. Value Driven Outcomes (VDO): a pragmatic, modular, and extensible software framework for understanding and improving health care costs and outcomes.

    Science.gov (United States)

    Kawamoto, Kensaku; Martin, Cary J; Williams, Kip; Tu, Ming-Chieh; Park, Charlton G; Hunter, Cheri; Staes, Catherine J; Bray, Bruce E; Deshmukh, Vikrant G; Holbrook, Reid A; Morris, Scott J; Fedderson, Matthew B; Sletta, Amy; Turnbull, James; Mulvihill, Sean J; Crabtree, Gordon L; Entwistle, David E; McKenna, Quinn L; Strong, Michael B; Pendleton, Robert C; Lee, Vivian S

    2015-01-01

    To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes). In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement. A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they spent in the unit; actual medication acquisition costs are allocated to patients based on utilization; and radiology costs are allocated based on the minutes required for study performance. Relevant process and outcome measures are also available. A visualization layer facilitates the identification of value improvement opportunities, such as high-volume, high-cost case types with high variability in costs across providers. Initial implementation was completed within 6 months, and all project objectives were fulfilled. The framework has been improved iteratively and is now a foundational tool for delivering high-value care. The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  10. Value Driven Outcomes (VDO): a pragmatic, modular, and extensible software framework for understanding and improving health care costs and outcomes

    Science.gov (United States)

    Kawamoto, Kensaku; Martin, Cary J; Williams, Kip; Tu, Ming-Chieh; Park, Charlton G; Hunter, Cheri; Staes, Catherine J; Bray, Bruce E; Deshmukh, Vikrant G; Holbrook, Reid A; Morris, Scott J; Fedderson, Matthew B; Sletta, Amy; Turnbull, James; Mulvihill, Sean J; Crabtree, Gordon L; Entwistle, David E; McKenna, Quinn L; Strong, Michael B; Pendleton, Robert C; Lee, Vivian S

    2015-01-01

    Objective To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes). Materials and methods In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement. Results A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they spent in the unit; actual medication acquisition costs are allocated to patients based on utilization; and radiology costs are allocated based on the minutes required for study performance. Relevant process and outcome measures are also available. A visualization layer facilitates the identification of value improvement opportunities, such as high-volume, high-cost case types with high variability in costs across providers. Initial implementation was completed within 6 months, and all project objectives were fulfilled. The framework has been improved iteratively and is now a foundational tool for delivering high-value care. Conclusions The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value. PMID:25324556

  11. The outcome competency framework for practitioners in infection prevention and control: use of the outcome logic model for evaluation.

    Science.gov (United States)

    Burnett, E; Curran, E; Loveday, H P; Kiernan, M A; Tannahill, M

    2014-01-01

    Healthcare is delivered in a dynamic environment with frequent changes in populations, methods, equipment and settings. Infection prevention and control practitioners (IPCPs) must ensure that they are competent in addressing the challenges they face and are equipped to develop infection prevention and control (IPC) services in line with a changing world of healthcare provision. A multifaceted Framework was developed to assist IPCPs to enhance competence at an individual, team and organisational level to enable quality performance and improved quality of care. However, if these aspirations are to be met, it is vital that competency frameworks are fit for purpose or they risk being ignored. The aim of this unique study was to evaluate short and medium term outcomes as set out in the Outcome Logic Model to assist with the evaluation of the impact and success of the Framework. This study found that while the Framework is being used effectively in some areas, it is not being used as much or in the ways that were anticipated. The findings will enable future work on revision, communication and dissemination, and will provide intelligence to those initiating education and training in the utilisation of the competences.

  12. Conceptual framework for patient-important treatment outcomes for pelvic organ prolapse.

    Science.gov (United States)

    Sung, Vivian W; Rogers, Rebecca G; Barber, Matthew D; Clark, Melissa A

    2014-04-01

    To develop a comprehensive conceptual framework representing the most important outcomes for women seeking treatment for pelvic organ prolapse (POP). Twenty-five women with POP were recruited and participated in four semi-structured focus groups to refine and assess the content validity of a conceptual framework representing patient-important outcomes for POP. Specifically, the focus groups addressed the following three aims: (1) to evaluate the content and appropriateness of domains in our framework; (2) to identify gaps in the framework; and (3) to determine the relative importance of our framework domains from the patient perspective. Sessions were transcribed, coded, and qualitatively and quantitatively analyzed using analytic induction and deductive analysis to identify themes and domains relevant to women with POP. Our focus groups confirmed the importance of vaginal bulge symptoms (discomfort, bother, and adaptation), and the overarching domains and subdomains of physical (physical function and participation), social (social function, relationships, and sexual function), and mental health (emotional distress, preoccupation, and body image). Patients ranked outcomes in the following order of importance: (1) the resolution of vaginal bulge symptoms, (2) improvement in physical function; (3) improvement in sexual function; (4) improvement in body image perception; and (5) improvement in social function. We developed a conceptual framework for patient important outcomes of women seeking treatment for POP. This framework can improve the transparency and interpretation of POP study findings from the patient perspective. Vaginal bulge and its associated discomfort are most important for the definition of POP treatment success from the patient perspective. © 2013 Wiley Periodicals, Inc.

  13. Activity Performance Management Framework Based on Outcome Based Budgeting Malaysian Nuclear Agency

    International Nuclear Information System (INIS)

    Aisya Raihan Abdul Kadir; Mohd Azmi Sidid Omar; Noriah Jamal

    2015-01-01

    The implementation of the Outcome Based Budgeting (OBB) in the planning and implementation of national development and public spending will emphasize the impact and effectiveness of programs and activities in line with the policies and objectives of the four pillars in the National Transformation programme, which is 1 Malaysia: People First, Performance Now, Government Transformation Programme (GTP), Economic Transformation Programme (ETP) and Malaysia Five Year Development Plan. OBB effective implementation at the ministry level was implemented by the Ministry OBB Implementation Committee (OIC) and Program Performance Management Committee (PPMC). At the agency it will be implemented by the Performance Management Committee Activities (APMC). OBB involve strategic implementation cycle consisting of four main processes, namely, outcome-based planning, budgeting, monitoring, evaluation, and reporting performance. OBB will be fully implemented in 2016 to replace the Modified Budgeting System (MBS). Performance Management Framework Activity (APMF) is based on outcome-based planning has been developed using methodologies such as ProLL Model (Logic and Linkages Programme), Problem Tree Analysis (PTA), Top-down approach, SMART principle, Framework Approach and rigour test. By applying this methodology several Activity Performance Management Framework (APMF) has been produced which consists of 3 output, 6 KPI output, 3 outcome and 8 KPI outcome in line with the direction and outcome of programme level and ministries level. APMF was planned at the beginning of each year and reporting of the performance on a quarterly basis through My Results application. (author)

  14. Symptom outcomes important to women with anal incontinence: a conceptual framework.

    Science.gov (United States)

    Sung, Vivian W; Rogers, Rebecca G; Bann, Carla M; Arya, Lily; Barber, Matthew D; Lowder, Jerry; Lukacz, Emily S; Markland, Alayne; Siddiqui, Nazema; Wilmot, Amanda; Meikle, Susan F

    2014-05-01

    To develop a framework that describes the most important symptom outcomes for anal incontinence treatment from the patient perspective. A conceptual framework was developed by the Pelvic Floor Disorders Network based on four semistructured focus groups and confirmed in two sets of 10 cognitive interviews including women with anal incontinence. We explored: 1) patient-preferred terminology for describing anal incontinence symptoms; 2) patient definitions of treatment "success"; 3) importance of symptoms and outcomes in the framework; and 4) conceptual gaps (defined as outcomes not previously identified as important). Sessions were conducted according to grounded theory transcribed, coded, and qualitatively and quantitatively analyzed to identify relevant themes. Content and face validity of the framework were further assessed using cognitive interviews. Thirty-four women participated in focus groups and 20 in cognitive interviews. Overall, 29 (54%) were aged 60 years or older, 42 (78%) were white, and 10 (19%) had a high school degree or less. Two overarching outcome themes were identified: "primary bowel leakage symptoms" and "ancillary bowel symptoms." Subdomains important in primary bowel leakage symptoms included leakage characteristics (symptom frequency, amount of leakage, symptom bother) and conditions when bowel leakage occurs (predictability, awareness, urgency). Subdomains important under ancillary bowel symptoms included emptying disorders (constipation, obstructed defecation, and wiping issues) and discomfort (pain, burning). New outcomes identified included predictability, awareness, wiping issues, and discomfort. Women with anal incontinence desire a wide range of symptom outcomes after treatment. These are captured in our conceptual framework, which can aid clinicians and researchers in assessing anal incontinence. LEVEL OF EVIEDENCE: II.

  15. Modeling the economic outcomes of immuno-oncology drugs: alternative model frameworks to capture clinical outcomes.

    Science.gov (United States)

    Gibson, E J; Begum, N; Koblbauer, I; Dranitsaris, G; Liew, D; McEwan, P; Tahami Monfared, A A; Yuan, Y; Juarez-Garcia, A; Tyas, D; Lees, M

    2018-01-01

    Economic models in oncology are commonly based on the three-state partitioned survival model (PSM) distinguishing between progression-free and progressive states. However, the heterogeneity of responses observed in immuno-oncology (I-O) suggests that new approaches may be appropriate to reflect disease dynamics meaningfully. This study explored the impact of incorporating immune-specific health states into economic models of I-O therapy. Two variants of the PSM and a Markov model were populated with data from one clinical trial in metastatic melanoma patients. Short-term modeled outcomes were benchmarked to the clinical trial data and a lifetime model horizon provided estimates of life years and quality adjusted life years (QALYs). The PSM-based models produced short-term outcomes closely matching the trial outcomes. Adding health states generated increased QALYs while providing a more granular representation of outcomes for decision making. The Markov model gave the greatest level of detail on outcomes but gave short-term results which diverged from those of the trial (overstating year 1 progression-free survival by around 60%). Increased sophistication in the representation of disease dynamics in economic models is desirable when attempting to model treatment response in I-O. However, the assumptions underlying different model structures and the availability of data for health state mapping may be important limiting factors.

  16. The population health perspective as a framework for studying child maltreatment outcomes.

    Science.gov (United States)

    Tonmyr, L; MacMillan, H L; Jamieson, E; Kelly, K

    2002-01-01

    The population health perspective (PHP) is commonly used in addressing a wide range of health issues. This article examines the strengths and limitations of the perspective. The determinants of health that are an integral part of the PHP are used as a framework in considering the range of outcomes associated with exposure to child maltreatment. Directions for further research are outlined.

  17. Modeling the economic outcomes of immuno-oncology drugs: alternative model frameworks to capture clinical outcomes

    Directory of Open Access Journals (Sweden)

    Gibson EJ

    2018-03-01

    Full Text Available EJ Gibson,1 N Begum,1 I Koblbauer,1 G Dranitsaris,2 D Liew,3 P McEwan,4 AA Tahami Monfared,5,6 Y Yuan,7 A Juarez-Garcia,7 D Tyas,8 M Lees9 1Wickenstones Ltd, Didcot, UK; 2Augmentium Pharma Consulting Inc, Toronto, ON, Canada; 3Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, VIC, Australia; 4Health Economics and Outcomes Research Ltd, Cardiff, UK; 5Bristol-Myers Squibb Canada, Saint-Laurent, QC Canada; 6Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada; 7Bristol-Myers Squibb, Princeton, NJ, USA; 8Bristol-Myers Squibb, Uxbridge, UK; 9Bristol-Myers Squibb, Rueil-Malmaison, France Background: Economic models in oncology are commonly based on the three-state partitioned survival model (PSM distinguishing between progression-free and progressive states. However, the heterogeneity of responses observed in immuno-oncology (I-O suggests that new approaches may be appropriate to reflect disease dynamics meaningfully. Materials and methods: This study explored the impact of incorporating immune-specific health states into economic models of I-O therapy. Two variants of the PSM and a Markov model were populated with data from one clinical trial in metastatic melanoma patients. Short-term modeled outcomes were benchmarked to the clinical trial data and a lifetime model horizon provided estimates of life years and quality adjusted life years (QALYs. Results: The PSM-based models produced short-term outcomes closely matching the trial outcomes. Adding health states generated increased QALYs while providing a more granular representation of outcomes for decision making. The Markov model gave the greatest level of detail on outcomes but gave short-term results which diverged from those of the trial (overstating year 1 progression-free survival by around 60%. Conclusion: Increased sophistication in the representation of disease dynamics in economic models

  18. A framework for monitoring social process and outcomes in environmental programs.

    Science.gov (United States)

    Chapman, Sarah

    2014-12-01

    When environmental programs frame their activities as being in the service of human wellbeing, social variables need to be integrated into monitoring and evaluation (M&E) frameworks. This article draws upon ecosystem services theory to develop a framework to guide the M&E of collaborative environmental programs with anticipated social benefits. The framework has six components: program need, program activities, pathway process variables, moderating process variables, outcomes, and program value. Needs are defined in terms of ecosystem services, as well as other human needs that must be addressed to achieve outcomes. The pathway variable relates to the development of natural resource governance capacity in the target community. Moderating processes can be externalities such as the inherent capacity of the natural system to service ecosystem needs, local demand for natural resources, policy or socio-economic drivers. Internal program-specific processes relate to program service delivery, targeting and participant responsiveness. Ecological outcomes are expressed in terms of changes in landscape structure and function, which in turn influence ecosystem service provision. Social benefits derived from the program are expressed in terms of the value of the eco-social service to user-specified goals. The article provides suggestions from the literature for identifying indicators and measures for components and component variables, and concludes with an example of how the framework was used to inform the M&E of an adaptive co-management program in western Kenya. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. A framework for the study of coping, illness behaviour and outcomes.

    Science.gov (United States)

    Shaw, C

    1999-05-01

    This paper presents a theoretical framework for the study of coping, illness attribution, health behaviour and outcomes. It is based upon models developed within health psychology and aims to provide a theoretical basis for nurse researchers to utilize psychosocial variables. It is an interactionist model which views outcomes as dependent upon both situation and person variables. The situation is viewed as the health threat or illness symptoms as well as the psychosocial context within which the person is operating. This context includes socio-economic factors, social support, social norms, and external factors such as the mass media. The experience of health threat is dependent upon individual appraisal, and the framework incorporates Folkman and Lazarus' transactional model of stress, as well as Leventhal's illness representation model. Behaviour and the perception of threat are also dependent upon outcome expectancies and the appraisal of one's own coping resources, and so the concepts of locus of control and self-efficacy are also incorporated. This framework allows one to identify determinants of behaviour and outcome, and will aid nurses in identifying areas for psycho-social intervention.

  20. Evaluating social outcomes of HIV/AIDS interventions: a critical assessment of contemporary indicator frameworks.

    Science.gov (United States)

    Mannell, Jenevieve; Cornish, Flora; Russell, Jill

    2014-01-01

    Contemporary HIV-related theory and policy emphasize the importance of addressing the social drivers of HIV risk and vulnerability for a long-term response. Consequently, increasing attention is being given to social and structural interventions, and to social outcomes of HIV interventions. Appropriate indicators for social outcomes are needed in order to institutionalize the commitment to addressing social outcomes. This paper critically assesses the current state of social indicators within international HIV/AIDS monitoring and evaluation frameworks. We analyzed the indicator frameworks of six international organizations involved in efforts to improve and synchronize the monitoring and evaluation of the HIV/AIDS response. Our analysis classifies the 328 unique indicators according to what they measure and assesses the degree to which they offer comprehensive measurement across three dimensions: domains of the social context, levels of change and organizational capacity. The majority of indicators focus on individual-level (clinical and behavioural) interventions and outcomes, neglecting structural interventions, community interventions and social outcomes (e.g. stigma reduction; community capacity building; policy-maker sensitization). The main tool used to address social aspects of HIV/AIDS is the disaggregation of data by social group. This raises three main limitations. Indicator frameworks do not provide comprehensive coverage of the diverse social drivers of the epidemic, particularly neglecting criminalization, stigma, discrimination and gender norms. There is a dearth of indicators for evaluating the social impacts of HIV interventions. Indicators of organizational capacity focus on capacity to effectively deliver and manage clinical services, neglecting capacity to respond appropriately and sustainably to complex social contexts. Current indicator frameworks cannot adequately assess the social outcomes of HIV interventions. This limits knowledge about

  1. Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

    Science.gov (United States)

    Nawaz, Saira; Thomas, Craig; Young, Andrea

    2015-01-01

    We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

  2. Patient-reported outcomes in insomnia: development of a conceptual framework and endpoint model.

    Science.gov (United States)

    Kleinman, Leah; Buysse, Daniel J; Harding, Gale; Lichstein, Kenneth; Kalsekar, Anupama; Roth, Thomas

    2013-01-01

    This article describes qualitative research conducted with patients with clinical diagnoses of insomnia and focuses on the development of a conceptual framework and endpoint model that identifies a hierarchy and interrelationships of potential outcomes in insomnia research. Focus groups were convened to discuss how patients experience insomnia and to generate items for patient-reported questionnaires on insomnia and associated daytime consequences. Results for the focus group produced two conceptual frameworks: one for sleep and one for daytime impairment. Each conceptual framework consists of hypothesized domains and items in each domain based on patient language taken from the focus group. These item pools may ultimately serve as a basis to develop new questionnaires to assess insomnia.

  3. Practical framework for Bloom's based teaching and assessment of engineering outcomes

    Science.gov (United States)

    Mead, Patricia F.; Bennett, Mary M.

    2009-06-01

    ABET's outcomes-based assessment and evaluation requirements for engineering school accreditation has been a catalyst for curricular reform for engineering programs across the U.S. and around the world. Norfolk State University launched programs in Electronics and Optical Engineering in 2003. In 2007, Norfolk State became one of only six accredited Optical Engineering programs in the United States. In preparation for their first ABET evaluation in fall 2007, the faculty initiated an embedded-assessment program to insure continuous improvement toward the desired learning outcomes. The initial program design includes embedded assessments that have been generated using a practical framework for the creation of course activities based on Bloom's Learning Taxonomy. The framework includes specific performance criteria for each ABET-defined learning outcome. The embedded assessments are generated by individual faculty for courses that they are assigned to teach, and the performance criteria provide sufficient information to guide the faculty as they generate the embedded assignments. The assignments are typically administered through course exams, projects, electronic portfolio assignments, and other structured educational activities. The effectiveness of the assessment design is being evaluated through faculty surveys, faculty group discussions, and student performance. This paper outlines the assessment and evaluation plan, and the integrated processes that have been used to support the evaluation of learning outcomes using embedded assessment instruments.

  4. Does outcome feedback make you a better emergency physician? A systematic review and research framework proposal.

    Science.gov (United States)

    Lavoie, Curtis F; Schachter, Howard; Stewart, Aviva T; McGowan, Jessie

    2009-11-01

    The organization of emergency medical care limits the ability of emergency physicians to know the outcomes of most of their patients after the patients leave the emergency department. This lack of outcome feedback may hinder the practice of emergency medicine (EM) by preventing "calibration" of the decision tools of practitioners. We sought to determine what is currently known about outcome feedback in EM, including its incidence, impact and modifiers. We searched the following databases: PreMEDLINE, MEDLINE, EMBASE, CINAHL, CENTRAL, PsycINFO, DARE, Health Technology Assessment Database and AMED. We performed manual searches on abstract databases, reference lists, various health information and research websites, and nonindexed journals. Selection entailed a 2-step screening pro cess to exclude articles not pertaining to outcome feedback in EM. Our search yielded 1128 bibliographic records, from which screening identified 7 relevant reports: 5 surveys, 1 system level evaluation and 1 intervention trial. All studies were found to have "inadequate" or "unable to assess" reporting and study quality. Systems for outcome feedback to EM residents have been increasingly available since 1984, though they are perceived to be inadequate. Commonly used mechanisms for outcome feedback include automatic routing of discharge summaries, case conferences for admitted patients and telephone calls to patients or families for discharged patients. With respect to attending emergency physicians, no conclusions or clinical recommendations can be made given the level of available evidence. The potential importance of outcome feedback remains, at this time, underevaluated. We propose a research framework, and hypothesize that increasing outcome feedback would increase emergency physician diagnostic accuracy, therapeutic outcomes, clinical efficiency and job satisfaction. Future research in this area should include surveys and focus groups, as well as simulated or real-world intervention

  5. An organizing framework for informal caregiver interventions: detailing caregiving activities and caregiver and care recipient outcomes to optimize evaluation efforts

    OpenAIRE

    Van Houtven, Courtney Harold; Voils, Corrine I; Weinberger, Morris

    2011-01-01

    Abstract Background Caregiver interventions may help improve the quality of informal care. Yet the lack of a systematic framework specifying the targets and outcomes of caregiver interventions hampers our ability to understand what has been studied, to evaluate existing programs, and to inform the design of future programs. Our goal was to develop an organizing framework detailing the components of the caregiving activities and the caregiver and care recipient outcomes that should be affected...

  6. Outcome-based ventilation: A framework for assessing performance, health, and energy impacts to inform office building ventilation decisions.

    Science.gov (United States)

    Rackes, A; Ben-David, T; Waring, M S

    2018-04-23

    This article presents an outcome-based ventilation (OBV) framework, which combines competing ventilation impacts into a monetized loss function ($/occ/h) used to inform ventilation rate decisions. The OBV framework, developed for U.S. offices, considers six outcomes of increasing ventilation: profitable outcomes realized from improvements in occupant work performance and sick leave absenteeism; health outcomes from occupant exposure to outdoor fine particles and ozone; and energy outcomes from electricity and natural gas usage. We used the literature to set low, medium, and high reference values for OBV loss function parameters, and evaluated the framework and outcome-based ventilation rates using a simulated U.S. office stock dataset and a case study in New York City. With parameters for all outcomes set at medium values derived from literature-based central estimates, higher ventilation rates' profitable benefits dominated negative health and energy impacts, and the OBV framework suggested ventilation should be ≥45 L/s/occ, much higher than the baseline ~8.5 L/s/occ rate prescribed by ASHRAE 62.1. Only when combining very low parameter estimates for profitable impacts with very high ones for health and energy impacts were all outcomes on the same order. Even then, however, outcome-based ventilation rates were often twice the baseline rate or more. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Defining molecular initiating events in the adverse outcome pathway framework for risk assessment.

    Science.gov (United States)

    Allen, Timothy E H; Goodman, Jonathan M; Gutsell, Steve; Russell, Paul J

    2014-12-15

    Consumer and environmental safety decisions are based on exposure and hazard data, interpreted using risk assessment approaches. The adverse outcome pathway (AOP) conceptual framework has been presented as a logical sequence of events or processes within biological systems which can be used to understand adverse effects and refine current risk assessment practices in ecotoxicology. This framework can also be applied to human toxicology and is explored on the basis of investigating the molecular initiating events (MIEs) of compounds. The precise definition of the MIE has yet to reach general acceptance. In this work we present a unified MIE definition: an MIE is the initial interaction between a molecule and a biomolecule or biosystem that can be causally linked to an outcome via a pathway. Case studies are presented, and issues with current definitions are addressed. With the development of a unified MIE definition, the field can look toward defining, classifying, and characterizing more MIEs and using knowledge of the chemistry of these processes to aid AOP research and toxicity risk assessment. We also present the role of MIE research in the development of in vitro and in silico toxicology and suggest how, by using a combination of biological and chemical approaches, MIEs can be identified and characterized despite a lack of detailed reports, even for some of the most studied molecules in toxicology.

  8. A framework for understanding outcomes of integrated care programs for the hospitalized elderly

    Directory of Open Access Journals (Sweden)

    Jacqueline M. Hartgerink

    2013-11-01

    Full Text Available Introduction: Integrated care has emerged as a new strategy to enhance the quality of care for hospitalised elderly. Current models do not provide insight into the mechanisms underlying integrated care delivery. Therefore, we developed a framework to identify the underlying mechanisms of integrated care delivery. We should understand how they operate and interact, so that integrated care programmes can enhance the quality of care and eventually patient outcomes.Theory and methods: Interprofessional collaboration among professionals is considered to be critical in integrated care delivery due to many interdependent work requirements. A review of integrated care components brings to light a distinction between the cognitive and behavioural components of interprofessional collaboration.Results: Effective integrated care programmes combine the interacting components of care delivery. These components affect professionals’ cognitions and behaviour, which in turn affect quality of care. Insight is gained into how these components alter the way care is delivered through mechanisms such as combining individual knowledge and actively seeking new information.Conclusion: We expect that insight into the cognitive and behavioural mechanisms will contribute to the understanding of integrated care programmes. The framework can be used to identify the underlying mechanisms of integrated care responsible for producing favourable outcomes, allowing comparisons across programmes.

  9. Theoretical framework and methodological development of common subjective health outcome measures in osteoarthritis: a critical review

    Directory of Open Access Journals (Sweden)

    Johnston Marie

    2007-03-01

    Full Text Available Abstract Subjective measures involving clinician ratings or patient self-assessments have become recognised as an important tool for the assessment of health outcome. The value of a health outcome measure is usually assessed by a psychometric evaluation of its reliability, validity and responsiveness. However, psychometric testing involves an accumulation of evidence and has recognised limitations. It has been suggested that an evaluation of how well a measure has been developed would be a useful additional criteria in assessing the value of a measure. This paper explored the theoretical background and methodological development of subjective health status measures commonly used in osteoarthritis research. Fourteen subjective health outcome measures commonly used in osteoarthritis research were examined. Each measure was explored on the basis of their i theoretical framework (was there a definition of what was being assessed and was it part of a theoretical model? and ii methodological development (what was the scaling strategy, how were the items generated and reduced, what was the response format and what was the scoring method?. Only the AIMS, SF-36 and WHOQOL defined what they were assessing (i.e. the construct of interest and no measure assessed was part of a theoretical model. None of the clinician report measures appeared to have implemented a scaling procedure or described the rationale for the items selected or scoring system. Of the patient self-report measures, the AIMS, MPQ, OXFORD, SF-36, WHOQOL and WOMAC appeared to follow a standard psychometric scaling method. The DRP and EuroQol used alternative scaling methods. The review highlighted the general lack of theoretical framework for both clinician report and patient self-report measures. This review also drew attention to the wide variation in the methodological development of commonly used measures in OA. While, in general the patient self-report measures had good methodological

  10. What makes a doctor a scholar: a systematic review and content analysis of outcome frameworks.

    Science.gov (United States)

    Hautz, Stefanie C; Hautz, Wolf E; Feufel, Markus A; Spies, Claudia D

    2016-04-22

    Many national outcome frameworks (OF) call for a sound scholarship education and scholarly behaviour of physicians. Educators however are known to interpret the scholar role in markedly different ways and at least one major initiative to unify several national outcome frameworks failed to agree on a common definition of the scholar role. Both circumstances currently limit the development of educational and assessment strategies specific for the scholar role. Given increasing physician mobility together with the global perspective inherent in a doctor's role as a scholar, we were interested in what different OFs define as the scholar role and attempted to identify communalities and differences between them. We conducted a systematic review for OF in medical education in PubMed and google. After in- and exclusion processes, we extracted all content listed under the scholar role (if present) and categorized it based on Boyer's established model of scholarship. Next, we extracted all content related to scholarship from OFs not explicitly defining a scholar role and used it to validate the categories resulting from step one. From 1816 search results, we identified 13 eligible OFs, seven of which explicitly specified a scholar role. The outcomes only partly map onto Boyer's definition of scholarship: Discovery, Integration, Application, and Teaching. We adapted and validated a model extending this definition to contain Common Basics (partly overlapping with Integration and Teaching), Clinical Application (specifying Application), Research (Discovery and partly Integration), Teaching and Education (partly overlapping with Teaching) and Lifelong Learning (no equivalent in Boyer's model). Whereas almost all OFs cover Common Basics, Clinical Application, and Lifelong Learning, fewer and less specific outcomes relate to Research or Teaching. The need to adapt existing models of scholarship may result from the changing demands directed at medical scholars. The considerable

  11. Action, outcome, and value: a dual-system framework for morality.

    Science.gov (United States)

    Cushman, Fiery

    2013-08-01

    Dual-system approaches to psychology explain the fundamental properties of human judgment, decision making, and behavior across diverse domains. Yet, the appropriate characterization of each system is a source of debate. For instance, a large body of research on moral psychology makes use of the contrast between "emotional" and "rational/cognitive" processes, yet even the chief proponents of this division recognize its shortcomings. Largely independently, research in the computational neurosciences has identified a broad division between two algorithms for learning and choice derived from formal models of reinforcement learning. One assigns value to actions intrinsically based on past experience, while another derives representations of value from an internally represented causal model of the world. This division between action- and outcome-based value representation provides an ideal framework for a dual-system theory in the moral domain.

  12. Can we decide which outcomes should be measured in every clinical trial? A scoping review of the existing conceptual frameworks and processes to develop core outcome sets.

    Science.gov (United States)

    Idzerda, Leanne; Rader, Tamara; Tugwell, Peter; Boers, Maarten

    2014-05-01

    The usefulness of randomized control trials to advance clinical care depends upon the outcomes reported, but disagreement on the choice of outcome measures has resulted in inconsistency and the potential for reporting bias. One solution to this problem is the development of a core outcome set: a minimum set of outcome measures deemed critical for clinical decision making. Within rheumatology the Outcome Measures in Rheumatology (OMERACT) initiative has pioneered the development of core outcome sets since 1992. As the number of diseases addressed by OMERACT has increased and its experience in formulating core sets has grown, clarification and update of the conceptual framework and formulation of a more explicit process of area/domain core set development has become necessary. As part of the update process of the OMERACT Filter criteria to version 2, a literature review was undertaken to compare and contrast the OMERACT conceptual framework with others within and outside rheumatology. A scoping search was undertaken to examine the extent, range, and nature of conceptual frameworks for core set outcome selection in health. We searched the following resources: Cochrane Library Methods Group Register; Medline; Embase; PsycInfo; Environmental Studies and Policy Collection; and ABI/INFORM Global. We also conducted a targeted Google search. Five conceptual frameworks were identified: the WHO tripartite definition of health; the 5 Ds (discomfort, disability, drug toxicity, dollar cost, and death); the International Classification of Functioning (ICF); PROMIS (Patient-Reported Outcomes Measurement System); and the Outcomes Hierarchy. Of these, only the 5 Ds and ICF frameworks have been systematically applied in core set development. Outside the area of rheumatology, several core sets were identified; these had been developed through a limited range of consensus-based methods with varying degrees of methodological rigor. None applied a framework to ensure content validity of

  13. Group interventions to improve health outcomes: a framework for their design and delivery

    Directory of Open Access Journals (Sweden)

    Avenell Alison

    2010-12-01

    Full Text Available Abstract Background Delivering an intervention to a group of patients to improve health outcomes is increasingly popular in public health and primary care, yet "group" is an umbrella term which encompasses a complex range of aims, theories, implementation processes and evaluation methods. We propose a framework for the design and process evaluation of health improvement interventions occurring in a group setting, which will assist practitioners, researchers and policy makers. Methods We reviewed the wider literature on health improvement interventions delivered to patient groups and identified a gap in the literature for designing, evaluating and reporting these interventions. We drew on our experiences conducting systematic reviews, intervention, mixed method and ethnographic studies of groups for breastfeeding and weight management. A framework for health improvement group design and delivery evolved through an iterative process of primary research, reference to the literature and research team discussion. Results Although there is an extensive literature on group processes in education, work, politics and psychological therapies, far less is known about groups where the aim is health improvement. Theories of behaviour change which are validated for individual use are often assumed to be generalisable to group settings, without being rigorously tested. Health improvement or behaviour change interventions delivered in a group setting are complex adaptive social processes with interactions between the group leader, participants, and the wider community and environment. Ecological models of health improvement, which embrace the complex relationship between behaviour, systems and the environment may be more relevant than an individual approach to behaviour change. Conclusion The evidence for effectiveness and cost-effectiveness of group compared with one-to-one interventions for many areas of health improvement in public health and primary care is

  14. EU Framework 6 Project: Predictive Toxicology (PredTox)-overview and outcome

    International Nuclear Information System (INIS)

    Suter, Laura; Schroeder, Susanne; Meyer, Kirstin; Gautier, Jean-Charles; Amberg, Alexander; Wendt, Maria; Gmuender, Hans; Mally, Angela; Boitier, Eric; Ellinger-Ziegelbauer, Heidrun; Matheis, Katja; Pfannkuch, Friedlieb

    2011-01-01

    In this publication, we report the outcome of the integrated EU Framework 6 Project: Predictive Toxicology (PredTox), including methodological aspects and overall conclusions. Specific details including data analysis and interpretation are reported in separate articles in this issue. The project, partly funded by the EU, was carried out by a consortium of 15 pharmaceutical companies, 2 SMEs, and 3 universities. The effects of 16 test compounds were characterized using conventional toxicological parameters and 'omics' technologies. The three major observed toxicities, liver hypertrophy, bile duct necrosis and/or cholestasis, and kidney proximal tubular damage were analyzed in detail. The combined approach of 'omics' and conventional toxicology proved a useful tool for mechanistic investigations and the identification of putative biomarkers. In our hands and in combination with histopathological assessment, target organ transcriptomics was the most prolific approach for the generation of mechanistic hypotheses. Proteomics approaches were relatively time-consuming and required careful standardization. NMR-based metabolomics detected metabolite changes accompanying histopathological findings, providing limited additional mechanistic information. Conversely, targeted metabolite profiling with LC/GC-MS was very useful for the investigation of bile duct necrosis/cholestasis. In general, both proteomics and metabolomics were supportive of other findings. Thus, the outcome of this program indicates that 'omics' technologies can help toxicologists to make better informed decisions during exploratory toxicological studies. The data support that hypothesis on mode of action and discovery of putative biomarkers are tangible outcomes of integrated 'omics' analysis. Qualification of biomarkers remains challenging, in particular in terms of identification, mechanistic anchoring, appropriate specificity, and sensitivity.

  15. Current trends in outcome studies for children with hearing loss and the need to establish a comprehensive framework of measuring outcomes in children with hearing loss in China

    Directory of Open Access Journals (Sweden)

    Xueman Liu

    2016-06-01

    Full Text Available Since the 1970s, outcome studies for children with hearing loss expanded from focusing on assessing auditory awareness and speech perception skills to evaluating language and speech development. Since the early 2000s, the multi-center large scale research systematically studied outcomes in the areas of auditory awareness, speech-perception, language development, speech development, educational achievements, cognitive development, and psychosocial development. These studies advocated the establishment of baseline and regular follow-up evaluations with a comprehensive framework centered on language development. Recent research interests also include understanding the vast differences in outcomes for children with hearing loss, understanding the relationships between neurocognitive development and language acquisition in children with hearing loss, and using outcome studies to guide evidence-based clinical practice. After the establishment of standardized Mandarin language assessments, outcomes research in Mainland China has the potential to expand beyond auditory awareness and speech perception studies.

  16. An organizing framework for informal caregiver interventions: detailing caregiving activities and caregiver and care recipient outcomes to optimize evaluation efforts

    Directory of Open Access Journals (Sweden)

    Van Houtven Courtney

    2011-11-01

    Full Text Available Abstract Background Caregiver interventions may help improve the quality of informal care. Yet the lack of a systematic framework specifying the targets and outcomes of caregiver interventions hampers our ability to understand what has been studied, to evaluate existing programs, and to inform the design of future programs. Our goal was to develop an organizing framework detailing the components of the caregiving activities and the caregiver and care recipient outcomes that should be affected by an intervention. In so doing, we characterize what has been measured in the published literature to date and what should be measured in future studies to enable comparisons across interventions and across time. Methods Our data set comprises 121 reports of caregiver interventions conducted in the United States and published between 2000 and 2009. We extracted information on variables that have been examined as primary and secondary outcomes. These variables were grouped into categories, which then informed the organizing framework. We calculated the frequency with which the interventions examined each framework component to identify areas about which we have the most knowledge and under-studied areas that deserve attention in future research. Results The framework stipulates that caregiver interventions seek to change caregiving activities, which in turn affect caregiver and care recipient outcomes. The most frequently assessed variables have been caregiver psychological outcomes (especially depression and burden and care recipient physical and health care use outcomes. Conclusions Based on the organizing framework, we make three key recommendations to guide interventions and inform research and policy. First, all intervention studies should assess quality and/or quantity of caregiving activities to help understand to what extent and how well the intervention worked. Second, intervention studies should assess a broad range of caregiver and care recipient

  17. An mHealth Framework to Improve Birth Outcomes in Benue State, Nigeria: A Study Protocol.

    Science.gov (United States)

    Ezeanolue, Echezona Edozie; Gbadamosi, Semiu Olatunde; Olawepo, John Olajide; Iwelunmor, Juliet; Sarpong, Daniel; Eze, Chuka; Ogidi, Amaka; Patel, Dina; Onoka, Chima

    2017-05-26

    The unprecedented coverage of mobile technology across the globe has led to an increase in the use of mobile health apps and related strategies to make health information available at the point of care. These strategies have the potential to improve birth outcomes, but are limited by the availability of Internet services, especially in resource-limited settings such as Nigeria. Our primary objective is to determine the feasibility of developing an integrated mobile health platform that is able to collect data from community-based programs, embed collected data into a smart card, and read the smart card using a mobile phone-based app without the need for Internet access. Our secondary objectives are to determine (1) the acceptability of the smart card among pregnant women and (2) the usability of the smart card by pregnant women and health facilities in rural Nigeria. We will leverage existing technology to develop a platform that integrates a database, smart card technology, and a mobile phone-based app to read the smart cards. We will recruit 300 pregnant women with one of the three conditions-HIV, hepatitis B virus infection, and sickle cell trait or disease-and four health facilities in their community. We will use Glasgow's Reach, Effectiveness, Adoption, Implementation, and Maintenance framework as a guide to assess the implementation, acceptability, and usability of the mHealth platform. We have recruited four health facilities and 300 pregnant women with at least one of the eligible conditions. Over the course of 3 months, we will complete the development of the mobile health platform and each participant will be offered a smart card; staff in each health facility will receive training on the use of the mobile health platform. Findings from this study could offer a new approach to making health data from pregnant women available at the point of delivery without the need for an Internet connection. This would allow clinicians to implement evidence

  18. Developing a framework to generate evidence of health outcomes from social media use in chronic disease management.

    Science.gov (United States)

    Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando

    2013-01-01

    While there is an abundance of evidence-based practice (EBP) recommendations guiding management of various chronic diseases, evidence suggesting best practice for using social media to improve health outcomes is inadequate. The variety of social media platforms, multiple potential uses, inconsistent definitions, and paucity of rigorous studies, make it difficult to measure health outcomes reliably in chronic disease management. Most published investigations report on an earlier generation of online tools, which are not as user-centered, participatory, engaging, or collaborative, and thus may work differently for health self-management. The challenge to establish a sound evidence base for social media use in chronic disease starts with the need to define criteria and methods to generate and evaluate evidence. The authors' key objective is to develop a framework for research and practice that addresses this challenge. This paper forms part of a larger research project that presents a conceptual framework of how evidence of health outcomes can be generated from social media use, allowing social media to be utilized in chronic disease management more effectively. Using mixed methods incorporating a qualitative literature review, a survey and a pilot intervention, the research closely examines the therapeutic affordances of social media, people with chronic pain (PWCP) as a subset of chronic disease management, valid outcome measurement of patient-reported (health) outcomes (PRO), the individual needs of people living with chronic disease, and finally translation of the combined results to improve evidence-based decision making about social media use in this context. Extensive review highlights various affordances of social media that may prove valuable to understanding social media's effect on individual health outcomes. However, without standardized PRO instruments, we are unable to definitively investigate these effects. The proposed framework that we offer outlines

  19. Applying Diffusion Theory to Electronic Publishing: A Conceptual Framework for Examining Issues and Outcomes.

    Science.gov (United States)

    Hahn, Karla L.; Schoch, Natalie A.

    1997-01-01

    Electronic publishing can best be understood as a cluster of related innovations which can be incorporated in different combinations. The innovation cluster is defined, and a framework is provided to characterize several recent publishing ventures demonstrating how the framework facilitates comparison and evaluation of individual implementations…

  20. A Framework to Evaluate Ecological and Social Outcomes of Collaborative Management: Lessons from Implementation with a Northern Arizona Collaborative Group

    Science.gov (United States)

    Muñoz-Erickson, Tischa A.; Aguilar-González, Bernardo; Loeser, Matthew R. R.; Sisk, Thomas D.

    2010-01-01

    As collaborative groups gain popularity as an alternative means for addressing conflict over management of public lands, the need for methods to evaluate their effectiveness in achieving ecological and social goals increases. However, frameworks that examine both effectiveness of the collaborative process and its outcomes are poorly developed or altogether lacking. This paper presents and evaluates the utility of the holistic ecosystem health indicator (HEHI), a framework that integrates multiple ecological and socioeconomic criteria to evaluate management effectiveness of collaborative processes. Through the development and application of the HEHI to a collaborative in northern Arizona, the Diablo Trust, we present the opportunities and challenges in using this framework to evaluate the ecological and social outcomes of collaborative adaptive management. Baseline results from the first application of the HEHI are presented as an illustration of its potential as a co-adaptive management tool. We discuss lessons learned from the process of selecting indicators and potential issues to their long-term implementation. Finally, we provide recommendations for applying this framework to monitoring and adaptive management in the context of collaborative management.

  1. A systematic review and development of a classification framework for factors associated with missing patient-reported outcome data.

    Science.gov (United States)

    Palmer, Michael J; Mercieca-Bebber, Rebecca; King, Madeleine; Calvert, Melanie; Richardson, Harriet; Brundage, Michael

    2018-02-01

    Missing patient-reported outcome data can lead to biased results, to loss of power to detect between-treatment differences, and to research waste. Awareness of factors may help researchers reduce missing patient-reported outcome data through study design and trial processes. The aim was to construct a Classification Framework of factors associated with missing patient-reported outcome data in the context of comparative studies. The first step in this process was informed by a systematic review. Two databases (MEDLINE and CINAHL) were searched from inception to March 2015 for English articles. Inclusion criteria were (a) relevant to patient-reported outcomes, (b) discussed missing data or compliance in prospective medical studies, and (c) examined predictors or causes of missing data, including reasons identified in actual trial datasets and reported on cover sheets. Two reviewers independently screened titles and abstracts. Discrepancies were discussed with the research team prior to finalizing the list of eligible papers. In completing the systematic review, four particular challenges to synthesizing the extracted information were identified. To address these challenges, operational principles were established by consensus to guide the development of the Classification Framework. A total of 6027 records were screened. In all, 100 papers were eligible and included in the review. Of these, 57% focused on cancer, 23% did not specify disease, and 20% reported for patients with a variety of non-cancer conditions. In total, 40% of the papers offered a descriptive analysis of possible factors associated with missing data, but some papers used other methods. In total, 663 excerpts of text (units), each describing a factor associated with missing patient-reported outcome data, were extracted verbatim. Redundant units were identified and sequestered. Similar units were grouped, and an iterative process of consensus among the investigators was used to reduce these units to a

  2. Tailored and integrated Web-based tools for improving psychosocial outcomes of cancer patients: the DoTTI development framework.

    Science.gov (United States)

    Smits, Rochelle; Bryant, Jamie; Sanson-Fisher, Rob; Tzelepis, Flora; Henskens, Frans; Paul, Christine; Stevenson, William

    2014-03-14

    Effective communication with cancer patients and their families about their disease, treatment options, and possible outcomes may improve psychosocial outcomes. However, traditional approaches to providing information to patients, including verbal information and written booklets, have a number of shortcomings centered on their limited ability to meet patient preferences and literacy levels. New-generation Web-based technologies offer an innovative and pragmatic solution for overcoming these limitations by providing a platform for interactive information seeking, information sharing, and user-centered tailoring. The primary goal of this paper is to discuss the advantages of comprehensive and iterative Web-based technologies for health information provision and propose a four-phase framework for the development of Web-based information tools. The proposed framework draws on our experience of constructing a Web-based information tool for hematological cancer patients and their families. The framework is based on principles for the development and evaluation of complex interventions and draws on the Agile methodology of software programming that emphasizes collaboration and iteration throughout the development process. The DoTTI framework provides a model for a comprehensive and iterative approach to the development of Web-based informational tools for patients. The process involves 4 phases of development: (1) Design and development, (2) Testing early iterations, (3) Testing for effectiveness, and (4) Integration and implementation. At each step, stakeholders (including researchers, clinicians, consumers, and programmers) are engaged in consultations to review progress, provide feedback on versions of the Web-based tool, and based on feedback, determine the appropriate next steps in development. This 4-phase framework is evidence-informed and consumer-centered and could be applied widely to develop Web-based programs for a diverse range of diseases.

  3. Assets, Economic Opportunity and Toxic Stress: A Framework for Understanding Child and Educational Outcomes

    Science.gov (United States)

    Shanks, Trina R. Williams; Robinson, Christine

    2013-01-01

    A large body of evidence indicates that socioeconomic status (SES) is a strong predictor of school achievement, college graduation and child outcomes in general. Better developmental and health outcomes are strongly associated with family assets, income and education. We introduce a model incorporating a range of theoretical and empirical…

  4. Issues in Developing the IFSP: A Framework for Establishing Family Outcomes.

    Science.gov (United States)

    Beckman, Paula J.; Bristol, Marie M.

    1991-01-01

    This paper identifies four key issues in the implementation of Individualized Family Service Plans (IFSPs) to provide services to young handicapped children as required by Public Law 99-457. These include sensitivity to cultural diversity, family assessment, intrusiveness, and establishing family outcomes. A typology of family outcomes which…

  5. Theoretical Framework to Extend Adverse Outcome Pathways to Include Pharmacokinetic Considerations

    Science.gov (United States)

    Adverse Outcome Pathways (AOPs) have generated intense interest for their utility in linking known population outcomes to a molecular initiating event (MIE) that can be quantified using in vitro methods. While there are tens of thousands of chemicals in commercial use, biology h...

  6. A Conceptual Framework: The Musical Self as a Unique Pathway to Outcomes in the Acute Pediatric Health Setting.

    Science.gov (United States)

    Shoemark, Helen; Rimmer, Jo; Bower, Janeen; Tucquet, Belinda; Miller, Lauren; Fisher, Michelle; Ogburn, Nicholas; Dun, Beth

    2018-03-09

    This article reports on a project at the Royal Children's Hospital Melbourne in which the music therapy team synthesized their practice and related theories to propose a new conceptual framework for music therapy in their acute pediatric setting. The impetus for the project was the realization that in the process of producing key statements about the non-musical benefits of music therapy, the cost was often the suppression of information about the patient's unique musical potential as the major (mediating) pathway from referral reason, to music therapy, and to effective outcomes. The purpose of the project was to articulate how this team of clinicians conceive of the patient's musical self as the major theoretical pathway for music therapy in an evidence-based acute medical setting. The clinicians' shared reflexive process across six months involved robust directed discussion, annotation of shared reading, and documentation of all engagement in words and diagrams. The outcome was a consensus framework including three constructs: the place of music in the life of the infant, child, and young people, Culture and Context, and Musical Manifestations. The constructs were tested in a clinical audit, and found to be robustly inclusive. In addition to the conceptual framework, this project serves to demonstrate a process by which clinical teams may reflect on their individual practice and theory together to create a consensus stance for the overall service they provide in the one setting.

  7. Propensity scores-potential outcomes framework to incorporate severity probabilities in the highway safety manual crash prediction algorithm.

    Science.gov (United States)

    Sasidharan, Lekshmi; Donnell, Eric T

    2014-10-01

    Accurate estimation of the expected number of crashes at different severity levels for entities with and without countermeasures plays a vital role in selecting countermeasures in the framework of the safety management process. The current practice is to use the American Association of State Highway and Transportation Officials' Highway Safety Manual crash prediction algorithms, which combine safety performance functions and crash modification factors, to estimate the effects of safety countermeasures on different highway and street facility types. Many of these crash prediction algorithms are based solely on crash frequency, or assume that severity outcomes are unchanged when planning for, or implementing, safety countermeasures. Failing to account for the uncertainty associated with crash severity outcomes, and assuming crash severity distributions remain unchanged in safety performance evaluations, limits the utility of the Highway Safety Manual crash prediction algorithms in assessing the effect of safety countermeasures on crash severity. This study demonstrates the application of a propensity scores-potential outcomes framework to estimate the probability distribution for the occurrence of different crash severity levels by accounting for the uncertainties associated with them. The probability of fatal and severe injury crash occurrence at lighted and unlighted intersections is estimated in this paper using data from Minnesota. The results show that the expected probability of occurrence of fatal and severe injury crashes at a lighted intersection was 1 in 35 crashes and the estimated risk ratio indicates that the respective probabilities at an unlighted intersection was 1.14 times higher compared to lighted intersections. The results from the potential outcomes-propensity scores framework are compared to results obtained from traditional binary logit models, without application of propensity scores matching. Traditional binary logit analysis suggests that

  8. A framework for understanding outcomes of mutual learning situations in IT projects

    DEFF Research Database (Denmark)

    Hansen, Magnus Rotvit Perlt

    2012-01-01

    How do we analyse and understand design decisions derived from mutual learning (ML) situations and how may practitioners take advantage of these in IT projects? In the following we present a framework of design decisions inferred from ML situations that occurred between end-users and stakeholders...

  9. Prognosis research strategy (PROGRESS) 1: A framework for researching clinical outcomes

    NARCIS (Netherlands)

    H. Hemingway; P. Croft (Peter); P. Perel (Pablo); J. Hayden (Jill); D. Abrams; A. Timmis (Adam); A. Briggs (Andrew); R. Udumyan (Ruzan); K.G.M. Moons (Karel); E.W. Steyerberg (Ewout); I. Roberts (Ian); S. Schroter (Sara); D.G. Altman (Douglas); R.D. Riley (Richard); N. Brunner; A. Hingorani (Aroon); P.A. Kyzas (Panayiotis); N. Malats (Núria); G. Peat; W. Sauerbrei (Willi); D.A.W.M. van der Windt (Daniëlle)

    2013-01-01

    textabstractUnderstanding and improving the prognosis of a disease or health condition is a priority in clinical research and practice. In this article, the authors introduce a framework of four interrelated themes in prognosis research, describe the importance of the first of these themes

  10. Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): A multidisciplinary position statement.

    Science.gov (United States)

    Stewart, Simon; Riegel, Barbara; Boyd, Cynthia; Ahamed, Yasmin; Thompson, David R; Burrell, Louise M; Carrington, Melinda J; Coats, Andrew; Granger, Bradi B; Hides, Julie; Weintraub, William S; Moser, Debra K; Dickson, Victoria Vaughan; McDermott, Cressida J; Keates, Ashley K; Rich, Michael W

    2016-06-01

    Multimorbidity in heart failure (HF), defined as HF of any aetiology and multiple concurrent conditions that require active management, represents an emerging problem within the ageing HF patient population worldwide. To inform this position paper, we performed: 1) an initial review of the literature identifying the ten most common conditions, other than hypertension and ischaemic heart disease, complicating the management of HF (anaemia, arrhythmias, cognitive dysfunction, depression, diabetes, musculoskeletal disorders, renal dysfunction, respiratory disease, sleep disorders and thyroid disease) and then 2) a review of the published literature describing the association between HF with each of the ten conditions. From these data we describe a clinical framework, comprising five key steps, to potentially improve historically poor health outcomes in this patient population. We identified five key steps (ARISE-HF) that could potentially improve clinical outcomes if applied in a systematic manner: 1) Acknowledge multimorbidity as a clinical syndrome that is associated with poor health outcomes, 2) Routinely profile (using a standardised protocol - adapted to the local health care system) all patients hospitalised with HF to determine the extent of concurrent multimorbidity, 3) Identify individualised priorities and person-centred goals based on the extent and nature of multimorbidity, 4) Support individualised, home-based, multidisciplinary, case management to supplement standard HF management, and 5) Evaluate health outcomes well beyond acute hospitalisation and encompass all-cause events and a person-centred perspective in affected individuals. We propose ARISE-HF as a framework for improving typically poor health outcomes in those affected by multimorbidity in HF. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  11. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

  12. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

    Directory of Open Access Journals (Sweden)

    Janya McCalman

    2018-03-01

    Full Text Available Continuous quality improvement (CQI processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  13. Obesity stigma as a determinant of poor birth outcomes in women with high BMI: a conceptual framework.

    Science.gov (United States)

    DeJoy, Sharon Bernecki; Bittner, Krystle

    2015-04-01

    Obesity stigma has been linked to poor health outcomes on an individual and population basis. However, little research has been conducted on the role of chronic or recent obesity stigma in the health disparities experienced by pregnant women with high body mass index. The purpose of this article is to discuss poor birth outcomes in this population from an integrated perinatal health framework perspective, incorporating obesity stigma as a social determinant. In studies of non-pregnant populations, obesity stigma has been associated with stress, unhealthy coping strategies, psychological disorders, and exacerbations of physical illness. This article examines the mechanisms by which obesity stigma influences health outcomes and suggests how they might apply to selected complications of pregnancy, including macrosomia, preterm birth and cesarean delivery. Given the rates of obesity and associated pregnancy complications in the United States, it is critical to examine the determinants of those problems from a life course and multiple determinants perspective. This paper offers a conceptual framework to guide exploratory research in this area, incorporating the construct of obesity stigma.

  14. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

    Science.gov (United States)

    McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

    2018-01-01

    Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

  15. Development of a patient-reported outcome measure of recovery after abdominal surgery: a hypothesized conceptual framework.

    Science.gov (United States)

    Alam, Roshni; Figueiredo, Sabrina M; Balvardi, Saba; Nauche, Bénédicte; Landry, Tara; Lee, Lawrence; Mayo, Nancy E; Feldman, Liane S; Fiore, Julio F

    2018-05-17

    We initiated a research program to develop a novel patient-reported outcome measure (PROM) to assess postoperative recovery from the perspective of abdominal surgery patients. In light of FDA recommendations, the first stage of our program aimed to, based on previous literature and expert input, develop a hypothesized conceptual framework portraying the health domains that are potentially relevant to the process of recovery after abdominal surgery. This study was conducted in three phases: (1) systematic review to identify PROMs with measurement properties appraised in the context of recovery after abdominal surgery, (2) content analysis to categorize the health domains covered by the PROMs according to the ICF, and (3) two-round Delphi study to gain expert input regarding which of these health domains are relevant to the process of recovery. Participants were experts in perioperative care identified through two major surgical societies (35 invited). The systematic review identified 19 PROMs covering 66 ICF domains. 23 experts (66%) participated in the Delphi process. After Round 2, experts agreed that 22 health domains (8 body functions, 14 activities and participation) are potentially relevant to the process of recovery after abdominal surgery. These domains were organized into a diagram, representing our hypothesized conceptual framework. This hypothesized conceptual framework is an important first step in our research program and will be further refined based on in-depth qualitative interviews with patients. The sound methodological approach used to derive this framework may be valuable for studies aimed to develop PROMs according to FDA standards.

  16. Penalized regression procedures for variable selection in the potential outcomes framework.

    Science.gov (United States)

    Ghosh, Debashis; Zhu, Yeying; Coffman, Donna L

    2015-05-10

    A recent topic of much interest in causal inference is model selection. In this article, we describe a framework in which to consider penalized regression approaches to variable selection for causal effects. The framework leads to a simple 'impute, then select' class of procedures that is agnostic to the type of imputation algorithm as well as penalized regression used. It also clarifies how model selection involves a multivariate regression model for causal inference problems and that these methods can be applied for identifying subgroups in which treatment effects are homogeneous. Analogies and links with the literature on machine learning methods, missing data, and imputation are drawn. A difference least absolute shrinkage and selection operator algorithm is defined, along with its multiple imputation analogs. The procedures are illustrated using a well-known right-heart catheterization dataset. Copyright © 2015 John Wiley & Sons, Ltd.

  17. Towards a conceptual framework for exploring multilevel relationships between Lean Management and Six Sigma, enabling HRM, strategic climate and outcomes in healthcare

    NARCIS (Netherlands)

    Koeijer, R.; Paauwe, J.; Huijsman, R.

    2014-01-01

    This article provides a theory-driven framework simultaneously linking Lean Management and Six Sigma (LM&SS), enabling HRM and strategic climate to outcomes in health care. This framework contributes toward our understanding of direct and indirect (moderating and mediating) effects related to LM&SS

  18. Linking mechanistic data to endpoints of regulatory concern using the adverse outcome pathway framework.

    Science.gov (United States)

    In order to increase the uptake and use of high throughput screening data in environmental risk assessment, it is important to establish scientifically credible links between measures of biological pathway perturbation and apical adverse outcomes in humans and wildlife. The adver...

  19. Outcomes-Balanced Framework for Emergency Management: A Predictive Model for Preparedness

    Science.gov (United States)

    2013-09-01

    Management Total Quality Management (TQM) was developed by W. Edwards Deming in the post-World War II reconstruction period in Japan. It ushered in a...FIGURES Figure 1. From Total Quality Management Principles ....................................................30 Figure 2. Outcomes Logic Model (After...THIRA Threat and Hazard Identification and Risk Assessment TQM Total Quality Management UTL Universal Task List xiv ACKNOWLEDGMENTS German

  20. Support Vector Hazards Machine: A Counting Process Framework for Learning Risk Scores for Censored Outcomes.

    Science.gov (United States)

    Wang, Yuanjia; Chen, Tianle; Zeng, Donglin

    2016-01-01

    Learning risk scores to predict dichotomous or continuous outcomes using machine learning approaches has been studied extensively. However, how to learn risk scores for time-to-event outcomes subject to right censoring has received little attention until recently. Existing approaches rely on inverse probability weighting or rank-based regression, which may be inefficient. In this paper, we develop a new support vector hazards machine (SVHM) approach to predict censored outcomes. Our method is based on predicting the counting process associated with the time-to-event outcomes among subjects at risk via a series of support vector machines. Introducing counting processes to represent time-to-event data leads to a connection between support vector machines in supervised learning and hazards regression in standard survival analysis. To account for different at risk populations at observed event times, a time-varying offset is used in estimating risk scores. The resulting optimization is a convex quadratic programming problem that can easily incorporate non-linearity using kernel trick. We demonstrate an interesting link from the profiled empirical risk function of SVHM to the Cox partial likelihood. We then formally show that SVHM is optimal in discriminating covariate-specific hazard function from population average hazard function, and establish the consistency and learning rate of the predicted risk using the estimated risk scores. Simulation studies show improved prediction accuracy of the event times using SVHM compared to existing machine learning methods and standard conventional approaches. Finally, we analyze two real world biomedical study data where we use clinical markers and neuroimaging biomarkers to predict age-at-onset of a disease, and demonstrate superiority of SVHM in distinguishing high risk versus low risk subjects.

  1. A case study to illustrate the utility of the Aggregate Exposure Pathway and Adverse Outcome Pathway frameworks for integrating human health and ecological data into cumulative risk assessment

    Science.gov (United States)

    Cumulative risk assessment (CRA) methods, which evaluate the risk of multiple adverse outcomes (AOs) from multiple chemicals, promote the use of a conceptual site model (CSM) to integrate risk from relevant stressors. The Adverse Outcome Pathway (AOP) framework can inform these r...

  2. The ascent to competence conceptual framework: an outcome of a study of belongingness.

    Science.gov (United States)

    Levett-Jones, Tracy; Lathlean, Judith

    2009-10-01

    This paper presents qualitative findings from a study that explored nursing students' experience of belongingness when undertaking clinical placements. The aim is to locate the professional and practical implications of the research within an Ascent to Competence conceptual framework. The need to belong exerts a powerful influence on cognitive processes, emotional patterns, behavioural responses, health and well-being and failure to satisfy this need can have devastating consequences. The literature suggests that diminished belongingness may impede students' motivation for learning and influence the degree to which they are willing to conform rather than adopt a questioning approach to clinical practice. A mixed methods, cross national, multi-site case study approach was adopted with third-year preregistration nursing students from three universities (two in Australia and one in England) participating; 362 in the quantitative phase and 18 in the qualitative phase. Qualitative findings demonstrated that, although the primary purpose of clinical education is to facilitate students' progress towards the attainment of competence, the realisation of this goal is impacted by a wide range of individual, interpersonal, contextual and organisational factors which can be conceptualised hierarchically. By this structuring it is possible to see how belongingness is a crucial precursor to students' learning and success. The framework demonstrates that students progress to a stage where attainment of competence is possible only after their previous needs for safety and security, belongingness, healthy self-concept and learning have been met. The future of the nursing profession depends upon the development of confident, competent professionals with a healthy self-concept and a commitment to patient-centred care and self-directed learning. This paper demonstrates that the realisation of this goal is strongly influenced by the extent to which students' clinical placement

  3. The Event Chain of Survival in the Context of Music Festivals: A Framework for Improving Outcomes at Major Planned Events.

    Science.gov (United States)

    Lund, Adam; Turris, Sheila

    2017-08-01

    Despite the best efforts of event producers and on-site medical teams, there are sometimes serious illnesses, life-threatening injuries, and fatalities related to music festival attendance. Producers, clinicians, and researchers are actively seeking ways to reduce the mortality and morbidity associated with these events. After analyzing the available literature on music festival health and safety, several major themes emerged. Principally, stakeholder groups planning in isolation from one another (ie, in silos) create fragmentation, gaps, and overlap in plans for major planned events (MPEs). The authors hypothesized that one approach to minimizing this fragmentation may be to create a framework to "connect the dots," or join together the many silos of professionals responsible for safety, security, health, and emergency planning at MPEs. Adapted from the well-established literature regarding the management of cardiac arrests, both in and out of hospital, the "chain of survival" concept is applied to the disparate groups providing services that support event safety in the context of music festivals. The authors propose this framework for describing, understanding, coordinating and planning around the integration of safety, security, health, and emergency service for events. The adapted Event Chain of Survival contains six interdependent links, including: (1) event producers; (2) police and security; (3) festival health; (4) on-site medical services; (5) ambulance services; and (6) off-site medical services. The authors argue that adapting and applying this framework in the context of MPEs in general, and music festivals specifically, has the potential to break down the current disconnected approach to event safety, security, health, and emergency planning. It offers a means of shifting the focus from a purely reactive stance to a more proactive, collaborative, and integrated approach. Improving health outcomes for music festival attendees, reducing gaps in planning

  4. Leveraging Employer Practices in Global Regulatory Frameworks to Improve Employment Outcomes for People with Disabilities

    Directory of Open Access Journals (Sweden)

    Matthew C. Saleh

    2018-03-01

    Full Text Available Work is an important part of life, providing both economic security and a forum to contribute one’s talents and skills to society, thereby anchoring the individual in a social role. However, access to work is not equally available to people with disabilities globally. Regulatory environments that prohibit discrimination and support vocational training and educational opportunities constitute a critical first step toward economic independence. However, they have not proven sufficient in themselves. In this article, we aim to infuse deeper consideration of employer practice and demand-side policy reforms into global policy discussions of the right to work for people with disabilities. We begin by documenting the employment and economic disparities existing for people with disabilities globally, followed by a description of the international, regional, and local regulatory contexts aiming to improve labor market outcomes for people with disabilities. Next, we examine how policies can leverage employer interests to further address inequalities. We discuss employer policies and practices demonstrated in the research to facilitate recruitment, hiring, career development, retention, and meaningful workplace inclusion. The goal of the article is to synthesize existing international literature on employment rights for people with disabilities with the employer perspective.

  5. Conceptualising the prevention of adverse obstetric outcomes among immigrants using the 'three delays' framework in a high-income context.

    Science.gov (United States)

    Binder, Pauline; Johnsdotter, Sara; Essén, Birgitta

    2012-12-01

    Women from high-mortality settings in sub-Saharan Africa can remain at risk for adverse maternal outcomes even after migrating to low-mortality settings. To conceptualise underlying socio-cultural factors, we assume a 'maternal migration effect' as pre-migration influences on pregnant women's post-migration care-seeking and consistent utilisation of available care. We apply the 'three delays' framework, developed for low-income African contexts, to a high-income western scenario, and aim to identify delay-causing influences on the pathway to optimal facility treatment. We also compare factors influencing the expectations of women and maternal health providers during care encounters. In 2005-2006, we interviewed 54 immigrant African women and 62 maternal providers in greater London, United Kingdom. Participants were recruited by snowball and purposive sampling. We used a hermeneutic, naturalistic study design to create a qualitative proxy for medical anthropology. Data were triangulated to the framework and to the national health system maternity care guidelines. This maintained the original three phases of (1) care-seeking, (2) facility accessibility, and (3) receipt of optimal care, but modified the framework for a migration context. Delays to reciprocal care encounters in Phase 3 result from Phase 1 factors of 'broken trust, which can be mutually held between women and providers. An additional factor is women's 'negative responses to future care', which include rationalisations made during non-emergency situations about future late-booking, low-adherence or refusal of treatment. The greatest potential for delay was found during the care encounter, suggesting that perceived Phase 1 factors have stronger influence on Phase 3 than in the original framework. Phase 2 'language discordance' can lead to a 'reliance on interpreter service', which can cause delays in Phase 3, when 'reciprocal incongruent language ability' is worsened by suboptimal interpreter systems

  6. The injury List of All Deficits (LOAD) Framework--conceptualizing the full range of deficits and adverse outcomes following injury and violence.

    Science.gov (United States)

    Lyons, Ronan A; Finch, Caroline F; McClure, Rod; van Beeck, Ed; Macey, Steven

    2010-09-01

    Over recent years, there has been increasing recognition that the burden of injuries and violence includes more than just the direct and indirect monetary costs associated with their medical outcomes. However, quantification of the total burden has been seriously hampered by lack of a framework for considering the range of outcomes which comprise the burden, poor identification of the outcomes and their imprecise measurement. This article proposes a new conceptual framework, the List of All Deficits (or LOAD) Framework, that has been developed from extensive expert discussion and consensus meetings to facilitate the measurement of the full burden of injuries and violence. The LOAD Framework recognises the multidimensional nature of injury burden across individual, family and societal domains. This classification of potential consequences of injury was built on the International Classification of Functioning concept of disability. Examples of empirical support for each consequence were obtained from the scientific literature. Determining the multidimensional injury burden requires the assessment and combination of 20 domains of potential consequences. The resulting LOAD Framework classification and concept diagram describes 12 groups of injury consequences for individuals, three for family and close friends and five for wider society. Understanding the extent of the negative implications (or deficits) of injury, through application of the LOAD Framework, is needed to put existing burden of injury studies into context and to highlight the inter-relationship between the direct and indirect burden of injury relative to other conditions.

  7. Defining the value framework for prostate brachytherapy using patient-centered outcome metrics and time-driven activity-based costing.

    Science.gov (United States)

    Thaker, Nikhil G; Pugh, Thomas J; Mahmood, Usama; Choi, Seungtaek; Spinks, Tracy E; Martin, Neil E; Sio, Terence T; Kudchadker, Rajat J; Kaplan, Robert S; Kuban, Deborah A; Swanson, David A; Orio, Peter F; Zelefsky, Michael J; Cox, Brett W; Potters, Louis; Buchholz, Thomas A; Feeley, Thomas W; Frank, Steven J

    2016-01-01

    Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. Patients with low-risk PCa treated with low-dose-rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to 1 year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. A total of 238 men were eligible for analysis. Median age was 64 (range, 46-81). Median followup was 5 years (0.5-12.1). There were no acute Grade 3-5 complications. Expanded Prostate Cancer Index Composite 50 scores were favorable, with no clinically significant changes from baseline to last followup at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. We successfully created a visual framework to define the value of PBT using the International Consortium for Health Outcomes Measurement standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  8. Defining the Value Framework for Prostate Brachytherapy using Patient-Centered Outcome Metrics and Time-Driven Activity-Based Costing

    Science.gov (United States)

    Thaker, Nikhil G.; Pugh, Thomas J.; Mahmood, Usama; Choi, Seungtaek; Spinks, Tracy E.; Martin, Neil E.; Sio, Terence T.; Kudchadker, Rajat J.; Kaplan, Robert S.; Kuban, Deborah A.; Swanson, David A.; Orio, Peter F.; Zelefsky, Michael J.; Cox, Brett W.; Potters, Louis; Buchholz, Thomas A.; Feeley, Thomas W.; Frank, Steven J.

    2017-01-01

    PURPOSE Value, defined as outcomes over costs, has been proposed as a measure to evaluate prostate cancer (PCa) treatments. We analyzed standardized outcomes and time-driven activity-based costing (TDABC) for prostate brachytherapy (PBT) to define a value framework. METHODS AND MATERIALS Patients with low-risk PCa treated with low-dose rate PBT between 1998 and 2009 were included. Outcomes were recorded according to the International Consortium for Health Outcomes Measurement (ICHOM) standard set, which includes acute toxicity, patient-reported outcomes, and recurrence and survival outcomes. Patient-level costs to one year after PBT were collected using TDABC. Process mapping and radar chart analyses were conducted to visualize this value framework. RESULTS A total of 238 men were eligible for analysis. Median age was 64 (range, 46–81). Median follow-up was 5 years (0.5–12.1). There were no acute grade 3–5 complications. EPIC-50 scores were favorable, with no clinically significant changes from baseline to last follow-up at 48 months for urinary incontinence/bother, bowel bother, sexual function, and vitality. Ten-year outcomes were favorable, including biochemical failure-free survival of 84.1%, metastasis-free survival 99.6%, PCa-specific survival 100%, and overall survival 88.6%. TDABC analysis demonstrated low resource utilization for PBT, with 41% and 10% of costs occurring in the operating room and with the MRI scan, respectively. The radar chart allowed direct visualization of outcomes and costs. CONCLUSIONS We successfully created a visual framework to define the value of PBT using the ICHOM standard set and TDABC costs. PBT is associated with excellent outcomes and low costs. Widespread adoption of this methodology will enable value comparisons across providers, institutions, and treatment modalities. PMID:26916105

  9. A conceptual framework of stress vulnerability, depression, and health outcomes in women: potential uses in research on complementary therapies for depression.

    Science.gov (United States)

    Kinser, Patricia A; Lyon, Debra E

    2014-09-01

    Depression is a chronic mental health condition that affects millions of individuals worldwide. It is well-established that psychological stress plays an integral role in depression and that depression has numerous negative health outcomes. However, a closer look at components of stress vulnerabilities and depression is required to allow for the development and testing of appropriate interventions. This article describes a conceptual framework about the complex and bidirectional relationship between stress vulnerability, depression, and health outcomes in women. The authors elucidate how the framework can be applied in clinical research about cellular aging and on the mechanisms of complementary and alternative medicine (CAM) for depression, using yoga as an example of a CAM modality. The proposed conceptual framework may be helpful for adding depth to the body of knowledge about the use of mind-body therapies for individuals at high risk of stress vulnerability and/or depression.

  10. The influence of stress responses on surgical performance and outcomes: Literature review and the development of the surgical stress effects (SSE) framework.

    Science.gov (United States)

    Chrouser, Kristin L; Xu, Jie; Hallbeck, Susan; Weinger, Matthew B; Partin, Melissa R

    2018-02-22

    Surgical adverse events persist despite several decades of system-based quality improvement efforts, suggesting the need for alternative strategies. Qualitative studies suggest stress-induced negative intraoperative interpersonal dynamics might contribute to performance errors and undesirable patient outcomes. Understanding the impact of intraoperative stressors may be critical to reducing adverse events and improving outcomes. We searched MEDLINE, psycINFO, EMBASE, Business Source Premier, and CINAHL databases (1996-2016) to assess the relationship between negative (emotional and behavioral) responses to acute intraoperative stressors and provider performance or patient surgical outcomes. Drawing on theory and evidence from reviewed studies, we present the Surgical Stress Effects (SSE) framework. This illustrates how emotional and behavioral responses to stressors can influence individual surgical provider (e.g. surgeon, nurse) performance, team performance, and patient outcomes. It also demonstrates how uncompensated intraoperative threats and errors can lead to adverse events, highlighting evidence gaps for future research efforts. Published by Elsevier Inc.

  11. A transactional framework for pediatric rehabilitation: shifting the focus to situated contexts, transactional processes, and adaptive developmental outcomes.

    Science.gov (United States)

    King, Gillian; Imms, Christine; Stewart, Debra; Freeman, Matt; Nguyen, Tram

    2018-07-01

    A paradigm shift is taking place in pediatric rehabilitation research, practice, and policy - a shift towards the real-life contexts of clients rather than requiring clients to navigate the world of pediatric rehabilitation. This article proposes a conceptual framework to bring about a broader awareness of clients' lives and transactional processes of change over the life course. The framework draws attention to transactional processes by which individuals, situated in life contexts, change and adapt over the life course and, in turn, influence their contextual settings and broader environments. This framework is based on (a) basic tenets derived from foundational theories taking a life course perspective to change, and (b) transactional processes identified from relevant pediatric rehabilitation models that bring these foundational theories into the pediatric rehabilitation sphere. The framework identifies three types of transactional processes relevant to pediatric rehabilitation: facilitative, resiliency, and socialization processes. These processes describe how contexts and people mutually influence each other via opportunities and situated experiences, thus facilitating capacity, adaptation to adversity, and socialization to new roles and life transitions. The utility of the framework is considered for research, practice, service organizations, and policy. Implications for Rehabilitation The framework supports practitioners going beyond person and environment as separate entities, to provide services to the "situated person" in real-life contexts The framework shifts the focus from "body structures/functions" and "person in activity" to "person in changing and challenging life contexts" Working from a transactional perspective, practitioner-client conversations will change; practitioners will view client situations through a lens of opportunities and experiences, assess client experiences in real-life contexts, and strive to create context-based therapy

  12. The 'Outcome Reporting in Brief Intervention Trials: Alcohol' (ORBITAL) framework: protocol to determine a core outcome set for efficacy and effectiveness trials of alcohol screening and brief intervention.

    Science.gov (United States)

    Shorter, G W; Heather, N; Bray, Jeremy W; Giles, E L; Holloway, A; Barbosa, C; Berman, A H; O'Donnell, A J; Clarke, M; Stockdale, K J; Newbury-Birch, D

    2017-12-22

    The evidence base to assess the efficacy and effectiveness of alcohol brief interventions (ABI) is weakened by variation in the outcomes measured and by inconsistent reporting. The 'Outcome Reporting in Brief Intervention Trials: Alcohol' (ORBITAL) project aims to develop a core outcome set (COS) and reporting guidance for its use in future trials of ABI in a range of settings. An international Special Interest Group was convened through INEBRIA (International Network on Brief Interventions for Alcohol and Other Drugs) to inform the development of a COS for trials of ABI. ORBITAL will incorporate a systematic review to map outcomes used in efficacy and effectiveness trials of ABI and their measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. This will support a multi-round Delphi study to prioritise outcomes. Delphi panellists will be drawn from a range of settings and stakeholder groups, and the Delphi study will also be used to determine if a single COS is relevant for all settings. A consensus meeting with key stakeholder representation will determine the final COS and associated guidance for its use in trials of ABI. ORBITAL will develop a COS for alcohol screening and brief intervention trials, with outcomes stratified into domains and guidance on outcome measurement instruments. The standardisation of ABI outcomes and their measurement will support the ongoing development of ABI studies and a systematic synthesis of emerging research findings. We will track the extent to which the COS delivers on this promise through an exploration of the use of the guidance in the decade following COS publication.

  13. [The methodological basis of expert assessment of unfavourable outcomes of the stomatological treatment in the framework of civil law proceedings].

    Science.gov (United States)

    Pigolkin, Iu I; Murzova, T V; Mirzoev, Kh M

    2011-01-01

    The authors discuss peculiarities of the performance of forensic medical expertise in the cases of unfavourable outcomes of the stomatological treatment. The methodological basis of expert assessment has been created to be applied in situations related to the unfavourable outcomes of dental care.

  14. Effective Doctoral Education: Interpreting Factors and Outcomes of Success through a New Framework, Autoethnography, and Quantitative Study of Passion

    Science.gov (United States)

    Anderson, Nathan Charles

    2013-01-01

    The purpose of this disquisition is to increase knowledge about the factors and outcomes of success in doctoral education. Enhanced understanding about the factors and outcomes of success could help optimize effectiveness of the complex systems that educate doctoral students. To achieve the purpose of this disquisition, three manuscripts were…

  15. Tiered Approaches to Incorporate the Adverse Outcome Pathway Framework into Chemical-Specific Risk-Based Decision Making

    Science.gov (United States)

    The concept of Adverse Outcome Pathways (AOPs) arose as a means of addressing the challenges associated with establishing relationships between high-throughout (HT) in vitro dose response data and in vivo biological outcomes. However, AOP development has also been met with challe...

  16. A discrete event modelling framework for simulation of long-term outcomes of sequential treatment strategies for ankylosing spondylitis

    NARCIS (Netherlands)

    A. Tran-Duy (An); A. Boonen (Annelies); M.A.F.J. van de Laar (Mart); A. Franke (Andre); J.L. Severens (Hans)

    2011-01-01

    textabstractObjective: To develop a modelling framework which can simulate long-term quality of life, societal costs and cost-effectiveness as affected by sequential drug treatment strategies for ankylosing spondylitis (AS). Methods: Discrete event simulation paradigm was selected for model

  17. A discrete event modelling framework for simulation of long-term outcomes of sequential treatment strategies for ankylosing spondylitis

    NARCIS (Netherlands)

    Tran-Duy, A.; Boonen, A.; Laar, M.A.F.J.; Franke, A.C.; Severens, J.L.

    2011-01-01

    Objective To develop a modelling framework which can simulate long-term quality of life, societal costs and cost-effectiveness as affected by sequential drug treatment strategies for ankylosing spondylitis (AS). Methods Discrete event simulation paradigm was selected for model development. Drug

  18. Minimum data set to measure rehabilitation needs and health outcome after major trauma: application of an international framework.

    Science.gov (United States)

    Hoffman, Karen P; Playford, Diane E; Grill, Eva; Soberg, Helene L; Brohi, Karim

    2016-06-01

    Measurement of long term health outcome after trauma remains non-standardized and ambiguous which limits national and international comparison of burden of injuries. The World Health Organization (WHO) has recommended the application of the International Classification of Function, Disability and Health (ICF) to measure rehabilitation and health outcome worldwide. No previous poly-trauma studies have applied the ICF comprehensively to evaluate outcome after injury. To apply the ICF categorization in patients with traumatic injuries to identify a minimum data set of important rehabilitation and health outcomes to enable national and international comparison of outcome data. A mixed methods design of patient interviews and an on-line survey. An ethnically diverse urban major trauma center in London. Adult patients with major traumatic injuries (poly-trauma) and international health care professionals (HCPs) working in acute and post-acute major trauma settings. Mixed methods investigated patients and health care professionals (HCPs) perspectives of important rehabilitation and health outcomes. Qualitative patient data and quantitative HCP data were linked to ICF categories. Combined data were refined to identify a minimum data set of important rehabilitation and health outcome categories. Transcribed patient interview data (N.=32) were linked to 234 (64%) second level ICF categories. Two hundred and fourteen HCPs identified 121 from a possible 140 second level ICF categories (86%) as relevant and important. Patients and HCPs strongly agreed on ICF body structures and body functions categories which include temperament, energy and drive, memory, emotions, pain and repair function of the skin. Conversely, patients prioritised domestic tasks, recreation and work compared to HCP priorities of self-care and mobility. Twenty six environmental factors were identified. Patient and HCP data were refined to recommend a 109 possible ICF categories for a minimum data set. The

  19. Tuning-AHELO Conceptual Framework of Expected and Desired Learning Outcomes in Economics. OECD Education Working Papers No. 59

    Science.gov (United States)

    OECD Publishing (NJ1), 2011

    2011-01-01

    The Organisation for Economic Cooperation and Development (OECD) Secretariat, at the invitation of the AHELO Group of National Experts, contracted the Tuning Association to undertake initial development work on learning outcomes to be used for valid and reliable assessments of students from diverse institutions and countries. The two disciplines…

  20. Economic consequences of overweight and obesity in infertility : a framework for evaluating the costs and outcomes of fertility care

    NARCIS (Netherlands)

    Koning, A. M. H.; Kuchenbecker, W. K. H.; Groen, H.; Hoek, A.; Land, J. A.; Khan, K. S.; Mol, B. W. J.

    2010-01-01

    Overweight and obesity are an epidemic in Western society, and have a strong impact on fertility. We studied the consequences of overweight and obesity with respect to fecundity, costs of fertility treatment and pregnancy outcome in subfertile women. We searched the literature for systematic reviews

  1. Economic consequences of overweight and obesity in infertility: a framework for evaluating the costs and outcomes of fertility care

    NARCIS (Netherlands)

    Koning, A. M. H.; Kuchenbecker, W. K. H.; Groen, H.; Hoek, A.; Land, J. A.; Khan, K. S.; Mol, B. W. J.

    2010-01-01

    Overweight and obesity are an epidemic in Western society, and have a strong impact on fertility. We studied the consequences of overweight and obesity with respect to fecundity, costs of fertility treatment and pregnancy outcome in subfertile women. We searched the literature for systematic reviews

  2. A Bioecological Framework to Evaluate Communicative Participation Outcomes for Preschoolers Receiving Speech-Language Therapy Interventions in Ontario, Canada

    Science.gov (United States)

    Cunningham, Barbara J.; Rosenbaum, Peter L.

    2015-01-01

    Background: The Preschool Speech and Language Program (PSLP) in Ontario, Canada, is a publicly funded intervention service for children from birth to 5 years with communication disorders. It has begun a population-level programme evaluation of children's communicative participation outcomes following therapy. Data are currently being collected for…

  3. Alignment of Outcome Instruments Used in Hand Therapy With the Occupational Therapy Practice Framework: Domain and Process and the International Classification of Functioning, Disability and Health: A Scoping Review.

    Science.gov (United States)

    Lesher, Danielle Ann-Marie; Mulcahey, M J; Hershey, Peter; Stanton, Donna Breger; Tiedgen, Andrea C

    We sought to identify outcome instruments used in rehabilitation of the hand and upper extremity; to determine their alignment with the constructs of the International Classification of Functioning, Disability and Health (ICF) and the Occupational Therapy Practice Framework: Domain and Process; and to report gaps in the constructs measured by outcome instruments as a basis for future research. We searched CINAHL, MEDLINE, OTseeker, and the Cochrane Central Register of Controlled Trials using scoping review methodology and evaluated outcome instruments for concordance with the ICF and the Framework. We identified 18 outcome instruments for analysis. The findings pertain to occupational therapists' focus on body functions, body structures, client factors, and activities of daily living; a gap in practice patterns in use of instruments; and overestimation of the degree to which instruments used are occupationally based. Occupational therapy practitioners should use outcome instruments that embody conceptual frameworks for classifying function and activity. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  4. Does the proportion of pay linked to performance affect the job satisfaction of general practitioners?

    Science.gov (United States)

    Allen, Thomas; Whittaker, William; Sutton, Matt

    2017-01-01

    There is concern that pay-for-performance (P4P) can negatively affect general practitioners (GPs) by reducing their autonomy, increasing their wage dispersion or eroding their intrinsic motivation. This is especially a concern for the Quality and Outcomes Framework (QOF), a highly powered P4P scheme for UK GPs. The QOF affected all GPs but the exposure of their income to P4P varied. GPs did not know their level of exposure before the QOF was introduced and could not choose or manage it. We examine whether changes in GPs' job satisfaction before and after the introduction of the QOF in 2004 were correlated with the proportion of their income that became exposed to P4P. We use data on 1920 GPs observed at three time points spanning the introduction of the QOF; 2004, 2005 and 2008. We estimate the effect of exposure to P4P using a continuous difference-in-differences model. We find no significant effects of P4P exposure on overall job satisfaction or 12 additional measures of working lives in either the short or longer term. The level of exposure to P4P does not harm job satisfaction or other aspects of working lives. Policies influencing the exposure of income to P4P are unlikely to alter GP job satisfaction subject to final income remaining constant. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Establishing and evaluating the key functions of an interactive systems framework using an assets-getting to outcomes intervention.

    Science.gov (United States)

    Chinman, Matthew; Acosta, Joie; Ebener, Patricia; Q Burkhart; Clifford, Michael; Corsello, Maryann; Duffey, Tim; Hunter, Sarah; Jones, Margaret; Lahti, Michel; Malone, Patrick S; Paddock, Susan; Phillips, Andrea; Savell, Susan; Scales, Peter C; Tellett-Royce, Nancy

    2012-12-01

    Community practitioners can face difficulty in achieving outcomes demonstrated by prevention science. Building a community practitioner's prevention capacity-the knowledge and skills needed to conduct critical prevention practices-could improve the quality of prevention and its outcomes. The purpose of this article is to: (1) describe how an intervention called Assets-Getting To Outcomes (AGTO) was used to establish the key functions of the ISF and present early lessons learned from that intervention's first 6 months and (2) examine whether there is an empirical relationship between practitioner capacity at the individual level and the performance of prevention at the program level-a relationship predicted by the ISF but untested. The article describes an operationalization of the ISF in the context of a five-year randomized controlled efficacy trial that combines two complementary models designed to build capacity: Getting To Outcomes (GTO) and Developmental Assets. The trial compares programs and individual practitioners from six community-based coalitions using AGTO with programs and practitioners from six similar coalitions that are not. In this article, we primarily focus on what the ISF calls innovation specific capacity and discuss how the combined AGTO innovation structures and uses feedback about its capacity-building activities, which can serve as a model for implementing the ISF. Focus group discussions used to gather lessons learned from the first 6 months of the AGTO intervention suggest that while the ISF may have been conceptualized as three distinct systems, in practice they are less distinct. Findings from the baseline wave of data collection of individual capacity and program performance suggest that practitioner capacity predicts, in part, performance of prevention programs. Empirically linking practitioner capacity and performance of prevention provides empirical support for both the ISF and AGTO.

  6. Barriers to antiretroviral therapy adherence in developed countries: a qualitative synthesis to develop a conceptual framework for a new patient-reported outcome measure.

    Science.gov (United States)

    Engler, Kim; Lènàrt, Andras; Lessard, David; Toupin, Isabelle; Lebouché, Bertrand

    2018-05-02

    Suboptimal adherence to antiretroviral therapy (ART) remains common. Patient-centered tools are needed to comprehensively assess adherence barriers in HIV clinical practice. Thus, we conducted a research synthesis to produce a conceptual framework for a new patient-reported outcome measure (PRO) for use in routine HIV care in Canada and France. A PRO's conceptual framework graphically represents the concepts to be measured and the potential relationships between them. Towards ensuring the framework's relevance to the target populations' concerns, qualitative studies with HIV-positive adults on barriers to ART adherence in developed countries were synthesized with thematic analysis, attending to the cross-study prevalence and interrelationships of barrier themes. In March 2016, searches within Medline, PsychINFO, and Embase produced 5,284 records. Two reviewers determined the final sample (n = 41). Analysis generated three levels of ART adherence barrier themes. Twenty Level 2 themes and their component subthemes (Level 3) were organized into 6 higher-order themes (Level 1): Cognitive and emotional aspects (100% of studies contributing content -prevalence), Lifestyle factors (95%), Social and material context (95%), Characteristics of ART (90%), Health experience and state (73%), and Healthcare services and system (66%). As to interrelationships, study authors articulated relationships between all higher-order themes (Level 3). Linkages between Level 2 barrier themes showed great variability, from 21% to 95%. Overall, this synthesis contributes an exceptionally detailed conceptual framework and report of ART adherence barriers, applicable to a wide range of PLHIV. It suggests that a key to understanding many barriers is through their interconnections. It also identifies gaps in barrier research. Concerning the new PRO's development, comprehensiveness will need to be weighed against other concerns (e.g., respondent burden) and the provision of barrier

  7. A discrete event modelling framework for simulation of long-term outcomes of sequential treatment strategies for ankylosing spondylitis.

    Science.gov (United States)

    Tran-Duy, An; Boonen, Annelies; van de Laar, Mart A F J; Franke, Angelinus C; Severens, Johan L

    2011-12-01

    To develop a modelling framework which can simulate long-term quality of life, societal costs and cost-effectiveness as affected by sequential drug treatment strategies for ankylosing spondylitis (AS). Discrete event simulation paradigm was selected for model development. Drug efficacy was modelled as changes in disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)) and functional status (Bath Ankylosing Spondylitis Functional Index (BASFI)), which were linked to costs and health utility using statistical models fitted based on an observational AS cohort. Published clinical data were used to estimate drug efficacy and time to events. Two strategies were compared: (1) five available non-steroidal anti-inflammatory drugs (strategy 1) and (2) same as strategy 1 plus two tumour necrosis factor α inhibitors (strategy 2). 13,000 patients were followed up individually until death. For probability sensitivity analysis, Monte Carlo simulations were performed with 1000 sets of parameters sampled from the appropriate probability distributions. The models successfully generated valid data on treatments, BASDAI, BASFI, utility, quality-adjusted life years (QALYs) and costs at time points with intervals of 1-3 months during the simulation length of 70 years. Incremental cost per QALY gained in strategy 2 compared with strategy 1 was €35,186. At a willingness-to-pay threshold of €80,000, it was 99.9% certain that strategy 2 was cost-effective. The modelling framework provides great flexibility to implement complex algorithms representing treatment selection, disease progression and changes in costs and utilities over time of patients with AS. Results obtained from the simulation are plausible.

  8. Intervening to Improve Outcomes for Siblings in Foster Care: Conceptual, Substantive, and Methodological Dimensions of a Prevention Science Framework

    Science.gov (United States)

    Kothari, Brianne H.; Blakeslee, Jennifer; Lamson-Siu, Emilie; Bank, Lew; Linares, L. Oriana; Waid, Jeffrey; Sorenson, Paul; Jimenez, Jessica; Pearson, Eva; Shlonsky, Aron

    2014-01-01

    In recent years, the child welfare field has devoted significant attention to siblings in foster care. Policymakers and practitioners have supported efforts to connect siblings via shared foster placements and visitation while researchers have focused on illuminating the empirical foundations of sibling placement and sibling intervention in child welfare. The current paper synthesizes literature on sibling relationship development and sibling issues in child welfare in the service of presenting a typology of sibling-focused interventions for use with foster youth. The paper provides two examples of current intervention research studies focused on enhancing sibling developmental processes and understanding their connection to child welfare outcomes. The paper concludes by presenting an emerging agenda informing policy, practice, and research on siblings in foster care. PMID:24634558

  9. Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick's framework: a mixed methods study.

    Science.gov (United States)

    Kumar, Arunaz; Sturrock, Sam; Wallace, Euan M; Nestel, Debra; Lucey, Donna; Stoyles, Sally; Morgan, Jenny; Neil, Peter; Schlipalius, Michelle; Dekoninck, Philip

    2018-02-17

    The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick's framework. We explored participants' acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants' perception of usefulness of PROMPT in their clinical practice. Mixed methods approach with a pre-test/post-test design. Healthcare network providing obstetric care in Victoria, Australia. Medical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011-2012 (n=15 361 births) and 2014-2015 (n=12 388 births). Attendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills. Clinical outcomes compared before and after embedding PROMPT in educational practice. Assessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice. There was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies. Participants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period

  10. Stat-6 signaling pathway and not Interleukin-1 mediates multi-walled carbon nanotube-induced lung fibrosis in mice: insights from an adverse outcome pathway framework

    DEFF Research Database (Denmark)

    Nikota, Jake; Banville, Allyson; Goodwin, Laura Rose

    2017-01-01

    Background: The accumulation of MWCNTs in the lung environment leads to inflammation and the development of disease similar to pulmonary fibrosis in rodents. Adverse Outcome Pathways (AOPs) are a framework for defining and organizing the key events that comprise the biological changes leading...... to undesirable events. A putative AOP has been developed describing MWCNT-induced pulmonary fibrosis; inflammation and the subsequent healing response induced by inflammatory mechanisms have been implicated in disease progression. The objective of the present study was to address a key data gap in this AOP...... development. In contrast, STAT6 KO mice exhibited suppressed acute inflammation and attenuated fibrotic disease in response to MWCNT administration compared to STAT6 WT mice. Whole genome analysis of all post-exposure time points identified a subset of differentially expressed genes associated with fibrosis...

  11. Abschlusskompetenzen für alle Gesundheitsberufe: das schweizerische Rahmenwerk und seine Konzeption [Learning Outcomes for Health Professions: The Concept of the Swiss Competencies Framework

    Directory of Open Access Journals (Sweden)

    Sottas, Beat

    2011-02-01

    Full Text Available [english] Modern conceptions of education are based on normative goals concerning learning outcomes in terms of competencies to acquire. The objective of the Swiss competencies framework was to define general and profession-specific learning outcomes for Bachelor’s and Master’s degree programmes in nursing, physiotherapy, occupational therapy (ergotherapy, midwifery, nutrition counselling, and technicians in medical radiology. In addition, national authorities needed an instrument that allowed the integration of the old professional trainings into a nationally-harmonised education system and that showed the specificities of the levels (higher vocational education; bachelor and master degree at university level. While the general learning outcomes were derived from legal bases, the profession-specific learning outcomes are elaborated according to the competency-based CanMEDS framework. In the CanMEDS framework, knowledge, skills, and attitudes are condensed into meta-competencies which in turn are divided into seven roles, including the medical expert (central role. Taxonomic characteristics and indicators were elaborated in an iterative process that involved regulators, the universities of applied sciences and professional organisations. For the degree programmes mentioned above, the framework developed focuses not only on professional expertise, but also on collaboration with other health professions. Moreover, the interface-management in care taking processes is a critical success factor. Based on this conception, three levels of objectives were identified: general competencies, profession-specific learning outcomes and learning objectives to be implemented in the universities of applied sciences. The general competencies are composed of four dimensions and apply to all health professionals. The profession-specific learning outcomes for the Bachelor’s and Master’s degree programmes are outlined with 3 to 5 indicators each in all seven

  12. Application of Donabedian quality-of-care framework to assess the outcomes of preconception care in urban health centers, Mashhad, Iran in 2012

    Directory of Open Access Journals (Sweden)

    Fatemeh Ghaffari

    2013-12-01

    Full Text Available Background and aim: Improving patient health status is the primary goal of healthcare system. and planning to improve the health care services without taking into account the views of care receivers is not possible .In this regard, Donabedian Model as an appropriate framework in assessing the quality of health care, has particular attention to the issue of "outcomes", which are sometimes seen as the most important indicators of quality. This study therefore aimed to assess the outcomes of preconception care including changes to health knowledge as well as patient satisfaction in urban health centers, Mashhad, Iran in 2012. Methods: In this descriptive study, 350 women of reproductive age who received preconception care in urban health centers of Mashhad, Iran, were selected using a two stage sampling design. Demographic and obstetric data were collected through a self-structured questionnaire.  Outcomes of preconception care including health knowledge as well as patient satisfaction were measured using a questionnaire adopted from Donabedian Model. Data were analyzed with SPSS Software version 16 and statistical tests such as ANOVA, Chi-square and Pearson correlation coefficient. Findings: The mean age of women was 22.5 ± 26.93 and the mean score of their marriage years was 6.32±4.77.  67.4% of subjects experienced between one and six pregnancies. The mean score of health knowledge of preconception care was 53.4 ± 8.14 and the highest score of its subdomains was related to the personal hygiene. The mean score of patients' satisfaction of preconception care was 84.11 ± 56.75 and its highest score was in relation to counseling and provided care. Conclusion: According to the results, planning to provide better education services for clients, raising public awareness regarding preconception care and more emphasis on preconception care importance in continuous education of health care providers are recommended.  

  13. Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework.

    Science.gov (United States)

    Kontopantelis, Evangelos; Buchan, Iain; Reeves, David; Checkland, Kath; Doran, Tim

    2013-08-02

    To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. Retrospective longitudinal study. Data for 2007-2008 to 2010-2011, extracted from the clinical computer systems of general practices in England. All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice. Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement. Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels). Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system.

  14. The feasibility of introducing an adult safeguarding measure for inclusion in the Adult Social Care Outcomes Framework (ASCOF): findings from a pilot study.

    Science.gov (United States)

    Norrie, Caroline; Manthorpe, Jill; Cartwright, Cher; Rayat, Pritpal

    2016-06-30

    There are currently no national measures in England reporting the experiences of people who have been involved with adult safeguarding services following concerns that they may be at risk of abuse or neglect. The Health and Social Care Information Centre (HSCIC) aimed to develop a new adult safeguarding outcome measure (survey) for local authorities (LAs) that could be added to the Adult Social Care Outcomes Framework (ASCOF). The ASCOF is a national collection of social care outcomes performance indicators collected from the perspective of people receiving partial or total funding from a LA for care services. An outcome measure (a face-to-face interview based survey consisting of 7 questions) was piloted in 40 LAs with 382 adults at risk (or their representative) who had been the subject of a safeguarding investigation. The aim was to investigate the feasibility of the survey in three domains: i) if a statistically representative sample of adults at risk (or their family, friend, carer or advocate) could be recruited; ii) analysis of survey responses and its acceptability to participants iii) feedback from LAs about the survey's administration. Overall the survey results met statistical confidence; however the individual results for adults at risk did not, due to the high proportion of representatives who responded because adults at risk were unable. Responses to the survey were generally positive; 72 % of participants felt that the help received during the safeguarding investigation had made them or the adult at risk (if reporting as a proxy) feel 'quite a bit' or 'a lot safer'. These results are the most robust data collected in England on the perspectives of adults at risk and their representatives on safeguarding services. Participants reported they appreciated being asked for feedback. LAs suggested survey administration improvements. This survey is one way LAs can meet their new legal requirement under the Care Act 2014 to 'seek feedback' from adults at

  15. Small median tumor diameter at cure threshold (lung cancers in male smokers predicts both chest X-ray and CT screening outcomes in a novel simulation framework.

    Science.gov (United States)

    Goldwasser, Deborah L; Kimmel, Marek

    2013-01-01

    The effectiveness of population-wide lung cancer screening strategies depends on the underlying natural course of lung cancer. We evaluate the expected stage distribution in the Mayo CT screening study under an existing simulation model of non-small cell lung cancer (NSCLC) progression calibrated to the Mayo lung project (MLP). Within a likelihood framework, we evaluate whether the probability of 5-year NSCLC survival conditional on tumor diameter at detection depends significantly on screening detection modality, namely chest X-ray and computed tomography. We describe a novel simulation framework in which tumor progression depends on cellular proliferation and mutation within a stem cell compartment of the tumor. We fit this model to randomized trial data from the MLP and produce estimates of the median radiologic size at the cure threshold. We examine the goodness of model fit with respect to radiologic tumor size and 5-year NSCLC survival among incident cancers in both the MLP and Mayo CT studies. An existing model of NSCLC progression under-predicts the number of advanced-stage incident NSCLCs among males in the Mayo CT study (p-value = 0.004). The probability of 5-year NSCLC survival conditional on tumor diameter depends significantly on detection modality (p-value = 0.0312). In our new model, selected solution sets having a median tumor diameter of 16.2-22.1 mm at cure threshold among aggressive NSCLCs predict both MLP and Mayo CT outcomes. We conclude that the median lung tumor diameter at cure threshold among aggressive NSCLCs in male smokers may be small (<20 mm). Copyright © 2012 UICC.

  16. Assessing the implementation process and outcomes of newly introduced assistant roles: a qualitative study to examine the utility of the Calderdale Framework as an appraisal tool

    Directory of Open Access Journals (Sweden)

    Nancarrow S

    2012-12-01

    Full Text Available Susan Nancarrow,1 Anna Moran,1 Leah Wiseman,2 Alison C Pighills,3 Karen Murphy41School of Health and Human Sciences, Southern Cross University, East Lismore, NSW; 2School of Community Health, Charles Sturt University, Albury, NSW; 3Faculty of Medicine Health and Molecular Sciences, James Cook University, Education and Research Centre, Mackay Base Hospital, Mackay, QLD; 4ACT Government Health Directorate, Canberra, ACT, AustraliaAbstract: Internationally, the health workforce has undergone rapid transformation to help meet growing staffing demands and population requirements. Several tools have been developed to support workforce change processes. The Calderdale Framework (CF is one such tool designed to facilitate competency-based training by engaging team members in a seven step process involving awareness raising, service and task analysis, competency identification, establishing support systems, training, and sustaining. This paper explores the utility of the CF as an appraisal tool to assess whether adherence to the tool influences outcomes. The CF was applied retrospectively to three complete evaluations of allied health assistant role introduction: a new podiatry assistant role (Australia, speech pathology assistant (Australia, and occupational therapy assistant practitioner role (UK. Adherence to the CF was associated with more effective and efficient use of the role, role flexibility and career development opportunities for assistants, and role sustainability. Services are less likely to succeed in their workforce change process if they fail to plan for and use a structured approach to change, assign targeted leadership, undertake staff engagement and consultation, and perform an initial service analysis. The CF provides a clear template for appraising the implementation of new roles and highlights the potential consequences of not adhering to particular steps in the implementation process.Keywords: workforce change, allied health

  17. Financial incentives improve recognition but not treatment of cardiovascular risk factors in severe mental illness.

    Directory of Open Access Journals (Sweden)

    Carol L Wilson

    Full Text Available Severe mental illness (SMI is associated with premature cardiovascular disease, prompting the UK primary care payment-for-performance system (Quality and Outcomes Framework, QOF to incentivise annual physical health reviews. This study aimed to assess the QOF's impact on detection and treatment of cardiovascular risk factors in people with SMI.A retrospective open cohort study of UK general practice was conducted between 1996 and 2014, using segmented logistic regression with 2004 and 2011 as break points, reflecting the introduction of relevant QOF incentives in these years. 67239 SMI cases and 359951 randomly-selected unmatched controls were extracted from the Clinical Practice Research Datalink (CPRD.There was strong evidence (p≤0.015 the 2004 QOF indicator (general health resulted in an immediate increase in recording of elevated cholesterol (odds ratio 1.37 (95% confidence interval 1.24 to 1.51; obesity (OR 1.21 (1.06 to 1.38; and hypertension (OR 1.19 (1.04 to 1.38 in the SMI group compared with the control group, which was sustained in subsequent years. Similar findings were found for diabetes, although the evidence was weaker (p = 0.059; OR 1.21 (0.99 to 1.49. There was evidence (p<0.001 of a further, but unsustained, increase in recording of elevated cholesterol and obesity in the SMI group following the 2011 QOF indicator (cardiovascular specific. There was no clear evidence that the QOF indicators affected the prescribing of lipid modifying medications or anti-diabetic medications.Incentivising general physical health review for SMI improves identification of cardiovascular risk factors, although the additional value of specifically incentivising cardiovascular risk factor assessment is unclear. However, incentives do not affect pharmacological management of these risks.

  18. Improving the identification of people with dementia in primary care: evaluation of the impact of primary care dementia coding guidance on identified prevalence.

    Science.gov (United States)

    Russell, Paul; Banerjee, Sube; Watt, Jen; Adleman, Rosalyn; Agoe, Belinda; Burnie, Nerida; Carefull, Alex; Chandan, Kiran; Constable, Dominie; Daniels, Mark; Davies, David; Deshmukh, Sid; Huddart, Martin; Jabin, Ashrafi; Jarrett, Penelope; King, Jenifer; Koch, Tamar; Kumar, Sanjoy; Lees, Stavroula; Mir, Sinan; Naidoo, Dominic; Nyame, Sylvia; Sasae, Ryuichiro; Sharma, Tushar; Thormod, Clare; Vedavanam, Krish; Wilton, Anja; Flaherty, Breda

    2013-12-23

    Improving dementia care is a policy priority nationally and internationally; there is a 'diagnosis gap' with less than half of the cases of dementia ever diagnosed. The English Health Department's Quality and Outcomes Framework (QOF) encourages primary care recognition and recording of dementia. The codes for dementia are complex with the possibility of underidentification through miscoding. We developed guidance on coding of dementia; we report the impact of applying this to 'clean up' dementia coding and records at a practice level. The guidance had five elements: (1) identify Read Codes for dementia; (2) access QOF dementia register; (3) generate lists of patients who may have dementia; (4) compare search with QOF data and (5) review cases. In each practice, one general practitioner conducted the exercise. The number of dementia QOF registers before and after the exercise was recorded with the hours taken to complete the exercise. London primary care. 23 (85%) of 27 practices participated, covering 79 312 (19 562 over 65 s) participants. The number on dementia QOF registers; time taken. The number of people with dementia on QOF registers increased from 1007 to 1139 (χ(2)=8.17, p=0.004), raising identification rates by 8.8%. It took 4.7 h per practice, on an average. These data demonstrate the potential of a simple primary care coding exercise, requiring no specific training, to increase the dementia identification rate. An improvement of 8.8% between 2011 and 2012 is equivalent to that of the fourth most improved primary care trust in the UK. In absolute terms, if this effects were mirrored across the UK primary care, the number of cases with dementia identified would rise by over 70 000 from 364 329 to 434 488 raising the recognition rate from 46% to 54.8%. Implementing this exercise appears to be a simple and effective way to improve recognition rates in primary care.

  19. Using an expanded outcomes framework and continuing education evidence to improve facilitation of patient-centered medical home recognition and transformation.

    Science.gov (United States)

    Van Hoof, Thomas J; Kelvey-Albert, Michele; Katz, Matthew; Lalime, Ken; Sacks, Ken; Meehan, Thomas P

    2014-01-01

    The patient-centered medical home is a model for delivering primary care in the United States. Primary care clinicians and their staffs require assistance in understanding the innovation and in applying it to practice. The purpose of this article is to describe and to critique a continuing education program that is relevant to, and will become more common in, primary care. A multifaceted educational strategy prepared 20 primary care private practices to achieve National Committee for Quality Assurance Level 3 recognition as Patient-Centered Medical Homes. Eighteen (90%) practices submitted an application to the National Committee for Quality Assurance. On the first submission attempt, 13 of 18 (72%) achieved Level 3 recognition and 5 (28%) achieved Level 1 recognition. An interactive multifaceted educational strategy can be successful in preparing primary care practices for Patient-Centered Medical Homes recognition, but the strategy may not ensure transformation. Future educational activities should consider an expanded outcomes framework and the evidence of effective continuing education to be more successful with recognition and transformation.

  20. Nano-risk Science: application of toxicogenomics in an adverse outcome pathway framework for risk assessment of multi-walled carbon nanotubes.

    Science.gov (United States)

    Labib, Sarah; Williams, Andrew; Yauk, Carole L; Nikota, Jake K; Wallin, Håkan; Vogel, Ulla; Halappanavar, Sabina

    2016-03-15

    A diverse class of engineered nanomaterials (ENMs) exhibiting a wide array of physical-chemical properties that are associated with toxicological effects in experimental animals is in commercial use. However, an integrated framework for human health risk assessment (HHRA) of ENMs has yet to be established. Rodent 2-year cancer bioassays, clinical chemistry, and histopathological endpoints are still considered the 'gold standard' for detecting substance-induced toxicity in animal models. However, the use of data derived from alternative toxicological tools, such as genome-wide expression profiling and in vitro high-throughput assays, are gaining acceptance by the regulatory community for hazard identification and for understanding the underlying mode-of-action. Here, we conducted a case study to evaluate the application of global gene expression data in deriving pathway-based points of departure (PODs) for multi-walled carbon nanotube (MWCNT)-induced lung fibrosis, a non-cancer endpoint of regulatory importance. Gene expression profiles from the lungs of mice exposed to three individual MWCNTs with different physical-chemical properties were used within the framework of an adverse outcome pathway (AOP) for lung fibrosis to identify key biological events linking MWCNT exposure to lung fibrosis. Significantly perturbed pathways were categorized along the key events described in the AOP. Benchmark doses (BMDs) were calculated for each perturbed pathway and were used to derive transcriptional BMDs for each MWCNT. Similar biological pathways were perturbed by the different MWCNT types across the doses and post-exposure time points studied. The pathway BMD values showed a time-dependent trend, with lower BMDs for pathways perturbed at the earlier post-exposure time points (24 h, 3d). The transcriptional BMDs were compared to the apical BMDs derived by the National Institute for Occupational Safety and Health (NIOSH) using alveolar septal thickness and fibrotic lesions

  1. Smoking cessation treatment and outcomes patterns simulation: a new framework for evaluating the potential health and economic impact of smoking cessation interventions.

    Science.gov (United States)

    Getsios, Denis; Marton, Jenő P; Revankar, Nikhil; Ward, Alexandra J; Willke, Richard J; Rublee, Dale; Ishak, K Jack; Xenakis, James G

    2013-09-01

    simulation predicting 19 % more smoking-related diseases and 10 % higher costs associated with smoking-related diseases. Differences are most prominent in predictions of the time that individuals abstain from smoking: 13.2 years on average over a lifetime allowing for multiple quit attempts, versus only 1.2 years with single quit attempts. Differences in abstinence time estimates become substantial only 5 years into the simulation. In the multiple quit attempt simulations, younger individuals survived longer, yet had lower lifetime smoking-related disease and total costs, while the opposite was true for those with high levels of nicotine dependence. By allowing for multiple quit attempts over the course of individuals' lives, the simulation can provide more reliable estimates on the health and economic impact of interventions designed to increase abstinence from smoking. Furthermore, the individual nature of the simulation allows for evaluation of outcomes in populations with different baseline profiles. DES provides a framework for comprehensive and appropriate predictions when applied to smoking cessation over smoker lifetimes.

  2. Plasma biomarker analysis in pediatric ARDS: generating future framework from a pilot randomized control trial of methylprednisoloneA framework for identifying plasma biomarkers related to clinical outcomes in pediatric ARDS

    Directory of Open Access Journals (Sweden)

    Dai eKimura

    2016-03-01

    Full Text Available Objective: Lung injury activates multiple pro-inflammatory pathways, including neutrophils, epithelial and endothelial injury, and coagulation factors leading to acute respiratory distress syndrome (ARDS. Low-dose methylprednisolone therapy (MPT improved oxygenation and ventilation in early pediatric ARDS without altering duration of mechanical ventilation or mortality. We evaluated the effects of MPT on biomarkers of endothelial (Ang-2, sICAM-1 or epithelial (sRAGE injury, neutrophil activation (MMP-8, and coagulation (PAI-1. Design: Double-blind, placebo-controlled randomized trialSetting: Tertiary-care Pediatric Intensive Care Unit Patients: Mechanically ventilated children (0-18 years with early ARDS.Interventions: Blood samples were collected on Days 0 (before MPT, 7, and 14 during low-dose MPT (n=17 vs. placebo (n=18 therapy. The MPT group received a 2mg/kg loading dose followed by 1mg/kg/day continuous infusions from days 1-7, tapered off over 7 days; placebo group received equivalent amounts of 0.9% saline. We analyzed plasma samples using a multiplex assay for 5 biomarkers of ARDS. Multiple regression models were constructed to predict associations between changes in biomarkers and the clinical outcomes reported earlier including: P/F ratio on days 8&9, plateau pressure on days 1&2, PaCO2 on days 2&3, racemic epinephrine following extubation, and supplemental oxygen at ICU discharge.Results: No differences occurred in biomarker concentrations between the groups on Day 0. On Day 7, reduction in MMP-8 levels (p=0.0016 occurred in the MPT group, whereas increases in sICAM-1 levels (p=0.0005 occurred in the placebo group (no increases in sICAM-1 in the MPT group. sRAGE levels decreased in both MPT and placebo groups (p<0.0001 from Day 0 to Day 7. On Day 7, sRAGE levels were positively correlated with MPT group PaO2/FiO2 ratios on Day 8 (r=0.93, p=0.024. O2 requirements at ICU transfer positively correlated with Day 7 MMP-8 (r=0.85, p=0

  3. Effect of social deprivation on blood pressure monitoring and control in England: a survey of data from the quality and outcomes framework.

    Science.gov (United States)

    Ashworth, Mark; Medina, Jibby; Morgan, Myfanwy

    2008-10-28

    To determine levels of blood pressure monitoring and control in primary care and to determine the effect of social deprivation on these levels. Retrospective longitudinal survey, 2005 to 2007. General practices in England. Data obtained from 8515 practices (99.3% of all practices) in year 1, 8264 (98.3%) in year 2, and 8192 (97.8%) in year 3. Blood pressure indicators and chronic disease prevalence estimates contained within the UK quality and outcomes framework; social deprivation scores for each practice, ethnicity data obtained from the 2001 national census; general practice characteristics. In 2005, 82.3% of adults (n=52.8m) had an up to date blood pressure recording; by 2007, this proportion had risen to 88.3% (n=53.2m). Initially, there was a 1.7% gap between mean blood pressure recording levels in practices located in the least deprived fifth of communities compared with the most deprived fifth, but, three years later, this gap had narrowed to 0.2%. Achievement of target blood pressure levels in 2005 for practices located in the least deprived communities ranged from 71.0% (95% CI 70.4% to 71.6%) for diabetes to 85.1% (84.7% to 85.6%) for coronary heart disease; practices in the most deprived communities achieved 68.9% (68.4% to 69.5%) and 81.8 % (81.3% to 82.3%) respectively. Three years later, target achievement in the least deprived practices had risen to 78.6% (78.1% to 79.1%) and 89.4% (89.1% to 89.7%) respectively. Target achievement in the most deprived practices rose similarly, to 79.2% (78.8% to 79.6%) and 88.4% (88.2% to 88.7%) respectively. Similar changes were observed for the achievement of blood pressure targets in hypertension, cerebrovascular disease, and chronic kidney disease. Since the reporting of performance indicators for primary care and the incorporation of pay for performance in 2004, blood pressure monitoring and control have improved substantially. Improvements in achievement have been accompanied by the near disappearance of the

  4. The impact of pay-for-performance on professional boundaries in UK general practice: an ethnographic study.

    Science.gov (United States)

    Grant, Suzanne; Huby, Guro; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw; Guthrie, Bruce

    2009-03-01

    The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact of the new contract and the financial incentives contained within it on professional boundaries in UK general practice. The distribution of clinical and administrative work has changed significantly and there has been a new concentration of authority, with QOF decision making and monitoring being led by an internal QOF team of clinical and managerial staff who make the major practice-level decisions about QOF, monitor progress against targets, and intervene to resolve areas or indicators at risk of missing targets. General practitioners and nurses, however, appear to have accommodated these changes by re-creating long established narratives on professional boundaries and clinical hierarchies. This paper is concerned with the impact of these new arrangements on existing clinical hierarchies.

  5. A framework for evaluating forest restoration alternatives and their outcomes, over time, to inform monitoring: Bioregional inventory originated simulation under management

    Science.gov (United States)

    Jeremy S. Fried; Theresa B. Jain; Sara Loreno; Robert F. Keefe; Conor K. Bell

    2017-01-01

    The BioSum modeling framework summarizes current and prospective future forest conditions under alternative management regimes along with their costs, revenues and product yields. BioSum translates Forest Inventory and Analysis (FIA) data for input to the Forest Vegetation Simulator (FVS), summarizes FVS outputs for input to the treatment operations cost model (OpCost...

  6. A concept taxonomy and an instrument hierarchy: tools for establishing and evaluating the conceptual framework of a patient-reported outcome (PRO) instrument as applied to product labeling claims.

    Science.gov (United States)

    Erickson, Pennifer; Willke, Richard; Burke, Laurie

    2009-01-01

    To facilitate development and evaluation of a PRO instrument conceptual framework, we propose two tools--a PRO concept taxonomy and a PRO instrument hierarchy. FDA's draft guidance on patient reported outcome (PRO) measures states that a clear description of the conceptual framework of an instrument is useful for evaluating its adequacy to support a treatment benefit claim for use in product labeling the draft guidance, however does not propose tools for establishing or evaluating a PRO instrument's conceptual framework. We draw from our review of PRO concepts and instruments that appear in prescription drug labeling approved in the United States from 1997 to 2007. We propose taxonomy terms that define relationships between PRO concepts, including "family,"compound concept," and "singular concept." Based on the range of complexity represented by the concepts, as defined by the taxonomy, we propose nine instrument orders for PRO measurement. The nine orders range from individual event counts to multi-item, multiscale instruments. This analysis of PRO concepts and instruments illustrates that the taxonomy and hierarchy are applicable to PRO concepts across a wide range of therapeutic areas and provide a basis for defining the instrument conceptual framework complexity. Although the utility of these tools in the drug development, review, and approval processes has not yet been demonstrated, these tools could be useful to improve communication and enhance efficiency in the instrument development and review process.

  7. A methodological framework for assessing agreement between cost-effectiveness outcomes estimated using alternative sources of data on treatment costs and effects for trial-based economic evaluations.

    Science.gov (United States)

    Achana, Felix; Petrou, Stavros; Khan, Kamran; Gaye, Amadou; Modi, Neena

    2018-01-01

    A new methodological framework for assessing agreement between cost-effectiveness endpoints generated using alternative sources of data on treatment costs and effects for trial-based economic evaluations is proposed. The framework can be used to validate cost-effectiveness endpoints generated from routine data sources when comparable data is available directly from trial case report forms or from another source. We illustrate application of the framework using data from a recent trial-based economic evaluation of the probiotic Bifidobacterium breve strain BBG administered to babies less than 31 weeks of gestation. Cost-effectiveness endpoints are compared using two sources of information; trial case report forms and data extracted from the National Neonatal Research Database (NNRD), a clinical database created through collaborative efforts of UK neonatal services. Focusing on mean incremental net benefits at £30,000 per episode of sepsis averted, the study revealed no evidence of discrepancy between the data sources (two-sided p values >0.4), low probability estimates of miscoverage (ranging from 0.039 to 0.060) and concordance correlation coefficients greater than 0.86. We conclude that the NNRD could potentially serve as a reliable source of data for future trial-based economic evaluations of neonatal interventions. We also discuss the potential implications of increasing opportunity to utilize routinely available data for the conduct of trial-based economic evaluations.

  8. Development and application of the adverse outcome pathway framework for understanding and predicting chronic toxicity: II. A focus on growth impairment in fish

    NARCIS (Netherlands)

    Groh, K.J.; Carvalho, R.N.; Chipman, J.K.; Denslow, N.D.; Halder, M.; Murphy, C.A.; Roelofs, D.; Rolaki, A.; Schirmer, K.; Watanabe, K.H.

    2015-01-01

    Adverse outcome pathways (AOPs) organize knowledge on the progression of toxicity through levels of biological organization. By determining the linkages between toxicity events at different levels, AOPs lay the foundation for mechanism-based alternative testing approaches to hazard assessment. Here,

  9. Nano-risk Science: application of toxicogenomics in an adverse outcome pathway framework for risk assessment of multi-walled carbon nanotubes

    DEFF Research Database (Denmark)

    Labib, Sarah; Williams, Andrew; Yauk, Carole L.

    2016-01-01

    -based points of departure (PODs) for multi-walled carbon nanotube (MWCNT)-induced lung fibrosis, a non-cancer endpoint of regulatory importance. Methods: Gene expression profiles from the lungs of mice exposed to three individual MWCNTs with different physical-chemical properties were used within the framework...... with fibrosis were 14.0-30.4 mu g/mouse, which are comparable to the BMDs derived by NIOSH for MWCNT-induced lung fibrotic lesions (21.0-27.1 mu g/mouse). Conclusions: The results demonstrate that transcriptomic data can be used to as an effective mechanism-based method to derive acceptable levels of exposure...

  10. PHP frameworks

    OpenAIRE

    Srša, Aljaž

    2016-01-01

    The thesis presents one of the four most popular PHP web frameworks: Laravel, Symfony, CodeIgniter and CakePHP. These frameworks are compared with each other according to the four criteria, which can help with the selection of a framework. These criteria are size of the community, quality of official support, comprehensibility of framework’s documentation and implementation of functionalities in individual frameworks, which are automatic code generation, routing, object-relational mapping and...

  11. Beyond safety outcomes: An investigation of the impact of safety climate on job satisfaction, employee engagement and turnover using social exchange theory as the theoretical framework.

    Science.gov (United States)

    Huang, Yueng-Hsiang; Lee, Jin; McFadden, Anna C; Murphy, Lauren A; Robertson, Michelle M; Cheung, Janelle H; Zohar, Dov

    2016-07-01

    Safety climate, a measure of the degree to which safety is perceived by employees to be a priority in their company, is often implicated as a key factor in the promotion of injury-reducing behavior and safe work environments. Using social exchange theory as a theoretical basis, this study hypothesized that safety climate would be related to employees' job satisfaction, engagement, and turnover rate, highlighting the beneficial effects of safety climate beyond typical safety outcomes. Survey data were collected from 6207 truck drivers from two U.S. trucking companies. The objective turnover rate was collected one year after the survey data collection. Results showed that employees' safety climate perceptions were linked to employees' level of job satisfaction, engagement, and objective turnover rate, thus supporting the application of social exchange theory. Job satisfaction was also a significant mediator between safety climate and the two human resource outcomes (i.e., employee engagement and turnover rate). This study is among the first to assess the impact of safety climate beyond safety outcomes among lone workers (using truck drivers as an exemplar). Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE).

    Science.gov (United States)

    Paquette-Warren, Jann; Harris, Stewart B; Naqshbandi Hayward, Mariam; Tompkins, Jordan W

    2016-10-01

    Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real-world evaluation. Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real-world comprehensive evaluations in health care settings. The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub-steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built-in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale-up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. © 2016 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  13. Quantifying the "So what?" of Restoration: A Framework for Evaluating the Ecological and Socio-economic Outcomes of Restoration Activities in the Gulf of Mexico

    Science.gov (United States)

    Henkel, J. R.; Dausman, A.; Cowan, J.; Sutter, B.

    2017-12-01

    Healthy and sustainable ecosystems are essential for thriving and resilient coastal communities. As a result of settlements following the Deepwater Horizon oil spill, the Gulf Coast Ecosystem Restoration Council (Council) and other funding entities, will receive billions of dollars over the next 15 years for restoration projects and programs. These and future restoration efforts present an opportunity to improve the function of coastal wetlands in the Gulf of Mexico, and potentially address long-standing barriers to ecosystem health and resilience in the region. In its Comprehensive Plans, the Council has committed to science-based decision-making, collaboration among its eleven state and federal members, and close coordination with other Gulf restoration and conservation funding efforts including NRDA, NFWF and other federal programs to leverage resources and integrate complementary restoration efforts. To help fulfill these commitments the Council is exploring methods and tools to collect and assess data to evaluate and report on both ecological and socio-economic outcomes of restoration projects. Application of these tools in coordination with restoration partners, will demonstrate the cascading benefits of ecosystem restoration in a quantifiable way, and can help decision-makers increase investments in ecosystem restoration that will support the long-term sustainability of coastal systems. An understanding of ecosystem function and services can also provide a transparent lens for communicating the results of successful ecosystem restoration projects to the public (helping answer the "So what?" of ecosystem restoration). As the Council moves forward making decisions based on the best available science, improving ecosystem functioning and services will play a role in project and program selection and will result in more resilient ecosystems. This will enable the Council to help communities enhance their ability to recover from natural and manmade disasters and

  14. The perception of the illness with subsequent outcome measure in more favorable in continuos peritoneal dialysis vs hemodialysis in the framework of appraisal model of stress.

    Science.gov (United States)

    Nowak, Zbigniew; Laudański, Krzysztof

    2014-01-01

    The aim of the study was to use the appraisal model of stress to compare hemodialysis (HD) and continuous peritoneal dialysis (CAPD) patients with special focus on the perception of end-stage renal disease and subsequent emotional profile and health related quality of life (HQoL) in. We hypothesize that different circumstances related to both modes of therapies will result in dissimilar perception of chronic illness with subsequent changes in emotional profile and heath related quality of life. The total of 88 patients with end stage renal disease (ESRD) enrolled in hemodialysis (n=52; HD) or continuous peritoneal dialysis (n=36; CAPD) were given a battery of psychological tests: The Profile of Mood States, The Nottingham Health Profile, The Stress Situation Assessment Questionnaire, The Social Appreciation Questionnaire and The Situation and Trait and Anxiety Inventory. All patients perceived ESRD in terms of a loss and a threat. Moreover, CAPD patients evaluated ESRD as a challenge. Despite different perception of ESRD no significant difference in the level of fear, anxiety or emotional profile was found. Both HD and CAPD patient were reported more fatigue/inertia and confusion/bewilderment than control groups. The main health related complaints were similar in both ESRD patients with major complaints of sleeping disturbances, motor limitations and lack of energy. From the psychological point of view, CAPD treatment seems more like challenge to the enrolled patient which is positive outcome. Despite different appraisal of stress mood and health related complaints were similar in both groups. This may be a result of optimal regulation of cognitive perception of the stress depending on the circumstances of therapy.

  15. Validity of Torque-Data Collection at Multiple Sites: A Framework for Collaboration on Clinical-Outcomes Research in Sports Medicine.

    Science.gov (United States)

    Kuenze, Christopher; Eltouhky, Moataz; Thomas, Abbey; Sutherlin, Mark; Hart, Joseph

    2016-05-01

    Collecting torque data using a multimode dynamometer is common in sports-medicine research. The error in torque measurements across multiple sites and dynamometers has not been established. To assess the validity of 2 calibration protocols across 3 dynamometers and the error associated with torque measurement for each system. Observational study. 3 university laboratories at separate institutions. 2 Biodex System 3 dynamometers and 1 Biodex System 4 dynamometer. System calibration was completed using the manufacturer-recommended single-weight method and an experimental calibration method using a series of progressive weights. Both calibration methods were compared with a manually calculated theoretical torque across a range of applied weights. Relative error, absolute error, and percent error were calculated at each weight. Each outcome variable was compared between systems using 95% confidence intervals across low (0-65 Nm), moderate (66-110 Nm), and high (111-165 Nm) torque categorizations. Calibration coefficients were established for each system using both calibration protocols. However, within each system the calibration coefficients generated using the single-weight (System 4 = 2.42 [0.90], System 3a = 1.37 [1.11], System 3b = -0.96 [1.45]) and experimental calibration protocols (System 4 = 3.95 [1.08], System 3a = -0.79 [1.23], System 3b = 2.31 [1.66]) were similar and displayed acceptable mean relative error compared with calculated theoretical torque values. Overall, percent error was greatest for all 3 systems in low-torque conditions (System 4 = 11.66% [6.39], System 3a = 6.82% [11.98], System 3b = 4.35% [9.49]). The System 4 significantly overestimated torque across all 3 weight increments, and the System 3b overestimated torque over the moderate-torque increment. Conversion of raw voltage to torque values using the single-calibration-weight method is valid and comparable to a more complex multiweight calibration process; however, it is clear that

  16. Translation of research outcome

    African Journals Online (AJOL)

    unhcc

    2017-01-03

    Jan 3, 2017 ... we must act”1 - Translation of research outcome for health policy, strategy and ... others iron-out existing gaps on Health Policy .... within the broader framework of global call and ... research: defining the terrain; identifying.

  17. The effects of pay for performance on disparities in stroke, hypertension, and coronary heart disease management: interrupted time series study.

    Science.gov (United States)

    Lee, John Tayu; Netuveli, Gopalakrishnan; Majeed, Azeem; Millett, Christopher

    2011-01-01

    The Quality and Outcomes Framework (QOF), a major pay-for-performance programme, was introduced into United Kingdom primary care in April 2004. The impact of this programme on disparities in health care remains unclear. This study examines the following questions: has this pay for performance programme improved the quality of care for coronary heart disease, stroke and hypertension in white, black and south Asian patients? Has this programme reduced disparities in the quality of care between these ethnic groups? Did general practices with different baseline performance respond differently to this programme? Retrospective cohort study of patients registered with family practices in Wandsworth, London during 2007. Segmented regression analysis of interrupted time series was used to take into account the previous time trend. Primary outcome measures were mean systolic and diastolic blood pressure, and cholesterol levels. Our findings suggest that the implementation of QOF resulted in significant short term improvements in blood pressure control. The magnitude of benefit varied between ethnic groups with a statistically significant short term reduction in systolic BP in white and black but not in south Asian patients with hypertension. Disparities in risk factor control were attenuated only on few measures and largely remained intact at the end of the study period. Pay for performance programmes such as the QOF in the UK should set challenging but achievable targets. Specific targets aimed at reducing ethnic disparities in health care may also be needed.

  18. Informatics approaches in the Biological Characterization of Adverse Outcome Pathways

    Science.gov (United States)

    Adverse Outcome Pathways (AOPs) are a conceptual framework to characterize toxicity pathways by a series of mechanistic steps from a molecular initiating event to population outcomes. This framework helps to direct risk assessment research, for example by aiding in computational ...

  19. Framework for Sustainability Assessment by Transportation Agencies

    DEFF Research Database (Denmark)

    Ramani, Tara Lakshmi; Zietsman, Josias; Gudmundsson, Henrik

    2011-01-01

    and outcomes. The framework development process was an extension of findings from literature review, case studies, and interviews conducted as part of ongoing research under the NCHRP project Sustainability Performance Measures for State Departments of Transportation and Other Transportation Agencies...

  20. A Framework on Impression Management in Negotiation

    DEFF Research Database (Denmark)

    Mathiasen, Ditte Dahl; Esbjerg, Lars

    2014-01-01

    In this paper we develop a dramaturgical framework to provide us with a new understanding of how negotiators use impression management behaviour during the negotiation process to position themselves in an endeavour to reach a desirable outcome.......In this paper we develop a dramaturgical framework to provide us with a new understanding of how negotiators use impression management behaviour during the negotiation process to position themselves in an endeavour to reach a desirable outcome....

  1. ZEND FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Lupasc Adrian

    2013-12-01

    Full Text Available In this paper we present Zend Architecture, which is an open source technology for developing web applications and services, based on object-oriented components, and the Model-View-Controller architectural pattern, also known as MVC, which is the fundament of this architecture. The MVC presentation emphasises its main characteristics, such as facilitating the components reuse by dividing the application into distinct interconnected modules, tasks distribution in the process of developing an application, the MVC life cycle and also the essential features of the components in which it separates the application: model, view, controller. The controller coordinates the models and views and it’s responsible with manipulating the user events through the corresponding actions. The model contains application rules, respectively the scripts that implement the database manipulation. The third component, the view represents the controllers interface with the user or the way it displays the response to the event triggered by the user. Another aspect treated in this paper consists in highlighting the Zend architecture advantages and disadvantages. Among the framework advantages, we can enumerate good code organization, due to its delimitation into three sections, presentation, logic and data access, and dividing the code into components, which facilitates the code reuse and testing. Other advantages are the open-source license and the support for multiple database systems. The main disadvantages are represented by its size and complexity, that makes it hard to understand for a beginner programmer, the resources it needs etc. The last section of the paper presents a comparison between Zend and other PHP architectures, like Symphony, CakePHP and CodeIgniter, which includes their essential features and points out their similarities and differences, based on the unique functions that set them apart from others. The main thing that distinguishes ZF from the

  2. Ontario's Quality Assurance Framework: A Critical Response

    Science.gov (United States)

    Heap, James

    2013-01-01

    Ontario's Quality Assurance Framework (QAF) is reviewed and found not to meet all five criteria proposed for a strong quality assurance system focused on student learning. The QAF requires a statement of student learning outcomes and a method and means of assessing those outcomes, but it does not require that data on achievement of intended…

  3. A revised Self- and Family Management Framework.

    Science.gov (United States)

    Grey, Margaret; Schulman-Green, Dena; Knafl, Kathleen; Reynolds, Nancy R

    2015-01-01

    Research on self- and family management of chronic conditions has advanced over the past 6 years, but the use of simple frameworks has hampered the understanding of the complexities involved. We sought to update our previously published model with new empirical, synthetic, and theoretical work. We used synthesis of previous studies to update the framework. We propose a revised framework that clarifies facilitators and barriers, processes, proximal outcomes, and distal outcomes of self- and family management and their relationships. We offer the revised framework as a model that can be used in studies aimed at advancing self- and family management science. The use of the framework to guide studies would allow for the design of studies that can address more clearly how self-management interventions work and under what conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Second generation registry framework.

    Science.gov (United States)

    Bellgard, Matthew I; Render, Lee; Radochonski, Maciej; Hunter, Adam

    2014-01-01

    Information management systems are essential to capture data be it for public health and human disease, sustainable agriculture, or plant and animal biosecurity. In public health, the term patient registry is often used to describe information management systems that are used to record and track phenotypic data of patients. Appropriate design, implementation and deployment of patient registries enables rapid decision making and ongoing data mining ultimately leading to improved patient outcomes. A major bottleneck encountered is the static nature of these registries. That is, software developers are required to work with stakeholders to determine requirements, design the system, implement the required data fields and functionality for each patient registry. Additionally, software developer time is required for ongoing maintenance and customisation. It is desirable to deploy a sophisticated registry framework that can allow scientists and registry curators possessing standard computing skills to dynamically construct a complete patient registry from scratch and customise it for their specific needs with little or no need to engage a software developer at any stage. This paper introduces our second generation open source registry framework which builds on our previous rare disease registry framework (RDRF). This second generation RDRF is a new approach as it empowers registry administrators to construct one or more patient registries without software developer effort. New data elements for a diverse range of phenotypic and genotypic measurements can be defined at any time. Defined data elements can then be utilised in any of the created registries. Fine grained, multi-level user and workgroup access can be applied to each data element to ensure appropriate access and data privacy. We introduce the concept of derived data elements to assist the data element standards communities on how they might be best categorised. We introduce the second generation RDRF that

  5. Programming Entity Framework

    CERN Document Server

    Lerman, Julia

    2010-01-01

    Get a thorough introduction to ADO.NET Entity Framework 4 -- Microsoft's core framework for modeling and interacting with data in .NET applications. The second edition of this acclaimed guide provides a hands-on tour of the framework latest version in Visual Studio 2010 and .NET Framework 4. Not only will you learn how to use EF4 in a variety of applications, you'll also gain a deep understanding of its architecture and APIs. Written by Julia Lerman, the leading independent authority on the framework, Programming Entity Framework covers it all -- from the Entity Data Model and Object Service

  6. Utilisation of diagnostic computerised tomography imaging and immediate clinical outcomes in older people with stroke before and after introduction of the National Service Framework for older people. A comparative study of hospital-based stroke registry data (1997-2003): Norfolk experience.

    Science.gov (United States)

    Myint, Phyo K; Vowler, Sarah L; Redmayne, Oliver; Fulcher, Robert A

    2006-07-01

    how the National Service Framework (NSF) for older people in England might be associated with changes in clinically relevant stroke outcome has not been investigated. We looked for changes in computerised tomography (CT) scan rate, inpatient case-fatality rate (CFR), length of acute hospital stay and discharge destination for older people with stroke, compared with their younger counterparts, for a period before, and after, the introduction of the NSF. two periods, 4 years before and 2 years after the publication of the NSF, were selected to compare the above outcomes between three age categories: or = 85 years of age. Annual summary data for these periods were compared for the magnitude of changes in all age categories for all outcomes measured between pre- and post-NSF periods. n = 5,219. Utilisation of CT imaging had increased in all age groups post-NSF, with the most significant improvement in the oldest group. This change was associated with a greater proportion of people who had CT in this age group being discharged home in the post-NSF period. There was no change in the mortality from stroke in any age group during the study. Although the length of acute hospital stay increased, this was associated with a higher percentage of home discharges particularly in > 65-year olds, suggesting better clinical outcome in those who survived. in this single-centre analysis, the post-NSF period appeared to be associated with improvement in outcome in older people with stroke. Continual monitoring using stroke registry data may help to assess whether these effects are sustained in the longer term.

  7. Programming Entity Framework

    CERN Document Server

    Lerman, Julia

    2009-01-01

    Programming Entity Framework is a thorough introduction to Microsoft's new core framework for modeling and interacting with data in .NET applications. This highly-acclaimed book not only gives experienced developers a hands-on tour of the Entity Framework and explains its use in a variety of applications, it also provides a deep understanding of its architecture and APIs -- knowledge that will be extremely valuable as you shift to the Entity Framework version in .NET Framework 4.0 and Visual Studio 2010. From the Entity Data Model (EDM) and Object Services to EntityClient and the Metadata Work

  8. Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram.

    Science.gov (United States)

    Chang, Hyejung

    2015-10-01

    Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions.

  9. Integrated Monetary and Exchange Rate Frameworks

    NARCIS (Netherlands)

    L. Vinhas de Souza

    2002-01-01

    textabstractHere the author empirically estimates if the different monetary and exchange rate frameworks observed in the Accession Countries of Central and Eastern Europe and the Baltics do yield different outcomes in terms of level and variance of a set of nominal and real variables. The author

  10. A new GISc framework and competency set for curricula ...

    African Journals Online (AJOL)

    HDuplessis

    Science (GISc) competency sets are used to develop a new framework of essential ... some KAs, in particular Physics and Organisational and Institutional Aspects are .... A more detailed and quantitative analysis at topic, outcome and keyword ...

  11. Course Development Cycle Time: A Framework for Continuous Process Improvement.

    Science.gov (United States)

    Lake, Erinn

    2003-01-01

    Details Edinboro University's efforts to reduce the extended cycle time required to develop new courses and programs. Describes a collaborative process improvement framework, illustrated data findings, the team's recommendations for improvement, and the outcomes of those recommendations. (EV)

  12. 10-Year Framework of Programmes on Sustainable Consumption and Production

    Science.gov (United States)

    One of the important programmatic outcomes from the U.N. Conference on Sustainable Development (Rio+20) was the adoption of the 10-Year Framework of Programmes (10YFP) on Sustainable Consumption and Production (SCP).

  13. Frameworks in CS1

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak; Caspersen, Michael Edelgaard

    2002-01-01

    point for introducing graphical user interface frameworks such as Java Swing and AWT as the students are not overwhelmed by all the details of such frameworks right away but given a conceptual road-map and practical experience that allow them to cope with the complexity.......In this paper we argue that introducing object-oriented frameworks as subject already in the CS1 curriculum is important if we are to train the programmers of tomorrow to become just as much software reusers as software producers. We present a simple, graphical, framework that we have successfully...... used to introduce the principles of object-oriented frameworks to students at the introductory programming level. Our framework, while simple, introduces central abstractions such as inversion of control, event-driven programming, and variability points/hot-spots. This has provided a good starting...

  14. Quality Attribute Techniques Framework

    Science.gov (United States)

    Chiam, Yin Kia; Zhu, Liming; Staples, Mark

    The quality of software is achieved during its development. Development teams use various techniques to investigate, evaluate and control potential quality problems in their systems. These “Quality Attribute Techniques” target specific product qualities such as safety or security. This paper proposes a framework to capture important characteristics of these techniques. The framework is intended to support process tailoring, by facilitating the selection of techniques for inclusion into process models that target specific product qualities. We use risk management as a theory to accommodate techniques for many product qualities and lifecycle phases. Safety techniques have motivated the framework, and safety and performance techniques have been used to evaluate the framework. The evaluation demonstrates the ability of quality risk management to cover the development lifecycle and to accommodate two different product qualities. We identify advantages and limitations of the framework, and discuss future research on the framework.

  15. Supply chain management: a framework of understanding

    Directory of Open Access Journals (Sweden)

    Du Toit, Deirdre

    2014-11-01

    Full Text Available The topic of supply chain management (SCM is complex to understand because it encompasses many different flows of activities, components, functions, and role-players. The literature is scattered across multiple functions, varies in scope, and is often confined to certain elements within SCM. This article aims to provide a literature overview of SCM. It is explained with the aid of a newly-developed framework of understanding that offers a graphical representation of the term. It unifies and condenses different components within SCM and shows the relationship between them. The framework was developed by identifying the main themes in the definitions for SCM, examining existing categorisations and frameworks in SCM, and analysing frameworks in other disciplines. The outcome of this article can be used as a guide to explain and orientate researchers and practitioners in the field.

  16. JT Bachman Leadership Framework

    Science.gov (United States)

    2017-07-01

    DAHLGREN DIVISION NAVAL SURFACE WARFARE CENTER Dahlgren, Virginia 22448-5100 NSWCDD/MP-17/300 JT BACHMAN LEADERSHIP FRAMEWORK...REPORT TYPE Miscellaneous Publication 3. DATES COVERED (From - To) 27 Sept 2016 – 08 June 2017 4. TITLE AND SUBTITLE JT BACHMAN LEADERSHIP FRAMEWORK...distribution is unlimited. 13. SUPPLEMENTARY NOTES 14. ABSTRACT This document describes the leadership framework of a civil servant following

  17. Ramadan, Fasting and Educational Outcomes

    Science.gov (United States)

    Oosterbeek, Hessel; van der Klaauw, Bas

    2013-01-01

    Using a difference-in-differences framework, we estimate the impact of Ramadan on educational outcomes of Muslim students living in a non-Muslim country. For identification we exploit that the number of Ramadan weeks during the course that we study, varies from year to year, ranging from zero to four. Our main finding is that Ramadan observance…

  18. Ramadan, fasting and educational outcomes

    NARCIS (Netherlands)

    Oosterbeek, H.; van der Klaauw, B.

    2011-01-01

    Using a difference-in-differences framework, we estimate the impact of Ramadan on educational outcomes of Muslim students living in a non-Muslim country. For identification we exploit the fact that the number of Ramadan weeks during the course that we study, varies from year to year, ranging from

  19. Ramadan, fasting and educational outcomes

    NARCIS (Netherlands)

    Oosterbeek, H.; van der Klaauw, B.

    2013-01-01

    Using a difference-in-differences framework, we estimate the impact of Ramadan on educational outcomes of Muslim students living in a non-Muslim country. For identification we exploit that the number of Ramadan weeks during the course that we study, varies from year to year, ranging from zero to

  20. Frameworks in CS1

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak; Caspersen, Michael Edelgaard

    2002-01-01

    In this paper we argue that introducing object-oriented frameworks as subject already in the CS1 curriculum is important if we are to train the programmers of tomorrow to become just as much software reusers as software producers. We present a simple, graphical, framework that we have successfull...... point for introducing graphical user interface frameworks such as Java Swing and AWT as the students are not overwhelmed by all the details of such frameworks right away but given a conceptual road-map and practical experience that allow them to cope with the complexity....

  1. Frameworks in CS1

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak; Caspersen, Michael Edelgaard

    2002-01-01

    point for introducing graphical user interface frameworks such as Java Swing and AWT as the students are not overwhelmed by all the details of such frameworks right away but given a conceptual road-map and practical experience that allow them to cope with the complexity.......In this paper we argue that introducing object-oriented frameworks as subject already in the CS1 curriculum is important if we are to train the programmers of tomorrow to become just as much software reusers as software producers. We present a simple, graphical, framework that we have successfully...

  2. Compiling a register of patients with moderate or severe learning disabilities: experience at one United Kingdom general practice

    Science.gov (United States)

    2011-01-01

    Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks. Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice. Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed. Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap. Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities. PMID:22479290

  3. Compiling a register of patients with moderate or severe learning disabilities: experience at one United Kingdom general practice.

    Science.gov (United States)

    Lodge, Keri-Michèle; Milnes, David; Gilbody, Simon M

    2011-03-01

    Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks.Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice.Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed.Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap.Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities.

  4. Decision support frameworks and tools for conservation

    Science.gov (United States)

    Schwartz, Mark W.; Cook, Carly N.; Pressey, Robert L.; Pullin, Andrew S.; Runge, Michael C.; Salafsky, Nick; Sutherland, William J.; Williamson, Matthew A.

    2018-01-01

    The practice of conservation occurs within complex socioecological systems fraught with challenges that require transparent, defensible, and often socially engaged project planning and management. Planning and decision support frameworks are designed to help conservation practitioners increase planning rigor, project accountability, stakeholder participation, transparency in decisions, and learning. We describe and contrast five common frameworks within the context of six fundamental questions (why, who, what, where, when, how) at each of three planning stages of adaptive management (project scoping, operational planning, learning). We demonstrate that decision support frameworks provide varied and extensive tools for conservation planning and management. However, using any framework in isolation risks diminishing potential benefits since no one framework covers the full spectrum of potential conservation planning and decision challenges. We describe two case studies that have effectively deployed tools from across conservation frameworks to improve conservation actions and outcomes. Attention to the critical questions for conservation project planning should allow practitioners to operate within any framework and adapt tools to suit their specific management context. We call on conservation researchers and practitioners to regularly use decision support tools as standard practice for framing both practice and research.

  5. Toward a Framework for Translational Research in School Psychology

    Science.gov (United States)

    Edwards, Oliver W.

    2017-01-01

    This article addresses a translational research framework for school psychology. Translational research uses outcomes of basic and applied science to enhance the overall well-being of persons. This transdisciplinary framework connects disciplines and uses their resources, capacities, systems, and procedures to advance prevention, intervention, and…

  6. The SOPHY Framework

    DEFF Research Database (Denmark)

    Laursen, Karl Kaas; Pedersen, Martin Fejrskov; Bendtsen, Jan Dimon

    The goal of the Sophy framework (Simulation, Observation and Planning in Hybrid Systems) is to implement a multi-level framework for description, simulation, observation, fault detection and recovery, diagnosis and autonomous planning in distributed embedded hybrid systems. A Java-based distributed...

  7. The SOPHY framework

    DEFF Research Database (Denmark)

    Laursen, Karl Kaas; Pedersen, M. F.; Bendtsen, Jan Dimon

    2005-01-01

    The goal of the Sophy framework (Simulation, Observation and Planning in Hybrid Systems) is to implement a multi-level framework for description, simulation, observation, fault detection and recovery, diagnosis and autonomous planning in distributed embedded hybrid systems. A Java-based distributed...

  8. Overlooking the Conceptual Framework

    Science.gov (United States)

    Leshem, Shosh; Trafford, Vernon

    2007-01-01

    The conceptual framework is alluded to in most serious texts on research, described in some and fully explained in few. However, examiners of doctoral theses devote considerable attention to exploring its function within social science doctoral vivas. A literature survey explores how the conceptual framework is itself conceptualised and explained.…

  9. Framework for the Future

    Science.gov (United States)

    Schuller, Tom

    2008-01-01

    The main goal of the Inquiry into the Future for Lifelong Learning is to provide a "strategic framework" for the future. In this article, the author considers the key components that will make up the framework. These are: (1) a statement of vision and values; (2) a stock-take of the current position; (3) an "investment…

  10. A framework for telehealth program evaluation.

    Science.gov (United States)

    Nepal, Surya; Li, Jane; Jang-Jaccard, Julian; Alem, Leila

    2014-04-01

    Evaluating telehealth programs is a challenging task, yet it is the most sensible first step when embarking on a telehealth study. How can we frame and report on telehealth studies? What are the health services elements to select based on the application needs? What are the appropriate terms to use to refer to such elements? Various frameworks have been proposed in the literature to answer these questions, and each framework is defined by a set of properties covering different aspects of telehealth systems. The most common properties include application, technology, and functionality. With the proliferation of telehealth, it is important not only to understand these properties, but also to define new properties to account for a wider range of context of use and evaluation outcomes. This article presents a comprehensive framework for delivery design, implementation, and evaluation of telehealth services. We first survey existing frameworks proposed in the literature and then present our proposed comprehensive multidimensional framework for telehealth. Six key dimensions of the proposed framework include health domains, health services, delivery technologies, communication infrastructure, environment setting, and socioeconomic analysis. We define a set of example properties for each dimension. We then demonstrate how we have used our framework to evaluate telehealth programs in rural and remote Australia. A few major international studies have been also mapped to demonstrate the feasibility of the framework. The key characteristics of the framework are as follows: (a) loosely coupled and hence easy to use, (b) provides a basis for describing a wide range of telehealth programs, and (c) extensible to future developments and needs.

  11. Evaluation Framework for NASA's Educational Outreach Programs

    Science.gov (United States)

    Berg, Rick; Booker, Angela; Linde, Charlotte; Preston, Connie

    1999-01-01

    The objective of the proposed work is to develop an evaluation framework for NASA's educational outreach efforts. We focus on public (rather than technical or scientific) dissemination efforts, specifically on Internet-based outreach sites for children.The outcome of this work is to propose both methods and criteria for evaluation, which would enable NASA to do a more analytic evaluation of its outreach efforts. The proposed framework is based on IRL's ethnographic and video-based observational methods, which allow us to analyze how these sites are actually used.

  12. A comprehensive health service evaluation and monitoring framework.

    Science.gov (United States)

    Reeve, Carole; Humphreys, John; Wakerman, John

    2015-12-01

    To develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services. A targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders. The framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable. Data collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. A framework for consciousness.

    Science.gov (United States)

    Crick, Francis; Koch, Christof

    2003-02-01

    Here we summarize our present approach to the problem of consciousness. After an introduction outlining our general strategy, we describe what is meant by the term 'framework' and set it out under ten headings. This framework offers a coherent scheme for explaining the neural correlates of (visual) consciousness in terms of competing cellular assemblies. Most of the ideas we favor have been suggested before, but their combination is original. We also outline some general experimental approaches to the problem and, finally, acknowledge some relevant aspects of the brain that have been left out of the proposed framework.

  14. Exposures to airborne particulate matter and adverse perinatal outcomes: a biologically plausible mechanistic framework for exploring potential Exposição à matéria particulada aérea e efeitos perinatais adversos: referencial mecanístico biologicamente plausível para exploração de potenciais

    Directory of Open Access Journals (Sweden)

    Srimathi Kannan

    2007-12-01

    Full Text Available This article has three objectives: to describe the biologically plausible mechanistic pathways by which exposure to particulate matter (PM may lead to adverse perinatal outcomes of low birth weight (LBW, intrauterine growth retardation (IUGR, and preterm delivery (PTD; review evidence showing that nutrition affects biologic pathways; and explain mechanisms by which nutrition may modify the impact of PM exposure on perinatal outcomes. We propose an interdisciplinary framework that brings together maternal and infant nutrition, air pollution exposure assessment, and cardiopulmonary and perinatal epidemiology. Five possible biologic mechanisms have been put forth in the emerging environmental sciences literature and provide corollaries for the proposed framework. The literature indicates that the effects of PM on LBW, PTD, and IUGR may manifest through the cardiovascular mechanisms of oxidative stress, inflammation, coagulation, endothelial function, and hemodynamic responses. PM exposure studies relating mechanistic pathways to perinatal outcomes should consider the likelihood that biologic responses and adverse birth outcomes may be derived from both PM and non-PM sources. We present strategies for empirically testing the proposed model and developing future research efforts.São três os objetivos deste artigo: descrever rotas mecanísticas biologicamente plausíveis pelas quais a exposição à matéria particulada (MP pode levar a efeitos perinatais adversos, como baixo peso ao nascer (BPN, retardo do crescimento intra-uterino (RCIU e nascimentos pré-termo (NPT; fazer uma revisão de evidências mostrando que a nutrição afeta rotas biológicas; explicar os mecanismos através dos quais a nutrição pode modificar o impacto da exposição a MP nos efeitos perinatais adversos. Propomos um referencial interdisciplinar que aproxime nutrição materna e infantil, avaliação de poluição do ar e epidemiologia cardiopulmonar e perinatal

  15. DXC'09 Framework

    Data.gov (United States)

    National Aeronautics and Space Administration — The DXC Framework is a collection of programs and APIs for running and evaluating diagnostic algorithms (DAs). It is complementary to system XML catalogs and...

  16. Conductive open frameworks

    Science.gov (United States)

    Yaghi, Omar M.; Wan, Shun; Doonan, Christian J.; Wang, Bo; Deng, Hexiang

    2018-05-22

    The disclosure relates generally to materials that comprise conductive covalent organic frameworks. The disclosure also relates to materials that are useful to store and separate gas molecules and sensors.

  17. VBE reference framework

    NARCIS (Netherlands)

    Afsarmanesh, H.; Camarinha-Matos, L.M.; Ermilova, E.; Camarinha-Matos, L.M.; Afsarmanesh, H.; Ollus, M.

    2008-01-01

    Defining a comprehensive and generic "reference framework" for Virtual organizations Breeding Environments (VBEs), addressing all their features and characteristics, is challenging. While the definition and modeling of VBEs has become more formalized during the last five years, "reference models"

  18. The stapl Skeleton Framework

    KAUST Repository

    Zandifar, Mani; Thomas, Nathan; Amato, Nancy M.; Rauchwerger, Lawrence

    2015-01-01

    from programmers and enables them to express parallel programs as a composition of existing elementary skeletons such as map, map-reduce, scan, zip, butterfly, allreduce, alltoall and user-defined custom skeletons. Skeletons in this framework

  19. Extensible Systems Dynamics Framework

    National Research Council Canada - National Science Library

    Brooks, Christopher; Lee, Edward A

    2008-01-01

    .... The Pedigree Management and Assessment Framework (PMAF) enables the publisher of information to record standard pedigree, such as information about the source, manner of collection, and the chain of modification of that information...

  20. Towards an Integrated Framework for Special Economic Zones (SEZs)

    DEFF Research Database (Denmark)

    Aggarwal, Aradhna

    tool to achieve a variety of goals. The drivers of success and economic outcomes of SEZs depend on the strategic approach adopted by policy makers towards SEZs. There is no single recipe of their success or development outcomes. Finally, institutions evolve in the process of development. So must......This paper presents a comprehensive conceptual framework for the rationale, success factors and development outcomes of Special Economic Zones (SEZs), and analyses their performance in selected Asian countries within that framework. It draws on the tenets of the literature on ‘dynamics...

  1. Quality of diabetes care worldwide and feasibility of implementation of the Alphabet Strategy: GAIA project (Global Alphabet Strategy Implementation Audit).

    Science.gov (United States)

    Lee, James D; Saravanan, Ponnusamy; Varadhan, Lakshminarayanan; Morrissey, John R; Patel, Vinod

    2014-10-11

    The Alphabet Strategy (AS) is a diabetes care checklist ensuring "important, simple things are done right all the time." Current audits of diabetes care in developed countries reveal wide variations in quality with performance of care processes frequently sub-optimal. This study had three components:• an audit to assess diabetes care quality worldwide,• a questionnaire study seeking opinions on the merits of the AS,• a pilot study to assess the practicality of implementation of the AS in a low socioeconomic setting. Audit data was collected from 52 centres across 32 countries. Data from 4537 patients were converted to Quality and Outcome Framework (QOF) scores to enable inter-centre comparison. These were compared to each country's Gross Domestic Product (GDP), and Total Health Expenditure percentage per capita (THE%). The opinions of diabetes patients and healthcare professionals from the diabetes care team at each of these centres were sought through a structured questionnaire. A retrospective audit on 100 randomly selected case notes was conducted prior to AS implementation in a diabetes outpatient clinic in India, followed by a prospective audit after four months to assess its impact on care quality. QOF scores showed wide variation across the centres (mean 49.0, range 10.2-90.1). Although there was a positive relationship between GDP and THE% to QOF scores, there were exceptions. 91% of healthcare professionals felt the AS approach was practical. Patients found the checklist to be a useful education tool. Significant improvements in several aspects of care as well as 36% improvement in QOF score were seen following implementation. International centres observed large variations in care quality, with standards frequently sub-optimal. 71% of health care professionals would consider adopting the AS in their daily practice. Implementation in a low resource country resulted in significant improvements in some aspects of diabetes care. The AS checklist for

  2. The effects of financial incentives for case finding for depression in patients with diabetes and coronary heart disease: interrupted time series analysis.

    Science.gov (United States)

    McLintock, Kate; Russell, Amy M; Alderson, Sarah L; West, Robert; House, Allan; Westerman, Karen; Foy, Robbie

    2014-08-20

    To evaluate the effects of Quality and Outcomes Framework (QOF) incentivised case finding for depression on diagnosis and treatment in targeted and non-targeted long-term conditions. Interrupted time series analysis. General practices in Leeds, UK. 65 (58%) of 112 general practices shared data on 37,229 patients with diabetes and coronary heart disease targeted by case finding incentives, and 101,008 patients with four other long-term conditions not targeted (hypertension, epilepsy, chronic obstructive pulmonary disease and asthma). Incentivised case finding for depression using two standard screening questions. Clinical codes indicating new depression-related diagnoses and new prescriptions of antidepressants. We extracted routinely recorded data from February 2002 through April 2012. The number of new diagnoses and prescriptions for those on registers was modelled with a binomial regression, which provided the strength of associations between time periods and their rates. New diagnoses of depression increased from 21 to 94/100,000 per month in targeted patients between the periods 2002-2004 and 2007-2011 (OR 2.09; 1.92 to 2.27). The rate increased from 27 to 77/100,000 per month in non-targeted patients (OR 1.53; 1.46 to 1.62). The slopes in prescribing for both groups flattened to zero immediately after QOF was introduced but before incentivised case finding (p<0.01 for both). Antidepressant prescribing in targeted patients returned to the pre-QOF secular upward trend (Wald test for equivalence of slope, z=0.73, p=0.47); the slope was less steep for non-targeted patients (z=-4.14, p<0.01). Incentivised case finding increased new depression-related diagnoses. The establishment of QOF disrupted rising trends in new prescriptions of antidepressants, which resumed following the introduction of incentivised case finding. Prescribing trends are of concern given that they may include people with mild-to-moderate depression unlikely to respond to such treatment

  3. BEX Mejora continua framework

    OpenAIRE

    García Ramírez, David

    2014-01-01

    Memoria de la implementación de un software que permite la gestión y control de todo el framework que requiere gestionar el departamento de mejora continua (BEX Business Excelence). Memòria de la implementació d'un programari que permet la gestió i control de tot el framework que requereix gestionar el departament de millora contínua (BEX Business Excelence). Master thesis for the Free Software program.

  4. Gender Dimensions Framework Application

    OpenAIRE

    Rubin, D.

    2011-01-01

    This is a presentation of the The Gender Dimensions Framework (GDF). The GDF was developed to provide guidance to USAID staff and partner organizations for working with USAID projects looking at promoting equitable opportunities in agricultural value chains. The GDF contemplates four dimensions: access to and control over key productive assets (tangible and intangible); beliefs and perceptions; practices and participation, and legal frameworks. CCRA-7 (Gendered Knowledge)

  5. The multicultural orientation framework: A narrative review.

    Science.gov (United States)

    Davis, Don E; DeBlaere, Cirleen; Owen, Jesse; Hook, Joshua N; Rivera, David P; Choe, Elise; Van Tongeren, D R; Worthington, Everett L; Placeres, Vanessa

    2018-03-01

    After several decades of slow progress, researchers are beginning to make advances in linking constructs based on the multicultural competencies tradition-especially those focused on qualities of the therapist-to therapy outcomes. The multicultural orientation framework was developed in response to several trends within the multicultural competencies tradition, with a particular emphasis on integrating the multicultural competencies tradition into research on psychotherapy process. We provide a narrative review of studies that include one of the three constructs (i.e., cultural humility, cultural opportunities, and cultural comfort) articulated by the multicultural orientation framework. Results indicate initial evidence linking multicultural orientation constructs to therapy outcomes (e.g., perceived improvement, racial/ethnic disparities in termination, and therapy alliance). Results also supported the social bond and social oil hypotheses from theorizing on humility. Implications for future research and therapy practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  6. A relational framework for understanding bullying: Developmental antecedents and outcomes.

    Science.gov (United States)

    Rodkin, Philip C; Espelage, Dorothy L; Hanish, Laura D

    2015-01-01

    This article reviews current research on the relational processes involved in peer bullying, considering developmental antecedents and long-term consequences. The following themes are highlighted: (a) aggression can be both adaptive and maladaptive, and this distinction has implications for bullies' functioning within peer social ecologies; (b) developmental antecedents and long-term consequences of bullying have not been well-distinguished from the extant research on aggressive behavior; (c) bullying is aggression that operates within relationships of power and abuse. Power asymmetry and repetition elements of traditional bullying definitions have been hard to operationalize, but without these specifications and more dyadic measurement approaches there may be little rationale for a distinct literature on bullying--separate from aggression. Applications of a relational approach to bullying are provided using gender as an example. Implications for future research are drawn from the study of relationships and interpersonal theories of developmental psychopathology. (c) 2015 APA, all rights reserved).

  7. Framework for sequential approximate optimization

    NARCIS (Netherlands)

    Jacobs, J.H.; Etman, L.F.P.; Keulen, van F.; Rooda, J.E.

    2004-01-01

    An object-oriented framework for Sequential Approximate Optimization (SAO) isproposed. The framework aims to provide an open environment for thespecification and implementation of SAO strategies. The framework is based onthe Python programming language and contains a toolbox of Python

  8. Maternal nutrition and birth outcomes.

    Science.gov (United States)

    Abu-Saad, Kathleen; Fraser, Drora

    2010-01-01

    In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.

  9. The art framework

    International Nuclear Information System (INIS)

    Green, C; Kowalkowski, J; Paterno, M; Fischler, M; Garren, L; Lu, Q

    2012-01-01

    Future “Intensity Frontier” experiments at Fermilab are likely to be conducted by smaller collaborations, with fewer scientists, than is the case for recent “Energy Frontier” experiments. art is a C++ event-processing framework designed with the needs of such experiments in mind. An evolution from the framework of the CMS experiment, art was designed and implemented to be usable by multiple experiments without imposing undue maintenance effort requirements on either the art developers or experiments using it. We describe the key requirements and features of art and the rationale behind evolutionary changes, additions and simplifications with respect to the CMS framework. In addition, our package distribution system and our collaborative model with respect to the multiple experiments using art helps keep the maintenance burden low. We also describe in-progress and future enhancements to the framework, including strategies we are using to allow multi-threaded use of the art framework in today's multi- and many-core environments.

  10. Factors predicting team climate, and its relationship with quality of care in general practice

    Directory of Open Access Journals (Sweden)

    Eccles Martin P

    2009-08-01

    Full Text Available Abstract Background Quality of care in general practice may be affected by the team climate perceived by its health and non-health professionals. Better team working is thought to lead to higher effectiveness and quality of care. However, there is limited evidence available on what affects team functioning and its relationship with quality of care in general practice. This study aimed to explore individual and practice factors that were associated with team climate, and to explore the relationship between team climate and quality of care. Methods Cross sectional survey of a convenience sample of 14 general practices and their staff in South Tyneside in the northeast of England. Team climate was measured using the short version of Team Climate Inventory (TCI questionnaire. Practice characteristics were collected during a structured interview with practice managers. Quality was measured using the practice Quality and Outcome Framework (QOF scores. Results General Practitioners (GP had a higher team climate scores compared to other professionals. Individual's gender and tenure, and number of GPs in the practice were significantly predictors of a higher team climate. There was no significant correlation between mean practice team climate scores (or subscales with QOF scores. Conclusion The absence of a relationship between a measure of team climate and quality of care in this exploratory study may be due to a number of methodological problems. Further research is required to explore how to best measure team functioning and its relationship with quality of care.

  11. Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen; McDonald, Ruth; Grant, Suzanne; Campbell, Stephen; Guthrie, Bruce

    2008-07-01

    In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of 'pay-for-performance', including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, QOF) represent a move towards a more biomedical model of health and illness, which is contrary to the ideal of providing holistic (or biopsychosocial) care that has been traditionally espoused by GPs. This paper reports results from two linked studies (in England and Scotland) investigating the early stages of the new contract. We describe the way in which four practices with different organisational approaches and espoused identities have all changed their practice structures, consultations and clinical care in response to QOF in ways which will result in patients receiving a more biomedical type of care. In spite of these observed changes, respondents continued to maintain discursive claims to holism. We discuss how this disconnection between rhetoric and reality can be maintained, and consider its implications for the future development of GPs' claims to a professional identity.

  12. Factors predicting team climate, and its relationship with quality of care in general practice.

    Science.gov (United States)

    Goh, Teik T; Eccles, Martin P; Steen, Nick

    2009-08-04

    Quality of care in general practice may be affected by the team climate perceived by its health and non-health professionals. Better team working is thought to lead to higher effectiveness and quality of care. However, there is limited evidence available on what affects team functioning and its relationship with quality of care in general practice. This study aimed to explore individual and practice factors that were associated with team climate, and to explore the relationship between team climate and quality of care. Cross sectional survey of a convenience sample of 14 general practices and their staff in South Tyneside in the northeast of England. Team climate was measured using the short version of Team Climate Inventory (TCI) questionnaire. Practice characteristics were collected during a structured interview with practice managers. Quality was measured using the practice Quality and Outcome Framework (QOF) scores. General Practitioners (GP) had a higher team climate scores compared to other professionals. Individual's gender and tenure, and number of GPs in the practice were significantly predictors of a higher team climate. There was no significant correlation between mean practice team climate scores (or subscales) with QOF scores. The absence of a relationship between a measure of team climate and quality of care in this exploratory study may be due to a number of methodological problems. Further research is required to explore how to best measure team functioning and its relationship with quality of care.

  13. Cardiovascular disease treatment among patients with severe mental illness: a data linkage study between primary and secondary care.

    Science.gov (United States)

    Woodhead, Charlotte; Ashworth, Mark; Broadbent, Matthew; Callard, Felicity; Hotopf, Matthew; Schofield, Peter; Soncul, Murat; Stewart, Robert J; Henderson, Max J

    2016-06-01

    Suboptimal treatment of cardiovascular diseases (CVD) among patients with severe mental illness (SMI) may contribute to physical health disparities. To identify SMI characteristics associated with meeting CVD treatment and prevention guidelines. Population-based electronic health record database linkage between primary care and the sole provider of secondary mental health care services in south east London, UK. Cardiovascular disease prevalence, risk factor recording, and Quality and Outcomes Framework (QOF) clinical target achievement were compared among 4056 primary care patients with SMI whose records were linked to secondary healthcare records and 270 669 patients without SMI who were not known to secondary care psychiatric services, using multivariate logistic regression modelling. Data available from secondary care records were then used to identify SMI characteristics associated with QOF clinical target achievement. Patients with SMI and with coronary heart disease and heart failure experienced reduced prescribing of beta blockers and angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB). A diagnosis of schizophrenia, being identified with any indicator of risk or illness severity, and being prescribed with depot injectable antipsychotic medication was associated with the lowest likelihood of prescribing. Linking primary and secondary care data allows the identification of patients with SMI most at risk of undertreatment for physical health problems. © British Journal of General Practice 2016.

  14. Harmonising Nursing Terminologies Using a Conceptual Framework.

    Science.gov (United States)

    Jansen, Kay; Kim, Tae Youn; Coenen, Amy; Saba, Virginia; Hardiker, Nicholas

    2016-01-01

    The International Classification for Nursing Practice (ICNP®) and the Clinical Care Classification (CCC) System are standardised nursing terminologies that identify discrete elements of nursing practice, including nursing diagnoses, interventions, and outcomes. While CCC uses a conceptual framework or model with 21 Care Components to classify these elements, ICNP, built on a formal Web Ontology Language (OWL) description logic foundation, uses a logical hierarchical framework that is useful for computing and maintenance of ICNP. Since the logical framework of ICNP may not always align with the needs of nursing practice, an informal framework may be a more useful organisational tool to represent nursing content. The purpose of this study was to classify ICNP nursing diagnoses using the 21 Care Components of the CCC as a conceptual framework to facilitate usability and inter-operability of nursing diagnoses in electronic health records. Findings resulted in all 521 ICNP diagnoses being assigned to one of the 21 CCC Care Components. Further research is needed to validate the resulting product of this study with practitioners and develop recommendations for improvement of both terminologies.

  15. Java online monitoring framework

    International Nuclear Information System (INIS)

    Ronan, M.; Kirkby, D.; Johnson, A.S.; Groot, D. de

    1997-10-01

    An online monitoring framework has been written in the Java Language Environment to develop applications for monitoring special purpose detectors during commissioning of the PEP-II Interaction Region. PEP-II machine parameters and signals from several of the commissioning detectors are logged through VxWorks/EPICS and displayed by Java display applications. Remote clients are able to monitor the machine and detector performance using graphical displays and analysis histogram packages. In this paper, the design and implementation of the object-oriented Java framework is described. Illustrations of data acquisition, display and histograming applications are also given

  16. Sustainability assessment framework for scenarios – SAFS

    Energy Technology Data Exchange (ETDEWEB)

    Arushanyan, Yevgeniya, E-mail: yevgeniya.arushanyan@abe.kth.se [KTH Royal Institute of Technology, School of Architecture and the Built Environment, Department of Sustainable Development, Environmental Science and Engineering, Division of Environmental Strategies Research, Drottning Kristinas väg 30, 10044 Stockholm (Sweden); KTH Royal Institute of Technology, Centre for Sustainable Communications (CESC), Lindstedtsvägen 5, 100 44 Stockholm (Sweden); Ekener, Elisabeth; Moberg, Åsa [KTH Royal Institute of Technology, School of Architecture and the Built Environment, Department of Sustainable Development, Environmental Science and Engineering, Division of Environmental Strategies Research, Drottning Kristinas väg 30, 10044 Stockholm (Sweden); KTH Royal Institute of Technology, Centre for Sustainable Communications (CESC), Lindstedtsvägen 5, 100 44 Stockholm (Sweden)

    2017-03-15

    To address current challenges regarding sustainable development and support planning for this form of development, new learning about different possible futures and their potential sustainability implications is needed. One way of facilitating this learning is by combining the futures studies and sustainability assessment (SA) research fields. This paper presents the sustainability assessment framework for scenarios (SAFS), a method developed for assessing the environmental and social risks and opportunities of future scenarios, provides guidelines for its application and demonstrates how the framework can be applied. SAFS suggests assessing environmental and social aspects using a consumption perspective and a life cycle approach, and provides qualitative results. SAFS does not suggest any modelling using precise data, but instead offers guidelines on how to carry out a qualitative assessment, where both the process of assessing and the outcome of the assessment are valuable and can be used as a basis for discussion. The benefits, drawbacks and potential challenges of applying SAFS are also discussed in the paper. SAFS uses systems thinking looking at future societies as a whole, considering both environmental and social consequences. This encourages researchers and decision-makers to consider the whole picture, and not just individual elements, when considering different futures. - Highlights: • The paper presents a new methodological framework for qualitative sustainability assessment of future scenarios with transformative changes. • The framework suggests qualitative assessment with consumption perspective and a life cycle approach. • The paper presents the framework and provides guidelines for its application. • The paper demonstrates on an example how the framework can be applied. • The benefits, drawbacks and challenges of the framework application and the need for further development are discussed.

  17. Sustainability assessment framework for scenarios – SAFS

    International Nuclear Information System (INIS)

    Arushanyan, Yevgeniya; Ekener, Elisabeth; Moberg, Åsa

    2017-01-01

    To address current challenges regarding sustainable development and support planning for this form of development, new learning about different possible futures and their potential sustainability implications is needed. One way of facilitating this learning is by combining the futures studies and sustainability assessment (SA) research fields. This paper presents the sustainability assessment framework for scenarios (SAFS), a method developed for assessing the environmental and social risks and opportunities of future scenarios, provides guidelines for its application and demonstrates how the framework can be applied. SAFS suggests assessing environmental and social aspects using a consumption perspective and a life cycle approach, and provides qualitative results. SAFS does not suggest any modelling using precise data, but instead offers guidelines on how to carry out a qualitative assessment, where both the process of assessing and the outcome of the assessment are valuable and can be used as a basis for discussion. The benefits, drawbacks and potential challenges of applying SAFS are also discussed in the paper. SAFS uses systems thinking looking at future societies as a whole, considering both environmental and social consequences. This encourages researchers and decision-makers to consider the whole picture, and not just individual elements, when considering different futures. - Highlights: • The paper presents a new methodological framework for qualitative sustainability assessment of future scenarios with transformative changes. • The framework suggests qualitative assessment with consumption perspective and a life cycle approach. • The paper presents the framework and provides guidelines for its application. • The paper demonstrates on an example how the framework can be applied. • The benefits, drawbacks and challenges of the framework application and the need for further development are discussed.

  18. Outcomes-Based Assessment and Learning: Trialling Change in a Postgraduate Civil Engineering Course

    Science.gov (United States)

    El-Maaddawy, Tamer; Deneen, Christopher

    2017-01-01

    This paper aims to demonstrate how assessment tasks can function within an outcomes-based learning framework to evaluate student attainment of learning outcomes. An outcomes-based learning framework designed to integrate teaching, learning, and assessment activities was developed and implemented in a civil engineering master-level course. The…

  19. State Energy Resilience Framework

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, J. [Argonne National Lab. (ANL), Argonne, IL (United States); Finster, M. [Argonne National Lab. (ANL), Argonne, IL (United States); Pillon, J. [Argonne National Lab. (ANL), Argonne, IL (United States); Petit, F. [Argonne National Lab. (ANL), Argonne, IL (United States); Trail, J. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-12-01

    The energy sector infrastructure’s high degree of interconnectedness with other critical infrastructure systems can lead to cascading and escalating failures that can strongly affect both economic and social activities.The operational goal is to maintain energy availability for customers and consumers. For this body of work, a State Energy Resilience Framework in five steps is proposed.

  20. Framework for online teaching

    DEFF Research Database (Denmark)

    Strobel, Bjarne W.

    2014-01-01

    The following framework for online teaching is a guidance to inspire you on how to to use e-learning in your teaching. Maybe you want to make a whole online course (distance learning) or maybe you want to use e-learning as a part of a course (blended learning). If you want to go further or have...

  1. Play framework cookbook

    CERN Document Server

    Reelsen, Alexander

    2015-01-01

    This book is aimed at advanced developers who are looking to harness the power of Play 2.x. This book will also be useful for professionals looking to dive deeper into web development. Play 2 .x is an excellent framework to accelerate your learning of advanced topics.

  2. Play framework essentials

    CERN Document Server

    Richard-Foy, Julien

    2014-01-01

    This book targets Java and Scala developers who already have some experience in web development and who want to master Play framework quickly and efficiently. This book assumes you have a good level of knowledge and understanding of efficient Java and Scala code.

  3. Mastering entity framework

    CERN Document Server

    Singh, Rahul Rajat

    2015-01-01

    This book is for .NET developers who are developing data-driven applications using ADO.NET or other data access technologies. This book is going to give you everything you need to effectively develop and manage data-driven applications using Entity Framework.

  4. Reverse logistics - a framework

    NARCIS (Netherlands)

    M.P. de Brito (Marisa); R. Dekker (Rommert)

    2002-01-01

    textabstractIn this paper we define and compare Reverse Logistics definitions. We start by giving an understanding framework of Reverse Logistics: the why-what-how. By this means, we put in context the driving forces for Reverse Logistics, a typology of return reasons, a classification of

  5. Danish Technology Framework

    DEFF Research Database (Denmark)

    Bonke, Sten; Jørgensen, Tom Rydahl

    This report investigates the occurrence of foundation failures within the context of the Danish construction technology framework. The report comprises a definition/typology section on the basis of which Danish regulatory and administrative procedures in relation to foundation failures are reviewed....

  6. Metal Organic Frameworks (MOFs)

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 12; Issue 11. Molecule Matters - Metal Organic Frameworks (MOFs). R Sarvanakumar S Sankararaman. Feature Article Volume 12 Issue 11 November 2007 pp 77-86. Fulltext. Click here to view fulltext PDF. Permanent link:

  7. Framework of product experience

    NARCIS (Netherlands)

    Desmet, P.; Hekkert, P.

    2007-01-01

    In this paper, we introduce a general framework for product experience that applies to all affective responses that can be experienced in human-product interaction. Three distinct components or levels of product experiences are discussed: aesthetic experience, experience of meaning, and emotional

  8. An evaluation framework for participatory modelling

    Science.gov (United States)

    Krueger, T.; Inman, A.; Chilvers, J.

    2012-04-01

    Strong arguments for participatory modelling in hydrology can be made on substantive, instrumental and normative grounds. These arguments have led to increasingly diverse groups of stakeholders (here anyone affecting or affected by an issue) getting involved in hydrological research and the management of water resources. In fact, participation has become a requirement of many research grants, programs, plans and policies. However, evidence of beneficial outcomes of participation as suggested by the arguments is difficult to generate and therefore rare. This is because outcomes are diverse, distributed, often tacit, and take time to emerge. In this paper we develop an evaluation framework for participatory modelling focussed on learning outcomes. Learning encompasses many of the potential benefits of participation, such as better models through diversity of knowledge and scrutiny, stakeholder empowerment, greater trust in models and ownership of subsequent decisions, individual moral development, reflexivity, relationships, social capital, institutional change, resilience and sustainability. Based on the theories of experiential, transformative and social learning, complemented by practitioner experience our framework examines if, when and how learning has occurred. Special emphasis is placed on the role of models as learning catalysts. We map the distribution of learning between stakeholders, scientists (as a subgroup of stakeholders) and models. And we analyse what type of learning has occurred: instrumental learning (broadly cognitive enhancement) and/or communicative learning (change in interpreting meanings, intentions and values associated with actions and activities; group dynamics). We demonstrate how our framework can be translated into a questionnaire-based survey conducted with stakeholders and scientists at key stages of the participatory process, and show preliminary insights from applying the framework within a rural pollution management situation in

  9. The probability outcome correpondence principle : a dispositional view of the interpretation of probability statements

    NARCIS (Netherlands)

    Keren, G.; Teigen, K.H.

    2001-01-01

    This article presents a framework for lay people's internal representations of probabilities, which supposedly reflect the strength of underlying dispositions, or propensities, associated with the predicted event. From this framework, we derive the probability-outcome correspondence principle, which

  10. Postacute rehabilitation quality of care: toward a shared conceptual framework.

    Science.gov (United States)

    Jesus, Tiago Silva; Hoenig, Helen

    2015-05-01

    There is substantial interest in mechanisms for measuring, reporting, and improving the quality of health care, including postacute care (PAC) and rehabilitation. Unfortunately, current activities generally are either too narrow or too poorly specified to reflect PAC rehabilitation quality of care. In part, this is caused by a lack of a shared conceptual understanding of what construes quality of care in PAC rehabilitation. This article presents the PAC-rehab quality framework: an evidence-based conceptual framework articulating elements specifically pertaining to PAC rehabilitation quality of care. The widely recognized Donabedian structure, process, and outcomes (SPO) model furnished the underlying structure for the PAC-rehab quality framework, and the International Classification of Functioning, Disability and Health (ICF) framed the functional outcomes. A comprehensive literature review provided the evidence base to specify elements within the SPO model and ICF-derived framework. A set of macrolevel-outcomes (functional performance, quality of life of patient and caregivers, consumers' experience, place of discharge, health care utilization) were defined for PAC rehabilitation and then related to their (1) immediate and intermediate outcomes, (2) underpinning care processes, (3) supportive team functioning and improvement processes, and (4) underlying care structures. The role of environmental factors and centrality of patients in the framework are explicated as well. Finally, we discuss why outcomes may best measure and reflect the quality of PAC rehabilitation. The PAC-rehab quality framework provides a conceptually sound, evidence-based framework appropriate for quality of care activities across the PAC rehabilitation continuum. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Policies on pets for healthy cities: a conceptual framework

    OpenAIRE

    Rock, Melanie J.; Adams, Cindy L.; Degeling, Chris; Massolo, Alessandro; McCormack, Gavin R.

    2014-01-01

    Drawing on the One Health concept, and integrating a dual focus on public policy and practices of caring from the Ottawa Charter for Health Promotion, we outline a conceptual framework to help guide the development and assessment of local governments' policies on pets. This framework emphasizes well-being in human populations, while recognizing that these outcomes relate to the well-being of non-human animals. Five intersecting spheres of activity, each associated with local governments' juri...

  12. A framework for analyzing performance in higher education

    OpenAIRE

    Lola C. Duque

    2013-01-01

    Drawing on Tinto’s dropout intentions model (1975), Bean’s socialization model (1985), Astin’s involvement theory (1999), and the service marketing literature, this research presents a conceptual framework for analyzing students’ satisfaction, perceived learning outcomes, and dropout intentions. This framework allows for a better understanding of how students assess the university experience and how these perceptions affect future intentions. This article presents four studies ...

  13. A multilevel evolutionary framework for sustainability analysis

    Directory of Open Access Journals (Sweden)

    Timothy M. Waring

    2015-06-01

    Full Text Available Sustainability theory can help achieve desirable social-ecological states by generalizing lessons across contexts and improving the design of sustainability interventions. To accomplish these goals, we argue that theory in sustainability science must (1 explain the emergence and persistence of social-ecological states, (2 account for endogenous cultural change, (3 incorporate cooperation dynamics, and (4 address the complexities of multilevel social-ecological interactions. We suggest that cultural evolutionary theory broadly, and cultural multilevel selection in particular, can improve on these fronts. We outline a multilevel evolutionary framework for describing social-ecological change and detail how multilevel cooperative dynamics can determine outcomes in environmental dilemmas. We show how this framework complements existing sustainability frameworks with a description of the emergence and persistence of sustainable institutions and behavior, a means to generalize causal patterns across social-ecological contexts, and a heuristic for designing and evaluating effective sustainability interventions. We support these assertions with case examples from developed and developing countries in which we track cooperative change at multiple levels of social organization as they impact social-ecological outcomes. Finally, we make suggestions for further theoretical development, empirical testing, and application.

  14. Modern Logical Frameworks Design

    DEFF Research Database (Denmark)

    Murawska, Agata Anna

    2017-01-01

    lack support for reasoning about, or programming with, the mechanised systems. Our main motivation is to eventually make it possible to model and reason about complex concurrent systems and protocols. No matter the application, be it the development of a logic for multiparty session types...... or a cryptographic protocol used in a voting system, we need the ability to model and reason about both the building blocks of these systems and the intricate connections between them. To this end, this dissertation is an investigation into LF-based formalisms that might help address the aforementioned issues. We...... design and provide the meta-theory of two new frameworks, HyLF and Lincx. The former aims to extend the expressiveness of LF to include proof irrelevance and some user-defined behaviours, using ideas from hybrid logics. The latter is a showcase for an easier to implement framework, while also allowing...

  15. V&V framework

    Energy Technology Data Exchange (ETDEWEB)

    Hills, Richard G. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Maniaci, David Charles [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Naughton, Jonathan W. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    A Verification and Validation (V&V) framework is presented for the development and execution of coordinated modeling and experimental program s to assess the predictive capability of computational models of complex systems through focused, well structured, and formal processes.The elements of the framework are based on established V&V methodology developed by various organizations including the Department of Energy, National Aeronautics and Space Administration, the American Institute of Aeronautics and Astronautics, and the American Society of Mechanical Engineers. Four main topics are addressed: 1) Program planning based on expert elicitation of the modeling physics requirements, 2) experimental design for model assessment, 3) uncertainty quantification for experimental observations and computational model simulations, and 4) assessment of the model predictive capability. The audience for this document includes program planners, modelers, experimentalist, V &V specialist, and customers of the modeling results.

  16. Framework for Maintenance Planning

    DEFF Research Database (Denmark)

    Soares, C. Guedes; Duarte, J. Caldeira; Garbatov, Y.

    2010-01-01

    the design and during the whole life span of operational use, within an integrated framework founded on risk and reliability based techniques. The document addresses designers, decision makers and professionals responsible for or involved in establishing maintenance plans. The purpose of this document......The present document presents a framework for maintenance planning. Maintenance plays a fundamental role in counteracting degradation effects, which are present in all infrastructure and industrial products. Therefore, maintenance planning is a very critical aspect to consider both during...... is to present maintenance as an integrated approach that needs to be planned, designed, engineered, and controlled by proper qualitative and quantitative techniques. This document outlines the basic premises for maintenance planning and provides the general philosophies that can be followed and points to a best...

  17. Landscape Environmental Assessment Framework

    Energy Technology Data Exchange (ETDEWEB)

    2017-07-20

    LEAF Version 2.0 is a framework comprising of three models RUSLE2, WEPS, and AGNPS. The framework can predict row crop, crop residue, and energy crop yields at a sub-field resolutions for various combinations of soil, climate and crop management and residue harvesting practices. It estimates the loss of soil, carbon, and nutrients to the atmosphere, to the groundwater, and to runoff. It also models the overland flow of water and washed-off sediments, nutrients and other chemicals to provide estimates of sediment, nutrient, and chemical loadings to water bodies within a watershed. AGNPS model and wash-off calculations are the new additions to this version of LEAF. Development of LEAF software is supported by DOE's BETO program.

  18. TECHNOLOGY MANAGEMENT PROCESS FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Ikura Yamamoto

    2012-02-01

    Full Text Available The effective management of technology as a source of competitive advantage is of vital importance for many organizations. It is necessary to understand, communicate and integrate technology strategy with marketing, financial, operations and human resource strategies. This is of particular importance when one considers the increasing cost, pace and complexity of technology developments, combined with shortening product life cycles. A five process model provides a framework within which technology management activities can be understood: identification, selection, acquisition, exploitation and protection. Based on this model, a technology management assessment procedure has been developed, using an ``action research’’ approach. This paper presents an industrial case study describing the first full application of the procedure within a high-volume manufacturing business. The impact of applying the procedure is assessed in terms of benefits to the participating business, together with improvements to the assessment procedure itself, in the context of the action research framework. Keyword: Technology, Strategy, Management, Assessment

  19. Computer information systems framework

    International Nuclear Information System (INIS)

    Shahabuddin, S.

    1989-01-01

    Management information systems (MIS) is a commonly used term in computer profession. The new information technology has caused management to expect more from computer. The process of supplying information follows a well defined procedure. MIS should be capable for providing usable information to the various areas and levels of organization. MIS is different from data processing. MIS and business hierarchy provides a good framework for many organization which are using computers. (A.B.)

  20. Robustness - theoretical framework

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Rizzuto, Enrico; Faber, Michael H.

    2010-01-01

    More frequent use of advanced types of structures with limited redundancy and serious consequences in case of failure combined with increased requirements to efficiency in design and execution followed by increased risk of human errors has made the need of requirements to robustness of new struct...... of this fact sheet is to describe a theoretical and risk based framework to form the basis for quantification of robustness and for pre-normative guidelines....

  1. The stapl Skeleton Framework

    KAUST Repository

    Zandifar, Mani

    2015-01-01

    © Springer International Publishing Switzerland 2015. This paper describes the stapl Skeleton Framework, a highlevel skeletal approach for parallel programming. This framework abstracts the underlying details of data distribution and parallelism from programmers and enables them to express parallel programs as a composition of existing elementary skeletons such as map, map-reduce, scan, zip, butterfly, allreduce, alltoall and user-defined custom skeletons. Skeletons in this framework are defined as parametric data flow graphs, and their compositions are defined in terms of data flow graph compositions. Defining the composition in this manner allows dependencies between skeletons to be defined in terms of point-to-point dependencies, avoiding unnecessary global synchronizations. To show the ease of composability and expressivity, we implemented the NAS Integer Sort (IS) and Embarrassingly Parallel (EP) benchmarks using skeletons and demonstrate comparable performance to the hand-optimized reference implementations. To demonstrate scalable performance, we show a transformation which enables applications written in terms of skeletons to run on more than 100,000 cores.

  2. Clinical simulation practise framework.

    Science.gov (United States)

    Khalili, Hossein

    2015-02-01

    Historically, simulation has mainly been used to teach students hands-on skills in a relatively safe environment. With changes in the patient population, professional regulations and clinical environments, clinical simulation practise (CSP) must assist students to integrate and apply their theoretical knowledge and skills with their critical thinking, clinical judgement, prioritisation, problem solving, decision making, and teamwork skills to provide holistic care and treatment to their patients. CSP holds great potential to derive a positive transformation in students' transition into the workplace, by associating and consolidating learning from classrooms to clinical settings, and creating bridges between theory and practice. For CSP to be successful in filling the gap, the design and management of the simulation is crucial. In this article a new framework called 'Clinical simulation practise framework: A knowledge to action strategy in health professional education' is being introduced that aims to assist educators and curriculum developers in designing and managing their simulations. This CSP framework theorises that simulation as an experiential educational tool could improve students' competence, confidence and collaboration in performing professional practice in real settings if the CSP provides the following three dimensions: (1) a safe, positive, reflective and fun simulated learning environment; (2) challenging, but realistic, and integrated simulated scenarios; and (3) interactive, inclusive, interprofessional patient-centred simulated practise. © 2015 John Wiley & Sons Ltd.

  3. THE STAR OFFLINE FRAMEWORK

    International Nuclear Information System (INIS)

    FINE, V.; FISYAK, Y.; PEREVOZTCHIKOV, V.; WENAUS, T.

    2000-01-01

    The Solenoidal Tracker At RHIC (STAR) is a-large acceptance collider detector, commissioned at Brookhaven National Laboratory in 1999. STAR has developed a software framework supporting simulation, reconstruction and analysis in offline production, interactive physics analysis and online monitoring environments that is well matched both to STAR's present status of transition between Fortran and C++ based software and to STAR's evolution to a fully OO software base. This paper presents the results of two years effort developing a modular C++ framework based on the ROOT package that encompasses both wrapped Fortran components (legacy simulation and reconstruction code) served by IDL-defined data structures, and fully OO components (all physics analysis code) served by a recently developed object model for event data. The framework supports chained components, which can themselves be composite subchains, with components (''makers'') managing ''data sets'' they have created and are responsible for. An St-DataSet class from which data sets and makers inherit allows the construction of hierarchical organizations of components and data, and centralizes almost all system tasks such as data set navigation, I/O, database access, and inter-component communication. This paper will present an overview of this system, now deployed and well exercised in production environments with real and simulated data, and in an active physics analysis development program

  4. Highlighting the gap between critical outcomes requirements and built environment education in South Africa

    CSIR Research Space (South Africa)

    Ampofo-Anti, NL

    2007-06-01

    Full Text Available This paper aims to highlight the discrepancies between current built environment education and Critical Outcomes requirements of the South African National Qualifications Framework (NQF)...

  5. Molr - A delegation framework for accelerator commissioning

    CERN Document Server

    Valliappan, Nachiappan

    2017-01-01

    Accelerator commissioning is the process of preparing an accelerator for beam operations. A typical commissioning period at CERN involves running thousands of tests on many complex systems and machinery to ensure smooth beam operations and correct functioning of the machine protection systems. AccTesting is a software framework which helps orchestrate the commissioning of CERN’s accelerators and it’s equipment systems. This involves running and managing tests provided by various commissioning tools and analyzing their outcomes. Currently, AccTesting only supports a specific set of commissioning tools. In this project, we aim to widen the spectrum of commissioning tools supported by AccTesting by developing a generic and programmable integration framework called Molr, which would enable the integration of more commissioning tools with AccTesting. In this report, we summarize the work done during the summer student project and lay out a brief overview of the current status and next steps for Molr.

  6. Lanthanide metal-organic frameworks

    International Nuclear Information System (INIS)

    Cheng, Peng

    2015-01-01

    This book contains the following nine chapters: lanthanide metal-organic frameworks: syntheses, properties, and potential applications (Stephen Fordham, Xuan Wang, Mathieu Bosch, Hong-Cai Zhou); 2. chiral lanthanide metal-organic frameworks (Weisheng Liu, Xiaoliang Tang); 3. Porous lanthanide metal-organic frameworks for gas storage and separation (Bin Li, Banglin Chen); 4. Luminescent lanthanide metal-organic frameworks (Xue-Zhi Song, Shu-Yan Song, Hong-Jie Zhang); 5. Metal-organic frameworks based on lanthanide clusters (Lian Chen, Feilong Jiang, Kang Zhou, Mingyan Wu, Maochun Hong); 6. metal-organic frameworks with d-f cyanide bridges: structural diversity, bonding regime, and magnetism (Marilena Ferbinteanu, Fanica Cimpoesu, Stefania Tanase); 7. transition-lanthanide heterometal-organic frameworks: synthesis, structures, and properties (Wei Shi, Ke Liu, Peng Cheng); 8: MOFs of uranium and the actinides (Juan Su, Jiesheng Chen); 9. Nanostructured and/or nanoscale lanthanide metal-organic frameworks (Zhonghao Zhang, Zhiping Zheng).

  7. Lanthanide metal-organic frameworks

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Peng (ed.) [Nankai Univ., Tianjin (China). Dept. of Chemistry

    2015-03-01

    This book contains the following nine chapters: lanthanide metal-organic frameworks: syntheses, properties, and potential applications (Stephen Fordham, Xuan Wang, Mathieu Bosch, Hong-Cai Zhou); 2. chiral lanthanide metal-organic frameworks (Weisheng Liu, Xiaoliang Tang); 3. Porous lanthanide metal-organic frameworks for gas storage and separation (Bin Li, Banglin Chen); 4. Luminescent lanthanide metal-organic frameworks (Xue-Zhi Song, Shu-Yan Song, Hong-Jie Zhang); 5. Metal-organic frameworks based on lanthanide clusters (Lian Chen, Feilong Jiang, Kang Zhou, Mingyan Wu, Maochun Hong); 6. metal-organic frameworks with d-f cyanide bridges: structural diversity, bonding regime, and magnetism (Marilena Ferbinteanu, Fanica Cimpoesu, Stefania Tanase); 7. transition-lanthanide heterometal-organic frameworks: synthesis, structures, and properties (Wei Shi, Ke Liu, Peng Cheng); 8: MOFs of uranium and the actinides (Juan Su, Jiesheng Chen); 9. Nanostructured and/or nanoscale lanthanide metal-organic frameworks (Zhonghao Zhang, Zhiping Zheng).

  8. Assessment of Evaluation Frameworks for Design of a Sexual Risk Prevention Game for Black Adolescent Girls.

    Science.gov (United States)

    Sockolow, Paulina; Joppa, Meredith; Zhu, Jichen

    2018-01-01

    Adolescent sexual risk behavior (SRB), a major public health problem affects urban Black adolescent girls increasing their health disparities and risks for sexually transmitted infections. Collaborating with these adolescents, we designed a game for smartphones that incorporates elements of trauma-informed care and social cognitive theory to reduce SRB. Game researchers promote use of a comprehensive, multipurpose framework for development and evaluation of games for health applications. Our first game development step was framework selection and measurable health outcomes identification. Literature search identified two health game frameworks, both incorporating pedagogical theory, learning theory, and gaming requirements. Arnab used the IM + LM-GM framework to develop and implement a game in a school intervention program. Yusoff's framework was developed for use during game design. We investigated concordance and discordance between our SRB game design characteristics and each framework's components. Findings indicated Arnab's framework was sufficiently comprehensive to guide development of our game and outcome measure selection.

  9. An Integrative data mining approach to identifying Adverse Outcome Pathway (AOP) Signatures

    Science.gov (United States)

    The Adverse Outcome Pathway (AOP) framework is a tool for making biological connections and summarizing key information across different levels of biological organization to connect biological perturbations at the molecular level to adverse outcomes for an individual or populatio...

  10. Integrating publicly-available data to generate computationally-predicted adverse outcome pathways for hepatic steatosis

    Science.gov (United States)

    The adverse outcome pathway (AOP) framework provides a way of organizing knowledge related to the key biological events that result in a particular health outcome. For the majority of environmental chemicals, the availability of curated pathways characterizing potential toxicity ...

  11. Zend framework 2 cookbook

    CERN Document Server

    Callaars, Josephus

    2013-01-01

    This book is written in a practical, cookbook style with numerous examples and recipes. This style allows you to go both directly to your topic of interest or follow topics throughout a chapter to gain an in-depth knowledge of certain areas.'Zend Framework 2 Cookbook"" is for PHP developers who are fairly advanced in programming in PHP. It will also be useful for developers who have a keen interest in expanding their knowledge outside the boundaries of simply scripting pages together. As unit testing and MVC will be discussed, it is beneficial for the reader to know what these technologies are

  12. Developing frameworks for protocol implementation

    NARCIS (Netherlands)

    de Barros Barbosa, C.; de barros Barbosa, C.; Ferreira Pires, Luis

    1999-01-01

    This paper presents a method to develop frameworks for protocol implementation. Frameworks are software structures developed for a specific application domain, which can be reused in the implementation of various different concrete systems in this domain. The use of frameworks support a protocol

  13. A PROOF Analysis Framework

    International Nuclear Information System (INIS)

    González Caballero, I; Cuesta Noriega, A; Rodríguez Marrero, A; Fernández del Castillo, E

    2012-01-01

    The analysis of the complex LHC data usually follows a standard path that aims at minimizing not only the amount of data but also the number of observables used. After a number of steps of slimming and skimming the data, the remaining few terabytes of ROOT files hold a selection of the events and a flat structure for the variables needed that can be more easily inspected and traversed in the final stages of the analysis. PROOF arises at this point as an efficient mechanism to distribute the analysis load by taking advantage of all the cores in modern CPUs through PROOF Lite, or by using PROOF Cluster or PROOF on Demand tools to build dynamic PROOF cluster on computing facilities with spare CPUs. However using PROOF at the level required for a serious analysis introduces some difficulties that may scare new adopters. We have developed the PROOF Analysis Framework (PAF) to facilitate the development of new analysis by uniformly exposing the PROOF related configurations across technologies and by taking care of the routine tasks as much as possible. We describe the details of the PAF implementation as well as how we succeeded in engaging a group of CMS physicists to use PAF as their daily analysis framework.

  14. Selection vector filter framework

    Science.gov (United States)

    Lukac, Rastislav; Plataniotis, Konstantinos N.; Smolka, Bogdan; Venetsanopoulos, Anastasios N.

    2003-10-01

    We provide a unified framework of nonlinear vector techniques outputting the lowest ranked vector. The proposed framework constitutes a generalized filter class for multichannel signal processing. A new class of nonlinear selection filters are based on the robust order-statistic theory and the minimization of the weighted distance function to other input samples. The proposed method can be designed to perform a variety of filtering operations including previously developed filtering techniques such as vector median, basic vector directional filter, directional distance filter, weighted vector median filters and weighted directional filters. A wide range of filtering operations is guaranteed by the filter structure with two independent weight vectors for angular and distance domains of the vector space. In order to adapt the filter parameters to varying signal and noise statistics, we provide also the generalized optimization algorithms taking the advantage of the weighted median filters and the relationship between standard median filter and vector median filter. Thus, we can deal with both statistical and deterministic aspects of the filter design process. It will be shown that the proposed method holds the required properties such as the capability of modelling the underlying system in the application at hand, the robustness with respect to errors in the model of underlying system, the availability of the training procedure and finally, the simplicity of filter representation, analysis, design and implementation. Simulation studies also indicate that the new filters are computationally attractive and have excellent performance in environments corrupted by bit errors and impulsive noise.

  15. CREDIT Performance Indicator Framework

    DEFF Research Database (Denmark)

    Frandsen, Anne Kathrine; Bertelsen, Niels Haldor; Haugbølle, Kim

    2010-01-01

    During the past two years the Nordic Baltic research project CREDIT (Construction and Real Estate – Developing Indicators for Transparency) has worked with the aim to improve transparency of value creation in building and real estate. One of the central deliverables of the CREDIT project was a fr......During the past two years the Nordic Baltic research project CREDIT (Construction and Real Estate – Developing Indicators for Transparency) has worked with the aim to improve transparency of value creation in building and real estate. One of the central deliverables of the CREDIT project...... was a framework of indicators relevant in building and real estate and applicable in the Nordic and Baltic countries as well as a proposal for a set of key indicators. The study resulting in CREDIT Performance Indicator Framework has been based on 28 case studies of evaluation practises in the building and real...... estate sector each addressing three interlinked levels: building/ projects level, company or enterprise level and benchmarking system level. Additionally it has been based on dialogue with researchers and professional organisation, international research and standardisation work and national building...

  16. Value: A Framework for Radiation Oncology

    Science.gov (United States)

    Teckie, Sewit; McCloskey, Susan A.; Steinberg, Michael L.

    2014-01-01

    In the current health care system, high costs without proportional improvements in quality or outcome have prompted widespread calls for change in how we deliver and pay for care. Value-based health care delivery models have been proposed. Multiple impediments exist to achieving value, including misaligned patient and provider incentives, information asymmetries, convoluted and opaque cost structures, and cultural attitudes toward cancer treatment. Radiation oncology as a specialty has recently become a focus of the value discussion. Escalating costs secondary to rapidly evolving technologies, safety breaches, and variable, nonstandardized structures and processes of delivering care have garnered attention. In response, we present a framework for the value discussion in radiation oncology and identify approaches for attaining value, including economic and structural models, process improvements, outcome measurement, and cost assessment. PMID:25113759

  17. Information Literacy for Archives and Special Collections: Defining Outcomes

    Science.gov (United States)

    Carini, Peter

    2016-01-01

    This article provides the framework for a set of standards and outcomes that would constitute information literacy with primary sources. Based on a working model used at Dartmouth College's Rauner Special Collections Library in Hanover, New Hampshire, these concepts create a framework for teaching with primary source materials intended to produce…

  18. Commentary: Using Potential Outcomes to Understand Causal Mediation Analysis

    Science.gov (United States)

    Imai, Kosuke; Jo, Booil; Stuart, Elizabeth A.

    2011-01-01

    In this commentary, we demonstrate how the potential outcomes framework can help understand the key identification assumptions underlying causal mediation analysis. We show that this framework can lead to the development of alternative research design and statistical analysis strategies applicable to the longitudinal data settings considered by…

  19. .Network analytics for adverse outcome pathways

    Science.gov (United States)

    Adverse Outcome Pathways (AOPs) organize toxicological knowledge from the molecular level up to the population level, providing evidence-based causal linkages at each step. The AOPWiki serves as a repository of AOPs. With the international adoption of the AOP framework, the AOPw...

  20. Outcome manipulation in corporate prediction markets

    DEFF Research Database (Denmark)

    Ottaviani, Marco; Sørensen, Peter Norman

    2007-01-01

    This paper presents a framework for applying prediction markets to corporate decision-making. The analysis is motivated by the recent surge of interest in markets as information aggregation devices and their potential use within firms. We characterize the amount of outcome manipulation that results...

  1. CONTINUOUS QUALITY IMPROVEMENT (CQI FRAMEWORK: A CASE OF INDUSTRIAL ENGINEERING DEPARTMENT

    Directory of Open Access Journals (Sweden)

    Tooba Sikander

    2017-06-01

    Full Text Available This paper aims to present an educational framework for outcomes based continuous quality improvement. Well defined program outcomes, program educational objectives and assessment process have been developed to ensure graduates’ outcomes achievement. Direct and indirect tools have been used for assessment process. Course evaluation surveys, alumni surveys, and employer surveys have been deployed for indirect outcome assessment. Exams, quizzes, assignments and projects, on the other hand, have been used for direct outcome assessment. In developed framework, the educational processes committees and facilities committees have been integrated to continuously evaluate and monitor the educational processes. Furthermore, program outcomes and course learning outcomes are proposed to be evaluated and continuously monitored by programs goals committee and continuous course improvement committee respectively. Forms and procedures have been developed to assess student outcomes.

  2. Use of theoretical and conceptual frameworks in qualitative research.

    Science.gov (United States)

    Green, Helen Elise

    2014-07-01

    To debate the definition and use of theoretical and conceptual frameworks in qualitative research. There is a paucity of literature to help the novice researcher to understand what theoretical and conceptual frameworks are and how they should be used. This paper acknowledges the interchangeable usage of these terms and researchers' confusion about the differences between the two. It discusses how researchers have used theoretical and conceptual frameworks and the notion of conceptual models. Detail is given about how one researcher incorporated a conceptual framework throughout a research project, the purpose for doing so and how this led to a resultant conceptual model. Concepts from Abbott (1988) and Witz ( 1992 ) were used to provide a framework for research involving two case study sites. The framework was used to determine research questions and give direction to interviews and discussions to focus the research. Some research methods do not overtly use a theoretical framework or conceptual framework in their design, but this is implicit and underpins the method design, for example in grounded theory. Other qualitative methods use one or the other to frame the design of a research project or to explain the outcomes. An example is given of how a conceptual framework was used throughout a research project. Theoretical and conceptual frameworks are terms that are regularly used in research but rarely explained. Textbooks should discuss what they are and how they can be used, so novice researchers understand how they can help with research design. Theoretical and conceptual frameworks need to be more clearly understood by researchers and correct terminology used to ensure clarity for novice researchers.

  3. Online Counseling: Reviewing the Literature from a Counseling Psychology Framework

    Science.gov (United States)

    Mallen, Michael J.; Vogel, David L.; Rochlen, Aaron B.; Day, Susan X.

    2005-01-01

    This article reviews the online-counseling literature with an emphasis on current applications and considerations for future research. It focuses on primary themes of counseling psychology including the history of process-outcome research and multiculturalism. It explores current gaps in the literature from a counseling psychology framework,…

  4. A Conceptual Framework Curriculum Evaluation Electrical Engineering Education

    Science.gov (United States)

    Imansari, Nurulita; Sutadji, Eddy

    2017-01-01

    This evaluation is a conceptual framework that has been analyzed in the hope that can help research related an evaluation of the curriculum. The Model of evaluation used was CIPPO model. CIPPO Model consists of "context," "input," "process," "product," and "outcomes." On the dimension of the…

  5. Sustainable Supply Chain Design by the P-Graph Framework

    Science.gov (United States)

    The present work proposes a computer-aided methodology for designing sustainable supply chains in terms of sustainability metrics by resorting to the P-graph framework. The methodology is an outcome of the collaboration between the Office of Research and Development (ORD) of the ...

  6. Adaptable component frameworks

    DEFF Research Database (Denmark)

    Katajainen, Jyrki; Simonsen, Bo

    2009-01-01

    The CPH STL is a special edition of the STL, the containers and algorithms part of the C++ standard library. The specification of the generic components of the STL is given in the C++ standard. Any implementation of the STL, e.g. the one that ships with your standard-compliant C++ compiler, should...... for vector, which is undoubtedly the most used container of the C++ standard library. In particular, we specify the details of a vector implementation that is safe with respect to referential integrity and strong exception safety. Additionally, we report the experiences and lessons learnt from...... the development of component frameworks which we hope to be of benefit to persons engaged in the design and implementation of generic software libraries....

  7. BARC safety framework

    International Nuclear Information System (INIS)

    Jayarajan, K.; Taly, Y.K.

    2017-01-01

    BARC has a large number facilities and a large number of employees. It has a variety of activities, carried out in different parts of India. All activities related nuclear fuel cycle are carried out in BARC. In addition, BARC has many non-nuclear facilities and projects. Therefore, regulation of BARC facilities is a challenging task. BSC was constituted in the year 2000 to address the challenges of regulating safety of the projects, plants and facilities of BARC. It has a comprehensive regulatory framework, which makes use of the expertise of more than one thousand experts of BARC for safety and regulatory activities. BSC has completed hundred meetings and issued regulatory consents to many projects, facilities and activities. During the last 17 years, BSC has constituted 44 committees in three tiers, which had conducted more than 2000 meetings to support safety and regulatory activities of BSC

  8. Interviews within experimental frameworks

    DEFF Research Database (Denmark)

    Reinhard, CarrieLynn D.

    2010-01-01

    , an amount of control was required over the nature of those experiences.  With these requirements, a hybrid study was designed by deconstructing the conceptualization of "the experiment" and utilizing both quantitative and qualitative methods.  The resulting study involved the following: a within......-subjects experimental design served as the framework for the study, while in-depth qualitative interviews were employed alongside surveys and audio and video recording as the data collection methods.  Data collection occurred while participants were engaging with the media products, via talk aloud protocols......, and afterwards when they were asked to recall and compare these situations in open-ended questionnaires and interviews structured using Dervin's Sense-Making Methodology.  Having completed the study using this mixed method(ology) approach, I discuss the effectiveness of this approach, and where the approach...

  9. Evolution of a multilevel framework for health program evaluation.

    Science.gov (United States)

    Masso, Malcolm; Quinsey, Karen; Fildes, Dave

    2017-07-01

    A well-conceived evaluation framework increases understanding of a program's goals and objectives, facilitates the identification of outcomes and can be used as a planning tool during program development. Herein we describe the origins and development of an evaluation framework that recognises that implementation is influenced by the setting in which it takes place, the individuals involved and the processes by which implementation is accomplished. The framework includes an evaluation hierarchy that focuses on outcomes for consumers, providers and the care delivery system, and is structured according to six domains: program delivery, impact, sustainability, capacity building, generalisability and dissemination. These components of the evaluation framework fit into a matrix structure, and cells within the matrix are supported by relevant evaluation tools. The development of the framework has been influenced by feedback from various stakeholders, existing knowledge of the evaluators and the literature on health promotion and implementation science. Over the years, the framework has matured and is generic enough to be useful in a wide variety of circumstances, yet specific enough to focus data collection, data analysis and the presentation of findings.

  10. Carepaths: a framework for quality patient care

    International Nuclear Information System (INIS)

    Mazanec, Susan; Antunez, Antonio; Novak, Louis; Vinkler, Robert; Stark, Bonita; Mangosh, Linda; Pillai, Kunjan; Jackson, Celeste; Wilkenfeld, Bruce

    1997-01-01

    Purpose/Objective: The goals of a carepath are to provide a framework for quality patient care, enhance collaborative practice, improve resource utilization, and increase patient satisfaction. Carepaths are designed to move the patient toward specific clinical outcomes, which have been defined by a multidisciplinary team. Carepaths enhance the quality improvement process by tracking clinical outcomes and patient satisfaction. The purpose of this report is to share the 1996 results of our breast cancer carepath. Methods: In 1994 the multidisciplinary Quality Improvement Committee of the Division of Radiation Oncology constructed a carepath for women with breast cancer receiving breast or chest wall radiation. Eleven clinical outcomes were defined which reflected the educational and selfcare focus of the carepath. Recording on the carepath of patient attainment of the outcomes was done by the RN, RTT and MD. Patient satisfaction tools were designed by the quality improvement committee in conjunction with the Department of Marketing Support. Each patient was given a written survey at two points along the carepath: post simulation and post treatment. Results: Ninety-five women were placed on the breast carepath in 1996. Outcomes were reviewed for 40 of these carepaths. The return rate of patient satisfaction surveys post simulation and post treatment approached 99%. Overall satisfaction was high with 76% of patients feeling 'very satisfied' with the simulation process and 93% 'very satisfied' with the treatment experience. Common themes noted in anecdotes related to comfort and privacy issues. Conclusions: Based on our experience, carepaths facilitated the structuring of a comprehensive and collaborative approach to patient care. Strategies for process improvement were guided by the ongoing surveillance of clinical outcomes and patient satisfaction

  11. Analysis framework for GLORIA

    Science.gov (United States)

    Żarnecki, Aleksander F.; Piotrowski, Lech W.; Mankiewicz, Lech; Małek, Sebastian

    2012-05-01

    GLORIA stands for “GLObal Robotic-telescopes Intelligent Array”. GLORIA will be the first free and open-access network of robotic telescopes of the world. It will be a Web 2.0 environment where users can do research in astronomy by observing with robotic telescopes, and/or analyzing data that other users have acquired with GLORIA, or from other free access databases, like the European Virtual Observatory. GLORIA project will define free standards, protocols and methodology for controlling Robotic Telescopes and related instrumentation, for conducting so called on-line experiments by scheduling observations in the telescope network, and for conducting so-called off-line experiments based on the analysis of astronomical meta-data produced by GLORIA or other databases. Luiza analysis framework for GLORIA was based on the Marlin package developed for the International Linear Collider (ILC), data analysis. HEP experiments have to deal with enormous amounts of data and distributed data analysis is a must, so the Marlin framework concept seemed to be well suited for GLORIA needs. The idea (and large parts of code) taken from Marlin is that every computing task is implemented as a processor (module) that analyzes the data stored in an internal data structure and created additional output is also added to that collection. The advantage of such a modular approach is to keep things as simple as possible. Every single step of the full analysis chain that goes eg. from raw images to light curves can be processed separately and the output of each step is still self consistent and can be fed in to the next step without any manipulation.

  12. Chromium metal organic frameworks and synthesis of metal organic frameworks

    Science.gov (United States)

    Zhou, Hong-Cai; Liu, Tian-Fu; Lian, Xizhen; Zou, Lanfang; Feng, Dawei

    2018-04-24

    The present invention relates to monocrystalline metal organic frameworks comprising chromium ions and carboxylate ligands and the use of the same, for example their use for storing a gas. The invention also relates to methods for preparing metal organic frameworks comprising chromium, titanium or iron ions and carboxylate ligands. The methods of the invention allow such metal organic frameworks to be prepared in monocrystalline or polycrystalline forms.

  13. Development of computationally predicted Adverse Outcome Pathway (AOP) networks through data mining and integration of publicly available in vivo, in vitro, phenotype, and biological pathway data

    Science.gov (United States)

    The Adverse Outcome Pathway (AOP) framework is increasingly being adopted as a tool for organizing and summarizing the mechanistic information connecting molecular perturbations by environmental stressors with adverse outcomes relevant for ecological and human health outcomes. Ho...

  14. A Triple Aim Framework For the Performance Assessment of Disease Management Programs

    NARCIS (Netherlands)

    Verbeek, N.A.; M.G. Franken (Margreet); M.A. Koopmanschap (Marc); M.P.M.H. Rutten-van Mölken (Maureen)

    2015-01-01

    markdownabstractObjectives: A structured and comprehensive assessment of disease management implementations is not straightforward due to the broadness of the interventions and the various evaluation possibilities. The aim of this study was to develop a comprehensive framework for outcome

  15. Social-ecological system framework: initial changes and continuing challenges

    Directory of Open Access Journals (Sweden)

    Michael D. McGinnis

    2014-06-01

    Full Text Available The social-ecological system (SES framework investigated in this special issue enables researchers from diverse disciplinary backgrounds working on different resource sectors in disparate geographic areas, biophysical conditions, and temporal domains to share a common vocabulary for the construction and testing of alternative theories and models that determine which influences on processes and outcomes are especially critical in specific empirical settings. We summarize changes that have been made to this framework and discuss a few remaining ambiguities in its formulation. Specifically, we offer a tentative rearrangement of the list of relevant attributes of governance systems and discuss other ways to make this framework applicable to policy settings beyond natural resource settings. The SES framework will continue to change as more researchers apply it to additional contexts; the main purpose of this article is to delineate the version that served as the basis for the theoretical innovations and empirical analyses detailed in other contributions to this special issue.

  16. Framework for pedagogical learning analytics

    OpenAIRE

    Heilala, Ville

    2018-01-01

    Learning analytics is an emergent technological practice and a multidisciplinary scientific discipline, which goal is to facilitate effective learning and knowledge of learning. In this design science research, I combine knowledge discovery process, a concept of pedagogical knowledge, ethics of learning analytics and microservice architecture. The result is a framework for pedagogical learning analytics. The framework is applied and evaluated in the context of agency analytics. The framework ...

  17. Framework for ecological risk assessment

    International Nuclear Information System (INIS)

    Rodier, D.; Norton, S.

    1992-02-01

    Increased interest in ecological issues such as global climate change, habitat loss, acid deposition, reduced biological diversity, and the ecological impacts of pesticides and toxic chemicals prompts this U.S. Environmental Protection Agency (EPA) report, A Framework for Ecological Risk Assessment ('Framework Report'). The report describes basic elements, or a framework, for evaluating scientific information on the adverse effects of physical and chemical stressors on the environment. The framework offers starting principles and a simple structure as guidance for current ecological risk assessments and as a foundation for future EPA proposals for risk assessment guidelines

  18. PUTATIVE ADVERSE OUTCOME PATHWAY FOR INHIBITON OF BRAIN AROMATASE IN FISH LEADING TO REPRODUCTIVE IMPAIRMENT

    Science.gov (United States)

    The adverse outcome pathway (AOP) provides a framework for organizing knowledge to define links between a molecular initiating event (MIE) and an adverse outcome (AO) occurring at a higher level of biological organization, such as the individual or population. The AOP framework p...

  19. A concept paper: Using the outcomes of common surgical conditions ...

    African Journals Online (AJOL)

    A concept paper: Using the outcomes of common surgical conditions as quality metrics to benchmark district surgical services in South Africa as part of a systematic quality improvement programme. ... This would provide a framework for the introduction of collection of these outcomes as a ... AJOL African Journals Online.

  20. Desired Outcomes for Children and Adolescents with Autistic Spectrum Disorders

    Science.gov (United States)

    Beresford, Bryony; Tozer, Rosemary; Rabiee, Parvaneh; Sloper, Patricia

    2007-01-01

    Within children's services, frameworks for assessing outcomes have been developed in the absence of consultation with children with autistic spectrum disorders and their parents. The research reported here worked with parents, other key adults and children with autistic spectrum disorders to identify desired outcomes. It found similarities with…

  1. BEACON: A Summary Framework to Overcome Potential Reimbursement Hurdles.

    Science.gov (United States)

    Dunlop, William C N; Mullins, C Daniel; Pirk, Olaf; Goeree, Ron; Postma, Maarten J; Enstone, Ashley; Heron, Louise

    2016-10-01

    To provide a framework for addressing payers' criteria during the development of pharmaceuticals. A conceptual framework was presented to an international health economic expert panel for discussion. A structured literature search (from 2010 to May 2015), using the following databases in Ovid: Medline(®) and Medline(®) In-Process (PubMed), Embase (Ovid), EconLit (EBSCOhost) and the National Health Service Economic Evaluation Database (NHS EED), and a 'grey literature' search, were conducted to identify existing criteria from the payer perspective. The criteria assessed by existing frameworks and guidelines were collated; the most commonly reported criteria were considered for inclusion in the framework. A mnemonic was conceived as a memory aide to summarise these criteria. Overall, 41 publications were identified as potentially relevant to the objective. Following further screening, 26 were excluded upon full-text review on the basis of no framework presented (n = 13), redundancy (n = 11) or abstract only (n = 2). Frameworks that captured criteria developed for or utilised by the pharmaceutical industry (n = 5) and reimbursement guidance (n = 10) were reviewed. The most commonly identified criteria-unmet need/patient burden, safety, efficacy, quality-of-life outcomes, environment, evidence quality, budget impact and comparator-were incorporated into the summary framework. For ease of communication, the following mnemonic was developed: BEACON (Burden/target population, Environment, Affordability/value, Comparator, Outcomes, Number of studies/quality of evidence). The BEACON framework aims to capture the 'essence' of payer requirements by addressing the most commonly described criteria requested by payers regarding the introduction of a new pharmaceutical.

  2. Executor Framework for DIRAC

    Science.gov (United States)

    Casajus Ramo, A.; Graciani Diaz, R.

    2012-12-01

    DIRAC framework for distributed computing has been designed as a group of collaborating components, agents and servers, with persistent database back-end. Components communicate with each other using DISET, an in-house protocol that provides Remote Procedure Call (RPC) and file transfer capabilities. This approach has provided DIRAC with a modular and stable design by enforcing stable interfaces across releases. But it made complicated to scale further with commodity hardware. To further scale DIRAC, components needed to send more queries between them. Using RPC to do so requires a lot of processing power just to handle the secure handshake required to establish the connection. DISET now provides a way to keep stable connections and send and receive queries between components. Only one handshake is required to send and receive any number of queries. Using this new communication mechanism DIRAC now provides a new type of component called Executor. Executors process any task (such as resolving the input data of a job) sent to them by a task dispatcher. This task dispatcher takes care of persisting the state of the tasks to the storage backend and distributing them among all the Executors based on the requirements of each task. In case of a high load, several Executors can be started to process the extra load and stop them once the tasks have been processed. This new approach of handling tasks in DIRAC makes Executors easy to replace and replicate, thus enabling DIRAC to further scale beyond the current approach based on polling agents.

  3. Executor Framework for DIRAC

    International Nuclear Information System (INIS)

    Casajus Ramo, A; Graciani Diaz, R

    2012-01-01

    DIRAC framework for distributed computing has been designed as a group of collaborating components, agents and servers, with persistent database back-end. Components communicate with each other using DISET, an in-house protocol that provides Remote Procedure Call (RPC) and file transfer capabilities. This approach has provided DIRAC with a modular and stable design by enforcing stable interfaces across releases. But it made complicated to scale further with commodity hardware. To further scale DIRAC, components needed to send more queries between them. Using RPC to do so requires a lot of processing power just to handle the secure handshake required to establish the connection. DISET now provides a way to keep stable connections and send and receive queries between components. Only one handshake is required to send and receive any number of queries. Using this new communication mechanism DIRAC now provides a new type of component called Executor. Executors process any task (such as resolving the input data of a job) sent to them by a task dispatcher. This task dispatcher takes care of persisting the state of the tasks to the storage backend and distributing them among all the Executors based on the requirements of each task. In case of a high load, several Executors can be started to process the extra load and stop them once the tasks have been processed. This new approach of handling tasks in DIRAC makes Executors easy to replace and replicate, thus enabling DIRAC to further scale beyond the current approach based on polling agents.

  4. The National School Safety Framework: A framework for preventing ...

    African Journals Online (AJOL)

    The National School Safety Framework (NSSF) – approved by the Minister of Education in April 2015 - is located within a range of international and national laws and policies that recognise the safety of learners and educators as a prerequisite for quality learning and teaching at school. The framework affirms the ...

  5. Evaluating the Impact of Educational Interventions on Patients and Communities: A Conceptual Framework.

    Science.gov (United States)

    Bzowyckyj, Andrew S; Dow, Alan; Knab, Mary S

    2017-11-01

    Health professions education programs can have direct effects on patients and communities as well as on learners. However, few studies have examined the patient and community outcomes of educational interventions. To better integrate education and health care delivery, educators and researchers would benefit from a unifying framework to guide the planning of educational interventions and evaluation of their impact on patients.The authors of this Perspective mirrored approaches from Miller's pyramid of educational assessment and Moore and colleagues' framework for evaluating continuing professional development to propose a conceptual framework for evaluating the impact of educational interventions on patients and communities. This proposed framework, which complements these existing frameworks for evaluating the impact of educational interventions on learners, includes four levels: (1) interaction; (2) acceptability; (3) individual outcomes (i.e., knowledge, skills, activation, behaviors, and individual health indicators); and (4) population outcomes (i.e., community health indicators, capacity, and disparities). The authors describe measures and outcomes at each level and provide an example of the application of their new conceptual framework.The authors encourage educators and researchers to use this conceptual framework to evaluate the impact of educational interventions on patients and to more clearly identify and define which educational interventions strengthen communities and enhance overall health outcomes.

  6. Framework for Evaluating the Impact of Advanced Practice Nursing Roles.

    Science.gov (United States)

    Bryant-Lukosius, Denise; Spichiger, Elisabeth; Martin, Jacqueline; Stoll, Hansruedi; Kellerhals, Sabine Degen; Fliedner, Monica; Grossmann, Florian; Henry, Morag; Herrmann, Luzia; Koller, Antje; Schwendimann, René; Ulrich, Anja; Weibel, Lukas; Callens, Betty; De Geest, Sabina

    2016-03-01

    To address the gap in evidence-based information required to support the development of advanced practice nursing (APN) roles in Switzerland, stakeholders identified the need for guidance to generate strategic evaluation data. This article describes an evaluation framework developed to inform decisions about the effective utilization of APN roles across the country. A participatory approach was used by an international group of stakeholders. Published literature and an evidenced-based framework for introducing APN roles were analyzed and applied to define the purpose, target audiences, and essential elements of the evaluation framework. Through subsequent meetings and review by an expert panel, the framework was developed and refined. A framework to evaluate different types of APN roles as they evolve to meet dynamic population health, practice setting, and health system needs was created. It includes a matrix of key concepts to guide evaluations across three stages of APN role development: introduction, implementation, and long-term sustainability. For each stage, evaluation objectives and questions examining APN role structures, processes, and outcomes from different perspectives (e.g., patients, providers, managers, policy-makers) were identified. A practical, robust framework based on well-established evaluation concepts and current understanding of APN roles can be used to conduct systematic evaluations. The evaluation framework is sufficiently generic to allow application in developed countries globally, both for evaluation as well as research purposes. © 2016 Sigma Theta Tau International.

  7. Evaluating genomic tests from bench to bedside: a practical framework

    Directory of Open Access Journals (Sweden)

    Lin Jennifer S

    2012-10-01

    Full Text Available Abstract The development of genomic tests is one of the most significant technological advances in medical testing in recent decades. As these tests become increasingly available, so does the need for a pragmatic framework to evaluate the evidence base and evidence gaps in order to facilitate informed decision-making. In this article we describe such a framework that can provide a common language and benchmarks for different stakeholders of genomic testing. Each stakeholder can use this framework to specify their respective thresholds for decision-making, depending on their perspective and particular needs. This framework is applicable across a broad range of test applications and can be helpful in the application and communication of a regulatory science for genomic testing. Our framework builds upon existing work and incorporates principles familiar to researchers involved in medical testing (both diagnostic and prognostic generally, as well as those involved in genomic testing. This framework is organized around six phases in the development of genomic tests beginning with marker identification and ending with population impact, and highlights the important knowledge gaps that need to be filled in establishing the clinical relevance of a test. Our framework focuses on the clinical appropriateness of the four main dimensions of test research questions (population/setting, intervention/index test, comparators/reference test, and outcomes rather than prescribing a hierarchy of study designs that should be used to address each phase.

  8. An information technology framework for strengthening telehealthcare service delivery.

    Science.gov (United States)

    Chen, Li-Chin; Chen, Chi-Wen; Weng, Yung-Ching; Shang, Rung-Ji; Yu, Hui-Chu; Chung, Yufang; Lai, Feipei

    2012-10-01

    Telehealthcare has been used to provide healthcare service, and information technology infrastructure appears to be essential while providing telehealthcare service. Insufficiencies have been identified, such as lack of integration, need of accommodation of diverse biometric sensors, and accessing diverse networks as different houses have varying facilities, which challenge the promotion of telehealthcare. This study designs an information technology framework to strengthen telehealthcare delivery. The proposed framework consists of a system architecture design and a network transmission design. The aim of the framework is to integrate data from existing information systems, to adopt medical informatics standards, to integrate diverse biometric sensors, and to provide different data transmission networks to support a patient's house network despite the facilities. The proposed framework has been evaluated with a case study of two telehealthcare programs, with and without the adoption of the framework. The proposed framework facilitates the functionality of the program and enables steady patient enrollments. The overall patient participations are increased, and the patient outcomes appear positive. The attitudes toward the service and self-improvement also are positive. The findings of this study add up to the construction of a telehealthcare system. Implementing the proposed framework further assists the functionality of the service and enhances the availability of the service and patient acceptances.

  9. Protocol Analysis of Group Problem Solving in Mathematics: A Cognitive-Metacognitive Framework for Assessment.

    Science.gov (United States)

    Artzt, Alice F.; Armour-Thomas, Eleanor

    The roles of cognition and metacognition were examined in the mathematical problem-solving behaviors of students as they worked in small groups. As an outcome, a framework that links the literature of cognitive science and mathematical problem solving was developed for protocol analysis of mathematical problem solving. Within this framework, each…

  10. Flower Power: The Armoured Expert in the CanMEDS Competency Framework?

    Science.gov (United States)

    Whitehead, Cynthia R.; Austin, Zubin; Hodges, Brian D.

    2011-01-01

    Competency frameworks based on roles definitions are currently being used extensively in health professions education internationally. One of the most successful and widely used models is the CanMEDS Roles Framework. The medical literature has raised questions about both the theoretical underpinnings and the practical application of outcomes-based…

  11. Development of the FOCUS (Focus on the Outcomes of Communication under Six), a Communication Outcome Measure for Preschool Children

    Science.gov (United States)

    Thomas-Stonell, Nancy L.; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter L.

    2010-01-01

    Aim: Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real-world changes in preschool children's communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived…

  12. A flexible regulatory framework

    International Nuclear Information System (INIS)

    Silvennoinen, T.

    2000-01-01

    Regulatory reform of the Finnish electricity market meant opening up potentially competitive parts of the electricity sector to competition and eliminating all unnecessary forms of regulation covering generation, wholesale supply, retail supply, and foreign trade in electricity. New types of control and regulatory mechanisms and institutions were set up for those parts of the electricity industry that were excluded from competition, such as network operations. Network activities now have to be licensed, whereas no licence is needed for generation or supply. A new sector-specific regulatory authority was established in 1995 to coincide with the implementation of the Electricity Market Act, known as the Electricity Market Authority. This is responsible for regulating network activities and retail supply to captive customers. The core function of the authority, which employs some 14 people, is to promote the smooth operation of the Finnish electricity market and to oversee the implementation of the Electricity Market Act and its provisions. Its most important duties are linked to overseeing the process by which network companies price their electricity. As price regulation no longer exists, all the companies in the electricity sector set their tariffs independently, even network companies. The job of controlling the pricing of network services is handed by the Electricity Market Authority, following the principles of competition control. Pricing control takes place ex post - after a pricing system has been adopted by a company and concentrates on individual cases and companies. There is no ex ante system of setting or approving prices and tariffs by the regulator. The tariffs and pricing of network services can be evaluated, however, by both the Electricity Market Authority and the Finnish Competition Authority, which have overlapping powers as regards the pricing of network activities. The Finnish regulatory framework can be described as a system of light

  13. A Conceptual Framework for the Evaluation of Emergency Risk Communications

    Science.gov (United States)

    Lin, Leesa; Gamhewage, Gaya M.

    2017-01-01

    Objectives. To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). Methods. The framework proposed is based on a systematic review of the scientific literature (2001–2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. Results. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees’ data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Conclusions. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies. PMID:28892436

  14. A Conceptual Framework for the Evaluation of Emergency Risk Communications.

    Science.gov (United States)

    Savoia, Elena; Lin, Leesa; Gamhewage, Gaya M

    2017-09-01

    To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). The framework proposed is based on a systematic review of the scientific literature (2001-2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees' data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies.

  15. The FairRoot framework

    International Nuclear Information System (INIS)

    Al-Turany, M; Bertini, D; Karabowicz, R; Kresan, D; Malzacher, P; Uhlig, F; Stockmanns, T

    2012-01-01

    The FairRoot framework is an object oriented simulation, reconstruction and data analysis framework based on ROOT. It includes core services for detector simulation and offline analysis. The framework delivers base classes which enable the users to easily construct their experimental setup in a fast and convenient way. By using the Virtual Monte Carlo concept it is possible to perform the simulations using either Geant3 or Geant4 without changing the user code or the geometry description. Using and extending the task mechanism of ROOT it is possible to implement complex analysis tasks in a convenient way. Moreover, using the FairCuda interface of the framework it is possible to run some of these tasks also on GPU. Data IO, as well as parameter handling and data base connections are also handled by the framework. Since some of the experiments will not have an experimental setup with a conventional trigger system, the framework can handle also free flowing input streams of detector data. For this mode of operation the framework provides classes to create the needed time sorted input streams of detector data out of the event based simulation data. There are also tools to do radiation studies and to visualize the simulated data. A CMake-CDash based building and monitoring system is also part of the FairRoot services which helps to build and test the framework on many different platforms in an automatic way, including also Continuous Integration.

  16. Supervisory Styles: A Contingency Framework

    Science.gov (United States)

    Boehe, Dirk Michael

    2016-01-01

    While the contingent nature of doctoral supervision has been acknowledged, the literature on supervisory styles has yet to deliver a theory-based contingency framework. A contingency framework can assist supervisors and research students in identifying appropriate supervisory styles under varying circumstances. The conceptual study reported here…

  17. ZigBee test framework

    NARCIS (Netherlands)

    Bui Tat Minh, B.

    2015-01-01

    This project aims to build up a common ZigBee test framework. The common test framework can be used by teams developing devices using ZigBee. The objective is to reuse of the test infrastructure, test xtures as well as to simplify the exchange of test engineers between teams. In this project, we

  18. Framework for Structuring Procurement Contracts

    Directory of Open Access Journals (Sweden)

    Lena Borg

    2014-12-01

    Full Text Available The aim of this paper is to propose a new framework for structuring contract types and payment methods. Concerning procurement contracts, the first important new feature of this framework is a stepwise structure with three main steps in the contract design: (1 what will be procured—should the contract only include construction, or should it include both construction and operation/maintenance (2 who will do the detailed design of the premise and (3 how many contractors will the client use? The second important new feature of this framework is that both step 2 and step 3 include a continuum of alternatives. Concerning payment methods, the new framework is primarily based on how the specific risks of the project are shared. These frameworks can be useful for policy formulation in that they can help to avoid some problematic ways of formulating policies.

  19. Parallel Framework for Cooperative Processes

    Directory of Open Access Journals (Sweden)

    Mitică Craus

    2005-01-01

    Full Text Available This paper describes the work of an object oriented framework designed to be used in the parallelization of a set of related algorithms. The idea behind the system we are describing is to have a re-usable framework for running several sequential algorithms in a parallel environment. The algorithms that the framework can be used with have several things in common: they have to run in cycles and the work should be possible to be split between several "processing units". The parallel framework uses the message-passing communication paradigm and is organized as a master-slave system. Two applications are presented: an Ant Colony Optimization (ACO parallel algorithm for the Travelling Salesman Problem (TSP and an Image Processing (IP parallel algorithm for the Symmetrical Neighborhood Filter (SNF. The implementations of these applications by means of the parallel framework prove to have good performances: approximatively linear speedup and low communication cost.

  20. Environmental Stewardship: A Conceptual Review and Analytical Framework

    Science.gov (United States)

    Bennett, Nathan J.; Whitty, Tara S.; Finkbeiner, Elena; Pittman, Jeremy; Bassett, Hannah; Gelcich, Stefan; Allison, Edward H.

    2018-04-01

    There has been increasing attention to and investment in local environmental stewardship in conservation and environmental management policies and programs globally. Yet environmental stewardship has not received adequate conceptual attention. Establishing a clear definition and comprehensive analytical framework could strengthen our ability to understand the factors that lead to the success or failure of environmental stewardship in different contexts and how to most effectively support and enable local efforts. Here we propose such a definition and framework. First, we define local environmental stewardship as the actions taken by individuals, groups or networks of actors, with various motivations and levels of capacity, to protect, care for or responsibly use the environment in pursuit of environmental and/or social outcomes in diverse social-ecological contexts. Next, drawing from a review of the environmental stewardship, management and governance literatures, we unpack the elements of this definition to develop an analytical framework that can facilitate research on local environmental stewardship. Finally, we discuss potential interventions and leverage points for promoting or supporting local stewardship and future applications of the framework to guide descriptive, evaluative, prescriptive or systematic analysis of environmental stewardship. Further application of this framework in diverse environmental and social contexts is recommended to refine the elements and develop insights that will guide and improve the outcomes of environmental stewardship initiatives and investments. Ultimately, our aim is to raise the profile of environmental stewardship as a valuable and holistic concept for guiding productive and sustained relationships with the environment.

  1. Environmental Stewardship: A Conceptual Review and Analytical Framework.

    Science.gov (United States)

    Bennett, Nathan J; Whitty, Tara S; Finkbeiner, Elena; Pittman, Jeremy; Bassett, Hannah; Gelcich, Stefan; Allison, Edward H

    2018-04-01

    There has been increasing attention to and investment in local environmental stewardship in conservation and environmental management policies and programs globally. Yet environmental stewardship has not received adequate conceptual attention. Establishing a clear definition and comprehensive analytical framework could strengthen our ability to understand the factors that lead to the success or failure of environmental stewardship in different contexts and how to most effectively support and enable local efforts. Here we propose such a definition and framework. First, we define local environmental stewardship as the actions taken by individuals, groups or networks of actors, with various motivations and levels of capacity, to protect, care for or responsibly use the environment in pursuit of environmental and/or social outcomes in diverse social-ecological contexts. Next, drawing from a review of the environmental stewardship, management and governance literatures, we unpack the elements of this definition to develop an analytical framework that can facilitate research on local environmental stewardship. Finally, we discuss potential interventions and leverage points for promoting or supporting local stewardship and future applications of the framework to guide descriptive, evaluative, prescriptive or systematic analysis of environmental stewardship. Further application of this framework in diverse environmental and social contexts is recommended to refine the elements and develop insights that will guide and improve the outcomes of environmental stewardship initiatives and investments. Ultimately, our aim is to raise the profile of environmental stewardship as a valuable and holistic concept for guiding productive and sustained relationships with the environment.

  2. Hydrogen Storage in Metal-Organic Frameworks

    Energy Technology Data Exchange (ETDEWEB)

    Long, Jeffrey R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-04-28

    The design and characterization of new materials for hydrogen storage is an important area of research, as the ability to store hydrogen at lower pressures and higher temperatures than currently feasible would lower operating costs for small hydrogen fuel cell vehicles. In particular, metal-organic frameworks (MOFs) represent promising materials for use in storing hydrogen in this capacity. MOFs are highly porous, three-dimensional crystalline solids that are formed via linkages between metal ions (e.g., iron, nickel, and zinc) and organic molecules. MOFs can store hydrogen via strong adsorptive interactions between the gas molecules and the pores of the framework, providing a high surface area for gas adsorption and thus the opportunity to store hydrogen at significantly lower pressures than with current technologies. By lowering the energy required for hydrogen storage, these materials hold promise in rendering hydrogen a more viable fuel for motor vehicles, which is a highly desirable outcome given the clean nature of hydrogen fuel cells (water is the only byproduct of combustion) and the current state of global climate change resulting from the combustion of fossil fuels. The work presented in this report is the result of collaborative efforts between researchers at Lawrence Berkeley National Lab (LBNL), the National Institute of Standards and Technology (NIST), and General Motors Corporation (GM) to discover novel MOFs promising for H2 storage and characterize their properties. Described herein are several new framework systems with improved gravimetric and volumetric capacity to strongly bind H2 at temperatures relevant for vehicle storage. These materials were rigorously characterized using neutron diffraction, to determine the precise binding locations of hydrogen within the frameworks, and high-pressure H2 adsorption measurements, to provide a comprehensive picture of H2 adsorption at all relevant pressures. A

  3. How to practice person-centred care: A conceptual framework.

    Science.gov (United States)

    Santana, Maria J; Manalili, Kimberly; Jolley, Rachel J; Zelinsky, Sandra; Quan, Hude; Lu, Mingshan

    2018-04-01

    Globally, health-care systems and organizations are looking to improve health system performance through the implementation of a person-centred care (PCC) model. While numerous conceptual frameworks for PCC exist, a gap remains in practical guidance on PCC implementation. Based on a narrative review of the PCC literature, a generic conceptual framework was developed in collaboration with a patient partner, which synthesizes evidence, recommendations and best practice from existing frameworks and implementation case studies. The Donabedian model for health-care improvement was used to classify PCC domains into the categories of "Structure," "Process" and "Outcome" for health-care quality improvement. The framework emphasizes the structural domain, which relates to the health-care system or context in which care is delivered, providing the foundation for PCC, and influencing the processes and outcomes of care. Structural domains identified include: the creation of a PCC culture across the continuum of care; co-designing educational programs, as well as health promotion and prevention programs with patients; providing a supportive and accommodating environment; and developing and integrating structures to support health information technology and to measure and monitor PCC performance. Process domains describe the importance of cultivating communication and respectful and compassionate care; engaging patients in managing their care; and integration of care. Outcome domains identified include: access to care and Patient-Reported Outcomes. This conceptual framework provides a step-wise roadmap to guide health-care systems and organizations in the provision PCC across various health-care sectors. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

  4. Impact of 'stretch' targets for cardiovascular disease management within a local pay-for-performance programme.

    Science.gov (United States)

    Pape, Utz J; Huckvale, Kit; Car, Josip; Majeed, Azeem; Millett, Christopher

    2015-01-01

    Pay-for-performance programs are often aimed to improve the management of chronic diseases. We evaluate the impact of a local pay for performance programme (QOF+), which rewarded financially more ambitious quality targets ('stretch targets') than those used nationally in the Quality and Outcomes Framework (QOF). We focus on targets for intermediate outcomes in patients with cardiovascular disease and diabetes. A difference-in-difference approach is used to compare practice level achievements before and after the introduction of the local pay for performance program. In addition, we analysed patient-level data on exception reporting and intermediate outcomes utilizing an interrupted time series analysis. The local pay for performance program led to significantly higher target achievements (hypertension: p-value <0.001, coronary heart disease: p-values <0.001, diabetes: p-values <0.061, stroke: p-values <0.003). However, the increase was driven by higher rates of exception reporting (hypertension: p-value <0.001, coronary heart disease: p-values <0.03, diabetes: p-values <0.05) in patients with all conditions except for stroke. Exception reporting allows practitioners to exclude patients from target calculations if certain criteria are met, e.g. informed dissent of the patient for treatment. There were no statistically significant improvements in mean blood pressure, cholesterol or HbA1c levels. Thus, achievement of higher payment thresholds in the local pay for performance scheme was mainly attributed to increased exception reporting by practices with no discernable improvements in overall clinical quality. Hence, active monitoring of exception reporting should be considered when setting more ambitious quality targets. More generally, the study suggests a trade-off between additional incentive for better care and monitoring costs.

  5. A framework for designing hand hygiene educational interventions in schools

    DEFF Research Database (Denmark)

    Appiah-Brempong, Emmanuel; Harris, Muriel J; Newton, Samuel

    2018-01-01

    OBJECTIVES: Hygiene education appears to be the commonest school-based intervention for preventing infectious diseases, especially in the developing world. Nevertheless, there remains a gap in literature regarding a school-specific theory-based framework for designing a hand hygiene educational...... (normative beliefs and motivation to comply). CONCLUSIONS: A framework underpinned by formalized psychosocial theories has relevance and could enhance the design of hand hygiene educational interventions, especially in schools....... of school-based hand hygiene educational interventions is summarized narratively. RESULTS: School-based hand hygiene educational interventions seeking to positively influence behavioural outcomes could consider enhancing psychosocial variables including behavioural capacity, attitudes and subjective norms...

  6. A framework for evaluating and utilizing medical terminology mappings.

    Science.gov (United States)

    Hussain, Sajjad; Sun, Hong; Sinaci, Anil; Erturkmen, Gokce Banu Laleci; Mead, Charles; Gray, Alasdair J G; McGuinness, Deborah L; Prud'Hommeaux, Eric; Daniel, Christel; Forsberg, Kerstin

    2014-01-01

    Use of medical terminologies and mappings across them are considered to be crucial pre-requisites for achieving interoperable eHealth applications. Built upon the outcomes of several research projects, we introduce a framework for evaluating and utilizing terminology mappings that offers a platform for i) performing various mappings strategies, ii) representing terminology mappings together with their provenance information, and iii) enabling terminology reasoning for inferring both new and erroneous mappings. We present the results of the introduced framework from SALUS project where we evaluated the quality of both existing and inferred terminology mappings among standard terminologies.

  7. Creating a nursing strategic planning framework based on evidence.

    Science.gov (United States)

    Shoemaker, Lorie K; Fischer, Brenda

    2011-03-01

    This article describes an evidence-informed strategic planning process and framework used by a Magnet-recognized public health system in California. This article includes (1) an overview of the organization and its strategic planning process, (2) the structure created within nursing for collaborative strategic planning and decision making, (3) the strategic planning framework developed based on the organization's balanced scorecard domains and the new Magnet model, and (4) the process undertaken to develop the nursing strategic priorities. Outcomes associated with the structure, process, and key initiatives are discussed throughout the article. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. An ethical framework for cardiac report cards: a qualitative study.

    Science.gov (United States)

    Richard, Shawn A; Rawal, Shail; Martin, Douglas K

    2005-03-28

    The recent proliferation of health care report cards, especially in cardiac care, has occurred in the absence of an ethical framework to guide in their development and implementation. An ethical framework is a consistent and comprehensive theoretical foundation in ethics, and is formed by integrating ethical theories, relevant literature, and other critical information (such as the views of stakeholders). An ethical framework in the context of cardiac care provides guidance for developing cardiac report cards (CRCs) that are relevant and legitimate to all stakeholders. The purpose of this study is to develop an ethical framework for CRCs. Delphi technique - 13 panelists: 2 administrators, 2 cardiac nurses, 5 cardiac patients, 2 cardiologists, 1 member of the media, and 1 outcomes researcher. Panelists' views regarding the ethics of CRCs were analyzed and organized into themes. We have organized panelists' views into ten principles that emerged from the data: 1) improving quality of care, 2) informed understanding, 3) public accountability, 4) transparency, 5) equity, 6) access to information 7) quality of information, 8) multi-stakeholder collaboration, 9) legitimacy, and 10) evaluation and continuous quality improvement. We have developed a framework to guide the development and dissemination of CRCs. This ethical framework can provide necessary guidance for those generating CRCs and may help them avoid a number of difficult issues associated with existing ones.

  9. An ethical framework for cardiac report cards: a qualitative study

    Directory of Open Access Journals (Sweden)

    Rawal Shail

    2005-03-01

    Full Text Available Abstract Background The recent proliferation of health care report cards, especially in cardiac care, has occurred in the absence of an ethical framework to guide in their development and implementation. An ethical framework is a consistent and comprehensive theoretical foundation in ethics, and is formed by integrating ethical theories, relevant literature, and other critical information (such as the views of stakeholders. An ethical framework in the context of cardiac care provides guidance for developing cardiac report cards (CRCs that are relevant and legitimate to all stakeholders. The purpose of this study is to develop an ethical framework for CRCs. Methods Delphi technique – 13 panelists: 2 administrators, 2 cardiac nurses, 5 cardiac patients, 2 cardiologists, 1 member of the media, and 1 outcomes researcher. Panelists' views regarding the ethics of CRCs were analyzed and organized into themes. Results We have organized panelists' views into ten principles that emerged from the data: 1 improving quality of care, 2 informed understanding, 3 public accountability, 4 transparency, 5 equity, 6 access to information 7 quality of information, 8 multi-stakeholder collaboration, 9 legitimacy, and 10 evaluation and continuous quality improvement. Conclusion We have developed a framework to guide the development and dissemination of CRCs. This ethical framework can provide necessary guidance for those generating CRCs and may help them avoid a number of difficult issues associated with existing ones.

  10. A theoretical framework to support research of health service innovation.

    Science.gov (United States)

    Fox, Amanda; Gardner, Glenn; Osborne, Sonya

    2015-02-01

    Health service managers and policy makers are increasingly concerned about the sustainability of innovations implemented in health care settings. The increasing demand on health services requires that innovations are both effective and sustainable; however, research in this field is limited, with multiple disciplines, approaches and paradigms influencing the field. These variations prevent a cohesive approach, and therefore the accumulation of research findings, in the development of a body of knowledge. The purpose of this paper is to provide a thorough examination of the research findings and provide an appropriate theoretical framework to examine sustainability of health service innovation. This paper presents an integrative review of the literature available in relation to sustainability of health service innovation and provides the development of a theoretical framework based on integration and synthesis of the literature. A theoretical framework serves to guide research, determine variables, influence data analysis and is central to the quest for ongoing knowledge development. This research outlines the sustainability of innovation framework; a theoretical framework suitable for examining the sustainability of health service innovation. If left unaddressed, health services research will continue in an ad hoc manner, preventing full utilisation of outcomes, recommendations and knowledge for effective provision of health services. The sustainability of innovation theoretical framework provides an operational basis upon which reliable future research can be conducted.

  11. Evaluation and Policy Analysis: A Communicative Framework

    Directory of Open Access Journals (Sweden)

    Cynthia Wallat

    1997-07-01

    Full Text Available A major challenge for the next generation of students of human development is to help shape the paradigms by which we analyze and evaluate public policies for children and families. Advocates of building research and policy connections point to health care and stress experiences across home, school, and community as critical policy issues that expand the scope of contexts and outcomes studied. At a minimum, development researchers and practitioners will need to be well versed in available methods of inquiry; they will need to be "methodologically multilingual" when conducting evaluation and policy analysis, producing reports, and reporting their interpretations to consumer and policy audiences. This article suggests how traditional approaches to policy inquiry can be reconsidered in light of these research inquiry and communicative skills needed by all policy researchers. A fifteen year review of both policy and discourse processes research is presented to suggest ways to conduct policy studies within a communicative framework.

  12. DXC'11 Framework and Oracle

    Data.gov (United States)

    National Aeronautics and Space Administration — The DXC Framework is a collection of programs and APIs for running and evaluating diagnostic algorithms (DAs) under identical experimental conditions. It is...

  13. DXC'10 Framework and Oracle

    Data.gov (United States)

    National Aeronautics and Space Administration — The DXC Framework is a collection of programs and APIs for running and evaluating diagnostic algorithms (DAs) under identical experimental conditions. It is...

  14. Evaluation Framework for Search Instruments

    International Nuclear Information System (INIS)

    Warren, Glen A.; Smith, Leon E.; Cooper, Matt W.; Kaye, William R.

    2005-01-01

    A framework for quantitatively evaluating current and proposed gamma-ray search instrument designs has been developed. The framework is designed to generate a large library of ''virtual neighborhoods'' that can be used to test and evaluate nearly any gamma-ray sensor type. Calculating nuisance-source emissions and combining various sources to create a large number of random virtual scenes places a significant computational burden on the development of the framework. To reduce this burden, a number of radiation transport simplifications have been made which maintain the essential physics ingredients for the quantitative assessment of search instruments while significantly reducing computational times. The various components of the framework, from the simulation and benchmarking of nuisance source emissions to the computational engine for generating the gigabytes of simulated search scenes, are discussed

  15. Integrated Systems Engineering Framework (ISEF)

    Data.gov (United States)

    Federal Laboratory Consortium — The ISEF is an integrated SE framework built to create and capture knowledge using a decision-centric method, high-quality data visualizations, intuitive navigation...

  16. Towards an enterprise interoperability framework

    CSIR Research Space (South Africa)

    Kotzé, P

    2010-06-01

    Full Text Available This paper presents relevant interoperability approaches and solutions applied to global/international networked (collaborative) enterprises or organisations and conceptualise an enhanced enterprise interoperability framework. The paper covers...

  17. Framework for systems engineering research

    CSIR Research Space (South Africa)

    Erasmus, L

    2013-08-01

    Full Text Available In this paper a framework is proposed to perform systems engineering research within South Africa. It is proposed that within the reference of the National Research Foundation (NRF) classification of research, systems engineering is a Field...

  18. Metallated metal-organic frameworks

    Energy Technology Data Exchange (ETDEWEB)

    Bury, Wojciech; Farha, Omar K.; Hupp, Joseph T.; Mondloch, Joseph E.

    2017-08-22

    Porous metal-organic frameworks (MOFs) and metallated porous MOFs are provided. Also provided are methods of metallating porous MOFs using atomic layer deposition and methods of using the metallated MOFs as catalysts and in remediation applications.

  19. Geologic Framework Model (GFM2000)

    International Nuclear Information System (INIS)

    T. Vogt

    2004-01-01

    The purpose of this report is to document the geologic framework model, version GFM2000 with regard to input data, modeling methods, assumptions, uncertainties, limitations, and validation of the model results, and the differences between GFM2000 and previous versions. The version number of this model reflects the year during which the model was constructed. This model supersedes the previous model version, documented in Geologic Framework Model (GFM 3.1) (CRWMS M and O 2000 [DIRS 138860]). The geologic framework model represents a three-dimensional interpretation of the geology surrounding the location of the monitored geologic repository for spent nuclear fuel and high-level radioactive waste at Yucca Mountain. The geologic framework model encompasses and is limited to an area of 65 square miles (168 square kilometers) and a volume of 185 cubic miles (771 cubic kilometers). The boundaries of the geologic framework model (shown in Figure 1-1) were chosen to encompass the exploratory boreholes and to provide a geologic framework over the area of interest for hydrologic flow and radionuclide transport modeling through the unsaturated zone (UZ). The upper surface of the model is made up of the surface topography and the depth of the model is constrained by the inferred depth of the Tertiary-Paleozoic unconformity. The geologic framework model was constructed from geologic map and borehole data. Additional information from measured stratigraphic sections, gravity profiles, and seismic profiles was also considered. The intended use of the geologic framework model is to provide a geologic framework over the area of interest consistent with the level of detailed needed for hydrologic flow and radionuclide transport modeling through the UZ and for repository design. The model is limited by the availability of data and relative amount of geologic complexity found in an area. The geologic framework model is inherently limited by scale and content. The grid spacing used in

  20. Geologic Framework Model (GFM2000)

    Energy Technology Data Exchange (ETDEWEB)

    T. Vogt

    2004-08-26

    The purpose of this report is to document the geologic framework model, version GFM2000 with regard to input data, modeling methods, assumptions, uncertainties, limitations, and validation of the model results, and the differences between GFM2000 and previous versions. The version number of this model reflects the year during which the model was constructed. This model supersedes the previous model version, documented in Geologic Framework Model (GFM 3.1) (CRWMS M&O 2000 [DIRS 138860]). The geologic framework model represents a three-dimensional interpretation of the geology surrounding the location of the monitored geologic repository for spent nuclear fuel and high-level radioactive waste at Yucca Mountain. The geologic framework model encompasses and is limited to an area of 65 square miles (168 square kilometers) and a volume of 185 cubic miles (771 cubic kilometers). The boundaries of the geologic framework model (shown in Figure 1-1) were chosen to encompass the exploratory boreholes and to provide a geologic framework over the area of interest for hydrologic flow and radionuclide transport modeling through the unsaturated zone (UZ). The upper surface of the model is made up of the surface topography and the depth of the model is constrained by the inferred depth of the Tertiary-Paleozoic unconformity. The geologic framework model was constructed from geologic map and borehole data. Additional information from measured stratigraphic sections, gravity profiles, and seismic profiles was also considered. The intended use of the geologic framework model is to provide a geologic framework over the area of interest consistent with the level of detailed needed for hydrologic flow and radionuclide transport modeling through the UZ and for repository design. The model is limited by the availability of data and relative amount of geologic complexity found in an area. The geologic framework model is inherently limited by scale and content. The grid spacing used in the

  1. A Procurement Performance Model for Construction Frameworks

    Directory of Open Access Journals (Sweden)

    Terence Y M Lam

    2015-07-01

    Full Text Available Collaborative construction frameworks have been developed in the United Kingdom (UK to create longer term relationships between clients and suppliers in order to improve project outcomes. Research undertaken into highways maintenance set within a major county council has confirmed that such collaborative procurement methods can improve time, cost and quality of construction projects. Building upon this and examining the same single case, this research aims to develop a performance model through identification of performance drivers in the whole project delivery process including pre and post contract phases. A priori performance model based on operational and sociological constructs was proposed and then checked by a pilot study. Factor analysis and central tendency statistics from the questionnaires as well as content analysis from the interview transcripts were conducted. It was confirmed that long term relationships, financial and non-financial incentives and stronger communication are the sociological behaviour factors driving performance. The interviews also established that key performance indicators (KPIs can be used as an operational measure to improve performance. With the posteriori performance model, client project managers can effectively collaboratively manage contractor performance through procurement measures including use of longer term and KPIs for the contract so that the expected project outcomes can be achieved. The findings also make significant contribution to construction framework procurement theory by identifying the interrelated sociological and operational performance drivers. This study is set predominantly in the field of highways civil engineering. It is suggested that building based projects or other projects that share characteristics are grouped together and used for further research of the phenomena discovered.

  2. Regulatory control, legislation and framework

    International Nuclear Information System (INIS)

    Parthasarathy, K.S.

    1998-01-01

    The legislation and regulations, a regulatory authority to authorise and inspect the regulated activities and to enforce the legislation and regulations, sufficient financial and man-power resources are the essential parts of a national infrastructure to implement the Basic Safety Standards. The legal framework consists of legislation (Act passed by Parliament) and the regulations (framed by the government and endorsed by the Parliament). This paper is primarily deals with the the legal framework set up in India for atomic energy activities

  3. An Unsupervised Online Spike-Sorting Framework.

    Science.gov (United States)

    Knieling, Simeon; Sridharan, Kousik S; Belardinelli, Paolo; Naros, Georgios; Weiss, Daniel; Mormann, Florian; Gharabaghi, Alireza

    2016-08-01

    Extracellular neuronal microelectrode recordings can include action potentials from multiple neurons. To separate spikes from different neurons, they can be sorted according to their shape, a procedure referred to as spike-sorting. Several algorithms have been reported to solve this task. However, when clustering outcomes are unsatisfactory, most of them are difficult to adjust to achieve the desired results. We present an online spike-sorting framework that uses feature normalization and weighting to maximize the distinctiveness between different spike shapes. Furthermore, multiple criteria are applied to either facilitate or prevent cluster fusion, thereby enabling experimenters to fine-tune the sorting process. We compare our method to established unsupervised offline (Wave_Clus (WC)) and online (OSort (OS)) algorithms by examining their performance in sorting various test datasets using two different scoring systems (AMI and the Adamos metric). Furthermore, we evaluate sorting capabilities on intra-operative recordings using established quality metrics. Compared to WC and OS, our algorithm achieved comparable or higher scores on average and produced more convincing sorting results for intra-operative datasets. Thus, the presented framework is suitable for both online and offline analysis and could substantially improve the quality of microelectrode-based data evaluation for research and clinical application.

  4. The global climate Policy Evaluation Framework

    International Nuclear Information System (INIS)

    Cohan, D.; Stafford, R.K.; Scheraga, J.D.; Herrod, S.

    1994-01-01

    The Policy Evaluation Framework (PEF) is a decision analysis tool that enables decision makers to continuously formulate policies that take into account the existing uncertainties, and to refine policies as new scientific information is developed. PEF integrates deterministic parametric models of physical, biological, and economic systems with a flexible decision tree system. The deterministic models represent greenhouse gas emissions, atmospheric accumulation of these gases, global and regional climate changes, ecosystem impacts, economic impacts, and mitigation and adaptation options, The decision tree system captures the key scientific and economic uncertainties, and reflects the wide range of possible outcomes of alternative policy actions. The framework contains considerable flexibility to allow a wide range of scientific and economic assumptions or scenarios to be represented and explored. A key feature of PEF is its capability to address both mitigation policies and investments in anticipatory adaptation to protect ecological and economic systems, as well as interactions among such options. PEF's time structure allows issues related to the timing and flexibility of alternatives to be evaluated, while the decision tree structure facilitates examining questions involving the value of information, contingent actions, and probabilistic representations. This paper is intended to introduce PEF to the global climate policy community. The paper provides an overview of the structure, modules, and capabilities of PEF, and discusses selected results from an initial set of illustrative applications

  5. Patterns for Effectively Documenting Frameworks

    Science.gov (United States)

    Aguiar, Ademar; David, Gabriel

    Good design and implementation are necessary but not sufficient pre-requisites for successfully reusing object-oriented frameworks. Although not always recognized, good documentation is crucial for effective framework reuse, and often hard, costly, and tiresome, coming with many issues, especially when we are not aware of the key problems and respective ways of addressing them. Based on existing literature, case studies and lessons learned, the authors have been mining proven solutions to recurrent problems of documenting object-oriented frameworks, and writing them in pattern form, as patterns are a very effective way of communicating expertise and best practices. This paper presents a small set of patterns addressing problems related to the framework documentation itself, here seen as an autonomous and tangible product independent of the process used to create it. The patterns aim at helping non-experts on cost-effectively documenting object-oriented frameworks. In concrete, these patterns provide guidance on choosing the kinds of documents to produce, how to relate them, and which contents to include. Although the focus is more on the documents themselves, rather than on the process and tools to produce them, some guidelines are also presented in the paper to help on applying the patterns to a specific framework.

  6. A KPI framework for process-based benchmarking of hospital information systems.

    Science.gov (United States)

    Jahn, Franziska; Winter, Alfred

    2011-01-01

    Benchmarking is a major topic for monitoring, directing and elucidating the performance of hospital information systems (HIS). Current approaches neglect the outcome of the processes that are supported by the HIS and their contribution to the hospital's strategic goals. We suggest to benchmark HIS based on clinical documentation processes and their outcome. A framework consisting of a general process model and outcome criteria for clinical documentation processes is introduced.

  7. Perverse Market Outcomes from Biodiversity Conservation Interventions

    OpenAIRE

    Lim, F.K.S.; Carrasco, L.R.; McHardy, J.; Edwards, D.P.

    2016-01-01

    Conservation interventions are being implemented at various spatial scales to reduce the impacts of rising global population and affluence on biodiversity and ecosystems. While the direct impacts of these conservation efforts are considered, the unintended consequences brought about by market feedback effects are often overlooked. Perverse market outcomes could result in reduced or even reversed net impacts of conservation efforts. We develop an economic framework to describe how the intended...

  8. The development of a sustainable development model framework

    International Nuclear Information System (INIS)

    Hannoura, Alim P.; Cothren, Gianna M.; Khairy, Wael M.

    2006-01-01

    The emergence of the 'sustainable development' concept as a response to the mining of natural resources for the benefit of multinational corporations has advanced the cause of long-term environmental management. A sustainable development model (SDM) framework that is inclusive of the 'whole' natural environment is presented to illustrate the integration of the sustainable development of the 'whole' ecosystem. The ecosystem approach is an inclusive framework that covers the natural environment relevant futures and constraints. These are dynamically interconnected and constitute the determinates of resources development component of the SDM. The second component of the SDM framework is the resources development patterns, i.e., the use of land, water, and atmospheric resources. All of these patterns include practices that utilize environmental resources to achieve a predefined outcome producing waste and by-products that require disposal into the environment. The water quality management practices represent the third component of the framework. These practices are governed by standards, limitations and available disposal means subject to quantity and quality permits. These interconnected standards, practices and permits shape the resulting environmental quality of the ecosystem under consideration. A fourth component, environmental indicators, of the SDM framework provides a measure of the ecosystem productivity and status that may differ based on societal values and culture. The four components of the SDM are interwoven into an outcome assessment process to form the management and feedback models. The concept of Sustainable Development is expressed in the management model as an objective function subject to desired constraints imposing the required bounds for achieving ecosystem sustainability. The development of the objective function and constrains requires monetary values for ecosystem functions, resources development activities and environmental cost. The

  9. GeoFramework: A Modeling Framework for Solid Earth Geophysics

    Science.gov (United States)

    Gurnis, M.; Aivazis, M.; Tromp, J.; Tan, E.; Thoutireddy, P.; Liu, Q.; Choi, E.; Dicaprio, C.; Chen, M.; Simons, M.; Quenette, S.; Appelbe, B.; Aagaard, B.; Williams, C.; Lavier, L.; Moresi, L.; Law, H.

    2003-12-01

    As data sets in geophysics become larger and of greater relevance to other earth science disciplines, and as earth science becomes more interdisciplinary in general, modeling tools are being driven in new directions. There is now a greater need to link modeling codes to one another, link modeling codes to multiple datasets, and to make modeling software available to non modeling specialists. Coupled with rapid progress in computer hardware (including the computational speed afforded by massively parallel computers), progress in numerical algorithms, and the introduction of software frameworks, these lofty goals of merging software in geophysics are now possible. The GeoFramework project, a collaboration between computer scientists and geoscientists, is a response to these needs and opportunities. GeoFramework is based on and extends Pyre, a Python-based modeling framework, recently developed to link solid (Lagrangian) and fluid (Eulerian) models, as well as mesh generators, visualization packages, and databases, with one another for engineering applications. The utility and generality of Pyre as a general purpose framework in science is now being recognized. Besides its use in engineering and geophysics, it is also being used in particle physics and astronomy. Geology and geophysics impose their own unique requirements on software frameworks which are not generally available in existing frameworks and so there is a need for research in this area. One of the special requirements is the way Lagrangian and Eulerian codes will need to be linked in time and space within a plate tectonics context. GeoFramework has grown beyond its initial goal of linking a limited number of exiting codes together. The following codes are now being reengineered within the context of Pyre: Tecton, 3-D FE Visco-elastic code for lithospheric relaxation; CitComS, a code for spherical mantle convection; SpecFEM3D, a SEM code for global and regional seismic waves; eqsim, a FE code for dynamic

  10. A Framework for Identifying and Understanding Enterprise Systems Benefits

    DEFF Research Database (Denmark)

    Schubert, Petra; Williams, Susan P.

    2011-01-01

    Purpose – Identifying the benefits arising from implementations of enterprise systems and realizing business value remains a significant challenge for both research and industry. This paper aims to consolidate previous work. It presents a framework for investigating enterprise systems benefits...... into aspects and criteria plus an attributed appraisal value. The resulting scheme for the “three-level benefit codes” provides a greater level of detail about the nature of expected and realized benefits. Practical implications – The high level of detail and the code scheme comprising 60 different codes...... and the method for deriving the codes allows companies to identify and define benefits as well as to assess the outcome of enterprise systems implementation projects. Originality/value – The paper empirically develops an applicable benefits framework, which addresses the lack of detail of previous frameworks....

  11. A Science Framework for Connecticut River Watershed Sustainability

    Science.gov (United States)

    Rideout, Stephen; Nicolson, Craig; Russell-Robinson, Susan L.; Mecray, Ellen L.

    2005-01-01

    Introduction: This document outlines a research framework for water resource managers and land-use planners in the four-state Connecticut River Watershed (CRW). It specifically focuses on developing the decision-support tools and data needed by managers in the watershed. The purpose of the Science Framework is to identify critical research issues and information required to better equip managers to make decisions on desirable changes in the CRW. This Science Framework is the result of a cooperative project between the U.S. Geological Survey (USGS), the University of Massachusetts at Amherst (UMass-Amherst), and the U.S. Fish and Wildlife Service (FWS). The cooperative project was guided by a Science Steering Committee (SC) and included several focus groups, a 70-person workshop in September 2004, and an open collaborative process by which the workshop outcomes were synthesized, written up, and then progressively refined through peer review. This document is the product of that collaborative process.

  12. Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme: a longitudinal observational study.

    Science.gov (United States)

    Kontopantelis, Evangelos; Reeves, David; Valderas, Jose M; Campbell, Stephen; Doran, Tim

    2013-01-01

    The UK's Quality and Outcomes Framework (QOF) was introduced in 2004/5, linking remuneration for general practices to recorded quality of care for chronic conditions, including diabetes mellitus. We assessed the effect of the incentives on recorded quality of care for diabetes patients and its variation by patient and practice characteristics. Using the General Practice Research Database we selected a stratified sample of 148 English general practices in England, contributing data from 2000/1 to 2006/7, and obtained a random sample of 653,500 patients in which 23,920 diabetes patients identified. We quantified annually recorded quality of care at the patient-level, as measured by the 17 QOF diabetes indicators, in a composite score and analysed it longitudinally using an Interrupted Time Series design. Recorded quality of care improved for all subgroups in the pre-incentive period. In the first year of the incentives, composite quality improved over-and-above this pre-incentive trend by 14.2% (13.7-14.6%). By the third year the improvement above trend was smaller, but still statistically significant, at 7.3% (6.7-8.0%). After 3 years of the incentives, recorded levels of care varied significantly for patient gender, age, years of previous care, number of co-morbid conditions and practice diabetes prevalence. The introduction of financial incentives was associated with improvements in the recorded quality of diabetes care in the first year. These improvements included some measures of disease control, but most captured only documentation of recommended aspects of clinical assessment, not patient management or outcomes of care. Improvements in subsequent years were more modest. Variation in care between population groups diminished under the incentives, but remained substantial in some cases.

  13. Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes.

    Science.gov (United States)

    Achana, Felix A; Cooper, Nicola J; Bujkiewicz, Sylwia; Hubbard, Stephanie J; Kendrick, Denise; Jones, David R; Sutton, Alex J

    2014-07-21

    Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on

  14. Towards an oral healthcare framework and policy analysis for Swaziland

    OpenAIRE

    Mndzebele, Samuel

    2010-01-01

    Background and Rationale: A synopsis by the researcher suggested that caries was becoming a public health problem among the youth, hence there was a need for deeper investigations which would lead to possible oral health interventions. Purpose: The purpose of the study was to assess dental care practices and experiences among teenagers in the Northern region of Swaziland. Based on the outcomes and views from health professionals; develop a framework for oral healthcare delivery and ...

  15. improving utilization of conceptual and theoretical framework

    African Journals Online (AJOL)

    DR. MRS. AKPABIO

    KEYWORDS: Conceptual, Framework, Nursing, Research, Theoretical. INTRODUCTION ... frameworks, define the concepts in the framework and apply them .... abstraction; clinical utility and perspective on the issues of interest. Thus, before ...

  16. From parallel practice to integrative health care: a conceptual framework

    Directory of Open Access Journals (Sweden)

    O'Hara Dennis

    2004-07-01

    Full Text Available Abstract Background "Integrative health care" has become a common term to describe teams of health care providers working together to provide patient care. However this term has not been well-defined and likely means many different things to different people. The purpose of this paper is to develop a conceptual framework for describing, comparing and evaluating different forms of team-oriented health care practices that have evolved in Western health care systems. Discussion Seven different models of team-oriented health care practice are illustrated in this paper: parallel, consultative, collaborative, coordinated, multidisciplinary, interdisciplinary and integrative. Each of these models occupies a position along the proposed continuum from the non-integrative to fully integrative approach they take to patient care. The framework is developed around four key components of integrative health care practice: philosophy/values; structure, process and outcomes. Summary This framework can be used by patients and health care practitioners to determine what styles of practice meet their needs and by policy makers, healthcare managers and researchers to document the evolution of team practices over time. This framework may also facilitate exploration of the relationship between different practice models and health outcomes.

  17. Sediment Evaluation Framework for the Pacific Northwest

    Science.gov (United States)

    The Sediment Evaluation Framework provides a regional framework for assessment, characterization and management of sediments in the Pacific Northwest to determine suitability for unconfined in-water disposal.

  18. Measuring Population Health Outcomes

    OpenAIRE

    Parrish, R. Gibson

    2010-01-01

    An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

  19. Disaster Metrics: A Comprehensive Framework for Disaster Evaluation Typologies.

    Science.gov (United States)

    Wong, Diana F; Spencer, Caroline; Boyd, Lee; Burkle, Frederick M; Archer, Frank

    2017-10-01

    Introduction The frequency of disasters is increasing around the world with more people being at risk. There is a moral imperative to improve the way in which disaster evaluations are undertaken and reported with the aim of reducing preventable mortality and morbidity in future events. Disasters are complex events and undertaking disaster evaluations is a specialized area of study at an international level. Hypothesis/Problem While some frameworks have been developed to support consistent disaster research and evaluation, they lack validation, consistent terminology, and standards for reporting across the different phases of a disaster. There is yet to be an agreed, comprehensive framework to structure disaster evaluation typologies. The aim of this paper is to outline an evolving comprehensive framework for disaster evaluation typologies. It is anticipated that this new framework will facilitate an agreement on identifying, structuring, and relating the various evaluations found in the disaster setting with a view to better understand the process, outcomes, and impacts of the effectiveness and efficiency of interventions. Research was undertaken in two phases: (1) a scoping literature review (peer-reviewed and "grey literature") was undertaken to identify current evaluation frameworks and typologies used in the disaster setting; and (2) a structure was developed that included the range of typologies identified in Phase One and suggests possible relationships in the disaster setting. No core, unifying framework to structure disaster evaluation and research was identified in the literature. The authors propose a "Comprehensive Framework for Disaster Evaluation Typologies" that identifies, structures, and suggests relationships for the various typologies detected. The proposed Comprehensive Framework for Disaster Evaluation Typologies outlines the different typologies of disaster evaluations that were identified in this study and brings them together into a single

  20. Towards a framework of nuclear competencies

    International Nuclear Information System (INIS)

    Ghitescu, P.

    2012-01-01

    selection, student interview for development of individual training plan, start of the training activities under a specific training scheme. The introduction and recognition of ECVET will lead to a common taxonomy of competencies, and will provide also information about qualifications and units in numerical form, enabling mutual recognition of a training scheme. The description of the learning outcomes to be achieved for qualifying to a specific job profile may follow the analysis phase of the systematic approach to training (SAT). This would ensure a common tool, already used by all trainers. All these steps contribute to establishing of a framework of nuclear competencies recognized and accepted throughout member states. (authors)

  1. Towards a framework of nuclear competencies

    Energy Technology Data Exchange (ETDEWEB)

    Ghitescu, P. [Univ. Politehnica Bucharest, Spl. Independentei 313, 060042 (Romania)

    2012-07-01

    prerequisites and student selection, student interview for development of individual training plan, start of the training activities under a specific training scheme. The introduction and recognition of ECVET will lead to a common taxonomy of competencies, and will provide also information about qualifications and units in numerical form, enabling mutual recognition of a training scheme. The description of the learning outcomes to be achieved for qualifying to a specific job profile may follow the analysis phase of the systematic approach to training (SAT). This would ensure a common tool, already used by all trainers. All these steps contribute to establishing of a framework of nuclear competencies recognized and accepted throughout member states. (authors)

  2. Learning Outcomes Report

    NARCIS (Netherlands)

    Stoyanov, Slavi; Spoelstra, Howard; Burgoyne, Louise; O’Tuathaigh, Colm

    2018-01-01

    Aim of the study The learning outcomes study, conducted as part of WP3 of the BioApp project, has as objectives: (a) generating a comprehensive list of the learning outcomes; (b) reaching an agreement on the scope and priority of the learning outcomes, and (c) making suggestions for the further

  3. An extended framework for science.

    Science.gov (United States)

    Cazalis, Roland

    2017-12-01

    We may be at the cusp of a next generation framework for science which can be facilitated by understanding current limitations in the context of a divergence of 'scientific' tradition from the Axial Age (800-200 BCE) to the present. A powerful advance may come from fusing certain elements from Western and Eastern traditions, synthesizing the framework with an apt understanding of the divergence. Key traits will include the ethopoetic nature of the scientist with attention to his/her experience of self. The framework will also 'access' knowledge through a state of mind less encumbered with paradoxes, duality, incompatibility and other aporias. Case studies in biology and physics illustrate possibilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Plasmon holographic experiments: theoretical framework

    International Nuclear Information System (INIS)

    Verbeeck, J.; Dyck, D. van; Lichte, H.; Potapov, P.; Schattschneider, P.

    2005-01-01

    A theoretical framework is described to understand the results of plasmon holography experiments leading to insight in the meaning of the experimental results and pointing out directions for future experiments. The framework is based on the formalism of mutual intensity to describe how coherence is transferred through an optical system. For the inelastic interaction with the object, an expression for the volume plasmon excitations in a free electron gas is used as a model for the behaviour of aluminium. The formalism leads to a clear graphical intuitive tool for understanding the experiments. It becomes evident that the measured coherence is solely related to the angular distribution of the plasmon scattering in the case of bulk plasmons. After describing the framework, the special case of coherence outside a spherical particle is treated and the seemingly controversial idea of a plasmon with a limited coherence length obtained from experiments is clarified

  5. Liquid metal–organic frameworks

    Energy Technology Data Exchange (ETDEWEB)

    Gaillac, Romain; Pullumbi, Pluton; Beyer, Kevin A.; Chapman, Karena W.; Keen, David A.; Bennett, Thomas D.; Coudert, François-Xavier

    2017-10-09

    Metal–organic frameworks (MOFs) are a family of chemically diverse materials, with applications in a wide range of fields, covering engineering, physics, chemistry, biology and medicine. Until recently, research has focused almost entirely on crystalline structures, yet now a clear trend is emerging, shifting the emphasis onto disordered states, including ‘defective by design’ crystals, as well as amorphous phases such as glasses and gels. Here we introduce a strongly associated MOF liquid, obtained by melting a zeolitic imidazolate framework. We combine in situ variable temperature X-ray, ex situ neutron pair distribution function experiments, and first-principles molecular dynamics simulations to study the melting phenomenon and the nature of the liquid obtained. We demonstrate from structural, dynamical, and thermodynamical information that the chemical configuration, coordinative bonding, and porosity of the parent crystalline framework survive upon formation of the MOF liquid.

  6. Liquid metal-organic frameworks

    Science.gov (United States)

    Gaillac, Romain; Pullumbi, Pluton; Beyer, Kevin A.; Chapman, Karena W.; Keen, David A.; Bennett, Thomas D.; Coudert, François-Xavier

    2017-11-01

    Metal-organic frameworks (MOFs) are a family of chemically diverse materials, with applications in a wide range of fields, covering engineering, physics, chemistry, biology and medicine. Until recently, research has focused almost entirely on crystalline structures, yet now a clear trend is emerging, shifting the emphasis onto disordered states, including `defective by design’ crystals, as well as amorphous phases such as glasses and gels. Here we introduce a strongly associated MOF liquid, obtained by melting a zeolitic imidazolate framework. We combine in situ variable temperature X-ray, ex situ neutron pair distribution function experiments, and first-principles molecular dynamics simulations to study the melting phenomenon and the nature of the liquid obtained. We demonstrate from structural, dynamical, and thermodynamical information that the chemical configuration, coordinative bonding, and porosity of the parent crystalline framework survive upon formation of the MOF liquid.

  7. A Framework for Enterprise Operating Systems Based on Zachman Framework

    Science.gov (United States)

    Ostadzadeh, S. Shervin; Rahmani, Amir Masoud

    Nowadays, the Operating System (OS) isn't only the software that runs your computer. In the typical information-driven organization, the operating system is part of a much larger platform for applications and data that extends across the LAN, WAN and Internet. An OS cannot be an island unto itself; it must work with the rest of the enterprise. Enterprise wide applications require an Enterprise Operating System (EOS). Enterprise operating systems used in an enterprise have brought about an inevitable tendency to lunge towards organizing their information activities in a comprehensive way. In this respect, Enterprise Architecture (EA) has proven to be the leading option for development and maintenance of enterprise operating systems. EA clearly provides a thorough outline of the whole information system comprising an enterprise. To establish such an outline, a logical framework needs to be laid upon the entire information system. Zachman Framework (ZF) has been widely accepted as a standard scheme for identifying and organizing descriptive representations that have prominent roles in enterprise-wide system development. In this paper, we propose a framework based on ZF for enterprise operating systems. The presented framework helps developers to design and justify completely integrated business, IT systems, and operating systems which results in improved project success rate.

  8. A preliminary conceptual framework for cancer couple dyads: live with love.

    Science.gov (United States)

    Li, Qiuping; Loke, Alice Y

    2015-01-01

    With the research focus on family caregiving shifting from the individual to the dyadic level, there is a need to develop a conceptual framework that focused on caregiver-patient dyads. The aim of this study was to develop a preliminary conceptual framework for cancer couple dyads, to "Live With Love." A literature search was conducted among 4 electronic databases to identify couple-based intervention studies related to couples coping with cancer. This report differs from a traditional literature review in that we synthesized the models or frameworks used in these studies rather than the outcomes of the studies. A preliminary Live With Love Conceptual Framework (P-LLCF) for cancer couple dyads was developed based on the conceptual frameworks adopted in related literature on spousal caregiving for patients with cancer. This P-LLCF contains 3 domains: event situation, dyadic mediators, and caregiver-patient dyads (appraisal, coping, and adjustment/outcomes). The various components in this P-LLCF will work together to benefit the positive dyadic adjustment/outcomes of the spousal caregiver-patient dyads in the cancer dyads' journey of coping with cancer. This P-LLCF sheds new light on the study of cancer couple dyads. It will be potentially valuable for guiding the related research and development of interventions on cancer couple dyads. Future research is needed to assess the outcome of interventions that focus on different components. It is also needed to develop measurements to assess dyadic adjustment/outcomes in nursing practice.

  9. The Ontario Psychosocial Oncology Framework: a quality improvement tool.

    Science.gov (United States)

    Li, Madeline; Green, Esther

    2013-05-01

    To overview the newly developed Psychosocial Health Care for Cancer Patients and Their Families: A Framework to Guide Practice in Ontario and Guideline Recommendations in the context of Canadian psychosocial oncology care and propose strategies for guideline uptake and implementation. Recommendations from the 2008 Institute of Medicine standard Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs were adapted into the Ontario Psychosocial Oncology (PSO) Framework. Existing practice guidelines developed by the Canadian Partnership against Cancer and Cancer Care Ontario and standards developed by the Canadian Association of Psychosocial Oncology are supporting resources for adopting a quality improvement (QI) approach to the implementation of the framework in Ontario. The developed PSO Framework, including 31 specific actionable recommendations, is intended to improve the quality of comprehensive cancer care at both the provider and system levels. Important QI change management processes are described as Educate - raising awareness among medical teams of the significance of psychosocial needs of patients, Evidence - developing a research evidence base for patient care benefits from psychosocial interventions, and Electronics - using technology to collect patient reported outcomes of both physical and emotional symptoms. The Ontario PSO Framework is unique and valuable in providing actionable recommendations that can be implemented through QI processes. Overall, the result will be improved psychosocial health care for the cancer population. Copyright © 2012 John Wiley & Sons, Ltd.

  10. Policies on pets for healthy cities: a conceptual framework.

    Science.gov (United States)

    Rock, Melanie J; Adams, Cindy L; Degeling, Chris; Massolo, Alessandro; McCormack, Gavin R

    2015-12-01

    Drawing on the One Health concept, and integrating a dual focus on public policy and practices of caring from the Ottawa Charter for Health Promotion, we outline a conceptual framework to help guide the development and assessment of local governments' policies on pets. This framework emphasizes well-being in human populations, while recognizing that these outcomes relate to the well-being of non-human animals. Five intersecting spheres of activity, each associated with local governments' jurisdiction over pets, are presented: (i) preventing threats and nuisances from pets, (ii) meeting pets' emotional and physical needs, (iii) procuring pets ethically, (iv) providing pets with veterinary services and (v) licensing and identifying pets. This conceptual framework acknowledges the tenets of previous health promotion frameworks, including overlapping and intersecting influences. At the same time, this framework proposes to advance our understanding of health promotion and, more broadly, population health by underscoring interdependence between people and pets as well as the dynamism of urbanized ecologies. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Professional Ethics of Software Engineers: An Ethical Framework.

    Science.gov (United States)

    Lurie, Yotam; Mark, Shlomo

    2016-04-01

    The purpose of this article is to propose an ethical framework for software engineers that connects software developers' ethical responsibilities directly to their professional standards. The implementation of such an ethical framework can overcome the traditional dichotomy between professional skills and ethical skills, which plagues the engineering professions, by proposing an approach to the fundamental tasks of the practitioner, i.e., software development, in which the professional standards are intrinsically connected to the ethical responsibilities. In so doing, the ethical framework improves the practitioner's professionalism and ethics. We call this approach Ethical-Driven Software Development (EDSD), as an approach to software development. EDSD manifests the advantages of an ethical framework as an alternative to the all too familiar approach in professional ethics that advocates "stand-alone codes of ethics". We believe that one outcome of this synergy between professional and ethical skills is simply better engineers. Moreover, since there are often different software solutions, which the engineer can provide to an issue at stake, the ethical framework provides a guiding principle, within the process of software development, that helps the engineer evaluate the advantages and disadvantages of different software solutions. It does not and cannot affect the end-product in and of-itself. However, it can and should, make the software engineer more conscious and aware of the ethical ramifications of certain engineering decisions within the process.

  12. Benchmarking JavaScript Frameworks

    OpenAIRE

    Mariano, Carl Lawrence

    2017-01-01

    JavaScript programming language has been in existence for many years already and is one of the most widely known, if not, the most used front-end programming language in web development. However, JavaScript is still evolving and with the emergence of JavaScript Frameworks (JSF), there has been a major change in how developers develop software nowadays. Developers these days often use more than one framework in order to fulfil their job which has given rise to the problem for developers when i...

  13. Theoretical Framework for Robustness Evaluation

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard

    2011-01-01

    This paper presents a theoretical framework for evaluation of robustness of structural systems, incl. bridges and buildings. Typically modern structural design codes require that ‘the consequence of damages to structures should not be disproportional to the causes of the damages’. However, although...... the importance of robustness for structural design is widely recognized the code requirements are not specified in detail, which makes the practical use difficult. This paper describes a theoretical and risk based framework to form the basis for quantification of robustness and for pre-normative guidelines...

  14. A pedagogical design pattern framework

    DEFF Research Database (Denmark)

    May, Michael; Neutzsky-Wulff, Anne Chresteria; Rosthøj, Susanne

    2016-01-01

    ”Design patterns” were originally proposed in architecture and later in software engineering as a methodology to sketch and share solutions to recurring design problems. In recent years ”pedagogical design patterns” have been introduced as a way to sketch and share good practices in teaching...... framework is applied to describe the learning design in four online and blended learning courses within different academic disciplines: Classical Greek, Biostatistics, Environmental Management in Europe, and Climate Change Impacts, Adaptation and Mitigation. Future perspectives for using the framework...

  15. A value framework in head and neck cancer care.

    Science.gov (United States)

    de Souza, Jonas A; Seiwert, Tanguy Y

    2014-01-01

    The care of head and neck squamous cell carcinoma has greatly evolved over the past 30 years. From single modality to a multidisciplinary care, there has also been a concurrent increase in treatment intensity, resulting, at many times, in more zealous regimens that patients must endure. In this article, we apply Porter's value model as a framework to balance survival, toxicities, cost, and trade-offs from a patient's perspective in head and neck cancer. This model defines value as the health outcome per dollar achieved. Domains and outcomes that are important to patients, including not only survival or short-term quality of life, but also functional outcomes, recovery, sustainability of recovery, and the lasting consequences of therapy are included in this framework. Other outcomes that are seldom measured in head and neck cancer, such as work disability and financial toxicities, are also included and further discussed. Within this value model and based on evidence, we further discuss de-escalation of care, intensity-modulated radiation therapy, newer surgical methods, and enhancements in the process of care as potential approaches to add value for patients. Finally, we argue that knowing the patient's preferences is essential in the value discussion, as the attribute that will ultimately provide the most value to the individual patient with head and neck cancer.

  16. Developing an evaluation framework for clinical redesign programs: lessons learnt.

    Science.gov (United States)

    Samaranayake, Premaratne; Dadich, Ann; Fitzgerald, Anneke; Zeitz, Kathryn

    2016-09-19

    Purpose The purpose of this paper is to present lessons learnt through the development of an evaluation framework for a clinical redesign programme - the aim of which was to improve the patient journey through improved discharge practices within an Australian public hospital. Design/methodology/approach The development of the evaluation framework involved three stages - namely, the analysis of secondary data relating to the discharge planning pathway; the analysis of primary data including field-notes and interview transcripts on hospital processes; and the triangulation of these data sets to devise the framework. The evaluation framework ensured that resource use, process management, patient satisfaction, and staff well-being and productivity were each connected with measures, targets, and the aim of clinical redesign programme. Findings The application of business process management and a balanced scorecard enabled a different way of framing the evaluation, ensuring measurable outcomes were connected to inputs and outputs. Lessons learnt include: first, the importance of mixed-methods research to devise the framework and evaluate the redesigned processes; second, the need for appropriate tools and resources to adequately capture change across the different domains of the redesign programme; and third, the value of developing and applying an evaluative framework progressively. Research limitations/implications The evaluation framework is limited by its retrospective application to a clinical process redesign programme. Originality/value This research supports benchmarking with national and international practices in relation to best practice healthcare redesign processes. Additionally, it provides a theoretical contribution on evaluating health services improvement and redesign initiatives.

  17. Unidad 8. Frameworks (curso 2011-2012)

    OpenAIRE

    Rizo, David

    2011-01-01

    Se estudia el concepto de 'framework' y 'librería', con un ejemplo de desarrollo y aplicación de un framework de ejemplo. Se presentan algunos frameworks/librerías de uso común en Java, como el Java Collections Framework, JDBC, Hibernate, Apache Commons, etc.

  18. Overview of Java application configuration frameworks

    OpenAIRE

    Denisov, Victor

    2013-01-01

    This paper reviews three major application configuration frameworks for Java-based applications: java.util.Properties, Apache Commons Configuration and Preferences API. Basic functionality of each framework is illustrated with code examples. Pros and cons of each framework are described in moderate detail. Suggestions are made about typical use cases for each framework.

  19. Developing a Performance Assessment Framework and Indicators for Communicable Disease Management in Natural Disasters.

    Science.gov (United States)

    Babaie, Javad; Ardalan, Ali; Vatandoost, Hasan; Goya, Mohammad Mehdi; Akbarisari, Ali

    2016-02-01

    Communicable disease management (CDM) is an important component of disaster public health response operations. However, there is a lack of any performance assessment (PA) framework and related indicators for the PA. This study aimed to develop a PA framework and indicators in CDM in disasters. In this study, a series of methods were used. First, a systematic literature review (SLR) was performed in order to extract the existing PA frameworks and indicators. Then, using a qualitative approach, some interviews with purposively selected experts were conducted and used in developing the PA framework and indicators. Finally, the analytical hierarchy process (AHP) was used for weighting of the developed indicators. The input, process, products, and outcomes (IPPO) framework was found to be an appropriate framework for CDM PA. Seven main functions were revealed to CDM during disasters. Forty PA indicators were developed for the four categories. There is a lack of any existing PA framework in CDM in disasters. Thus, in this study, a PA framework (IPPO framework) was developed for the PA of CDM in disasters through a series of methods. It can be an appropriate framework and its indicators could measure the performance of CDM in disasters.

  20. Framework for control system development

    International Nuclear Information System (INIS)

    Cork, C.; Nishimura, Hiroshi

    1992-01-01

    Control systems being developed for the present generation of accelerators will need to adapt to changing machine and operating state conditions. Such systems must also be capable of evolving over the life of the accelerator operation. In this paper we present a framework for the development of adaptive control systems

  1. Frameworks Coordinate Scientific Data Management

    Science.gov (United States)

    2012-01-01

    Jet Propulsion Laboratory computer scientists developed a unique software framework to help NASA manage its massive amounts of science data. Through a partnership with the Apache Software Foundation of Forest Hill, Maryland, the technology is now available as an open-source solution and is in use by cancer researchers and pediatric hospitals.

  2. A business analytics capability framework

    Directory of Open Access Journals (Sweden)

    Ranko Cosic

    2015-09-01

    Full Text Available Business analytics (BA capabilities can potentially provide value and lead to better organisational performance. This paper develops a holistic, theoretically-grounded and practically relevant business analytics capability framework (BACF that specifies, defines and ranks the capabilities that constitute an organisational BA initiative. The BACF was developed in two phases. First, an a priori conceptual framework was developed based on the Resource-Based View theory of the firm and a thematic content analysis of the BA literature. Second, the conceptual framework was further developed and refined using a three round Delphi study involving 16 BA experts. Changes from the Delphi study resulted in a refined and confirmed framework including detailed capability definitions, together with a ranking of the capabilities based on importance. The BACF will help academic researchers and industry practitioners to better understand the capabilities that constitute an organisational BA initiative and their relative importance. In future work, the capabilities in the BACF will be operationalised to measure their as-is status, thus enabling organisations to identify key areas of strength and weakness and prioritise future capability improvement efforts.

  3. Legal framework: Renewables in Honduras

    International Nuclear Information System (INIS)

    Matute, Leonardo

    2000-01-01

    The paper describes the framework (organic structure and legislation) in promotion of renewables in Honduras, the policies for promotion of the free market of energy, laws on environmental protection and law of electricity. Also describes treties and agreements suscribed by Honduras in these matters

  4. Technology entrepreneurship : a process framework

    NARCIS (Netherlands)

    Zhou, Zhao

    2013-01-01

    Scholars are in search of an integrated perspective to explain entrepreneurship in a coherent way. This study sets to contribute to this search with a process framework for understanding similar patterns of entrepreneurship actions over time in different settings. This research uses the multi-case

  5. Theoretical Framework for Robustness Evaluation

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard

    2011-01-01

    This paper presents a theoretical framework for evaluation of robustness of structural systems, incl. bridges and buildings. Typically modern structural design codes require that ‘the consequence of damages to structures should not be disproportional to the causes of the damages’. However, althou...

  6. Framework for control system development

    International Nuclear Information System (INIS)

    Cork, C.; Nishimura, Hiroshi.

    1991-11-01

    Control systems being developed for the present generation of accelerators will need to adapt to changing machine and operating state conditions. Such systems must also be capable of evolving over the life of the accelerator operation. In this paper we present a framework for the development of adaptive control systems

  7. 2008 Arts Education Assessment Framework

    Science.gov (United States)

    National Assessment Governing Board, 2008

    2008-01-01

    The National Assessment of Educational Progress (NAEP) for the arts measures students' knowledge and skills in creating, performing, and responding to works of music, theatre, and visual arts. This framework document asserts that dance, music, theatre and the visual arts are important parts of a full education. When students engage in the arts,…

  8. Framework of synchromodal transportation problems

    NARCIS (Netherlands)

    Juncker, M.A.M. de; Huizing, D.; Vecchyo, M.R.O. del; Phillipson, F.; Sangers, A.

    2017-01-01

    Problem statements and solution methods in mathematical synchromodal transportation problems depend greatly on a set of model choices for which no rule of thumb exists. In this paper, a framework is introduced with which the model choices in synchromodal transportation problems can be classified,

  9. The Guided System Development Framework

    DEFF Research Database (Denmark)

    Carvalho Quaresma, Jose Nuno; Probst, Christian W.; Nielson, Flemming

    2011-01-01

    The Service-Oriented Computing paradigm has had significant influence on the Internet. With the emergence of this paradigm, it is important to provide tools that help developers designing and verifying such systems. In this article, we present the Guided System Development (GSD) Framework that aids...

  10. TIMSS Advanced 2015 Assessment Frameworks

    Science.gov (United States)

    Mullis, Ina V. S., Ed.; Martin, Michael O., Ed.

    2014-01-01

    The "TIMSS Advanced 2015 Assessment Frameworks" provides the foundation for the two international assessments to take place as part of the International Association for the Evaluation of Educational Achievement's TIMSS (Trends in International Mathematics and Science Study) Advanced 2015--Advanced Mathematics and Physics. Chapter 1 (Liv…

  11. Framework for Traffic Congestion Management

    Directory of Open Access Journals (Sweden)

    Mahmud Hassan TALUKDAR

    2013-06-01

    Full Text Available Traffic Congestion is one of many serious global problems in all great cities resulted from rapid urbanization which always exert negative externalities upon society. The solution of traffic congestion is highly geocentric and due to its heterogeneous nature, curbing congestion is one of the hard tasks for transport planners. It is not possible to suggest unique traffic congestion management framework which could be absolutely applied for every great cities. Conversely, it is quite feasible to develop a framework which could be used with or without minor adjustment to deal with congestion problem. So, the main aim of this paper is to prepare a traffic congestion mitigation framework which will be useful for urban planners, transport planners, civil engineers, transport policy makers, congestion management researchers who are directly or indirectly involved or willing to involve in the task of traffic congestion management. Literature review is the main source of information of this study. In this paper, firstly, traffic congestion is defined on the theoretical point of view and then the causes of traffic congestion are briefly described. After describing the causes, common management measures, using world- wide, are described and framework for supply side and demand side congestion management measures are prepared.

  12. A Framework for Video Modeling

    NARCIS (Netherlands)

    Petkovic, M.; Jonker, Willem

    In recent years, research in video databases has increased greatly, but relatively little work has been done in the area of semantic content-based retrieval. In this paper, we present a framework for video modelling with emphasis on semantic content of video data. The video data model presented

  13. Dialogue Coherence: A Generation Framework

    NARCIS (Netherlands)

    Beun, R.J.; Eijk, R.M. van

    2007-01-01

    This paper presents a framework for the generation of coherent elementary conversational sequences at the speech act level. We will embrace the notion of a cooperative dialogue game in which two players produce speech acts to transfer relevant information with respect to their commitments.

  14. Framework of Synchromodal Transportation Problems

    NARCIS (Netherlands)

    Huncker, M.A.M. de; Huizing, D.; Ortega del Vecchyo, M.R.; Phillipson, F.; Sangers, A.

    2017-01-01

    Problem statements and solution methods in mathematical synchromodal transportation problems depend greatly on a set of model choices for which no rule of thumb exists. In this paper, a framework is introduced with which the model choices in synchromodal transportation problems can be classified,

  15. High-Level Application Framework for LCLS

    Energy Technology Data Exchange (ETDEWEB)

    Chu, P; Chevtsov, S.; Fairley, D.; Larrieu, C.; Rock, J.; Rogind, D.; White, G.; Zalazny, M.; /SLAC

    2008-04-22

    A framework for high level accelerator application software is being developed for the Linac Coherent Light Source (LCLS). The framework is based on plug-in technology developed by an open source project, Eclipse. Many existing functionalities provided by Eclipse are available to high-level applications written within this framework. The framework also contains static data storage configuration and dynamic data connectivity. Because the framework is Eclipse-based, it is highly compatible with any other Eclipse plug-ins. The entire infrastructure of the software framework will be presented. Planned applications and plug-ins based on the framework are also presented.

  16. Ecological Modelling of Individual and Contextual Influences: A Person-in-Environment Framework for Hypothetico-Deductive Information Behaviour Research

    Science.gov (United States)

    Sin, Sei-Ching Joanna

    2015-01-01

    Introduction: This paper discusses the person-in-environment framework, which proposes the inclusion of environmental factors, alongside personal factors, as the explanatory factors of individual-level information behaviour and outcome. Method: The paper first introduces the principles and schematic formulas of the person-in-environment framework.…

  17. Ethnicity Recording in Primary Care Computerised Medical Record Systems: An Ontological Approach

    Directory of Open Access Journals (Sweden)

    Zayd Tippu

    2017-03-01

    Full Text Available Background Ethnicity recording within primary care computerised medical record (CMR systems is suboptimal, exacerbated by tangled taxonomies within current coding systems. Objective To develop a method for extending ethnicity identification using routinely collected data. Methods We used an ontological method to maximise the reliability and prevalence of ethnicity information in the Royal College of General Practitioner’s Research and Surveillance database. Clinical codes were either directly mapped to ethnicity group or utilised as proxy markers (such as language spoken from which ethnicity could be inferred. We compared the performance of our method with the recording rates that would be identified by code lists utilised by the UK pay for the performance system, with the help of the Quality and Outcomes Framework (QOF. Results Data from 2,059,453 patients across 110 practices were included. The overall categorisable ethnicity using QOF codes was 36.26% (95% confidence interval (CI: 36.20%–36.33%. This rose to 48.57% (CI:48.50%–48.64% using the described ethnicity mapping process. Mapping increased across all ethnic groups. The largest increase was seen in the white ethnicity category (30.61%; CI: 30.55%–30.67% to 40.24%; CI: 40.17%–40.30%. The highest relative increase was in the ethnic group categorised as the other (0.04%; CI: 0.03%–0.04% to 0.92%; CI: 0.91%–0.93%. Conclusions This mapping method substantially increases the prevalence of known ethnicity in CMR data and may aid future epidemiological research based on routine data.

  18. A practical comparison of agile web frameworks

    OpenAIRE

    Díaz Clavijo, David

    2014-01-01

    [ES] Los web frameworks son herramientas para mejorar el desarrollo y mantenimiento de sitios web. Aprender a utilizar un framework requiere varios meses y existen más de 100 web frameworks. Por ello es interesante que haya estudios que muestren sus diferencias. En este proyecto se realizó una comparativa de web frameworks para valorar sus diferencias, debilidades y fortalezas. Para seleccionar los web frameworks se utilizaron variables como las estadísticas de uso, popularidad y resultados e...

  19. Combined use of the Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF): a systematic review.

    Science.gov (United States)

    Birken, Sarah A; Powell, Byron J; Presseau, Justin; Kirk, M Alexis; Lorencatto, Fabiana; Gould, Natalie J; Shea, Christopher M; Weiner, Bryan J; Francis, Jill J; Yu, Yan; Haines, Emily; Damschroder, Laura J

    2017-01-05

    Over 60 implementation frameworks exist. Using multiple frameworks may help researchers to address multiple study purposes, levels, and degrees of theoretical heritage and operationalizability; however, using multiple frameworks may result in unnecessary complexity and redundancy if doing so does not address study needs. The Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF) are both well-operationalized, multi-level implementation determinant frameworks derived from theory. As such, the rationale for using the frameworks in combination (i.e., CFIR + TDF) is unclear. The objective of this systematic review was to elucidate the rationale for using CFIR + TDF by (1) describing studies that have used CFIR + TDF, (2) how they used CFIR + TDF, and (2) their stated rationale for using CFIR + TDF. We undertook a systematic review to identify studies that mentioned both the CFIR and the TDF, were written in English, were peer-reviewed, and reported either a protocol or results of an empirical study in MEDLINE/PubMed, PsycInfo, Web of Science, or Google Scholar. We then abstracted data into a matrix and analyzed it qualitatively, identifying salient themes. We identified five protocols and seven completed studies that used CFIR + TDF. CFIR + TDF was applied to studies in several countries, to a range of healthcare interventions, and at multiple intervention phases; used many designs, methods, and units of analysis; and assessed a variety of outcomes. Three studies indicated that using CFIR + TDF addressed multiple study purposes. Six studies indicated that using CFIR + TDF addressed multiple conceptual levels. Four studies did not explicitly state their rationale for using CFIR + TDF. Differences in the purposes that authors of the CFIR (e.g., comprehensive set of implementation determinants) and the TDF (e.g., intervention development) propose help to justify the use of CFIR

  20. The ACTIVE conceptual framework as a structural equation model

    Science.gov (United States)

    Gross, Alden L.; Payne, Brennan R.; Casanova, Ramon; Davoudzadeh, Pega; Dzierzewski, Joseph M.; Farias, Sarah; Giovannetti, Tania; Ip, Edward H.; Marsiske, Michael; Rebok, George W.; Schaie, K. Warner; Thomas, Kelsey; Willis, Sherry; Jones, Richard N.

    2018-01-01

    Background/Study Context Conceptual frameworks are analytic models at a high level of abstraction. Their operationalization can inform randomized trial design and sample size considerations. Methods The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) conceptual framework was empirically tested using structural equation modeling (N=2,802). ACTIVE was guided by a conceptual framework for cognitive training in which proximal cognitive abilities (memory, inductive reasoning, speed of processing) mediate treatment-related improvement in primary outcomes (everyday problem-solving, difficulty with activities of daily living, everyday speed, driving difficulty), which in turn lead to improved secondary outcomes (health-related quality of life, health service utilization, mobility). Measurement models for each proximal, primary, and secondary outcome were developed and tested using baseline data. Each construct was then combined in one model to evaluate fit (RMSEA, CFI, normalized residuals of each indicator). To expand the conceptual model and potentially inform future trials, evidence of modification of structural model parameters was evaluated by age, years of education, sex, race, and self-rated health status. Results Preconceived measurement models for memory, reasoning, speed of processing, everyday problem-solving, instrumental activities of daily living (IADL) difficulty, everyday speed, driving difficulty, and health-related quality of life each fit well to the data (all RMSEA .95). Fit of the full model was excellent (RMSEA = .038; CFI = .924). In contrast with previous findings from ACTIVE regarding who benefits from training, interaction testing revealed associations between proximal abilities and primary outcomes are stronger on average by nonwhite race, worse health, older age, and less education (p conceptual model. Findings suggest that the types of people who show intervention effects on cognitive performance potentially may be

  1. The ACTIVE conceptual framework as a structural equation model.

    Science.gov (United States)

    Gross, Alden L; Payne, Brennan R; Casanova, Ramon; Davoudzadeh, Pega; Dzierzewski, Joseph M; Farias, Sarah; Giovannetti, Tania; Ip, Edward H; Marsiske, Michael; Rebok, George W; Schaie, K Warner; Thomas, Kelsey; Willis, Sherry; Jones, Richard N

    2018-01-01

    Background/Study Context: Conceptual frameworks are analytic models at a high level of abstraction. Their operationalization can inform randomized trial design and sample size considerations. The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) conceptual framework was empirically tested using structural equation modeling (N=2,802). ACTIVE was guided by a conceptual framework for cognitive training in which proximal cognitive abilities (memory, inductive reasoning, speed of processing) mediate treatment-related improvement in primary outcomes (everyday problem-solving, difficulty with activities of daily living, everyday speed, driving difficulty), which in turn lead to improved secondary outcomes (health-related quality of life, health service utilization, mobility). Measurement models for each proximal, primary, and secondary outcome were developed and tested using baseline data. Each construct was then combined in one model to evaluate fit (RMSEA, CFI, normalized residuals of each indicator). To expand the conceptual model and potentially inform future trials, evidence of modification of structural model parameters was evaluated by age, years of education, sex, race, and self-rated health status. Preconceived measurement models for memory, reasoning, speed of processing, everyday problem-solving, instrumental activities of daily living (IADL) difficulty, everyday speed, driving difficulty, and health-related quality of life each fit well to the data (all RMSEA .95). Fit of the full model was excellent (RMSEA = .038; CFI = .924). In contrast with previous findings from ACTIVE regarding who benefits from training, interaction testing revealed associations between proximal abilities and primary outcomes are stronger on average by nonwhite race, worse health, older age, and less education (p conceptual model. Findings suggest that the types of people who show intervention effects on cognitive performance potentially may be different from

  2. The Effects of Quality of Care on Costs: A Conceptual Framework

    Science.gov (United States)

    Nuckols, Teryl K; Escarce, José J; Asch, Steven M

    2013-01-01

    Context The quality of health care and the financial costs affected by receiving care represent two fundamental dimensions for judging health care performance. No existing conceptual framework appears to have described how quality influences costs. Methods We developed the Quality-Cost Framework, drawing from the work of Donabedian, the RAND/UCLA Appropriateness Method, reports by the Institute of Medicine, and other sources. Findings The Quality-Cost Framework describes how health-related quality of care (aspects of quality that influence health status) affects health care and other costs. Structure influences process, which, in turn, affects proximate and ultimate outcomes. Within structure, subdomains include general structural characteristics, circumstance-specific (e.g., disease-specific) structural characteristics, and quality-improvement systems. Process subdomains include appropriateness of care and medical errors. Proximate outcomes consist of disease progression, disease complications, and care complications. Each of the preceding subdomains influences health care costs. For example, quality improvement systems often create costs associated with monitoring and feedback. Providing appropriate care frequently requires additional physician visits and medications. Care complications may result in costly hospitalizations or procedures. Ultimate outcomes include functional status as well as length and quality of life; the economic value of these outcomes can be measured in terms of health utility or health-status-related costs. We illustrate our framework using examples related to glycemic control for type 2 diabetes mellitus or the appropriateness of care for low back pain. Conclusions The Quality-Cost Framework describes the mechanisms by which health-related quality of care affects health care and health status–related costs. Additional work will need to validate the framework by applying it to multiple clinical conditions. Applicability could be assessed

  3. An Expanded Theoretical Framework of Care Coordination Across Transitions in Care Settings.

    Science.gov (United States)

    Radwin, Laurel E; Castonguay, Denise; Keenan, Carolyn B; Hermann, Cherice

    2016-01-01

    For many patients, high-quality, patient-centered, and cost-effective health care requires coordination among multiple clinicians and settings. Ensuring optimal care coordination requires a clear understanding of how clinician activities and continuity during transitions affect patient-centeredness and quality outcomes. This article describes an expanded theoretical framework to better understand care coordination. The framework provides clear articulation of concepts. Examples are provided of ways to measure the concepts.

  4. Generation of computationally predicted Adverse Outcome Pathway networks through integration of publicly available in vivo, in vitro, phenotype, and biological pathway data.

    Science.gov (United States)

    The Adverse Outcome Pathway (AOP) framework is becoming a widely used tool for organizing and summarizing the mechanistic information connecting molecular perturbations by environmental stressors with adverse ecological and human health outcomes. However, the conventional process...

  5. Measuring outcomes in children's rehabilitation: a decision protocol.

    Science.gov (United States)

    Law, M; King, G; Russell, D; MacKinnon, E; Hurley, P; Murphy, C

    1999-06-01

    To develop and test the feasibility and clinical utility of a computerized self-directed software program designed to enable service providers in children's rehabilitation to make decisions about the most appropriate outcome measures to use in client and program evaluation. A before-and-after design was used to test the feasibility and initial impact of the decision-making outcome software in improving knowledge and use of clinical outcome measures. A children's rehabilitation center in a city of 50,000. All service providers in the children's rehabilitation center. Disciplines represented included early childhood education, occupational therapy, physical therapy, speech and language pathology, audiology, social work, and psychology. Using a conceptual framework based on the International Classification of Impairment, Disability, and Handicap (ICIDH), an outcome measurement decision-making protocol was developed. The decision-making protocol was computerized in an educational software program with an attached database of critically appraised measures. Participants learned about outcome measures through the program and selected outcome measures that met their specifications. The computer software was tested for feasibility in the children's rehabilitation center for 6 months. Knowledge and use of clinical outcome measures were determined before and after the feasibility testing using a survey of all service providers currently at the centre and audits of 30 randomly selected rehabilitation records (at pretest, posttest, and follow-up). Service providers indicated that the outcomes software was easy to follow and believed that the use of the ICIDH framework helped them in making decisions about selecting outcome measures. Results of the survey indicated that there were significant changes in the service providers' level of comfort with selecting measures and knowing what measures were available. Use of outcome measures as identified through the audit did not change

  6. An integrative theoretical framework of acculturation and salutogenesis.

    Science.gov (United States)

    Riedel, Jeannette; Wiesmann, Ulrich; Hannich, Hans-Joachim

    2011-12-01

    During the last two decades, the number of international migrants worldwide has constantly risen. In this context, cross-cultural dimensions of psychological disorders receive increased attention, especially depression, anxiety and post-traumatic stress disorders among the migrant population. In this paper we propose a theoretical framework for the understanding of migrant mental health. This framework combines elements from Berry's acculturation model and Antonovsky's salutogenic theory. The former illustrates the main factors that affect an individual's adaptation in a new cultural context. The term acculturative stress denotes unresolved problems resulting from intercultural contact that cannot be overcome easily by simply adjusting or assimilating. The latter specifies the relationship between culturally associated stress and mental health more distinctive, introducing the concepts of generalized resistance resources and sense of coherence that determine mental health outcomes of migrants during acculturative stress periods. Specifically, we provide an integrative framework of acculturation and salutogenesis that helps to integrate inconsistent findings in the migrant mental health literature. The current paper focuses on the effect of resource factors for positive mental health outcomes in the migrant population and summarises some implications for future research activities.

  7. A conceptual and disease model framework for osteoporotic kyphosis.

    Science.gov (United States)

    Bayliss, M; Miltenburger, C; White, M; Alvares, L

    2013-09-01

    This paper presents a multi-method research project to develop a conceptual framework for measuring outcomes in studies of osteoporotic kyphosis. The research involved literature research and qualitative interviews among clinicians who treat patients with kyphosis and among patients with the condition. Kyphosis due to at least one vertebral compression fracture is prevalent among osteoporotic patients, resulting in well-documented symptoms and impact on functioning and well-being. A three-part study led to development of a conceptual measurement framework for comprehensive assessment of symptoms, impact, and treatment benefit for kyphosis. A literature-based disease model (DM) was developed and tested with physicians (n = 10) and patients (n = 10), and FDA guidelines were used to develop a final disease model and a conceptual framework. The DM included signs, symptoms, causes/triggers, exacerbations, and functional status associated with kyphosis. The DM was largely confirmed, but physicians and patients added several concepts related to impact on functioning, and some concepts were not confirmed and removed from the DM. This study confirms the need for more comprehensive assessment of health outcomes in kyphosis, as most current studies omit key concepts.

  8. The interactive systems framework applied to the strategic prevention framework: the Rhode Island experience.

    Science.gov (United States)

    Florin, Paul; Friend, Karen B; Buka, Stephen; Egan, Crystelle; Barovier, Linda; Amodei, Brenda

    2012-12-01

    The Interactive Systems Framework for Dissemination and Implementation (ISF) was introduced as a heuristic systems level model to help bridge the gap between research and practice (Wandersman et al., in Am J Commun Psychol 41:171-181, 2008). This model describes three interacting systems with distinct functions that (1) distill knowledge to develop innovations; (2) provide supportive training and technical assistance for dissemination to; (3) a prevention delivery system responsible for implementation in the field. The Strategic Prevention Framework (SPF) is a major prevention innovation launched by the Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA). The SPF offers a structured, sequential, data-driven approach that explicitly targets environmental conditions in the community and aims for change in substance use and problems at the population level. This paper describes how the ISF was applied to the challenges of implementing the SPF in 14 Rhode Island communities, with a focus on the development of a new Training and Technical Assistance Resources Center to support SPF efforts. More specifically, we (1) describe each of the three ISF interacting systems as they evolved in Rhode Island; (2) articulate the lines of communication between the three systems; and (3) examine selected evaluation data to understand relationships between training and technical assistance and SPF implementation and outcomes.

  9. Computer-Aided Modeling Framework

    DEFF Research Database (Denmark)

    Fedorova, Marina; Sin, Gürkan; Gani, Rafiqul

    Models are playing important roles in design and analysis of chemicals based products and the processes that manufacture them. Computer-aided methods and tools have the potential to reduce the number of experiments, which can be expensive and time consuming, and there is a benefit of working...... development and application. The proposed work is a part of the project for development of methods and tools that will allow systematic generation, analysis and solution of models for various objectives. It will use the computer-aided modeling framework that is based on a modeling methodology, which combines....... In this contribution, the concept of template-based modeling is presented and application is highlighted for the specific case of catalytic membrane fixed bed models. The modeling template is integrated in a generic computer-aided modeling framework. Furthermore, modeling templates enable the idea of model reuse...

  10. The power reinforcement framework revisited

    DEFF Research Database (Denmark)

    Nielsen, Jeppe; Andersen, Kim Normann; Danziger, James N.

    2016-01-01

    Whereas digital technologies are often depicted as being capable of disrupting long-standing power structures and facilitating new governance mechanisms, the power reinforcement framework suggests that information and communications technologies tend to strengthen existing power arrangements within...... public organizations. This article revisits the 30-yearold power reinforcement framework by means of an empirical analysis on the use of mobile technology in a large-scale programme in Danish public sector home care. It explores whether and to what extent administrative management has controlled decision......-making and gained most benefits from mobile technology use, relative to the effects of the technology on the street-level workers who deliver services. Current mobile technology-in-use might be less likely to be power reinforcing because it is far more decentralized and individualized than the mainly expert...

  11. COLDEX New Data Acquisition Framework

    CERN Document Server

    Grech, Christian

    2015-01-01

    COLDEX (COLD bore EXperiment) is an experiment of the TE-VSC group installed in the Super Proton Synchrotron (SPS) which mimics a LHC type cryogenic vacuum system. In the framework of the High Luminosity upgrade of the LHC (HL-LHC project), COLDEX has been recommissioned in 2014 in order to validate carbon coatings performances at cryogenic temperature with LHC type beams. To achieve this mission, a data acquisition system is needed to retrieve and store information from the different experiment’s systems (vacuum, cryogenics, controls, safety) and perform specific calculations. This work aimed to completely redesign, implement, test and operate a brand new data acquisition framework based on communication with the experiment’s PLCs for the devices potentially available over network. The communication protocol to the PLCs is based on data retrieval both from CERN middleware infrastructures (CMW, JAPC) and on a novel open source Simatic S7 data exchange package over TCP/IP (libnodave).

  12. Zend Framework 2 application development

    CERN Document Server

    Valles, Christopher

    2013-01-01

    The book is really pragmatic, focusing on the key aspects you usually need to create an application. We skip the boring theory and jump straight to the action. Also, the examples don't try to be perfect, they just show the topic in question or the tool/components we are using. Here the focus is on the framework itself not on how to architect applications. The book will spend a lot of time reviewing the examples and each chapter is created around the example used to explain the topics so the example is first, then the explanation.This book is great for you if you are new to Zend Framework 2 and

  13. A Conceptual Framework for Graduate Teaching Assistant Professional Development Evaluation and Research.

    Science.gov (United States)

    Reeves, Todd D; Marbach-Ad, Gili; Miller, Kristen R; Ridgway, Judith; Gardner, Grant E; Schussler, Elisabeth E; Wischusen, E William

    2016-01-01

    Biology graduate teaching assistants (GTAs) are significant contributors to the educational mission of universities, particularly in introductory courses, yet there is a lack of empirical data on how to best prepare them for their teaching roles. This essay proposes a conceptual framework for biology GTA teaching professional development (TPD) program evaluation and research with three overarching variable categories for consideration: outcome variables, contextual variables, and moderating variables. The framework's outcome variables go beyond GTA satisfaction and instead position GTA cognition, GTA teaching practice, and undergraduate learning outcomes as the foci of GTA TPD evaluation and research. For each GTA TPD outcome variable, key evaluation questions and example assessment instruments are introduced to demonstrate how the framework can be used to guide GTA TPD evaluation and research plans. A common conceptual framework is also essential to coordinating the collection and synthesis of empirical data on GTA TPD nationally. Thus, the proposed conceptual framework serves as both a guide for conducting GTA TPD evaluation at single institutions and as a means to coordinate research across institutions at a national level. © 2016 T. D. Reeves et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  14. LSD: Large Survey Database framework

    Science.gov (United States)

    Juric, Mario

    2012-09-01

    The Large Survey Database (LSD) is a Python framework and DBMS for distributed storage, cross-matching and querying of large survey catalogs (>10^9 rows, >1 TB). The primary driver behind its development is the analysis of Pan-STARRS PS1 data. It is specifically optimized for fast queries and parallel sweeps of positionally and temporally indexed datasets. It transparently scales to more than >10^2 nodes, and can be made to function in "shared nothing" architectures.

  15. Privatization Framework: Political Economy Perspective

    OpenAIRE

    Bastian, Indra

    2009-01-01

    Privatization has been recognized as a worldwide phenomenon. In this pa-per, a political economy approach is developed to analyze privatization. The ap-proach assumes that political economy and privatization overlap in people’s need. So, the framework of political economy in privatization is based on the ‘need’ phi-losophy. Government and private sectors are contrasted in this respect, leading to a conclusion on privatization as a method to manage the economy. Keywords: privatization, politic...

  16. Spring Framework 5: Themes & Trends

    CERN Document Server

    CERN. Geneva

    2017-01-01

    Spring Framework 5.0/5.1, scheduled for release in early/late 2017, focuses on several key themes: reactive web applications based on Reactive Streams, comprehensive support for JDK 9 and HTTP/2, as well as the latest API generations in the Enterprise Java ecosystem. This talk presents the overall story in the context of wider industry trends, highlighting Spring’s unique programming model strategy.

  17. Technical framework for groundwater restoration

    International Nuclear Information System (INIS)

    1991-04-01

    This document provides the technical framework for groundwater restoration under Phase II of the Uranium Mill Tailings Remedial Action (UMTRA) Project. A preliminary management plan for Phase II has been set forth in a companion document titled ''Preplanning Guidance Document for Groundwater Restoration''. General principles of site characterization for groundwater restoration, restoration methods, and treatment are discussed in this document to provide an overview of standard technical approaches to groundwater restoration

  18. Entity Framework 41 Expert's Cookbook

    CERN Document Server

    Liles, Devlin

    2012-01-01

    This book takes a step-by-step problem solving approach that leads you through a problem and explains each step in detail to accomplish the goal. This books gives you concrete code examples as well as detailed information on the decisions involved. This book is for intermediate to advanced .NET developers who have used LINQ to SQL or Entity Framework in some form but want to have more control over the implementation.

  19. Towards a smart home framework

    OpenAIRE

    Alam, Muddasser; Alan, Alper; Rogers, Alex; Ramchurn, Sarvapali D.

    2013-01-01

    We present our Smart Home Framework (SHF) which simplifies the modelling, prototyping and simulation of smart infrastructure (i.e., smart home and smart communities). It provides the buildings blocks (e.g., home appliances) that can be extended and assembled together to build a smart infrastructure model to which appropriate AI techniques can be applied. This approach enables rapid modelling where new research initiatives can build on existing work.

  20. Framework and indicator testing protocol for developing and piloting quality indicators for the UK quality and outcomes framework

    NARCIS (Netherlands)

    Campbell, S.M.; Kontopantelis, E.; Hannon, K.; Burke, M.; Barber, A.; Lester, H.E.

    2011-01-01

    BACKGROUND: Quality measures should be subjected to a testing protocol before being used in practice using key attributes such as acceptability, feasibility and reliability, as well as identifying issues derived from actual implementation and unintended consequences. We describe the methodologies

  1. Studying the clinical encounter with the Adaptive Leadership framework.

    Science.gov (United States)

    Bailey, Donald E; Docherty, Sharron L; Adams, Judith A; Carthron, Dana L; Corazzini, Kirsten; Day, Jennifer R; Neglia, Elizabeth; Thygeson, Marcus; Anderson, Ruth A

    2012-08-01

    In this paper we discuss the concept of leadership as a personal capability, not contingent on one's position in a hierarchy. This type of leadership allows us to reframe both the care-giving and organizational roles of nurses and other front-line clinical staff. Little research has been done to explore what leadership means at the point of care, particularly in reference to the relationship between health care practitioners and patients and their family caregivers. The Adaptive Leadership framework, based on complexity science theory, provides a useful lens to explore practitioners' leadership behaviors at the point of care. This framework proposes that there are two broad categories of challenges that patients face: technical and adaptive. Whereas technical challenges are addressed with technical solutions that are delivered by practitioners, adaptive challenges require the patient (or family member) to adjust to a new situation and to do the work of adapting, learning, and behavior change. Adaptive leadership is the work that practitioners do to mobilize and support patients to do the adaptive work. The purpose of this paper is to describe this framework and demonstrate its application to nursing research. We demonstrate the framework's utility with five exemplars of nursing research problems that range from the individual to the system levels. The framework has the potential to guide researchers to ask new questions and to gain new insights into how practitioners interact with patients at the point of care to increase the patient's ability to tackle challenging problems and improve their own health care outcomes. It is a potentially powerful framework for developing and testing a new generation of interventions to address complex issues by harnessing and learning about the adaptive capabilities of patients within their life contexts.

  2. Framework for teleoperated microassembly systems

    Science.gov (United States)

    Reinhart, Gunther; Anton, Oliver; Ehrenstrasser, Michael; Patron, Christian; Petzold, Bernd

    2002-02-01

    Manual assembly of minute parts is currently done using simple devices such as tweezers or magnifying glasses. The operator therefore requires a great deal of concentration for successful assembly. Teleoperated micro-assembly systems are a promising method for overcoming the scaling barrier. However, most of today's telepresence systems are based on proprietary and one-of-a-kind solutions. Frameworks which supply the basic functions of a telepresence system, e.g. to establish flexible communication links that depend on bandwidth requirements or to synchronize distributed components, are not currently available. Large amounts of time and money have to be invested in order to create task-specific teleoperated micro-assembly systems from scratch. For this reason, an object-oriented framework for telepresence systems that is based on CORBA as a common middleware was developed at the Institute for Machine Tools and Industrial Management (iwb). The framework is based on a distributed architectural concept and is realized in C++. External hardware components such as haptic, video or sensor devices are coupled to the system by means of defined software interfaces. In this case, the special requirements of teleoperation systems have to be considered, e.g. dynamic parameter settings for sensors during operation. Consequently, an architectural concept based on logical sensors has been developed to achieve maximum flexibility and to enable a task-oriented integration of hardware components.

  3. The Joint COntrols Project Framework

    CERN Document Server

    González-Berges, M

    2003-01-01

    The Framework is one of the subprojects of the Joint COntrols Project (JCOP), which is collaboration between the four LHC experiments and CERN. By sharing development, this will reduce the overall effort required to build and maintain the experiment control systems. As such, the main aim of the Framework is to deliver a common set of software components, tools and guidelines that can be used by the four LHC experiments to build their control systems. Although commercial components are used wherever possible, further added value is obtained by customisation for HEP-specific applications. The supervisory layer of the Framework is based on the SCADA tool PVSS, which was selected after a detailed evaluation. This is integrated with the front-end layer via both OPC (OLE for Process Control), an industrial standard, and the CERN-developed DIM (Distributed Information Management System) protocol. Several components are already in production and being used by running fixed-target experiments at CERN as well as for th...

  4. Architectural frameworks: defining the structures for implementing learning health systems.

    Science.gov (United States)

    Lessard, Lysanne; Michalowski, Wojtek; Fung-Kee-Fung, Michael; Jones, Lori; Grudniewicz, Agnes

    2017-06-23

    The vision of transforming health systems into learning health systems (LHSs) that rapidly and continuously transform knowledge into improved health outcomes at lower cost is generating increased interest in government agencies, health organizations, and health research communities. While existing initiatives demonstrate that different approaches can succeed in making the LHS vision a reality, they are too varied in their goals, focus, and scale to be reproduced without undue effort. Indeed, the structures necessary to effectively design and implement LHSs on a larger scale are lacking. In this paper, we propose the use of architectural frameworks to develop LHSs that adhere to a recognized vision while being adapted to their specific organizational context. Architectural frameworks are high-level descriptions of an organization as a system; they capture the structure of its main components at varied levels, the interrelationships among these components, and the principles that guide their evolution. Because these frameworks support the analysis of LHSs and allow their outcomes to be simulated, they act as pre-implementation decision-support tools that identify potential barriers and enablers of system development. They thus increase the chances of successful LHS deployment. We present an architectural framework for LHSs that incorporates five dimensions-goals, scientific, social, technical, and ethical-commonly found in the LHS literature. The proposed architectural framework is comprised of six decision layers that model these dimensions. The performance layer models goals, the scientific layer models the scientific dimension, the organizational layer models the social dimension, the data layer and information technology layer model the technical dimension, and the ethics and security layer models the ethical dimension. We describe the types of decisions that must be made within each layer and identify methods to support decision-making. In this paper, we outline

  5. Evaluation of Frameworks for HSCT Design Optimization

    Science.gov (United States)

    Krishnan, Ramki

    1998-01-01

    This report is an evaluation of engineering frameworks that could be used to augment, supplement, or replace the existing FIDO 3.5 (Framework for Interdisciplinary Design and Optimization Version 3.5) framework. The report begins with the motivation for this effort, followed by a description of an "ideal" multidisciplinary design and optimization (MDO) framework. The discussion then turns to how each candidate framework stacks up against this ideal. This report ends with recommendations as to the "best" frameworks that should be down-selected for detailed review.

  6. Design of Mobile Augmented Reality in Health Care Education: A Theory-Driven Framework

    Science.gov (United States)

    Lilienthal, Anneliese; Shluzas, Lauren Aquino; Masiello, Italo; Zary, Nabil

    2015-01-01

    Background Augmented reality (AR) is increasingly used across a range of subject areas in health care education as health care settings partner to bridge the gap between knowledge and practice. As the first contact with patients, general practitioners (GPs) are important in the battle against a global health threat, the spread of antibiotic resistance. AR has potential as a practical tool for GPs to combine learning and practice in the rational use of antibiotics. Objective This paper was driven by learning theory to develop a mobile augmented reality education (MARE) design framework. The primary goal of the framework is to guide the development of AR educational apps. This study focuses on (1) identifying suitable learning theories for guiding the design of AR education apps, (2) integrating learning outcomes and learning theories to support health care education through AR, and (3) applying the design framework in the context of improving GPs’ rational use of antibiotics. Methods The design framework was first constructed with the conceptual framework analysis method. Data were collected from multidisciplinary publications and reference materials and were analyzed with directed content analysis to identify key concepts and their relationships. Then the design framework was applied to a health care educational challenge. Results The proposed MARE framework consists of three hierarchical layers: the foundation, function, and outcome layers. Three learning theories—situated, experiential, and transformative learning—provide foundational support based on differing views of the relationships among learning, practice, and the environment. The function layer depends upon the learners’ personal paradigms and indicates how health care learning could be achieved with MARE. The outcome layer analyzes different learning abilities, from knowledge to the practice level, to clarify learning objectives and expectations and to avoid teaching pitched at the wrong level

  7. Design of Mobile Augmented Reality in Health Care Education: A Theory-Driven Framework.

    Science.gov (United States)

    Zhu, Egui; Lilienthal, Anneliese; Shluzas, Lauren Aquino; Masiello, Italo; Zary, Nabil

    2015-09-18

    Augmented reality (AR) is increasingly used across a range of subject areas in health care education as health care settings partner to bridge the gap between knowledge and practice. As the first contact with patients, general practitioners (GPs) are important in the battle against a global health threat, the spread of antibiotic resistance. AR has potential as a practical tool for GPs to combine learning and practice in the rational use of antibiotics. This paper was driven by learning theory to develop a mobile augmented reality education (MARE) design framework. The primary goal of the framework is to guide the development of AR educational apps. This study focuses on (1) identifying suitable learning theories for guiding the design of AR education apps, (2) integrating learning outcomes and learning theories to support health care education through AR, and (3) applying the design framework in the context of improving GPs' rational use of antibiotics. The design framework was first constructed with the conceptual framework analysis method. Data were collected from multidisciplinary publications and reference materials and were analyzed with directed content analysis to identify key concepts and their relationships. Then the design framework was applied to a health care educational challenge. The proposed MARE framework consists of three hierarchical layers: the foundation, function, and outcome layers. Three learning theories-situated, experiential, and transformative learning-provide foundational support based on differing views of the relationships among learning, practice, and the environment. The function layer depends upon the learners' personal paradigms and indicates how health care learning could be achieved with MARE. The outcome layer analyzes different learning abilities, from knowledge to the practice level, to clarify learning objectives and expectations and to avoid teaching pitched at the wrong level. Suggestions for learning activities and the

  8. Lifestyle and IVF Outcomes.

    Science.gov (United States)

    Hornstein, Mark D

    2016-12-01

    Whereas much has been written about the prognostic factors associated with outcomes of in vitro fertilization (IVF) such as female age, diagnosis, and ovarian reserve, relatively little attention has been devoted to patient-oriented lifestyles that may influence IVF outcomes. Patients are particularly interested in this topic because many patients wish to partner with their physicians and want to know specific behaviors to improve their chances of IVF success. This brief review is not intended as an exhaustive literature search of all possible lifestyles that may influence assisted reproductive outcome nor is it intended to be a comprehensive review of individual topics. It does give, however, a brief overview of a number of areas in which patient-specific behaviors may influence outcomes in assisted reproduction. Specifically, this review will look at the effects of smoking, alcohol consumption, caffeine, diet, exercise, and exposure to the reproductive toxin bisphenol A on IVF outcomes. © The Author(s) 2016.

  9. Interpreting the NLN Jeffries Framework in the context of Nurse Educator preparation.

    Science.gov (United States)

    Young, Patricia K; Shellenbarger, Teresa

    2012-08-01

    The NLN Jeffries Framework describing simulation in nursing education has been used widely to guide construction of human patient simulation scenarios and serve as a theoretical framework for research on the use of simulation. This framework was developed with a focus on prelicensure nursing education. However, use of human patient simulation scenarios is also a way of providing practice experiences for graduate students learning the educator role. High-fidelity human patient simulation offers nurse educator faculty a unique opportunity to cultivate the practical knowledge of teaching in an interactive and dynamic environment. This article describes how the components of The NLN Jeffries Framework can help to guide simulation design for nurse educator preparation. Adapting the components of the framework-which include teacher, student, educational practices, design characteristics, and outcomes-helps to ensure that future faculty gain hands-on experience with nurse educator core competencies. Copyright 2012, SLACK Incorporated.

  10. Positive Youth Development and Nutrition: Interdisciplinary Strategies to Enhance Student Outcomes

    Science.gov (United States)

    Edwards, Oliver W.; Cheeley, Taylor

    2016-01-01

    Educational policies require the use of data and progress monitoring frameworks to guide instruction and intervention in schools. As a result, different problem-solving models such as multitiered systems of supports (MTSS) have emerged that use these frameworks to improve student outcomes. However, problem-focused models emphasize negative…

  11. The Digital Divide and Health Outcomes: A Teleretinal Imaging Study

    Science.gov (United States)

    Connolly, Kathleen Kihmm

    2013-01-01

    The purpose of this research project was to understand, explore and describe the digital divide and the relationship between technology utilization and health outcomes. Diabetes and diabetic eye disease was used as the real-life context for understanding change and exploring the digital divide. As an investigational framework, a telemedicine…

  12. The outcome of the 1995 NPT review and extension conference

    International Nuclear Information System (INIS)

    Dhanapala, J.

    1995-01-01

    The outcome of the 1995 Non-Proliferation Treaty(NPT) Review and Extension Conference is analyzed. The following issues are discussed: the campaign for an indefinite extension; the policy framework for the extension decision; extension options; the future of a permanently extended NPT

  13. Use of Putative Adverse Outcome Pathways for Chemical Hazard Identification

    Science.gov (United States)

    The Adverse Outcome Pathway (AOP) framework provides a knowledge infrastructure for evaluating health effects of environmental chemicals. In this work we are examining proof-of-concept issues in the development and prospective application of AOPs in chemical safety. Key outputs i...

  14. A framework for designing hand hygiene educational interventions in schools.

    Science.gov (United States)

    Appiah-Brempong, Emmanuel; Harris, Muriel J; Newton, Samuel; Gulis, Gabriel

    2018-03-01

    Hygiene education appears to be the commonest school-based intervention for preventing infectious diseases, especially in the developing world. Nevertheless, there remains a gap in literature regarding a school-specific theory-based framework for designing a hand hygiene educational intervention in schools. We sought to suggest a framework underpinned by psychosocial theories towards bridging this knowledge gap. Furthermore, we sought to propound a more comprehensive definition of hand hygiene which could guide the conceptualisation of hand hygiene interventions in varied settings. Literature search was guided by a standardized tool and literature was retrieved on the basis of a predetermined inclusion criteria. Databases consulted include PubMed, ERIC, and EBSCO host (Medline, CINAHL, PsycINFO, etc.). Evidence bordering on a theoretical framework to aid the design of school-based hand hygiene educational interventions is summarized narratively. School-based hand hygiene educational interventions seeking to positively influence behavioural outcomes could consider enhancing psychosocial variables including behavioural capacity, attitudes and subjective norms (normative beliefs and motivation to comply). A framework underpinned by formalized psychosocial theories has relevance and could enhance the design of hand hygiene educational interventions, especially in schools.

  15. A framework for the organization and delivery of systemic treatment.

    Science.gov (United States)

    Vandenberg, T; Coakley, N; Nayler, J; Degrasse, C; Green, E; Mackay, J A; McLennan, C; Smith, A; Wilcock, L; Trudeau, M E

    2009-01-01

    Increasing systemic treatment and shortages of oncology professionals in Canada require innovative approaches to the safe and effective delivery of intravenous (IV) cancer treatment. We conducted a systematic review of the clinical and scientific literature, and an environmental scan of models in Canada, the United Kingdom, Australia, and New Zealand. We then developed a framework for the organization and delivery of IV systemic treatment. The systematic review covered the medline, embase, cinahl, and HealthStar databases. The environmental scan retrieved published and unpublished sources, coupled with a free key word search using the Google search engine. The Systemic Treatment Working Group reviewed the evidence and developed a draft framework using evidence-based analysis, existing recommendations from various jurisdictions, and expert opinion based on experience and consensus. The draft was assessed by Ontario stakeholders and reviewed and approved by Cancer Care Ontario. The poor quantity and quality of the evidence necessitated a consensus-derived model. That model comprises four levels of care determined by a regional systemic treatment program and three integrated structures (integrated cancer programs, affiliate institutions, and satellite institutions), each with a defined scope of practice and a specific organizational framework. New models of care are urgently required beyond large centres, particularly in geographically remote or rural areas. Despite limited applicable evidence, the development and successful implementation of this framework is intended to create sustainable, accessible, quality care and to measurably improve patient outcomes.

  16. Trajectories of women's abortion-related care: A conceptual framework.

    Science.gov (United States)

    Coast, Ernestina; Norris, Alison H; Moore, Ann M; Freeman, Emily

    2018-03-01

    We present a new conceptual framework for studying trajectories to obtaining abortion-related care. It assembles for the first time all of the known factors influencing a trajectory and encourages readers to consider the ways these macro- and micro-level factors operate in multiple and sometimes conflicting ways. Based on presentation to and feedback from abortion experts (researchers, providers, funders, policymakers and advisors, advocates) (n = 325) between 03/06/2014 and 22/08/2015, and a systematic mapping of peer-reviewed literature (n = 424) published between 01/01/2011 and 30/10/2017, our framework synthesises the factors shaping abortion trajectories, grouped into three domains: abortion-specific experiences, individual contexts, and (inter)national and sub-national contexts. Our framework includes time-dependent processes involved in an individual trajectory, starting with timing of pregnancy awareness. This framework can be used to guide testable hypotheses about enabling and inhibiting influences on care-seeking behaviour and consideration about how abortion trajectories might be influenced by policy or practice. Research based on understanding of trajectories has the potential to improve women's experiences and outcomes of abortion-related care. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  17. Endurance with partnership: a preliminary conceptual framework for couples undergoing in vitro fertilisation treatment.

    Science.gov (United States)

    Ying, Liying; Wu, Lai Har; Wu, Xiangli; Shu, Jing; Loke, Alice Yuen

    2018-04-01

    Infertility affects both women and men in the physical, emotional, existential, and interpersonal realms. When couples seek in vitro fertilisation (IVF) treatment, they further suffer from the difficulties of the treatment and the uncertainty of its outcome. The aim of this study was to develop a preliminary conceptual framework for couples undergoing IVF treatment to give health professionals a better understanding of the experiences of such couples, and to guide the development of an intervention. The process of identifying frameworks adopted in intervention studies confirmed that there is no established framework for infertile couples undergoing IVF treatment. A skeletal framework identified from previous studies provides an internal structure for the proposed framework for couples undergoing IVF treatment, filled out with concepts drawn from a concept analysis and a qualitative study, knitting the structure together. This preliminary framework is the Endurance with Partnership Conceptual Framework (P-EPCF). It consists of four domains: the impacts of infertility and stressors, dyadic mediators, dyadic moderators and dyadic outcomes. According to the P-EPCF, the impacts of infertility and IVF treatment can be mediated by the couples' partnership and dyadic coping. Improvements in the psychological well-being and marital functioning of IVF couples can then be expected. The P-EPCF would be potentially valuable in guiding the development of a complex, couple-based intervention, which could focus on enhancing the partnership of couples and their coping strategies.

  18. A Dynamic Framework for Water Security

    Science.gov (United States)

    Srinivasan, Veena; Konar, Megan; Sivapalan, Murugesu

    2017-04-01

    Water security is a multi-faceted problem, going beyond mere balancing of supply and demand. Conventional attempts to quantify water security starting rely on static indices at a particular place and point in time. While these are simple and scalable, they lack predictive or explanatory power. 1) Most static indices focus on specific spatial scales and largely ignore cross-scale feedbacks between human and water systems. 2) They fail to account for the increasing spatial specialization in the modern world - some regions are cities others are agricultural breadbaskets; so water security means different things in different places. Human adaptation to environmental change necessitates a dynamic view of water security. We present a framework that defines water security as an emergent outcome of a coupled socio-hydrologic system. Over the medium term (5-25 years), water security models might hold governance, culture and infrastructure constant, but allow humans to respond to changes and thus predict how water security would evolve. But over very long time-frames (25-100 years), a society's values, norms and beliefs themselves may themselves evolve; these in turn may prompt changes in policy, governance and infrastructure. Predictions of water security in the long term involve accounting for such regime shifts in the cultural and political context of a watershed by allowing the governing equations of the models to change.

  19. A clinical governance framework for blood services.

    Science.gov (United States)

    Williamson, L M; Benjamin, R J; Devine, D V; Katz, L M; Pink, J

    2015-05-01

    The elements of clinical governance, which ensure excellence in clinical care, can be applied to blood services. In this survey, their application in a range of blood providers was gauged, with the aim of identifying best practice and producing a generalizable framework. The Medical Directors of members of the Alliance of Blood Operators surveyed how different elements of clinical governance operated within their organizations and developed recommendations applicable in the blood service environment. The recommendations that emerged highlighted the importance of an organization's culture, with the delivery of optimal clinical governance being a corporate responsibility. Senior management must agree and promote a set of values to ensure that the system operates with the patient and donor at its heart. All staff should understand how their role fits into the 'journey to the patient', and a culture of openness promoted. Thus, reporting of errors and risks should be actively sought and praised, with penalties applied for concealment. Systems should exist to collect, analyse and escalate clinical outcomes, safety data, clinical risk assessments, incident reports and complaints to inform organizational learning. Clinical governance principles from general health care can be applied within blood services to complement good manufacturing practice. This requires leadership, accountability, an open culture and a drive for continuous improvement and excellence in clinical care. © 2015 International Society of Blood Transfusion.

  20. A social-cognitive framework of multidisciplinary team innovation.

    Science.gov (United States)

    Paletz, Susannah B F; Schunn, Christian D

    2010-01-01

    The psychology of science typically lacks integration between cognitive and social variables. We present a new framework of team innovation in multidisciplinary science and engineering groups that ties factors from both literatures together. We focus on the effects of a particularly challenging social factor, knowledge diversity, which has a history of mixed effects on creativity, most likely because those effects are mediated and moderated by cognitive and additional social variables. In addition, we highlight the distinction between team innovative processes that are primarily divergent versus convergent; we propose that the social and cognitive implications are different for each, providing a possible explanation for knowledge diversity's mixed results on team outcomes. Social variables mapped out include formal roles, communication norms, sufficient participation and information sharing, and task conflict; cognitive variables include analogy, information search, and evaluation. This framework provides a roadmap for research that aims to harness the power of multidisciplinary teams. Copyright © 2009 Cognitive Science Society, Inc.

  1. Understanding retirement: the promise of life-span developmental frameworks.

    Science.gov (United States)

    Löckenhoff, Corinna E

    2012-09-01

    The impending retirement of large population cohorts creates a pressing need for practical interventions to optimize outcomes at the individual and societal level. This necessitates comprehensive theoretical models that acknowledge the multi-layered nature of the retirement process and shed light on the dynamic mechanisms that drive longitudinal patterns of adjustment. The present commentary highlights ways in which contemporary life-span developmental frameworks can inform retirement research, drawing on the specific examples of Bronfenbrenner's Ecological Model, Baltes and Baltes Selective Optimization with Compensation Framework, Schulz and Heckhausen's Motivational Theory of Life-Span Development, and Carstensen's Socioemotional Selectivity Theory. Ultimately, a life-span developmental perspective on retirement offers not only new interpretations of known phenomena but may also help to identify novel directions for future research as well as promising pathways for interventions.

  2. A Current Logical Framework: The Propositional Fragment

    National Research Council Canada - National Science Library

    Watkins, Kevin

    2003-01-01

    We present the propositional fragment CLF of the Concurrent Logical Framework (CLF). CLF extends the Linear Logical Framework to allow the natural representation of concurrent computations in an object language...

  3. Basemap Framework Submission for Christian MO

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — FEMA Framework Basemap datasets comprise six of the seven FGDC themes of geospatial data that are used by most GIS applications (Note: the seventh framework theme,...

  4. Basemap Framework Submission for Shawnee County, KS

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — FEMA Framework Basemap datasets comprise six of the seven FGDC themes of geospatial data that are used by most GIS applications (Note: the seventh framework theme,...

  5. Basemap Framework Submission for Crawford MO

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — FEMA Framework Basemap datasets comprise six of the seven FGDC themes of geospatial data that are used by most GIS applications (Note: the seventh framework theme,...

  6. Basemap Framework Submission for Douglas County, KS

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — FEMA Framework Basemap datasets comprise six of the seven FGDC themes of geospatial data that are used by most GIS applications (Note: the seventh framework theme,...

  7. Gas adsorption on metal-organic frameworks

    Science.gov (United States)

    Willis, Richard R [Cary, IL; Low, John J. , Faheem, Syed A.; Benin, Annabelle I [Oak Forest, IL; Snurr, Randall Q [Evanston, IL; Yazaydin, Ahmet Ozgur [Evanston, IL

    2012-07-24

    The present invention involves the use of certain metal organic frameworks that have been treated with water or another metal titrant in the storage of carbon dioxide. The capacity of these frameworks is significantly increased through this treatment.

  8. Improving ecosystem service frameworks to address wicked problems

    Directory of Open Access Journals (Sweden)

    Kathryn K. Davies

    2015-06-01

    Full Text Available Complex problems often result from the multiple interactions between human activities and ecosystems. The interconnected nature of ecological and social systems should be considered if these "wicked problems" are to be addressed. Ecosystem service approaches provide an opportunity to link ecosystem function with social values, but in practice the essential role that social dynamics play in the delivery of outcomes remains largely unexplored. Social factors such as management regimes, power relationships, skills, and values, can dramatically affect the definition and delivery of ecosystem services. Input from a diverse group of stakeholders improves the capacity of ecosystem service approaches to address wicked problems by acknowledging diverse sets of values and accounting for conflicting world views. Participatory modeling can incorporate both social and ecological dynamics into decision making that involves stakeholders, but is itself a complex social undertaking that may not yield precise or predictable outcomes. We explore the efficacy of different types of participatory modeling in relation to the integration of social values into ecosystem services frameworks and the generation of four important elements of social capital needed to address wicked problems: enhancing social learning and capacity building; increasing transparency; mediating power; and building trust. Our findings indicate that mediated modeling, group mapping, and mental/conceptual modeling are likely to generate elements of social capital that can improve ecosystem service frameworks. Participatory simulation, system dynamic modeling, and Bayesian belief networks, if utilized in isolation, were found to have a low likelihood of generating the social capital needed to improve ecosystem services frameworks. Scenario planning, companion modeling, group model building, and participatory mapping all generate a moderate to high level of social capital elements that improve the

  9. Competencies Framework for Climate Services.

    Science.gov (United States)

    Aguilar, Enric

    2016-04-01

    The World Climate Conference-3 (Geneva, 2009) established the Global Framework for Climate Services (GFCS) to enable better management of the risks of climate variability and change and adaptation to climate change at all levels, through development and incorporation of science-based climate information and prediction into planning, policy and practice. The GFCS defines Climate Services as the result of transforming climate data into climate information in a way that responds to user needs and assists decision-making by individuals and organizations. Capacity Development is a cross-cutting pillar of the GFCS to ensure that services are provided by institutions with professionals whom achieved the adequate set of competencies recommended by WMO, which are yet to be fully defined. The WMO-Commission for Climatology Expert Team on Education and Training, ET-ETR, has been working to define a Competencies Framework for Climate Services to help the institutions to deliver high quality climate services in compliance with WMO standards and regulations, specifically those defined by WMO's Commission for Climatology and the GFCS. This framework is based in 5 areas or competence, closely associated to the areas of work of climate services providers: create and manage climate data sets; derive products from climate data; create and/or interpret climate forecasts and model output; ensure the quality of climate information and services; communicate climatological information with users. With this contribution, we intend to introduce to a wider audience the rationale behind these 5 top-level competency statements and the performance criteria associated with them, as well as the plans of the ET-ETR for further developing them into an instrument to support education and training within the WMO members, specially the National Meteorological and Hydrological Services.

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

    Science.gov (United States)

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

    2013-04-01

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

  11. Framework for reactive mass transport

    DEFF Research Database (Denmark)

    Jensen, Mads Mønster; Johannesson, Björn; Geiker, Mette Rica

    2014-01-01

    Reactive transport modeling is applicable for a range of porous materials. Here the modeling framework is focused on cement-based materials, where ion diffusion and migration are described by the Poisson-Nernst-Planck equation system. A two phase vapor/liquid flow model, with a sorption hysteresis...... description is coupled to the system. The mass transport is solved by using the finite element method where the chemical equilibrium is solved explicitly by an operator splitting method. The IPHREEQC library is used as chemical equilibrium solver. The equation system, solved by IPHREEQC, is explained...

  12. Framework for Flux Qubit Design

    Science.gov (United States)

    Yan, Fei; Kamal, Archana; Krantz, Philip; Campbell, Daniel; Kim, David; Yoder, Jonilyn; Orlando, Terry; Gustavsson, Simon; Oliver, William; Engineering Quantum Systems Team

    A qubit design for higher performance relies on the understanding of how various qubit properties are related to design parameters. We construct a framework for understanding the qubit design in the flux regime. We explore different parameter regimes, looking for features desirable for certain purpose in the context of quantum computing. This research was funded by the Office of the Director of National Intelligence (ODNI), Intelligence Advanced Research Projects Activity (IARPA) via MIT Lincoln Laboratory under Air Force Contract No. FA8721-05-C-0002.

  13. BOA: Framework for Automated Builds

    CERN Document Server

    Ratnikova, N

    2003-01-01

    Managing large-scale software products is a complex software engineering task. The automation of the software development, release and distribution process is most beneficial in the large collaborations, where the big number of developers, multiple platforms and distributed environment are typical factors. This paper describes Build and Output Analyzer framework and its components that have been developed in CMS to facilitate software maintenance and improve software quality. The system allows to generate, control and analyze various types of automated software builds and tests, such as regular rebuilds of the development code, software integration for releases and installation of the existing versions.

  14. A conceptual framework of integrity

    Directory of Open Access Journals (Sweden)

    Antoni Barnard

    2008-10-01

    Full Text Available This article reports on the fndings of a qualitative study in which the construction of integrity of some business leaders was explored. Data were gathered through ten in-depth interviews with six South African business leaders commended to be champions of integrity. A grounded-theory approach to the data analysis elicited fve themes. These themes and their interrelatedness are discussed in this article and a conceptual framework of integrity is proposed. Integrity is conceptualised as a multifaceted and dynamic construct based on a moral foundation and inner drive that is managed by cognitive and affective processes manifesting various integrity-related behaviours.

  15. BOA: Framework for automated builds

    International Nuclear Information System (INIS)

    Ratnikova, N.

    2003-01-01

    Managing large-scale software products is a complex software engineering task. The automation of the software development, release and distribution process is most beneficial in the large collaborations, where the big number of developers, multiple platforms and distributed environment are typical factors. This paper describes Build and Output Analyzer framework and its components that have been developed in CMS to facilitate software maintenance and improve software quality. The system allows to generate, control and analyze various types of automated software builds and tests, such as regular rebuilds of the development code, software integration for releases and installation of the existing versions

  16. Legal framework for food fortification

    DEFF Research Database (Denmark)

    Dijkhuizen, Marjoleine Amma; Wieringa, Frank Tammo; Soekarjo, Damayanti D

    2013-01-01

    Food fortification is a cost-effective, powerful, and sustainable strategy to combat micronutrient deficiency, with the potential to reach large sections of the population with minimal cost and effort. However, the implementation of food fortification on a systematic and large scale, for instance...... the potential success of food fortification strategies. The lessons from these experiences show that a mandatory approach to fortification, with costing, monitoring and enforcement, and social marketing clearly defined and well embedded in the legal framework and in the implementation structures, is the best...

  17. Programming Entity Framework Code First

    CERN Document Server

    Lerman, Julia

    2011-01-01

    Take advantage of the Code First data modeling approach in ADO.NET Entity Framework, and learn how to build and configure a model based on existing classes in your business domain. With this concise book, you'll work hands-on with examples to learn how Code First can create an in-memory model and database by default, and how you can exert more control over the model through further configuration. Code First provides an alternative to the database first and model first approaches to the Entity Data Model. Learn the benefits of defining your model with code, whether you're working with an exis

  18. Regulatory frameworks for decentralised energy

    International Nuclear Information System (INIS)

    Woodman, Bridget; Baker, Philip

    2008-01-01

    This paper considers aspects of the current regulatory frameworks for markets and infrastructure which can inhibit the deployment of decentralised energy. The government has stated that decentralised energy can make a positive contribution to reducing the UK's carbon emissions, but recognises that at the moment the technologies face market and regulatory barriers. If it is to become a viable alternative to centralised generation, energy market design and the regulation of energy infrastructure will have to evolve to ensure that decentralised options are no longer locked out. (author)

  19. Pro ASPNET MVC 2 Framework

    CERN Document Server

    Freeman, A

    2010-01-01

    The ASP.NET MVC 3 Framework is the latest evolution of Microsoft's ASP.NET web platform. It provides a radically new high-productivity programming model that promotes cleaner code architecture, test-driven development, and powerful extensibility, combined with all the benefits of ASP.NET 4. In this, third edition, the core model-view-controller (MVC) architectural concepts are not simply explained or discussed in isolation, but are demonstrated in action. You'll work through an extended tutorial to create a working e-commerce web application that combines ASP.NET MVC with the latest C# languag

  20. Pro ASPNET MVC 3 Framework

    CERN Document Server

    Freeman, A

    2011-01-01

    The ASP.NET MVC 3 Framework is the latest evolution of Microsoft's ASP.NET web platform. It provides a high-productivity programming model that promotes cleaner code architecture, test-driven development, and powerful extensibility, combined with all the benefits of ASP.NET 4. In this third edition, the core model-view-controller (MVC) architectural concepts are not simply explained or discussed in isolation, but are demonstrated in action. You'll work through an extended tutorial to create a working e-commerce web application that combines ASP.NET MVC with the latest C# language features and

  1. Memory of titoism: Hegemony frameworks

    Directory of Open Access Journals (Sweden)

    Kuljić Todor

    2010-01-01

    Full Text Available The paper discusses today’s hegemony memory of titoism. The article presents the different reductions in the actually domestic memory culture which are connected with the demonisation and negative symbolisation of titoism. It was broader discussed diffent myths and ideologisations, the factors of a selective memory and a new context in the memory of titoism. Here are outlined the privatisation and the retraditionalisation as the main factors in the maintaing of a new frameworks for the memory of socialism and in the negative symbolisation of titoism.

  2. The ATLAS multithreaded offline framework

    CERN Document Server

    Snyder, Scott; The ATLAS collaboration

    2018-01-01

    In preparation for Run 3 of the LHC, scheduled to start in 2021, the ATLAS experiment is revising its offline software so as to better take advantage of machines with many cores. A major part of this effort is migrating the software to run as a fully multithreaded application, as this has been shown to significantly improve the memory scaling behavior. This talk will outline changes made to the software framework to support this migration, as well as describe a static code checker used to assist in locating violations of thread-safety rules. Preliminary experiences in migrating reconstruction algorithms will also be discussed.

  3. Java Web Frameworks Which One to Choose?

    OpenAIRE

    Nassourou, Mohamadou

    2010-01-01

    This article discusses web frameworks that are available to a software developer in Java language. It introduces MVC paradigm and some frameworks that implement it. The article presents an overview of Struts, Spring MVC, JSF Frameworks, as well as guidelines for selecting one of them as development environment.

  4. A Sustainable Evaluation Framework and Its Application

    Science.gov (United States)

    Powell, Robert B.; Stern, Marc J.; Ardoin, Nicole

    2006-01-01

    This article presents a framework for developing internally sustainable evaluation systems for environmental education organizations, although the framework can be applied to other types of organizations. The authors developed a sustainable evaluation framework (SEF) with the intent of creating an evaluation system that could be self-administered…

  5. Legal framework for a radiation safety infrastructure

    International Nuclear Information System (INIS)

    Bilbao, A.A.

    2000-01-01

    In this lecture the legal framework for a radiation safety infrastructure are presented. The objective of this lecture are: Legal framework; Regulatory programme; Role of Regulatory Authority in emergency situations; Assessment of the effectiveness of the regulatory programme; Cost effectiveness of the regulatory framework; and Priority actions

  6. An SOA-based architecture framework

    NARCIS (Netherlands)

    Aalst, van der W.M.P.; Beisiegel, M.; Hee, van K.M.; König, D.; Stahl, C.

    2007-01-01

    We present an Service-Oriented Architecture (SOA)– based architecture framework. The architecture framework is designed to be close to industry standards, especially to the Service Component Architecture (SCA). The framework is language independent and the building blocks of each system, activities

  7. Engineering governance: introducing a governance meta framework.

    OpenAIRE

    Brand, N.; Beens, B.; Vuuregge, E.; Batenburg, R.

    2011-01-01

    There is a need for a framework that depicts strategic choices within an organisation with regard to potential governance structures. The governance meta framework provides the necessary structure in the current developments of governance. Performance as well as conformance are embedded in this framework and provide the balance for all governance domains. (aut.ref.)

  8. Code-first development with Entity Framework

    CERN Document Server

    Barskiy, Sergey

    2015-01-01

    This book is intended for software developers with some prior experience with the Microsoft .NET framework who want to learn how to use Entity Framework. This book will get you up and running quickly, providing many examples that illustrate all the key concepts of Entity Framework.

  9. Evaluation of Conceptual Frameworks Applicable to the Study of Isolation Precautions Effectiveness

    Science.gov (United States)

    Crawford, Catherine; Shang, Jingjing

    2015-01-01

    Aims A discussion of conceptual frameworks applicable to the study of isolation precautions effectiveness according to Fawcett and DeSanto-Madeya’s (2013) evaluation technique and their relative merits and drawbacks for this purpose Background Isolation precautions are recommended to control infectious diseases with high morbidity and mortality, but effectiveness is not established due to numerous methodological challenges. These challenges, such as identifying empirical indicators and refining operational definitions, could be alleviated though use of an appropriate conceptual framework. Design Discussion paper Data Sources In mid-April 2014, the primary author searched five electronic, scientific literature databases for conceptual frameworks applicable to study isolation precautions, without limiting searches by publication date. Implications for Nursing By reviewing promising conceptual frameworks to support isolation precautions effectiveness research, this paper exemplifies the process to choose an appropriate conceptual framework for empirical research. Hence, researchers may build on these analyses to improve study design of empirical research in multiple disciplines, which may lead to improved research and practice. Conclusion Three frameworks were reviewed: the epidemiologic triad of disease, Donabedian’s healthcare quality framework and the Quality Health Outcomes model. Each has been used in nursing research to evaluate health outcomes and contains concepts relevant to nursing domains. Which framework can be most useful likely depends on whether the study question necessitates testing multiple interventions, concerns pathogen-specific characteristics and yields cross-sectional or longitudinal data. The Quality Health Outcomes model may be slightly preferred as it assumes reciprocal relationships, multi-level analysis and is sensitive to cultural inputs. PMID:26179813

  10. A Unit-Test Framework for Database Applications

    DEFF Research Database (Denmark)

    Christensen, Claus Abildgaard; Gundersborg, Steen; de Linde, Kristian

    The outcome of a test of an application that stores data in a database naturally depends on the state of the database. It is therefore important that test developers are able to set up and tear down database states in a simple and efficient manner. In existing unit-test frameworks, setting up...... test can be minimized. In addition, the reuse between unit tests can speed up the execution of test suites. A performance test on a medium-size project shows a 40% speed up and an estimated 25% reduction in the number of lines of test code....

  11. Molecular diagnostics clinical utility strategy: a six-part framework.

    Science.gov (United States)

    Frueh, Felix W; Quinn, Bruce

    2014-09-01

    The clinical utility of a molecular test rises proportional to a favorable regulatory risk/benefit assessment, and clinical utility is the driver of payer coverage decisions. Although a great deal has been written about clinical utility, debates still center on its 'definition.' We argue that the definition (an impact on clinical outcomes) is self-evident, and improved communications should focus on sequential steps in building and proving an adequate level of confidence for the diagnostic test's clinical value proposition. We propose a six-part framework to facilitate communications between test developers and health technology evaluators, relevant to both regulatory and payer decisions.

  12. Algebraic and algorithmic frameworks for optimized quantum measurements

    DEFF Research Database (Denmark)

    Laghaout, Amine; Andersen, Ulrik Lund

    2015-01-01

    von Neumann projections are the main operations by which information can be extracted from the quantum to the classical realm. They are, however, static processes that do not adapt to the states they measure. Advances in the field of adaptive measurement have shown that this limitation can...... be overcome by "wrapping" the von Neumann projectors in a higher-dimensional circuit which exploits the interplay between measurement outcomes and measurement settings. Unfortunately, the design of adaptive measurement has often been ad hoc and setup specific. We shall here develop a unified framework...

  13. European security framework for healthcare.

    Science.gov (United States)

    Ruotsalainen, Pekka; Pohjonen, Hanna

    2003-01-01

    eHealth and telemedicine services are promising business areas in Europe. It is clear that eHealth products and services will be sold and ordered from a distance and over national borderlines in the future. However, there are many barriers to overcome. For both national and pan-European eHealth and telemedicine applications a common security framework is needed. These frameworks set security requirements needed for cross-border eHealth services. The next step is to build a security infrastructure which is independent of technical platforms. Most of the European eHealth platforms are regional or territorial. Some countries are looking for a Public Key Infrastructure, but no large scale solutions do exist in healthcare. There is no clear candidate solution for European-wide interoperable eHealth platform. Gross-platform integration seems to be the most practical integration method at a European level in the short run. The use of Internet as a European integration platform is a promising solution in the long run.

  14. INTERNATIONAL LEGAL FRAMEWORK FOR MEDIA

    Directory of Open Access Journals (Sweden)

    Nevenka Ronkova

    2016-04-01

    Full Text Available The analysis of the international legal framework for media in a real structural form is a challenge that needs to be scientifically proven because of the exceptional role of media in general and its constant and substantial impact on the democratic processes taking place in the world. If we analyze media through the eyes of history, we cannot ignore the impression of the exceptional importance of freedom of expression as the source and promoter of many substantive changes and valuable components in the overall functioning of social and political settings. In this regard, special attention is given to the impact of media on contemporary trends related to the EU integration process, the development of democracy and the rule of law. It particularly emphasizes the freedom of expression, respect for values and standards principles, human rights and freedoms. The purpose of this paper is to analyze the international legal framework for the media and to show the determination of the most important covenants which represent a source of media law containing rules for the creation and implementation of media freedom, the expressive quality of ideas and definitely and inevitably this paper stresses the power of the media.

  15. DEFENSE PROGRAMS RISK MANAGEMENT FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Constantin PREDA

    2012-01-01

    Full Text Available For the past years defense programs have faced delays in delivering defense capabilities and budget overruns. Stakeholders are looking for ways to improve program management and the decision making process given the very fluid and uncertain economic and political environment. Consequently, they have increasingly resorted to risk management as the main management tool for achieving defense programs objectives and for delivering the defense capabilities strongly needed for the soldiers on the ground on time and within limited defense budgets. Following a risk management based decision-making approach the stakeholders are expected not only to protect program objectives against a wide range of risks but, at the same time, to take advantage of the opportunities to increase the likelihood of program success. The prerequisite for making risk management the main tool for achieving defense programs objectives is the design and implementation of a strong risk management framework as a foundation providing an efficient and effective application of the best risk management practices. The aim of this paper is to examine the risk management framework for defense programs based on the ISO 31000:2009 standard, best risk management practices and the defense programs’ needs and particularities. For the purposes of this article, the term of defense programs refers to joint defense programs.

  16. FRAMEWORK FOR COMPARING SEGMENTATION ALGORITHMS

    Directory of Open Access Journals (Sweden)

    G. Sithole

    2015-05-01

    Full Text Available The notion of a ‘Best’ segmentation does not exist. A segmentation algorithm is chosen based on the features it yields, the properties of the segments (point sets it generates, and the complexity of its algorithm. The segmentation is then assessed based on a variety of metrics such as homogeneity, heterogeneity, fragmentation, etc. Even after an algorithm is chosen its performance is still uncertain because the landscape/scenarios represented in a point cloud have a strong influence on the eventual segmentation. Thus selecting an appropriate segmentation algorithm is a process of trial and error. Automating the selection of segmentation algorithms and their parameters first requires methods to evaluate segmentations. Three common approaches for evaluating segmentation algorithms are ‘goodness methods’, ‘discrepancy methods’ and ‘benchmarks’. Benchmarks are considered the most comprehensive method of evaluation. This paper shortcomings in current benchmark methods are identified and a framework is proposed that permits both a visual and numerical evaluation of segmentations for different algorithms, algorithm parameters and evaluation metrics. The concept of the framework is demonstrated on a real point cloud. Current results are promising and suggest that it can be used to predict the performance of segmentation algorithms.

  17. Luiza: Analysis Framework for GLORIA

    Directory of Open Access Journals (Sweden)

    Aleksander Filip Żarnecki

    2013-01-01

    Full Text Available The Luiza analysis framework for GLORIA is based on the Marlin package, which was originally developed for data analysis in the new High Energy Physics (HEP project, International Linear Collider (ILC. The HEP experiments have to deal with enormous amounts of data and distributed data analysis is therefore essential. The Marlin framework concept seems to be well suited for the needs of GLORIA. The idea (and large parts of the code taken from Marlin is that every computing task is implemented as a processor (module that analyzes the data stored in an internal data structure, and the additional output is also added to that collection. The advantage of this modular approach is that it keeps things as simple as possible. Each step of the full analysis chain, e.g. from raw images to light curves, can be processed step-by-step, and the output of each step is still self consistent and can be fed in to the next step without any manipulation.

  18. Quality Assurance Framework for Mini-Grids

    Energy Technology Data Exchange (ETDEWEB)

    Baring-Gould, Ian [National Renewable Energy Lab. (NREL), Golden, CO (United States); Burman, Kari [National Renewable Energy Lab. (NREL), Golden, CO (United States); Singh, Mohit [National Renewable Energy Lab. (NREL), Golden, CO (United States); Esterly, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mutiso, Rose [US Department of Energy, Washington, DC (United States); McGregor, Caroline [US Department of Energy, Washington, DC (United States)

    2016-11-01

    Providing clean and affordable energy services to the more than 1 billion people globally who lack access to electricity is a critical driver for poverty reduction, economic development, improved health, and social outcomes. More than 84% of populations without electricity are located in rural areas where traditional grid extension may not be cost-effective; therefore, distributed energy solutions such as mini-grids are critical. To address some of the root challenges of providing safe, quality, and financially viable mini-grid power systems to remote customers, the U.S. Department of Energy (DOE) teamed with the National Renewable Energy Laboratory (NREL) to develop a Quality Assurance Framework (QAF) for isolated mini-grids. The QAF for mini-grids aims to address some root challenges of providing safe, quality, and affordable power to remote customers via financially viable mini-grids through two key components: (1) Levels of service: Defines a standard set of tiers of end-user service and links them to technical parameters of power quality, power availability, and power reliability. These levels of service span the entire energy ladder, from basic energy service to high-quality, high-reliability, and high-availability service (often considered 'grid parity'); (2) Accountability and performance reporting framework: Provides a clear process of validating power delivery by providing trusted information to customers, funders, and/or regulators. The performance reporting protocol can also serve as a robust monitoring and evaluation tool for mini-grid operators and funding organizations. The QAF will provide a flexible alternative to rigid top-down standards for mini-grids in energy access contexts, outlining tiers of end-user service and linking them to relevant technical parameters. In addition, data generated through implementation of the QAF will provide the foundation for comparisons across projects, assessment of impacts, and greater confidence that

  19. The Effect of Gender and Race Intersectionality on Student Learning Outcomes in Engineering

    Science.gov (United States)

    Ro, Hyun Kyoung; Loya, Karla I.

    2015-01-01

    Women and underrepresented minorities in traditionally White and male-dominated disciplines tend to report lower learning outcomes than their White peers. Adopting a feminist intersectionality framework, this study looks at the intersections of gender and race to investigate differences in self-assessed learning outcomes in engineering…

  20. Perceived Social Support and Locus of Control as the Predictors of Vocational Outcome Expectations

    Science.gov (United States)

    Isik, Erkan

    2013-01-01

    The purpose of this study was to examine the relationships of vocational outcome expectation to social support which is an environmental factor and locus of control which is a personal factor. With this purpose, using Social Cognitive Career Theory as the theoretical framework, 263 undergraduate students completed Vocational Outcome Expectations…

  1. Leveraging Competency Framework to Improve Teaching and Learning: A Methodological Approach

    Science.gov (United States)

    Shankararaman, Venky; Ducrot, Joelle

    2016-01-01

    A number of engineering education programs have defined learning outcomes and course-level competencies, and conducted assessments at the program level to determine areas for continuous improvement. However, many of these programs have not implemented a comprehensive competency framework to support the actual delivery and assessment of an…

  2. Do Frugal and Reverse Innovation Foster Sustainability? Introduction of a Conceptual Framework

    DEFF Research Database (Denmark)

    Brem, Alexander; Ivens, B.

    2013-01-01

    used in value creation, the sustainability of the actual value creation processes, and the sustainability of the outcomes of value creation processes. To complete our framework, we also argue for a positive link between the three dimensions of sustainability management and a company’s market...

  3. Global Business Literacy in the Classroom: Developing and Applying an Assessment Framework

    Science.gov (United States)

    Arevalo, Jorge A.; McCrea, Elizabeth; Yin, Jason Z.

    2012-01-01

    This study develops and applies a framework to evaluate undergraduate Global Business Literacy (GBL) learning outcomes, which is defined here as the ability to adapt and function in the global business context and to be knowledgeable about its core issues and trends. As a first step in a multi-stage research process, we used extant expatriate and…

  4. Creating the future together : toward a framework for research synthesis in entrepreneurship

    NARCIS (Netherlands)

    Burg, van J.C.; Romme, A.G.L.

    2014-01-01

    To develop a body of evidence-based knowledge on entrepreneurship, findings and contributions from the positivist, narrative and design research traditions in this area need to be combined. Therefore, a framework for research synthesis in terms of social mechanisms, contextual conditions and outcome

  5. First-Year Biology Students' Understandings of Meiosis: An Investigation Using a Structural Theoretical Framework

    Science.gov (United States)

    Quinn, Frances; Pegg, John; Panizzon, Debra

    2009-01-01

    Meiosis is a biological concept that is both complex and important for students to learn. This study aims to explore first-year biology students' explanations of the process of meiosis, using an explicit theoretical framework provided by the Structure of the Observed Learning Outcome (SOLO) model. The research was based on responses of 334…

  6. SUPPLY CHAIN OPTIMIZATION FOR SUSTAINABILITY AND PROFITABILITY BY THE P-GRAPH FRAMEWORK

    Science.gov (United States)

    The proposed methodology is an outcome of the collaboration between the Office of Research and Development (ORD) of the U.S. EPA and the research group led by the founders of the P graph framework. U.S. EPA/ORD has substantial creditable experience with the development of indicat...

  7. Measuring Flexicurity: Precautionary Notes, a New Framework, and an Empirical Example

    Science.gov (United States)

    Chung, Heejung

    2012-01-01

    Recently, there has been an increase and abundance of literature measuring flexicurity across countries. However, there is yet to be any agreement on the definition of the key concepts of flexicurity as well as the framework in which to base one's research. Due to this, the outcomes found in the existing studies are rather diverse, far from…

  8. Principals' Perceptions of "Quality" in Mauritian Schools Using the Baldrige Framework

    Science.gov (United States)

    Ah-Teck, Jean Claude; Starr, Karen

    2013-01-01

    Purpose: This article aims to report the findings of a research project exploring Mauritian principals' receptivity to the main tenets inherent in Total Quality Management (TQM). The Malcolm Baldrige National Quality Award (MBNQA) framework (aligned with, and an outcome of, the TQM movement) provides a set of criteria for organizational quality…

  9. The Customer Flow Toolkit: A Framework for Designing High Quality Customer Services.

    Science.gov (United States)

    New York Association of Training and Employment Professionals, Albany.

    This document presents a toolkit to assist staff involved in the design and development of New York's one-stop system. Section 1 describes the preplanning issues to be addressed and the intended outcomes that serve as the framework for creation of the customer flow toolkit. Section 2 outlines the following strategies to assist in designing local…

  10. Applying the Framework for Information Literacy to the Developmental Education Classroom

    Science.gov (United States)

    Garcia, Larissa

    2014-01-01

    Translating the new Framework for Information Literacy in Higher Education (ACRL November 2014) into learning outcomes, instructional content, and assessments might appear to be an overwhelming task; however, in many cases the revision exemplifies how many librarians have been teaching information literacy in the digital information landscape.…

  11. An interdisciplinary team communication framework and its application to healthcare 'e-teams' systems design.

    Science.gov (United States)

    Kuziemsky, Craig E; Borycki, Elizabeth M; Purkis, Mary Ellen; Black, Fraser; Boyle, Michael; Cloutier-Fisher, Denise; Fox, Lee Ann; MacKenzie, Patricia; Syme, Ann; Tschanz, Coby; Wainwright, Wendy; Wong, Helen

    2009-09-15

    There are few studies that examine the processes that interdisciplinary teams engage in and how we can design health information systems (HIS) to support those team processes. This was an exploratory study with two purposes: (1) To develop a framework for interdisciplinary team communication based on structures, processes and outcomes that were identified as having occurred during weekly team meetings. (2) To use the framework to guide 'e-teams' HIS design to support interdisciplinary team meeting communication. An ethnographic approach was used to collect data on two interdisciplinary teams. Qualitative content analysis was used to analyze the data according to structures, processes and outcomes. We present details for team meta-concepts of structures, processes and outcomes and the concepts and sub concepts within each meta-concept. We also provide an exploratory framework for interdisciplinary team communication and describe how the framework can guide HIS design to support 'e-teams'. The structures, processes and outcomes that describe interdisciplinary teams are complex and often occur in a non-linear fashion. Electronic data support, process facilitation and team video conferencing are three HIS tools that can enhance team function.

  12. An interdisciplinary team communication framework and its application to healthcare 'e-teams' systems design

    Directory of Open Access Journals (Sweden)

    MacKenzie Patricia

    2009-09-01

    Full Text Available Abstract Background There are few studies that examine the processes that interdisciplinary teams engage in and how we can design health information systems (HIS to support those team processes. This was an exploratory study with two purposes: (1 To develop a framework for interdisciplinary team communication based on structures, processes and outcomes that were identified as having occurred during weekly team meetings. (2 To use the framework to guide 'e-teams' HIS design to support interdisciplinary team meeting communication. Methods An ethnographic approach was used to collect data on two interdisciplinary teams. Qualitative content analysis was used to analyze the data according to structures, processes and outcomes. Results We present details for team meta-concepts of structures, processes and outcomes and the concepts and sub concepts within each meta-concept. We also provide an exploratory framework for interdisciplinary team communication and describe how the framework can guide HIS design to support 'e-teams'. Conclusion The structures, processes and outcomes that describe interdisciplinary teams are complex and often occur in a non-linear fashion. Electronic data support, process facilitation and team video conferencing are three HIS tools that can enhance team function.

  13. Decision making from economic and signal detection perspectives: development of an integrated framework

    Science.gov (United States)

    Lynn, Spencer K.; Wormwood, Jolie B.; Barrett, Lisa F.; Quigley, Karen S.

    2015-01-01

    Behavior is comprised of decisions made from moment to moment (i.e., to respond one way or another). Often, the decision maker cannot be certain of the value to be accrued from the decision (i.e., the outcome value). Decisions made under outcome value uncertainty form the basis of the economic framework of decision making. Behavior is also based on perception—perception of the external physical world and of the internal bodily milieu, which both provide cues that guide decision making. These perceptual signals are also often uncertain: another person's scowling facial expression may indicate threat or intense concentration, alternatives that require different responses from the perceiver. Decisions made under perceptual uncertainty form the basis of the signals framework of decision making. Traditional behavioral economic approaches to decision making focus on the uncertainty that comes from variability in possible outcome values, and typically ignore the influence of perceptual uncertainty. Conversely, traditional signal detection approaches to decision making focus on the uncertainty that arises from variability in perceptual signals and typically ignore the influence of outcome value uncertainty. Here, we compare and contrast the economic and signals frameworks that guide research in decision making, with the aim of promoting their integration. We show that an integrated framework can expand our ability to understand a wider variety of decision-making behaviors, in particular the complexly determined real-world decisions we all make every day. PMID:26217275

  14. Health outcome after major trauma: what are we measuring?

    Science.gov (United States)

    Hoffman, Karen; Cole, Elaine; Playford, E Diane; Grill, Eva; Soberg, Helene L; Brohi, Karim

    2014-01-01

    Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. MEDLINE, EMBASE, and CINAHL (from 2006-2012) were searched for studies evaluating health outcome after traumatic injuries. Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

  15. Health outcome after major trauma: what are we measuring?

    Directory of Open Access Journals (Sweden)

    Karen Hoffman

    Full Text Available Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.MEDLINE, EMBASE, and CINAHL (from 2006-2012 were searched for studies evaluating health outcome after traumatic injuries.Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF were used to evaluate to what extent outcome measures captured health impacts.34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%, functional activities (11% and environmental factors (2%.Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

  16. JASMINE Simulator - construction of framework

    Science.gov (United States)

    Yamada, Yoshiyuki; Ueda, Seiji; Kuwabara, Takashi; Yano, Taihei; Gouda, Naoteru

    2004-10-01

    JASMINE is an abbreviation of Japan Astrometry Satellite Mission for INfrared Exploration currently planned at National Astronomical Observatory of Japan. JASMINE stands at a stage where its basic design will be determined in a few years. Then it is very important for JASMINE to simulate the data stream generated by the astrometric fields in order to support investigations of accuracy, sampling strategy, data compression, data analysis, scientific performances, etc. It is found that the new software technologies of Object Oriented methodologies with Unified Modeling Language are ideal for the simulation system of JASMINE (JASMINE Simualtor). In this paper, we briefly introduce some concepts of such technologies and explain the framework of the JASMINE Simulator which is constructed by new technologies. We believe that these technologies are useful also for other future big projects of astronomcial research.

  17. Towards a nanorisk appraisal framework

    DEFF Research Database (Denmark)

    Senjen, Rye; Hansen, Steffen Foss

    2011-01-01

    The article discusses, in the context of nanotechnology, whether current concepts of chemical risk assessment can be used to assess nanorisk. Nanorisk can be defined from the narrow (eco)toxicological perspective to the broader sense to include societal/cultural impacts or even to the fundamental...... philosophical level, i.e. questioning societies need for the technology. We outline here the limitations of chemical risk assessment and other recent proposed risk governance paradigms in relation to nanotechnology and nanomaterials, including its inability to include societal risks (ownership, privacy......, security, nanodivide,1 convergence of nano-, bio-, etc.) and metaphysical risk (including the lay persons perspective on the risks of nanotechnology). Finally, we outline the fundamental principles and criteria that an alternative comprehensive framework should be based on....

  18. A Framework for Systemic Design

    Directory of Open Access Journals (Sweden)

    Alex Ryan

    2014-12-01

    Full Text Available As designers move upstream from traditional product and service design to engage with challenges characterised by complexity, uniqueness, value conflict, and ambiguity over objectives, they have increasingly integrated systems approaches into their practice. This synthesis of systems thinking with design thinking is forming a distinct new field of systemic design. This paper presents a framework for systemic design as a mindset, methodology, and set of methods that together enable teams to learn, innovate, and adapt to a complex and dynamic environment. We suggest that a systemic design mindset is inquiring, open, integrative, collaborative, and centred. We propose a systemic design methodology composed of six main activities: framing, formulating, generating, reflecting, inquiring, and facilitating. We view systemic design methods as a flexible and open-ended set of procedures for facilitating group collaboration that are both systemic and designerly.  

  19. ENTREPRENEURIAL LEADERSHIP: A THEORETICAL FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Yusuf ESMER

    2017-12-01

    Full Text Available Today, having just leadership or entrepreneurship qualities by business managers is not enough for success of enterprises. Managers need to have both leadership and entrepreneurship qualities in order to be successful. At this point, the concept of entrepreneurial leadership emerges. Entrepreneurial leadership is a new and modern type of leadership that is a combination of leadership qualities and spirit of entrepreneurship. In addition, entrepreneurial leadership is creating new products, new processes and expansion opportunities in existing businesses, working in social institutions and dealing with ignored social issues, participating in social and political movements, contributing to the change of current services and policies implemented by civil society organizations and governments. In recent times, entrepreneurial leadership has become a new phenomenon in business management that needs to be discussed. In this regard, in this study, the importance of entrepreneurial leadership is emphasized by examining the concept of entrepreneurial leadership within a theoretical framework.

  20. A Generalized DRM Architectural Framework

    Directory of Open Access Journals (Sweden)

    PATRICIU, V. V.

    2011-02-01

    Full Text Available Online digital goods distribution environment lead to the need for a system to protect digital intellectual property. Digital Rights Management (DRM is the system born to protect and control distribution and use of those digital assets. The present paper is a review of the current state of DRM, focusing on architectural design, security technologies, and important DRM deployments. The paper primarily synthesizes DRM architectures within a general framework. We also present DRM ecosystem as providing a better understanding of what is currently happening to content rights management from a technological point of view. This paper includes conclusions of several DRM initiative studies, related to rights management systems with the purpose of identifying and describing the most significant DRM architectural models. The basic functions and processes of the DRM solutions are identified.

  1. A framework for ALWR economics

    International Nuclear Information System (INIS)

    Braun, C.

    1993-01-01

    This paper discusses three major factors that determine the relative competitiveness of future advanced light water reactors (ALWRS) in comparison with then-concurrent fossil generation alternatives. These factors include: (a) ALWR capital cost assumptions, (b) fossil fuel prices (particularly natural gas price), and (c) ownership and financing arrangements, i.e., utility or independent power producer (IPP) plant ownership, construction, and operation. By properly selecting the right menu of assumptions, e.g., a low capital cost ALWR IPP versus a high gas price utility owner combined-cycle plant, one can investigate the competitiveness of future ALWRs under various ownership environments and the sensitivity of ALWR economics to different cost assumptions. Using standardized assumptions for fossil plant financing arrangements under different ownerships and plant capital cost and fuel price data, it is possible to create various frameworks into which ALWR cost assumptions could be inserted to investigate relative nuclear/fossil economics

  2. Selectivity in associative learning: A cognitive stage framework for blocking and cue competition phenomena

    Directory of Open Access Journals (Sweden)

    Yannick eBoddez

    2014-11-01

    Full Text Available Blocking is the most important phenomenon in the history of associative learning theory: For over 40 years, blocking has inspired a whole generation of learning models. Blocking is part of a family of effects that are typically termed cue competition effects. Common amongst all cue competition effects is that a cue-outcome relation is poorly learned or poorly expressed because the cue is trained in the presence of an alternative predictor or cause of the outcome. We provide an overview of the cognitive processes involved in cue competition effects in humans and propose a stage framework that brings these processes together. The framework contends that the behavioral display of cue competition is cognitively construed following three stages that include (1 an encoding stage, (2 a retention stage, and (3 a performance stage. We argue that the stage framework supports a comprehensive understanding of cue competition effects.

  3. A framework of knowledge creation processes in participatory simulation of hospital work systems

    DEFF Research Database (Denmark)

    Andersen, Simone Nyholm; Broberg, Ole

    2017-01-01

    Participatory simulation (PS) is a method to involve workers in simulating and designing their own future work system. Existing PS studies have focused on analysing the outcome, and minimal attention has been devoted to the process of creating this outcome. In order to study this process, we...... suggest applying a knowledge creation perspective. The aim of this study was to develop a framework describing the process of how ergonomics knowledge is created in PS. Video recordings from three projects applying PS of hospital work systems constituted the foundation of process mining analysis....... The analysis resulted in a framework revealing the sources of ergonomics knowledge creation as sequential relationships between the activities of simulation participants sharing work experiences; experimenting with scenarios; and reflecting on ergonomics consequences. We argue that this framework reveals...

  4. Improving adolescent health policy: incorporating a framework for assessing state-level policies.

    Science.gov (United States)

    Brindis, Claire D; Moore, Kristin

    2014-01-01

    Many US policies that affect health are made at the state, not the federal, level. Identifying state-level policies and data to analyze how different policies affect outcomes may help policy makers ascertain the usefulness of their public policies and funding decisions in improving the health of adolescent populations. A framework for describing and assessing the role of federal and state policies on adolescent health and well-being is proposed; an example of how the framework might be applied to the issue of teen childbearing is included. Such a framework can also help inform analyses of whether and how state and federal policies contribute to the variation across states in meeting adolescent health needs. A database on state policies, contextual variables, and health outcomes data can further enable researchers and policy makers to examine how these factors are associated with behaviors they aim to impact.

  5. The probabilistic innovation theoretical framework

    Directory of Open Access Journals (Sweden)

    Chris W. Callaghan

    2017-07-01

    Full Text Available Background: Despite technological advances that offer new opportunities for solving societal problems in real time, knowledge management theory development has largely not kept pace with these developments. This article seeks to offer useful insights into how more effective theory development in this area could be enabled. Aim: This article suggests different streams of literature for inclusion into a theoretical framework for an emerging stream of research, termed ‘probabilistic innovation’, which seeks to develop a system of real-time research capability. The objective of this research is therefore to provide a synthesis of a range of diverse literatures, and to provide useful insights into how research enabled by crowdsourced research and development can potentially be used to address serious knowledge problems in real time. Setting: This research suggests that knowledge management theory can provide an anchor for a new stream of research contributing to the development of real-time knowledge problem solving. Methods: This conceptual article seeks to re-conceptualise the problem of real-time research and locate this knowledge problem in relation to a host of rapidly developing streams of literature. In doing so, a novel perspective of societal problem-solving is enabled. Results: An analysis of theory and literature suggests that certain rapidly developing streams of literature might more effectively contribute to societally important real-time research problem solving if these steams are united under a theoretical framework with this goal as its explicit focus. Conclusion: Although the goal of real-time research is as yet not attainable, research that contributes to its attainment may ultimately make an important contribution to society.

  6. Adverse Outcome Pathway Networks II: Network Analytics.

    Science.gov (United States)

    Villeneuve, Daniel L; Angrish, Michelle M; Fortin, Marie C; Katsiadaki, Ioanna; Leonard, Marc; Margiotta-Casaluci, Luigi; Munn, Sharon; O'Brien, Jason M; Pollesch, Nathan L; Smith, L Cody; Zhang, Xiaowei; Knapen, Dries

    2018-02-28

    Toxicological responses to stressors are more complex than the simple one biological perturbation to one adverse outcome model portrayed by individual adverse outcome pathways (AOPs). Consequently, the AOP framework was designed to facilitate de facto development of AOP networks that can aid understanding and prediction of pleiotropic and interactive effects more common to environmentally realistic, complex exposure scenarios. The present paper introduces nascent concepts related to the qualitative analysis of AOP networks. First, graph theory-based approaches for identifying important topological features are illustrated using two example AOP networks derived from existing AOP descriptions. Second, considerations for identifying the most significant path(s) through an AOP network from either a biological or risk assessment perspective are described. Finally, approaches for identifying interactions among AOPs that may result in additive, synergistic, or antagonistic responses, or previously undefined emergent patterns of response, are introduced. Along with a companion article (Knapen et al. part I), these concepts set the stage for development of tools and case studies that will facilitate more rigorous analysis of AOP networks, and the utility of AOP network-based predictions, for use in research and regulatory decision-making. Collectively, this work addresses one of the major themes identified through a SETAC Horizon Scanning effort focused on advancing the AOP framework. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. Adverse outcome pathways (AOPs) to enhance EDC ...

    Science.gov (United States)

    Screening and testing for endocrine active chemicals was mandated under 1996 amendments to the Safe Drinking Water Act and Food Quality Protection Act. Efficiencies can be gained in the endocrine disruptor screening program by using available biological and toxicological knowledge to facilitate greater use of high throughput screening data and other data sources to inform endocrine disruptor assessments. Likewise, existing knowledge, when properly organized, can help aid interpretation of test results. The adverse outcome pathway (AOP) framework, which organizes information concerning measureable changes that link initial biological interactions with a chemical to adverse effects that are meaningful to risk assessment and management, can aid this process. This presentation outlines the ways in which the AOP framework has already been employed to support EDSP and how it may further enhance endocrine disruptor assessments in the future. Screening and testing for endocrine active chemicals was mandated under 1996 amendments to the Safe Drinking Water Act and Food Quality Protection Act. Efficiencies can be gained in the endocrine disruptor screening program by using available biological and toxicological knowledge to facilitate greater use of high throughput screening data and other data sources to inform endocrine disruptor assessments. Likewise, existing knowledge, when properly organized, can help aid interpretation of test results. The adverse outcome pathway

  8. X-framework: Space system failure analysis framework

    Science.gov (United States)

    Newman, John Steven

    Space program and space systems failures result in financial losses in the multi-hundred million dollar range every year. In addition to financial loss, space system failures may also represent the loss of opportunity, loss of critical scientific, commercial and/or national defense capabilities, as well as loss of public confidence. The need exists to improve learning and expand the scope of lessons documented and offered to the space industry project team. One of the barriers to incorporating lessons learned include the way in which space system failures are documented. Multiple classes of space system failure information are identified, ranging from "sound bite" summaries in space insurance compendia, to articles in journals, lengthy data-oriented (what happened) reports, and in some rare cases, reports that treat not only the what, but also the why. In addition there are periodically published "corporate crisis" reports, typically issued after multiple or highly visible failures that explore management roles in the failure, often within a politically oriented context. Given the general lack of consistency, it is clear that a good multi-level space system/program failure framework with analytical and predictive capability is needed. This research effort set out to develop such a model. The X-Framework (x-fw) is proposed as an innovative forensic failure analysis approach, providing a multi-level understanding of the space system failure event beginning with the proximate cause, extending to the directly related work or operational processes and upward through successive management layers. The x-fw focus is on capability and control at the process level and examines: (1) management accountability and control, (2) resource and requirement allocation, and (3) planning, analysis, and risk management at each level of management. The x-fw model provides an innovative failure analysis approach for acquiring a multi-level perspective, direct and indirect causation of

  9. Assessing sustainable remediation frameworks using sustainability principles.

    Science.gov (United States)

    Ridsdale, D Reanne; Noble, Bram F

    2016-12-15

    The remediation industry has grown exponentially in recent decades. International organizations of practitioners and remediation experts have developed several frameworks for integrating sustainability into remediation projects; however, there has been limited attention to how sustainability is approached and operationalized in sustainable remediation frameworks and practices - or whether sustainability plays any meaningful role at all in sustainable remediation. This paper examines how sustainability is represented in remediation frameworks and the guidance provided for practical application. Seven broad sustainability principles and review criteria are proposed and applied to a sample of six international remediation frameworks. Not all review criteria were equally satisfied and none of the frameworks fully met all criteria; however, the best performing frameworks were those identified as sustainability remediation frameworks. Intra-generational equity was addressed by all frameworks. Integrating social, economic and biophysical components beyond triple-bottom-line indicators was explicitly addressed only by the sustainable remediation frameworks. No frameworks provided principle- or rule-based guidance for dealing with trade-offs in sustainability decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Collaborative learning framework for online stakeholder engagement.

    Science.gov (United States)

    Khodyakov, Dmitry; Savitsky, Terrance D; Dalal, Siddhartha

    2016-08-01

    Public and stakeholder engagement can improve the quality of both research and policy decision making. However, such engagement poses significant methodological challenges in terms of collecting and analysing input from large, diverse groups. To explain how online approaches can facilitate iterative stakeholder engagement, to describe how input from large and diverse stakeholder groups can be analysed and to propose a collaborative learning framework (CLF) to interpret stakeholder engagement results. We use 'A National Conversation on Reducing the Burden of Suicide in the United States' as a case study of online stakeholder engagement and employ a Bayesian data modelling approach to develop a CLF. Our data modelling results identified six distinct stakeholder clusters that varied in the degree of individual articulation and group agreement and exhibited one of the three learning styles: learning towards consensus, learning by contrast and groupthink. Learning by contrast was the most common, or dominant, learning style in this study. Study results were used to develop a CLF, which helps explore multitude of stakeholder perspectives; identifies clusters of participants with similar shifts in beliefs; offers an empirically derived indicator of engagement quality; and helps determine the dominant learning style. The ability to detect learning by contrast helps illustrate differences in stakeholder perspectives, which may help policymakers, including Patient-Centered Outcomes Research Institute, make better decisions by soliciting and incorporating input from patients, caregivers, health-care providers and researchers. Study results have important implications for soliciting and incorporating input from stakeholders with different interests and perspectives. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  11. Model based risk assessment - the CORAS framework

    Energy Technology Data Exchange (ETDEWEB)

    Gran, Bjoern Axel; Fredriksen, Rune; Thunem, Atoosa P-J.

    2004-04-15

    Traditional risk analysis and assessment is based on failure-oriented models of the system. In contrast to this, model-based risk assessment (MBRA) utilizes success-oriented models describing all intended system aspects, including functional, operational and organizational aspects of the target. The target models are then used as input sources for complementary risk analysis and assessment techniques, as well as a basis for the documentation of the assessment results. The EU-funded CORAS project developed a tool-supported methodology for the application of MBRA in security-critical systems. The methodology has been tested with successful outcome through a series of seven trial within the telemedicine and ecommerce areas. The CORAS project in general and the CORAS application of MBRA in particular have contributed positively to the visibility of model-based risk assessment and thus to the disclosure of several potentials for further exploitation of various aspects within this important research field. In that connection, the CORAS methodology's possibilities for further improvement towards utilization in more complex architectures and also in other application domains such as the nuclear field can be addressed. The latter calls for adapting the framework to address nuclear standards such as IEC 60880 and IEC 61513. For this development we recommend applying a trial driven approach within the nuclear field. The tool supported approach for combining risk analysis and system development also fits well with the HRP proposal for developing an Integrated Design Environment (IDE) providing efficient methods and tools to support control room systems design. (Author)

  12. Development of a numerical pump testing framework.

    Science.gov (United States)

    Kaufmann, Tim A S; Gregory, Shaun D; Büsen, Martin R; Tansley, Geoff D; Steinseifer, Ulrich

    2014-09-01

    It has been shown that left ventricular assist devices (LVADs) increase the survival rate in end-stage heart failure patients. However, there is an ongoing demand for an increased quality of life, fewer adverse events, and more physiological devices. These challenges necessitate new approaches during the design process. In this study, computational fluid dynamics (CFD), lumped parameter (LP) modeling, mock circulatory loops (MCLs), and particle image velocimetry (PIV) are combined to develop a numerical Pump Testing Framework (nPTF) capable of analyzing local flow patterns and the systemic response of LVADs. The nPTF was created by connecting a CFD model of the aortic arch, including an LVAD outflow graft to an LP model of the circulatory system. Based on the same geometry, a three-dimensional silicone model was crafted using rapid prototyping and connected to an MCL. PIV studies of this setup were performed to validate the local flow fields (PIV) and the systemic response (MCL) of the nPTF. After validation, different outflow graft positions were compared using the nPTF. Both the numerical and the experimental setup were able to generate physiological responses by adjusting resistances and systemic compliance, with mean aortic pressures of 72.2-132.6 mm Hg for rotational speeds of 2200-3050 rpm. During LVAD support, an average flow to the distal branches (cerebral and subclavian) of 24% was found in the experiments and the nPTF. The flow fields from PIV and CFD were in good agreement. Numerical and experimental tools were combined to develop and validate the nPTF, which can be used to analyze local flow fields and the systemic response of LVADs during the design process. This allows analysis of physiological control parameters at early development stages and may, therefore, help to improve patient outcomes. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  13. Determinants of Network Outcomes

    DEFF Research Database (Denmark)

    Ysa, Tamyko; Sierra, Vicenta; Esteve, Marc

    2014-01-01

    The literature on network management is extensive. However, it generally explores network structures, neglecting the impact of management strategies. In this article we assess the effect of management strategies on network outcomes, providing empirical evidence from 119 urban revitalization...... networks. We go beyond current work by testing a path model for the determinants of network outcomes and considering the interactions between the constructs: management strategies, trust, complexity, and facilitative leadership. Our results suggest that management strategies have a strong effect on network...... outcomes and that they enhance the level of trust. We also found that facilitative leadership has a positive impact on network management as well as on trust in the network. Our findings also show that complexity has a negative impact on trust. A key finding of our research is that managers may wield more...

  14. Education and Occupational Outcomes

    DEFF Research Database (Denmark)

    Johnes, Geraint; Freguglia, Ricardo; Spricigo, Gisele

    2016-01-01

    Purpose: The purpose of this paper is to examine the dynamic relationship between policies related to educational provision and both educational participation and occupational outcomes in Brazil, using PNAD and RAIS-Migra data. Design/methodology/approach: Outcomes are examined using: static...... multinomial logit analysis, and structural dynamic discrete choice modelling. The latter approach, coupled with the quality of the RAIS-Migra data source, allows the authors to evaluate the education policy impacts over time. Findings: The main results show that the education level raises the propensity...... that the individual will be in formal sector work or still in education, and reduces the probability of the other outcomes. Transition into non-manual formal sector work following education may, however, occur via a spell of manual work. Originality/value: This is the first study of occupational destination...

  15. Improving surgical outcomes

    Directory of Open Access Journals (Sweden)

    Tony Walia

    2008-12-01

    Full Text Available Outcomes of cataract surgery are worse than we would like them to be. Community-based studies show that up to 40% of eyes have a postoperative presenting vision of < 6/60. Eyes with intraocular lenses (IOLs do better; however, it has been shown that even in prosperous middle-income countries, such as Venezuela, in 20% of pseudophakic eyes presenting vision was < 6/60 and in 15% best corrected vision was worse than 6/60.Poor outcomes matter. Patients deserve improved vision whenever possible and poor outcomes deter prospective patients from coming for surgery and probably reduce their willingness to pay for their treatment – particularly if they have to pay in advance!In this article, we offer some suggestions for improving the quality of cataract surgery. We admit that there is little evidence base for most of these suggestions and that some of them are controversial. However, we hope to stimulate debate.

  16. Outcomes in transfusion.

    Science.gov (United States)

    Sherman, L A

    1999-07-01

    Outcomes data in medicine can be limited by subjective methodologic issues such as poor selection of end points and use of nonvalidated systems for quality adjustment. Blood transfusion analyses are further complicated by the fact that transfusion seldom is primary therapy but is usually supportive or adjunctive. Thus, much of the outcome data in transfusion medicine are either unavailable or in one of two areas. The first area is prevention of bad sequelae of various cytopenias or factor deficiencies. The second is decreasing adverse effects of transfusion itself. A different useful area for outcome and root cause approaches in individual institutions is examining preanalytical and postanalytical processes of their own. Examples are sample labeling accuracy, quality and timeliness of blood suppliers, internal delivery processes and times, and product wastage. Use review can be changed to real time from retrospective time. By reducing complaints about service to objective data, realistic change can be made in internal and external processes.

  17. Teleophthalmology: improving patient outcomes?

    Directory of Open Access Journals (Sweden)

    Sreelatha OK

    2016-02-01

    Full Text Available Omana Kesary Sreelatha,1 Sathyamangalam VenkataSubbu Ramesh2 1Ophthalmology Department, Sultan Qaboos University Hospital, Muscat, Oman; 2Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, India Abstract: Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP. Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR, glaucoma, age-related macular degeneration (ARMD, and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time

  18. A Conceptual Framework to Address Stress-Associated ...

    Science.gov (United States)

    Chronic stress leads to a variety of mental and physiological disorders, and stress effects are the primary concern after traumatic injury and exposure to infectious diseases or toxic agents from disaster events. We developed a conceptual model to address the question of whether degradation of ecosystem services (ES) by disasters such as recent hurricanes and the Deepwater Horizon oil catastrophe produce acute and chronic stress that ultimately result in short- and long-term negative health outcomes in people. An interdisciplinary team with expertise in data mining, ecology, ecosystem services, ecotoxicology, landscape ecology, mental health, psychiatry, and stress physiology utilized the Driver-Pressure-State-Ecosystem Service model of Kelble et al. (2013), the mental health framework of Palinkas (2012) and McEwen’s (1993) allostatic load model of chronic stress as starting points. Initial modeling results were augmented via expert workshops and peer review. Our conceptual model connects effects of disasters to changes in specific ecosystem components (e.g., water quality, biodiversity, fishery populations) with resulting degradation of multiple ES such as commercial and recreational fishing, tourism, and sense of place. The model shows how the degraded ES produce acute and chronic stress in people and how such stress may lead to a variety of negative mental, physical and behavioral health outcomes. Using this framework, one can trace potential for str

  19. A conceptual framework for teaching research in nursing

    Directory of Open Access Journals (Sweden)

    SCD Wright

    2005-09-01

    Full Text Available Though research is often referred to the lifeblood, hallmark or cornerstone in the development of a profession (Brink, 1996:2, teaching research in Nursing is a challenge. The challenge does not just lie in teaching the subject, but in resistance and unwillingness of students to engage in the subject. In the experience of the researcher, registered nurses identify themselves with being a nurse and a caregiver; the role of researcher has never been internalised. The challenge is to achieve the outcome envisaged, namely, nurses who are knowledgeable consumers of research as well as continuous productive scholars in their application of nursing. Research generates knowledge and knowledge is the basis of caring with excellence. Nursing is an art and a science and the science must produce the knowledge upon which the art is based. The purpose of this article is to propose a conceptual framework of how to teach research in order to achieve such a successful outcome. The conceptual framework proposed in this article is based on four pillars, theoretical knowledge of research, scientific writing, psychological support and experiential learning. The importance of the research facilitator, not just as a teacher but also as a positive role model, is also described.

  20. Performance Assessment Framework for Private Finance Initiative Projects in Malaysia

    Directory of Open Access Journals (Sweden)

    Lop Nor Suzila

    2016-01-01

    Full Text Available Private Finance Initiative (PFI is viewed as restructuring the previous privatisation concept in delivering value for money for the Malaysian public infrastructure. Among the restructuring efforts in the privatisation is specifying the standard assessment of private concessionaires’ performance through the execution of key performance indicators (KPIs where the private concessionaires’ performance is benchmarked against the government’s standard. KPIs have served as useful tools in assessing performance of PFI projects. However, there is still lacking on determination methods performed to define and measure this KPIs and the absence of guidelines or a framework is also an issue in the implementation of the PFI procurement in Malaysia. Therefore, the objectives of this paper is to investigate the notion of performance assessment model approaches globally (i.e. UK, China, Australia, Serbia and Malaysia and to identify direction for PFI performance assessment tools (KPIs to be practiced in Malaysia. Based on the consideration of these models, this research paper propose an initial framework of performance assessment for PFI projects in Malaysia. The framework is deliberate to cover the performance of PFI at the operation and maintenance phase. The outcomes of this paper can serve as a theoretical base for the development of comprehensive and effective performance assessment for PFI projects in Malaysia.

  1. A definition, description, and framework for advanced practice in dietetics.

    Science.gov (United States)

    Wildish, Deborah Ellen Boyko; Evers, Susan

    2010-01-01

    We explored advanced practice (AP) across the diversity of dietetics to develop a definition, description, and framework for guiding future education, research agendas, and policy development. The process began with a literature review and discussion with dietitians exploring AP in other countries. Various concepts were identified, and these informed the phase 1 survey questions. Phase 1 was a 36-item survey created in SurveyMonkey, engaging a purposeful sample of key stakeholders (n=136). A modified Delphi approach, involving seven dietitians from different geographical locations and practice areas, finalized the phase 2 survey. An e-mail link to this 50-item survey was sent to a random sample of dietitians (n=885). The proposed AP framework entailed an iterative approach, integrating survey results with AP literature. Response rates were 40% for phase 1 and 35% for phase 2. In phase 1, 83% of respondents agreed that a depth and breadth definition captured all dietetic job roles, and 95% agreed that it differentiated AP from entry-level practice. Descriptive statistics are presented to provide demographic information and level of agreement with themes relevant to AP. A framework is presented, and discrepancies with phase 2 results indicate areas for professional development, such as leadership, mentorship, and outcome measurement.

  2. Techno-ecological synergy: a framework for sustainable engineering.

    Science.gov (United States)

    Bakshi, Bhavik R; Ziv, Guy; Lepech, Michael D

    2015-02-03

    Even though the importance of ecosystems in sustaining all human activities is well-known, methods for sustainable engineering fail to fully account for this role of nature. Most methods account for the demand for ecosystem services, but almost none account for the supply. Incomplete accounting of the very foundation of human well-being can result in perverse outcomes from decisions meant to enhance sustainability and lost opportunities for benefiting from the ability of nature to satisfy human needs in an economically and environmentally superior manner. This paper develops a framework for understanding and designing synergies between technological and ecological systems to encourage greater harmony between human activities and nature. This framework considers technological systems ranging from individual processes to supply chains and life cycles, along with corresponding ecological systems at multiple spatial scales ranging from local to global. The demand for specific ecosystem services is determined from information about emissions and resource use, while the supply is obtained from information about the capacity of relevant ecosystems. Metrics calculate the sustainability of individual ecosystem services at multiple spatial scales and help define necessary but not sufficient conditions for local and global sustainability. Efforts to reduce ecological overshoot encourage enhancement of life cycle efficiency, development of industrial symbiosis, innovative designs and policies, and ecological restoration, thus combining the best features of many existing methods. Opportunities for theoretical and applied research to make this framework practical are also discussed.

  3. A comprehensive conceptual framework for road safety strategies.

    Science.gov (United States)

    Hughes, B P; Anund, A; Falkmer, T

    2016-05-01

    Road safety strategies (generally called Strategic Highway Safety Plans in the USA) provide essential guidance for actions to improve road safety, but often lack a conceptual framework that is comprehensive, systems theory based, and underpinned by evidence from research and practice. This paper aims to incorporate all components, policy tools by which they are changed, and the general interactions between them. A framework of nine mutually interacting components that contribute to crashes and ten generic policy tools which can be applied to reduce the outcomes of these crashes was developed and used to assess 58 road safety strategies from 22 countries across 15 years. The work identifies the policy tools that are most and least widely applied to components, highlighting the potential for improvements to any individual road safety strategy, and the potential strengths and weaknesses of road safety strategies in general. The framework also provides guidance for the development of new road safety strategies, identifying potential consequences of policy tool based measures with regard to exposure and risk, useful for both mobility and safety objectives. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. A Framework for Measuring Low-Value Care.

    Science.gov (United States)

    Miller, George; Rhyan, Corwin; Beaudin-Seiler, Beth; Hughes-Cromwick, Paul

    2018-04-01

    It has been estimated that more than 30% of health care spending in the United States is wasteful, and that low-value care, which drives up costs unnecessarily while increasing patient risk, is a significant component of wasteful spending. To address the need for an ability to measure the magnitude of low-value care nationwide, identify the clinical services that are the greatest contributors to waste, and track progress toward eliminating low-value use of these services. Such an ability could provide valuable input to the efforts of policymakers and health systems to improve efficiency. We reviewed existing methods that could contribute to measuring low-value care and developed an integrated framework that combines multiple methods to comprehensively estimate and track the magnitude and principal sources of clinical waste. We also identified a process and needed research for implementing the framework. A comprehensive methodology for measuring and tracking low-value care in the United States would provide an important contribution toward reducing waste. Implementation of the framework described in this article appears feasible, and the proposed research program will allow moving incrementally toward full implementation while providing a near-term capability for measuring low-value care that can be enhanced over time. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. A preliminary framework for corporate real estate sustainable management

    Directory of Open Access Journals (Sweden)

    Fauzi Nurul Sahida

    2016-01-01

    Full Text Available The global warming issue has motivated corporations to go green in their business operations including transforming from conventional real estate to green features real estate. However green CRE is more complex to manage due to a building’s significant impact on environmental, social and economic aspects. Thus the need to have a best practice guide or framework as reference is crucial. Unfortunately, no best practice guidelines on CRE management have been found to be sufficient as much uncertainty still exists on the sustainable performance measurement components. This research aims to explore and then summarize the present sustainable CREM practices and components relating to sustainable performance measurement integrating a sustainable theory that balances environmental, economic and social impacts. These act as indicators to measure the outcomes of the practice in the form of a generic model on sustainability preliminary framework for CRESM. The objectives of this research include identifying corporate real estate sustainable management (CRESM practice and components of sustainable performance measurement. The research uses content analysis method to analyse data gathered from literature and previous studies. The findings will be demonstrated in the form of a framework model on CRESM that will include14 CREM strategies and 15 components derived from analysis.

  6. Project Management Framework to Organizational Transitions

    Science.gov (United States)

    Kotnour, Tim; Barton, Saul

    1996-01-01

    This paper describes a project management framework and associated models for organizational transitions. The framework contains an integrated set of steps an organization can take to lead an organizational transition such as downsizing and change in mission or role. The framework is designed to help an organization do the right work the right way with the right people at the right time. The underlying rationale for the steps in the framework is based on a set of findings which include: defining a transition as containing both near-term and long-term actions, designing actions which respond to drivers and achieve desired results, aligning the organization with the external environment, and aligning the internal components of the organization. The framework was developed based on best practices found in the literature, lessons learned from heads of organizations who have completed large-scale organizational changes, and concerns from employees at the Kennedy Space Center (KSC). The framework is described using KSC.

  7. ELPSA AS A LESSON DESIGN FRAMEWORK

    Directory of Open Access Journals (Sweden)

    Tom Lowrie

    2015-07-01

    Full Text Available This paper offers a framework for mathematics lesson design that is consistent with the way we learn about, and discover, most things in life. In addition, the framework provides a structure for identifying how mathematical concepts and understanding are acquired and developed. This framework is called ELPSA and represents five learning components, namely: Experience, Language, Pictorial, Symbolic and Applications. This framework has been used in developing lessons and teacher professional programs in Indonesia since 2012 in cooperation with the World Bank. This paper describes the theory that underlines the framework in general and in relation to each inter-connected component. Two explicit learning sequences for classroom practice are described, associated with Pythagoras theorem and probability. This paper then concludes with recommendations for using ELPSA in various institutional contexts.Keywords: ELPSA, lesson design framework, Pythagoras theorem, probability DOI: dx.doi.org/10.22342/jme.62.77

  8. Design and Analysis of Web Application Frameworks

    DEFF Research Database (Denmark)

    Schwarz, Mathias Romme

    -state manipulation vulnerabilities. The hypothesis of this dissertation is that we can design frameworks and static analyses that aid the programmer to avoid such errors. First, we present the JWIG web application framework for writing secure and maintainable web applications. We discuss how this framework solves...... some of the common errors through an API that is designed to be safe by default. Second, we present a novel technique for checking HTML validity for output that is generated by web applications. Through string analysis, we approximate the output of web applications as context-free grammars. We model......Numerous web application frameworks have been developed in recent years. These frameworks enable programmers to reuse common components and to avoid typical pitfalls in web application development. Although such frameworks help the programmer to avoid many common errors, we nd...

  9. Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures

    Directory of Open Access Journals (Sweden)

    Mallory Devon

    2006-11-01

    Full Text Available Abstract Background Central to the development of a sound evidence base for Complementary and Alternative Medicine (CAM interventions is the need for valid, reliable and relevant outcome measures to assess whether the interventions work. We assessed the specific needs for a database that would cover a wide range of outcomes measures for CAM research and considered a framework for such a database. Methods The study was a survey of CAM researchers, practitioners and students. An online questionnaire was emailed to the members of the Canadian Interdisciplinary Network for CAM Research (IN-CAM and the CAM Education and Research Network of Alberta (CAMera. The majority of survey questions were open-ended and asked about outcome measures currently used, outcome measures' assessment criteria, sources of information, perceived barriers to finding outcome measures and outcome domains of importance. Descriptive quantitative analysis and qualitative content analysis were used. Results One hundred and sixty-four completed surveys were received. Of these, 62 respondents reported using outcome measures in their CAM research and identified 92 different specific outcomes. The most important barriers were the fact that, for many health concepts, outcome measures do not yet exist, as well as issues related to accessibility of instruments. Important outcome domains identified included physical, psychological, social, spiritual, quality of life and holistic measures. Participants also mentioned the importance of individualized measures that assess unique patient-centered outcomes for each research participant, and measures to assess the context of healing and the process of healing. Conclusion We have developed a preliminary framework that includes all components of health-related outcomes. The framework provides a foundation for a larger, comprehensive collection of CAM outcomes. It fits very well in a whole systems perspective, which requires an expanded set of

  10. A framework for the study of symmetric full-correlation Bell-like inequalities

    International Nuclear Information System (INIS)

    Bancal, Jean-Daniel; Gisin, Nicolas; Liang, Yeong-Cherng; Branciard, Cyril; Brunner, Nicolas

    2012-01-01

    Full-correlation Bell-like inequalities represent an important subclass of Bell-like inequalities that have found applications in both a better understanding of fundamental physics and in quantum information science. Loosely speaking, these are inequalities where only measurement statistics involving all parties play a role. In this paper, we provide a framework for the study of a large family of such inequalities that are symmetrical with respect to arbitrary permutations of the parties. As an illustration of the power of our framework, we derive (i) a new family of Svetlichny inequalities for arbitrary numbers of parties, settings and outcomes, (ii) a new family of two-outcome device-independent entanglement witnesses for genuine n-partite entanglement and (iii) a new family of two-outcome Tsirelson inequalities for arbitrary numbers of parties and settings. We also discuss briefly the application of these new inequalities in the characterization of quantum correlations. (paper)

  11. Evaluating health-promoting schools in Hong Kong: development of a framework.

    Science.gov (United States)

    Lee, Albert; Cheng, Frances F K; St Leger, Lawry

    2005-06-01

    Health-promoting schools (HPS)/healthy schools have existed internationally for about 15 years. Yet there are few comprehensive evaluation frameworks available which enable the outcomes of HPS initiatives to be assessed. This paper identifies an evaluation framework developed in Hong Kong. The framework uses a range of approaches to explore what schools actually do in their health promotion and health education initiatives. The framework, which is based on the WHO (Western Pacific Regional Office) Guidelines for HPS, is described in detail. The appropriate instruments for data collection are described and their origins identified. The evaluation plan and protocol, which underpinned the very comprehensive evaluation in Hong Kong, are explained. Finally, a case is argued for evaluation of HPS to be more in line with the educational dynamics of schools and the research literature on effective schooling, rather than focusing primarily on health-related measures.

  12. Poverty and the violation of human rights: a proposed conceptual framework.

    Science.gov (United States)

    Schuftan, Claudio

    2012-01-01

    The paper proposes a conceptual framework linking the causes of poverty with the causes of human rights violations. Both are presented as outcomes of a cascading chain of determinants grouped as immediate, underlying, and basic causes. The framework will make situation analyses focused on poverty and human rights better adjusted to the reality on the ground. It is also the first step in using the human rights-based approach, now an established methodology being used by a growing number of health and development practitioners and seen by the United Nations system as the way forward. The framework also provides guidance to communities in identifying, in a participatory way, causes of the problems that affect them. The framework is presented in a diagram format followed by a list of the major determinants in each causal level.

  13. A new composite decision support framework for strategic and sustainable transport appraisals

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn; Salling, Kim Bang

    2015-01-01

    . The proposed framework is based on the use of cost-benefit analysis featuring feasibility risk assessment in combination with multi-criteria decision analysis and is supported by the concept of decision conferencing. The framework is applied for a transport related case study dealing with the complex decision....... The outcome of the case study demonstrates the decision making framework as a valuable decision support system (DSS), and it is concluded that appraisals of transport projects can be effectively supported by the use of the DSS. Finally, perspectives of the future modelling work are given.......This paper concerns the development of a new decision support framework for the appraisal of transport infrastructure projects. In such appraisals there will often be a need for including both conventional transport impacts as well as criteria of a more strategic and/or sustainable character...

  14. Adapting Maslow's Hierarchy of Needs as a Framework for Resident Wellness.

    Science.gov (United States)

    Hale, Andrew J; Ricotta, Daniel N; Freed, Jason; Smith, C Christopher; Huang, Grace C

    2018-04-30

    Burnout in graduate medical education is pervasive and has a deleterious impact on career satisfaction, personal well-being, and patient outcomes. Interventions in residency programs have often addressed isolated contributors to burnout; however, a more comprehensive framework for conceptualizing wellness is needed. In this article the authors propose Maslow's hierarchy of human needs (physiologic, safety, love/belonging, esteem, and self-actualization) as a potential framework for addressing wellness initiatives. There are numerous contributors to burnout among physician-trainees, and programs to combat burnout must be equally multifaceted. A holistic approach, considering both the trainees personal and professional needs, is recommended. Maslow's Needs can be adapted to create such a framework in graduate medical education. The authors review current evidence to support this model. This work surveys current interventions to mitigate burnout and organizes them into a scaffold that can be used by residency programs interested in a complete framework to supporting wellness.

  15. A security framework for nationwide health information exchange based on telehealth strategy.

    Science.gov (United States)

    Zaidan, B B; Haiqi, Ahmed; Zaidan, A A; Abdulnabi, Mohamed; Kiah, M L Mat; Muzamel, Hussaen

    2015-05-01

    This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

  16. Component framework support for developing device drivers

    OpenAIRE

    Michiels, Sam; Kenens, Peter; Matthijs, Frank; Walravens, Dirk; Berbers, Yolande; Verbaeten, Pierre

    2000-01-01

    In this paper, we advocate the use of component framework technology for developing state-of-the-art system software. Relevant contributions of DiPS (Distrinet Protocol Stack), a component framework, include its anonymous interaction model, connectors for handling non-functional issues such as the concurrency model, and builder support. DiPS has effectively been used in industrial protocol stacks. This paper shows how we are using the DiPS component framework to build and support flexib...

  17. Development of a General Purpose Gamification Framework

    OpenAIRE

    Vea, Eivind

    2016-01-01

    This report describes the design and implementation of a general purpose gamification framework developed in JavaScript on the Metor platform. Gamification is described as the use of game elements in none-game contexts. The purpose is to encourage and change user behaviour. Examples of existing gamification use cases and frameworks are described. A demo game shows how a general purpose framework can be used.

  18. A Software Rejuvenation Framework for Distributed Computing

    Science.gov (United States)

    Chau, Savio

    2009-01-01

    A performability-oriented conceptual framework for software rejuvenation has been constructed as a means of increasing levels of reliability and performance in distributed stateful computing. As used here, performability-oriented signifies that the construction of the framework is guided by the concept of analyzing the ability of a given computing system to deliver services with gracefully degradable performance. The framework is especially intended to support applications that involve stateful replicas of server computers.

  19. Cognitive outcome of surgery.

    Science.gov (United States)

    Gallagher, Anne; Jambaqué, Isabelle; Lassonde, Maryse

    2013-01-01

    Epilepsy surgery is now widely accepted as an effective therapeutic option for carefully selected children with medically refractory epilepsy. The surgical procedure may cause cognitive deficits or exacerbate existing impairments, but it may also improve cognitive abilities by the restoration of functions located in adjacent or contralateral areas that had been secondarily affected by the epilepsy or the underlying pathology. Compared to adults, better cognitive outcome has been reported in children, a finding probably due to the developing state of the brain, which possesses considerable structural and functional plasticity. More extensive and effective surgery such as hemispherectomy is more commonly used in the pediatric population, and this must also influence surgical outcome. However, studies related to cognitive outcome of epilepsy surgery in children are limited, and controversial results are often reported. In this chapter, we provide a current overview of the literature on cognitive outcomes in children who undergo different types of epilepsy surgery, including focal resections as well as corpus callosotomy and hemispherectomy. Early surgical intervention appears to be a rational option for the treatment of childhood epilepsy since many cognitive deficits are linked to the epileptic process and may disappear when seizures are controlled. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Economic Outcomes in Prosthodontics

    NARCIS (Netherlands)

    Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad W.; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan

    2013-01-01

    Purpose: A systematic literature review was conducted to identify the types of economic measures currently used in implant prosthodontics and determine the degree to which cost of care is considered in the context of any positive outcome of the care provided. Materials and Methods: A literature