WorldWideScience

Sample records for pretreatment implementation review

  1. Processes for pretreating lignocellulosic biomass: A review

    Energy Technology Data Exchange (ETDEWEB)

    McMillan, J.D.

    1992-11-01

    This paper reviews existing and proposed pretreatment processes for biomass. The focus is on the mechanisms by which the various pretreatments act and the influence of biomass structure and composition on the efficacy of particular pretreatment techniques. This analysis is used to identify pretreatment technologies and issues that warrant further research.

  2. Enhanced biogas production from rice straw with various pretreatment : a review

    Directory of Open Access Journals (Sweden)

    Fahriya Puspita Sari

    2014-04-01

    Full Text Available Rice straw is one of organic material that can be used for sustainable production of bioenergy and biofuels such as biogas (about 50-75% CH4 and 25-50% CO2. Out of all bioconversion technologies for biogas production, anaerobic digestion (AD is a most cost-effective bioconversion technology that has been implemented worldwide for commercial production of electricity, heat, and compressed natural gas (CNG from organic materials. However, the utilization of rice straw for biogas production via anaerobic digestion has not been widely adopted because the complicated structure of the plant cell wall makes it resistant to microbial attack. Pretreatment of recalcitrant rice straw is essential to achieve high biogas yield in the AD process. A number of different pretreatment techniques involving using physical pretreatment (hydrothermal and freeze, chemical pretreatment (sodium carbonate – sodium sulfite, hydrogen peroxide, NMMO, alkaline, and dilute acid and biological pretreatment (fungal pretreatment also combined pretretment (microwave irradiation and chemical approaches have been investigated, but there is no report that systematically compares the performance of these pretreatment methods for application on rice straw for biogas production. This paper reviews the methods that have been studied for pretreatment of rice straw for delignification, reducing sugar, and conversion to biogas. It describes the AD process, structural and compositional properties of rice straw, and various pretreatment techniques, including the pretreatment process, parameters, performance, and advantages vs. drawbacks.

  3. Extrusion Pretreatment of Lignocellulosic Biomass: A Review

    Directory of Open Access Journals (Sweden)

    Jun Zheng

    2014-10-01

    Full Text Available Bioconversion of lignocellulosic biomass to bioethanol has shown environmental, economic and energetic advantages in comparison to bioethanol produced from sugar or starch. However, the pretreatment process for increasing the enzymatic accessibility and improving the digestibility of cellulose is hindered by many physical-chemical, structural and compositional factors, which make these materials difficult to be used as feedstocks for ethanol production. A wide range of pretreatment methods has been developed to alter or remove structural and compositional impediments to (enzymatic hydrolysis over the last few decades; however, only a few of them can be used at commercial scale due to economic feasibility. This paper will give an overview of extrusion pretreatment for bioethanol production with a special focus on twin-screw extruders. An economic assessment of this pretreatment is also discussed to determine its feasibility for future industrial cellulosic ethanol plant designs.

  4. Pretreatment of microalgae to improve biogas production: a review.

    Science.gov (United States)

    Passos, Fabiana; Uggetti, Enrica; Carrère, Hélène; Ferrer, Ivet

    2014-11-01

    Microalgae have been intensively studied as a source of biomass for replacing conventional fossil fuels in the last decade. The optimization of biomass production, harvesting and downstream processing is necessary for enabling its full-scale application. Regarding biofuels, biogas production is limited by the characteristics of microalgae, in particular the complex cell wall structure of most algae species. Therefore, pretreatment methods have been investigated for microalgae cell wall disruption and biomass solubilization before undergoing anaerobic digestion. This paper summarises the state of the art of different pretreatment techniques used for improving microalgae anaerobic biodegradability. Pretreatments were divided into 4 categories: (i) thermal; (ii) mechanical; (iii) chemical and (iv) biological methods. According to experimental results, all of them are effective at increasing biomass solubilization and methane yield, pretreatment effect being species dependent. Pilot-scale research is still missing and would help evaluating the feasibility of full-scale implementation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Organic solvent pretreatment of lignocellulosic biomass for biofuels and biochemicals: A review.

    Science.gov (United States)

    Zhang, Ke; Pei, Zhijian; Wang, Donghai

    2016-01-01

    Lignocellulosic biomass represents the largest potential volume and lowest cost for biofuel and biochemical production. Pretreatment is an essential component of biomass conversion process, affecting a majority of downstream processes, including enzymatic hydrolysis, fermentation, and final product separation. Organic solvent pretreatment is recognized as an emerging way ahead because of its inherent advantages, such as the ability to fractionate lignocellulosic biomass into cellulose, lignin, and hemicellulose components with high purity, as well as easy solvent recovery and solvent reuse. Objectives of this review were to update and extend previous works on pretreatment of lignocellulosic biomass for biofuels and biochemicals using organic solvents, especially on ethanol, methanol, ethylene glycol, glycerol, acetic acid, and formic acid. Perspectives and recommendations were given to fully describe implementation of proper organic solvent pretreatment for future research. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Microalgal biomass pretreatment for bioethanol production: a review

    Directory of Open Access Journals (Sweden)

    Jesús Velazquez-Lucio

    2018-03-01

    Full Text Available Biofuels derived from microalgae biomass have received a great deal of attention owing to their high potentials as sustainable alternatives to fossil fuels. Microalgae have a high capacity of CO2 fixation and depending on their growth conditions, they can accumulate different quantities of lipids, proteins, and carbohydrates. Microalgal biomass can, therefore, represent a rich source of fermentable sugars for third generation bioethanol production. The utilization of microalgal carbohydrates for bioethanol production follows three main stages: i pretreatment, ii saccharification, and iii fermentation. One of the most important stages is the pretreatment, which is carried out to increase the accessibility to intracellular sugars, and thus plays an important role in improving the overall efficiency of the bioethanol production process. Diverse types of pretreatments are currently used including chemical, thermal, mechanical, biological, and their combinations, which can promote cell disruption, facilitate extraction, and result in the modification the structure of carbohydrates as well as the production of fermentable sugars. In this review, the different pretreatments used on microalgae biomass for bioethanol production are presented and discussed. Moreover, the methods used for starch and total carbohydrates quantification in microalgae biomass are also briefly presented and compared.

  7. Pretreatment biomarkers predicting PTSD psychotherapy outcomes: A systematic review.

    Science.gov (United States)

    Colvonen, Peter J; Glassman, Lisa H; Crocker, Laura D; Buttner, Melissa M; Orff, Henry; Schiehser, Dawn M; Norman, Sonya B; Afari, Niloofar

    2017-04-01

    Although our understanding of the relationship between posttraumatic stress disorder (PTSD), brain structure and function, neural networks, stress-related systems, and genetics is growing, there is considerably less attention given to which biological markers predict evidence-based PTSD psychotherapy outcomes. Our systematic PRISMA-informed review of 20 studies examined biomarkers as predictors of evidence-based PTSD psychotherapy outcomes. Results provide preliminary evidence that specific structural and functional neural systems (involved in information processing), glucocorticoid sensitivity and metabolism (part of the hypothalamic-pituitary-adrenal axis and the response to stress), heart rate (involved with fear habituation), gene methylation, and certain genotypes (associated with serotonin and glucocorticoids) predicted positive response to PTSD treatment. These pre-treatment biomarkers are associated with processes integral to PTSD treatment, such as those affecting fear learning and extinction, cognitive restructuring, information processing, emotional processing, and interoceptive monitoring. Identifying pre-treatment biomarkers that predict treatment response may offer insight into the mechanisms of psychological treatment, provide a foundation for improving the pharmaceutical augmentation of treatment, and inform treatment matching. Published by Elsevier Ltd.

  8. A review of wood thermal pretreatments to improve wood composite properties

    Science.gov (United States)

    Manuel Raul Pelaez-Samaniego; Vikram Yadama; Eini Lowell; Raul. Espinoza-Herrera

    2013-01-01

    The objective of this paper is to review the published literature on improving properties of wood composites through thermal pretreatment of wood. Thermal pretreatment has been conducted in moist environments using hot water or steam at temperatures up to 180 and 230 ˚C, respectively, or in dry environments using inert gases at temperatures up to 240 ...

  9. The effectiveness of pretreatment physics plan review for detecting errors in radiation therapy.

    Science.gov (United States)

    Gopan, Olga; Zeng, Jing; Novak, Avrey; Nyflot, Matthew; Ford, Eric

    2016-09-01

    The pretreatment physics plan review is a standard tool for ensuring treatment quality. Studies have shown that the majority of errors in radiation oncology originate in treatment planning, which underscores the importance of the pretreatment physics plan review. This quality assurance measure is fundamentally important and central to the safety of patients and the quality of care that they receive. However, little is known about its effectiveness. The purpose of this study was to analyze reported incidents to quantify the effectiveness of the pretreatment physics plan review with the goal of improving it. This study analyzed 522 potentially severe or critical near-miss events within an institutional incident learning system collected over a three-year period. Of these 522 events, 356 originated at a workflow point that was prior to the pretreatment physics plan review. The remaining 166 events originated after the pretreatment physics plan review and were not considered in the study. The applicable 356 events were classified into one of the three categories: (1) events detected by the pretreatment physics plan review, (2) events not detected but "potentially detectable" by the physics review, and (3) events "not detectable" by the physics review. Potentially detectable events were further classified by which specific checks performed during the pretreatment physics plan review detected or could have detected the event. For these events, the associated specific check was also evaluated as to the possibility of automating that check given current data structures. For comparison, a similar analysis was carried out on 81 events from the international SAFRON radiation oncology incident learning system. Of the 356 applicable events from the institutional database, 180/356 (51%) were detected or could have been detected by the pretreatment physics plan review. Of these events, 125 actually passed through the physics review; however, only 38% (47/125) were actually

  10. The effectiveness of pretreatment physics plan review for detecting errors in radiation therapy

    International Nuclear Information System (INIS)

    Gopan, Olga; Zeng, Jing; Novak, Avrey; Nyflot, Matthew; Ford, Eric

    2016-01-01

    Purpose: The pretreatment physics plan review is a standard tool for ensuring treatment quality. Studies have shown that the majority of errors in radiation oncology originate in treatment planning, which underscores the importance of the pretreatment physics plan review. This quality assurance measure is fundamentally important and central to the safety of patients and the quality of care that they receive. However, little is known about its effectiveness. The purpose of this study was to analyze reported incidents to quantify the effectiveness of the pretreatment physics plan review with the goal of improving it. Methods: This study analyzed 522 potentially severe or critical near-miss events within an institutional incident learning system collected over a three-year period. Of these 522 events, 356 originated at a workflow point that was prior to the pretreatment physics plan review. The remaining 166 events originated after the pretreatment physics plan review and were not considered in the study. The applicable 356 events were classified into one of the three categories: (1) events detected by the pretreatment physics plan review, (2) events not detected but “potentially detectable” by the physics review, and (3) events “not detectable” by the physics review. Potentially detectable events were further classified by which specific checks performed during the pretreatment physics plan review detected or could have detected the event. For these events, the associated specific check was also evaluated as to the possibility of automating that check given current data structures. For comparison, a similar analysis was carried out on 81 events from the international SAFRON radiation oncology incident learning system. Results: Of the 356 applicable events from the institutional database, 180/356 (51%) were detected or could have been detected by the pretreatment physics plan review. Of these events, 125 actually passed through the physics review; however

  11. Post Implementation Review Framework and Procedures

    Data.gov (United States)

    Social Security Administration — This template outlines the Social Security Administration's (SSA) approach to initiating, conducting, and completing Post Implementation Reviews (PIRs). The template...

  12. Pretreatment of Lignocellulosic Wastes to Improve Ethanol and Biogas Production: A Review

    Directory of Open Access Journals (Sweden)

    Keikhosro Karimi

    2008-09-01

    Full Text Available Lignocelluloses are often a major or sometimes the sole components of different waste streams from various industries, forestry, agriculture and municipalities. Hydrolysis of these materials is the first step for either digestion to biogas (methane or fermentation to ethanol. However, enzymatic hydrolysis of lignocelluloses with no pretreatment is usually not so effective because of high stability of the materials to enzymatic or bacterial attacks. The present work is dedicated to reviewing the methods that have been studied for pretreatment of lignocellulosic wastes for conversion to ethanol or biogas. Effective parameters in pretreatment of lignocelluloses, such as crystallinity, accessible surface area, and protection by lignin and hemicellulose are described first. Then, several pretreatment methods are discussed and their effects on improvement in ethanol and/or biogas production are described. They include milling, irradiation, microwave, steam explosion, ammonia fiber explosion (AFEX, supercritical CO2 and its explosion, alkaline hydrolysis, liquid hot-water pretreatment, organosolv processes, wet oxidation, ozonolysis, dilute- and concentrated-acid hydrolyses, and biological pretreatments.

  13. Influence of pretreatment techniques on anaerobic digestion of pulp and paper mill sludge: A review.

    Science.gov (United States)

    Veluchamy, C; Kalamdhad, Ajay S

    2017-12-01

    Pulp and paper industry is one of the most polluting, energy and water intensive industries in the world. Produced pulp and paper mill sludge (PPMS) faces a major problem for handling and its management. An anaerobic digestion has become an alternative source. This review provides a detailed summary of anaerobic digestion of PPMS - An overview of the developments and improvement opportunities. This paper explores the different pretreatment methods to enhance biogas production from the PPMS. First, the paper gives an overview of PPMS production, and then it reviews PPMS as a substrate for anaerobic digestion with or without pretreatment. Finally, it discuss the optimal condition and concentration of organic and inorganic compounds required for the anaerobic metabolic activity. Future research should focus on the combination of different pretreatment technologies, relationship between sludge composition, reactor design and its operation, and microbial community dynamics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. SU-E-T-148: Benchmarks and Pre-Treatment Reviews: A Study of Quality Assurance Effectiveness

    Energy Technology Data Exchange (ETDEWEB)

    Lowenstein, J; Nguyen, H; Roll, J; Walsh, A; Tailor, A; Followill, D [UT MD Anderson Cancer Center, Houston, TX (United States)

    2015-06-15

    Purpose: To determine the impact benchmarks and pre-treatment reviews have on improving the quality of submitted clinical trial data. Methods: Benchmarks are used to evaluate a site’s ability to develop a treatment that meets a specific protocol’s treatment guidelines prior to placing their first patient on the protocol. A pre-treatment review is an actual patient placed on the protocol in which the dosimetry and contour volumes are evaluated to be per protocol guidelines prior to allowing the beginning of the treatment. A key component of these QA mechanisms is that sites are provided timely feedback to educate them on how to plan per the protocol and prevent protocol deviations on patients accrued to a protocol. For both benchmarks and pre-treatment reviews a dose volume analysis (DVA) was performed using MIM softwareTM. For pre-treatment reviews a volume contour evaluation was also performed. Results: IROC Houston performed a QA effectiveness analysis of a protocol which required both benchmarks and pre-treatment reviews. In 70 percent of the patient cases submitted, the benchmark played an effective role in assuring that the pre-treatment review of the cases met protocol requirements. The 35 percent of sites failing the benchmark subsequently modified there planning technique to pass the benchmark before being allowed to submit a patient for pre-treatment review. However, in 30 percent of the submitted cases the pre-treatment review failed where the majority (71 percent) failed the DVA. 20 percent of sites submitting patients failed to correct their dose volume discrepancies indicated by the benchmark case. Conclusion: Benchmark cases and pre-treatment reviews can be an effective QA tool to educate sites on protocol guidelines and to minimize deviations. Without the benchmark cases it is possible that 65 percent of the cases undergoing a pre-treatment review would have failed to meet the protocols requirements.Support: U24-CA-180803.

  15. Sample pretreatment strategies for total reflection X-ray fluorescence analysis: A tutorial review

    Energy Technology Data Exchange (ETDEWEB)

    De La Calle, I.; Cabaleiro, N.; Romero, V.; Lavilla, I.; Bendicho, C., E-mail: bendicho@uvigo.es

    2013-12-01

    In the last years, there has been a revival of total reflection X-ray fluorescence spectrometry (TXRF), which was firstly applied for analytical purposes in the late 80s. The aim of this work is to discuss and compare the current approaches for sample pretreatment including in situ microdigestion, slurry preparation, acid digestion, extraction, etc. prior to TXRF analysis. Advantages and drawbacks inherent to each of those procedures are considered. A comprehensive revision in the period January 2008–July 2013 about different sample preparation strategies prior to TXRF analysis apart from early pioneering reports dealing with sample pretreatment are included in the review. Non-conventional sample pretreatment approaches such as microflow online preconcentration, lab-on-a-chip, etc., are also discussed. Finally, future prospects in sample preparation prior to TXRF analysis are outlined. - Highlights: • We review sample pretreatment for TXRF in a comprehensive way. • Strategies for analysis of solid, liquid and gaseous samples are discussed. • A tutorial review is presented covering the period January 2008–July 2013. • Future prospects for sample pretreament approaches in TXRF are outlined.

  16. Application of pretreatment methods on agricultural products prior to frying: a review.

    Science.gov (United States)

    Oladejo, Ayobami Olayemi; Ma, Haile; Qu, Wenjuan; Zhou, Cunshan; Wu, Bengang; Uzoejinwa, Benjamin Bernard; Onwude, Daniel I; Yang, Xue

    2018-01-01

    Frying is one of the methods of processing foods, which imparts flavour, taste, colour and crispness in the fried foods. In spite of an increase in the demand for fried foods by consumers all over the world, the danger posed by consuming too much fat is still a challenge. Many researchers have put forward many ideas on how to reduce the oil uptake and improve the nutritional and organoleptic qualities of foods during frying. Several pretreatment techniques applied to food materials prior to frying have been investigated by researchers in a bid to reduce the oil uptake and improve the quality parameters of fried foods. Therefore, this review focuses on the various pretreatment methods and the recent novel methods like ultrasound, infrared, superheated steam drying, microwave technique and pulsed electric field applied to foods prior to frying and its effects on the qualities of fried foods. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  17. Review of critical factors for SEA implementation

    International Nuclear Information System (INIS)

    Zhang Jie; Christensen, Per; Kørnøv, Lone

    2013-01-01

    The implementation process involved in translating Strategic Environmental Assessment (SEA) intention into action is vital to an effective SEA. Many factors influence implementation and thus the effectiveness of an SEA. Empirical studies have identified and documented some factors influencing the implementation of an SEA. This research is fragmented, however, and it is still not clear what are the most critical factors of effective SEA performance, and how these relate to different stages of the implementation process or other contextual circumstances. The paper takes its point of departure in implementation theory. Firstly, we introduce implementation theory, and then use it in practice to establish a more comprehensive model related to the stages in the implementation process. Secondly, we identify the critical factors in order to see how they are related to the different stages of SEA or are more general in character. Finally we map the different critical factors and how they influence the overall results of an SEA. Based on a literature review, we present a comprehensive picture of the critical factors and where they are found in the process. We conclude that most of the critical factors identified are of a more general character influencing the SEA process as such, while only one out of four of these factors relates to the specific stages of the SEA. Based on this mapping we can sketch a picture of the totality of critical factors. In this study 266 notions of critical factors were identified. Seen at the level of notions of critical factors, only 24% of these relate to specific stages while for 76% the critical factors are of a more general nature. These critical factors interact in complex ways and appear in different combinations in different stages of the implementation process so tracing the cause and effect is difficult. The pervasiveness of contextual and general factors also clearly suggests that there is no single way to put SEA into practice. The

  18. Literature review of physical and chemical pretreatment processes for lignocellulosic biomass

    NARCIS (Netherlands)

    Harmsen, P.F.H.; Huijgen, W.; Bermudez, L.; Bakker, R.

    2010-01-01

    Different pretreatment technologies published in public literature are described in terms of the mechanisms involved, advantages and disadvantages, and economic assessment. Pretreatment technologies for lignocellulosic biomass include biological, mechanical, chemical methods and various combinations

  19. SU-F-T-351: Establishing a Workflow for IMRT Pre-Treatment Reviews for NRG-GY006 Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Giaddui, T [Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States); Li, N; Moore, K; Mell, L [University of California, San Diego, San Diego, CA (United States); Curry, K [MIM Software, Inc., Clevealand, OH (United States); Leath, C [University of Alabama at Birmingham, Birmingham, AL (United States); Kunos, C [Northeastern Ohio University College, Clevealand, OH (United States); Xiao, Y [University of Pennsylvania, Philadelphia, PA (United States)

    2016-06-15

    Purpose: To establish a workflow for NRG-GY006 IMRT pre-treatment reviews, incorporating advanced radiotherapy technologies being evaluated as part of the clinical trial. Methods: Pre-Treatment reviews are required for every IMRT case as part of NRG-GY006 (a randomized phase II trial of radiation therapy and cisplatin alone or in combination with intravenous triapine in women with newly diagnosed bulky stage I B2, stage II, IIIB, or IVA cancer of the uterine cervix or stage II-IVA vaginal cancer. The pretreatment review process includes structures review and generating an active bone marrow(ABM)- to be used as an avoidance structure during IMRT optimization- and evaluating initial IMRT plan quality using knowledgeengineering based planning (KBP). Institutions will initially submit their simulation CT scan, structures file and PET/CT to IROC QA center for generating ABM. The ABM will be returned to the institution for use in planning. Institutions will then submit an initial IMRT plan for review and will receive information back following implementation of a KBP algorithm, for use in re-optimization, before submitting the final IMRT used for treatment. Results: ABM structure is generated using MIM vista software (Version 6.5, MIM corporation, Inc.). Here, the planning CT and the diagnostic PET/CT are fused and a sub threshold structure is auto segmented above the mean value of the SUV of the bone marrow. The generated ABM were compared with those generated with other software system (e.g. Velocity, Varian) and Dice coefficient (reflects the overlap of structures) ranged between 80 – 90% was achieved. A KBP model was built in Varian Eclipse TPS using the RapidPlan KBP software to perform plan quality assurance. Conclusion: The workflow for IMRT pretreatment reviews has been established. It represents a major improvement of NRG Oncology clinical trial quality assurance and incorporates the latest radiotherapy technologies as part of NCI clinical trials. This project

  20. Impact of the environmental conditions and substrate pre-treatment on whey protein hydrolysis: A review.

    Science.gov (United States)

    Cheison, Seronei Chelulei; Kulozik, Ulrich

    2017-01-22

    Proteins in solution are subject to myriad forces stemming from interactions with each other as well as with the solvent media. The role of the environmental conditions, namely pH, temperature, ionic strength remains under-estimated yet it impacts protein conformations and consequently its interaction with, and susceptibility to, the enzyme. Enzymes, being proteins are also amenable to the environmental conditions because they are either activated or denatured depending on the choice of the conditions. Furthermore, enzyme specificity is restricted to a narrow regime of optimal conditions while opportunities outside the optimum conditions remain untapped. In addition, the composition of protein substrate (whether mixed or single purified) have been underestimated in previous studies. In addition, protein pre-treatment methods like heat denaturation prior to hydrolysis is a complex phenomenon whose progression is influenced by the environmental conditions including the presence or absence of sugars like lactose, ionic strength, purity of the protein, and the molecular structure of the mixed proteins particularly presence of free thiol groups. In this review, we revisit protein hydrolysis with a focus on the impact of the hydrolysis environment and show that preference of peptide bonds and/or one protein over another during hydrolysis is driven by the environmental conditions. Likewise, heat-denaturing is a process which is dependent on not only the environment but the presence or absence of other proteins.

  1. Review of critical factors for SEA implementation

    DEFF Research Database (Denmark)

    Zhang, Jie; Christensen, Per; Kørnøv, Lone

    2013-01-01

    The implementation process involved in translating Strategic Environmental Assessment (SEA) intention into action is vital to an effective SEA. Many factors influence implementation and thus the effectiveness of an SEA. Empirical studies have identified and documented some factors influencing...... the implementation of an SEA. This research is fragmented, however, and it is still not clear what are the most critical factors of effective SEA performance, and how these relate to different stages of the implementation process or other contextual circumstances. The paper takes its point of departure...... tracing the cause and effect is difficult. The pervasiveness of contextual and general factors also clearly suggests that there is no single way to put SEA into practice. The paper identifies some of the critical factors for effective SEA implementation, but further research is still needed to conclude...

  2. Effect of Pre-treatment Education Programs on the Anxiety of Patients Receiving Radiotherapy: An Integrative Literature Review

    Directory of Open Access Journals (Sweden)

    Fatemeh Heshmati Nabavi

    2016-04-01

    Full Text Available Background: Stress and anxiety in cancer patients are caused by disease diagnosis, unfamiliar experiences, and therapy-related problems. In addition to the short duration of radiotherapy, receiving and understanding of the information about this treatment could be difficult for patients due to anxiety, fatigue, and mental pressure. Training of cancer patients about radiotherapy via educational programs could reduce pre-treatment anxiety. Aim: This systematic review aimed to integrate the information regarding the effects of pre-treatment educational training on the level of anxiety and distress symptoms of cancer patients receiving RT. Method: This systematic review was conducted to identify the studies comparing different methods of pre-treatment patient education before radiotherapy via searching in databases such as MEDLINE, PsycINFO, Web of Science, ClinicalKey, ProQuest, and PubMed. Selected studies included clinical reports on the effects of educational interventions on the anxiety of patients receiving radiotherapy. Excluded samples were commentaries and studies without intervention. Results: In total, we reviewed eight articles assessing the effect of educational interventions before radiotherapy on the anxiety of cancer patients. Educational interventions used in these studies included face-to-face consultation with a radiotherapist, group instructions with routine individual training using visual materials (e.g., brochures, booklets, videotapes, and PowerPoint presentations, group discussions, electronic instructions, written materials, and phone contact with a nurse. Implications for Practice: According our findings, pre-treatment education could reduce the anxiety of cancer patients before radiotherapy. These educational programs could be performed using written, visual, electronic, or face-to-face instructions. However, considering the condition of cancer patients and their treatment, selection of the appropriate training method

  3. Comprehensive review and compilation of pretreatments for mesophilic and thermophilic anaerobic digestion.

    Science.gov (United States)

    Bordeleau, É L; Droste, R L

    2011-01-01

    Organic matter hydrolysis prior to anaerobic digestion has been shown to improve biogas production (30-50%) and reduce solids (20-60%) by ultrasound, chemical, conventional heating, and microwave pretreatments. Numerous studies have been performed to determine the extent of digestion improvement but few focus on financial feasibility of these processes. A comprehensive model was created using Microsoft Excel and its Visual Basic Assistant to evaluate pretreatment permutations for conventional wastewater treatment plants. The four above-mentioned processes were evaluated for energetic and financial demands. Well-established energy equations and wastewater characteristics, both average and high, were used. Average and high flows were 460 and 750×10(3) m3/d, respectively. Net costs per influent flow for ultrasound, chemical, conventional heating, and microwave were 0.0166, 0.0217, 0.0124, 0.0119 $/m3 and 0.0264, 0.0357, 0.0187, and 0.0162 $/m3 for average and high conditions, respectively. The average cost increase from results excluding pretreatment use for all processes was 0.003 and 0.0055 $/m3 for average and high conditions, respectively. No matter the permutation, pretreatments requiring more energy to achieve required hydrolysis levels were costlier. If energetic recoveries are substantial, dewaterability is positively affected, and solids meet environmental constraints to be handled and disposed at lower costs, pretreatments can be viable.

  4. Utility installation review system : implementation report.

    Science.gov (United States)

    2009-03-01

    Each year, the Texas Department of Transportation (TxDOT) issues thousands of approvals that enable new : utility installations to occupy the state right of way (ROW). The current utility installation review process : relies on the physical delivery ...

  5. Balanced Scorecard implementation in small companies: a literature review

    Directory of Open Access Journals (Sweden)

    Estefanie Argüello-Solano

    2015-12-01

    Full Text Available The Balanced Scorecard (BSC has been used for performance measurement and strategy management for many years. This literature review analyzed studies about the implementation of the BSC in small companies, identifying implementation cases of BSC reported in small enterprises, factors of influence of small enterprises to implement the BSC model, main stages of implementation of the BSC in small enterprises, and future research lines. As a result 23 papers, 12 academic theses and 8 industry reports were identified. Our results shown that small enterprises can take advantage of its specific characteristics to implement the BSC and the implementation process in small companies may differ from the original BSC implementation process. There is little literature on the implementation of the BSC in small businesses, thus it is necessary additional empirical evidence on the effectiveness of CMI implementations in small businesses.

  6. Sustainable multifunctional landscapes: a review to implementation

    CSIR Research Space (South Africa)

    O'Farrell, PJ

    2010-05-01

    Full Text Available of ecosystem service provision into the future. A detailed understanding of the workings of our ecologi- cal systems, their thresholds, robustness and drivers is required if we are to develop and maintain such land- scapes [1,7]. Coupled... is discussed [2,8�,14]. Latest work also highlights the gap between science, policy and implementation [14] and demon- strates the necessity of engaging with stakeholders at multiple scales in order for the concept of multifunctional landscapes to find...

  7. Challenges in actual implementation of health policies: a review of ...

    African Journals Online (AJOL)

    Challenges in actual implementation of health policies: a review of payment exemption in Nigeria. CA Onoka, OE Onwujekwe, BSC Uzochukwu. Abstract. Background: As a response to the negative impact of implementation of user fees for health care services, an exemption scheme from payment was developed in many ...

  8. Implementation of school based physical activity interventions: a systematic review.

    Science.gov (United States)

    Naylor, Patti-Jean; Nettlefold, Lindsay; Race, Douglas; Hoy, Christa; Ashe, Maureen C; Wharf Higgins, Joan; McKay, Heather A

    2015-03-01

    Implementation science is an emerging area in physical activity (PA) research. We sought to establish the current state of the evidence related to implementation of school-based PA models to explore 1) the relationship between implementation and health outcomes, and 2) factors that influence implementation. We searched 7 electronic databases (1995-2014) and included controlled studies of school-based PA programmes for healthy youth (6-18 y) measuring at least one physical health-related outcome. For objective 1, studies linked implementation level to student-level health outcome(s). For objective 2, studies reported factors associated with implementation. There was substantial variability in how health outcomes and implementation were assessed. Few studies linked implementation and health outcomes (n=15 interventions). Most (11/15) reported a positive relationship between implementation and at least one health outcome. Implementation factors were reported in 29 interventions. Of 22 unique categories, time was the most prevalent influencing factor followed by resource availability/quality and supportive school climate. Implementation evaluation supports scale-up of effective school-based PA interventions and thus population-level change. Our review serves as a call to action to 1) address the link between implementation and outcome within the school-based PA literature and 2) improve and standardize definitions and measurement of implementation. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Review of technologies for the pretreatment of retrieved single-shell tank waste at Hanford

    International Nuclear Information System (INIS)

    Gerber, M.A.

    1992-08-01

    The purpose of the study reported here was to identify and evaluate innovative processes that could be used to pretreat mixed waste retrieved from the 149 single-shell tanks (SSTs) on the US Department of Energy's (DOE) Hanford site. The information was collected as part of the Single Shell Tank Waste Treatment project at Pacific Northwest Laboratory (PNL). The project is being conducted for Westinghouse Hanford Company under their SST Disposal Program

  10. A comprehensive review on pre-treatment strategy for lignocellulosic food industry waste: Challenges and opportunities.

    Science.gov (United States)

    Ravindran, Rajeev; Jaiswal, Amit Kumar

    2016-01-01

    Lignocellulose is a generic term used to describe plant biomass. It is the most abundant renewable carbon resource in the world and is mainly composed of lignin, cellulose and hemicelluloses. Most of the food and food processing industry waste are lignocellulosic in nature with a global estimate of up to 1.3 billion tons/year. Lignocellulose, on hydrolysis, releases reducing sugars which is used for the production of bioethanol, biogas, organic acids, enzymes and biosorbents. However, structural conformation, high lignin content and crystalline cellulose hinder its use for value addition. Pre-treatment strategies facilitate the exposure of more cellulose and hemicelluloses for enzymatic hydrolysis. The present article confers about the structure of lignocellulose and how it influences enzymatic degradation emphasising the need for pre-treatments along with a comprehensive analysis and categorisation of the same. Finally, this article concludes with a detailed discussion on microbial/enzymatic inhibitors that arise post pre-treatment and strategies to eliminate them. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Management implementation plan for a safety analysis and review system

    International Nuclear Information System (INIS)

    Hulburt, D.A.; Berkey, B.D.

    1981-04-01

    The US Department of Energy has issued an Order, DOE 5481.1, which establishes uniform requirements for the preparation and review of Safety Analysis for DOE Operations. The Management Implementation Plan specified herein establishes the administrative procedures and technical requirements for implementing DOE 5481.1 to Operations under the cognizance of the Pittsburgh Energy Technology Center. This Implementation Plan is applicable to all present and future Operations under the cognizance of PETC. The Plan identifies those Operations for which DOE 5481.1 is applicable and those Operations for which no further analysis is required because the initial determination and review has concluded that DOE 5481.1 does not apply

  12. Implementing Prehospital Evidence-Based Guidelines: A Systematic Literature Review.

    Science.gov (United States)

    Fishe, Jennifer N; Crowe, Remle P; Cash, Rebecca E; Nudell, Nikiah G; Martin-Gill, Christian; Richards, Christopher T

    2018-01-19

    As prehospital research advances, more evidence-based guidelines (EBGs) are implemented into emergency medical services (EMS) practice. However, incomplete or suboptimal prehospital EBG implementation may hinder improvement in patient outcomes. To inform future efforts, this study's objective was to review existing evidence pertaining to prehospital EBG implementation methods. This study was a systematic literature review and evaluation following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. PubMed, EMBASE, Scopus, and Google Advanced Search were searched without language or publication date filters for articles addressing prehospital EBG implementation. Conference proceedings, textbooks, and non-English articles were excluded. GRADE was applied to the remaining articles independently by three of five study investigators. Study characteristics and salient findings from the included articles are reported. The systematic literature review identified 1,367 articles, with 41 meeting inclusion criteria. Most articles described prehospital EBG implementation (n = 24, 59%), or implementation barriers (n = 13, 32%). Common study designs were statement documents (n = 12, 29%), retrospective cohort studies (n = 12, 29%), and cross-sectional studies (n = 9, 22%). Using GRADE, evidence quality was rated low (n = 18, 44%), or very low (n = 23, 56%). Salient findings from the articles included: (i) EBG adherence and patient outcomes depend upon successful implementation, (ii) published studies generally lack detailed implementation methods, (iii) EBG implementation takes longer than planned (mostly for EMS education), (iv) EMS systems' heterogeneity affects EBG implementation, and (v) multiple barriers limit successful implementation (e.g., financial constraints, equipment purchasing, coordination with hospitals, and regulatory agencies). This review found no direct evidence for best prehospital EBG implementation practices. There

  13. Biomass pretreatment

    Science.gov (United States)

    Hennessey, Susan Marie; Friend, Julie; Elander, Richard T; Tucker, III, Melvin P

    2013-05-21

    A method is provided for producing an improved pretreated biomass product for use in saccharification followed by fermentation to produce a target chemical that includes removal of saccharification and or fermentation inhibitors from the pretreated biomass product. Specifically, the pretreated biomass product derived from using the present method has fewer inhibitors of saccharification and/or fermentation without a loss in sugar content.

  14. A review on biomass classification and composition, cofiring issues and pretreatment methods

    Energy Technology Data Exchange (ETDEWEB)

    Jaya Shankar Tumuluru; Shahab Sokhansanj; Christopher T. Wright; Richard D. Boardman

    2011-08-01

    Presently around the globe there is a significant interest in using biomass for power generation as power generation from coal continues to raise environmental concerns. Biomass alone can be used for generation of power which can bring lot of environmental benefits. However the constraints of using biomass alone can include high investments costs for biomass feed systems and also uncertainty in the security of the feedstock supply due to seasonal variations and in most of the countries biomass is dispersed and the infrastructure for biomass supply is not well established. Alternatively cofiring biomass along with coal offer advantages like (a) reducing the issues related to biomass quality and buffers the system when there is insufficient feedstock quantity and (b) costs of adapting the existing coal power plants will be lower than building new systems dedicated only to biomass. However with the above said advantages there exists some technical constrains including low heating and energy density values, low bulk density, lower grindability index, higher moisture and ash content to successfully cofire biomass with coal. In order to successfully cofire biomass with coal, biomass feedstock specifications need to be established to direct pretreatment options that may include increasing the energy density, bulk density, stability during storage and grindability. Impacts on particle transport systems, flame stability, pollutant formation and boiler tube fouling/corrosion must also be minimized by setting feedstock specifications including composition and blend ratios if necessary. Some of these limitations can be overcome by using pretreatment methods. This paper discusses the impact of feedstock pretreatment methods like sizing, baling, pelletizing, briquetting, washing/leaching, torrefaction, torrefaction and pelletization and steam explosion in attainment of optimum feedstock characteristics to successfully cofire biomass with coal.

  15. Process and implementation of participatory ergonomic interventions: a systematic review.

    Science.gov (United States)

    van Eerd, Dwayne; Cole, Donald; Irvin, Emma; Mahood, Quenby; Keown, Kiera; Theberge, Nancy; Village, Judy; St Vincent, Marie; Cullen, Kim

    2010-10-01

    Participatory ergonomic (PE) interventions may vary in implementation. A systematic review was done to determine the evidence regarding context, barriers and facilitators to the implementation of participatory ergonomic interventions in workplaces. In total, 17 electronic databases were searched. Data on PE process and implementation were extracted from documents meeting content and quality criteria and synthesised. The search yielded 2151 references. Of these, 190 documents were relevant and 52 met content and quality criteria. Different ergonomic teams were described in the documents as were the type, duration and content of ergonomic training. PE interventions tended to focus on physical and work process changes and report positive impacts. Resources, programme support, ergonomic training, organisational training and communication were the most often noted facilitators or barriers. Successful PE interventions require the right people to be involved, appropriate ergonomic training and clear responsibilities. Addressing key facilitators and barriers such as programme support, resources, and communication is paramount. STATEMENT OF RELEVANCE: A recent systematic review has suggested that PE has some effect on reducing symptoms, lost days of work and claims. Systematic reviews of effectiveness provide practitioners with the desire to implement but do not provide clear information about how. This article reviews the literature on process and implementation of PE.

  16. Implementing Montessori Methods for Dementia: A Scoping Review.

    Science.gov (United States)

    Hitzig, Sander L; Sheppard, Christine L

    2017-10-01

    A scoping review was conducted to develop an understanding of Montessori-based programing (MBP) approaches used in dementia care and to identify optimal ways to implement these programs across various settings. Six peer-reviewed databases were searched for relevant abstracts by 2 independent reviewers. Included articles and book chapters were those available in English and published by the end of January 2016. Twenty-three articles and 2 book chapters met the inclusion criteria. Four approaches to implementing MBP were identified: (a) staff assisted (n = 14); (b) intergenerational (n = 5); (c) resident assisted (n = 4); and (d) volunteer or family assisted (n = 2). There is a high degree of variability with how MBP was delivered and no clearly established "best practices" or standardized protocol emerged across approaches except for resident-assisted MBP. The findings from this scoping review provide an initial road map on suggestions for implementing MBP across dementia care settings. Irrespective of implementation approach, there are several pragmatic and logistical issues that need to be taken into account for optimal implementation. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. A review on hydrothermal pre-treatment technologies and environmental profiles of algal biomass processing.

    Science.gov (United States)

    Patel, Bhavish; Guo, Miao; Izadpanah, Arash; Shah, Nilay; Hellgardt, Klaus

    2016-01-01

    The need for efficient and clean biomass conversion technologies has propelled Hydrothermal (HT) processing as a promising treatment option for biofuel production. This manuscript discussed its application for pre-treatment of microalgae biomass to solid (biochar), liquid (biocrude and biodiesel) and gaseous (hydrogen and methane) products via Hydrothermal Carbonisation (HTC), Hydrothermal Liquefaction (HTL) and Supercritical Water Gasification (SCWG) as well as the utility of HT water as an extraction medium and HT Hydrotreatment (HDT) of algal biocrude. In addition, the Solar Energy Retained in Fuel (SERF) using HT technologies is calculated and compared with benchmark biofuel. Lastly, the Life Cycle Assessment (LCA) discusses the limitation of the current state of art as well as introduction to new potential input categories to obtain a detailed environmental profile. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Targeted pre-treatment of hemp bast fibres for optimal performance in biocomposite materials: A review

    DEFF Research Database (Denmark)

    Liu, Ming; Thygesen, Anders; Summerscales, John

    2017-01-01

    . In order to achieve strong NFCs, well separated and cellulose-rich fibres are required. Hemp is taking a center stage in this regard as a source of suitable natural plant cellulose fibres because natural hemp bast fibres are long and inherently possess high strength. Classical field and water retting...... methods have been used for centuries for removal of non-cellulosic components from fibrous plant stems including from hemp, but carries a risk of reducing the mechanical properties of the fibres via damaging the cellulose. For NFCs new targeted fibre pre-treatment methods are needed to selectively...... and effectively remove non-cellulosic components from the plant fibres to produce cellulose rich fibres without introducing any damage to the fibres. A key feature for successful use of natural fibres such as hemp fibres in composite materials is optimal interfacial contact between the fibres and the hydrophobic...

  19. Implementation of improvement strategies in palliative care: an integrative review.

    Science.gov (United States)

    van Riet Paap, Jasper; Vernooij-Dassen, Myrra; Sommerbakk, Ragni; Moyle, Wendy; Hjermstad, Marianne J; Leppert, Wojciech; Vissers, Kris; Engels, Yvonne

    2015-07-26

    The European population is ageing, and as a consequence, an increasing number of patients are in need of palliative care, including those with dementia. Although a growing number of new insights and best practices in palliative care have been published, they are often not implemented in daily practice. The aim of this integrative review is to provide an overview of implementation strategies that have been used to improve the organisation of palliative care. Using an integrative literature review, we evaluated publications with strategies to improve the organisation of palliative care. Qualitative analysis of the included studies involved categorisation of the implementation strategies into subgroups, according to the type of implementation strategy. From the 2379 publications identified, 68 studies with an experimental or quasi-experimental design were included. These studies described improvements using educational strategies (n = 14), process mapping (n = 1), feedback (n = 1), multidisciplinary meetings (n = 1) and multi-faceted implementation strategies (n = 51). Fifty-three studies reported positive outcomes, 11 studies reported mixed effects and four studies showed a limited effect (two educational and two multi-faceted strategies). This review is one of the first to provide an overview of the available literature in relation to strategies used to improve the organisation of palliative care. Since most studies reported positive results, further research is needed to identify and improve the effects of strategies aiming to improve the organisation of palliative care.

  20. Implementing a Four-Phase Curriculum Review Model

    Science.gov (United States)

    LaCursia, Nancy

    2010-01-01

    This article describes how to implement the four-phase curriculum review model, a simplified process for renovating a high school health and physical education curriculum. Although this model was used at a large suburban high school, it could be adapted for use by smaller schools or other disciplines. The four phases of this model are: (1) needs…

  1. LEAN THINKING IN HEALTHCARE: REVIEW OF IMPLEMENTATION RESULTS

    Directory of Open Access Journals (Sweden)

    Marija Kovacevic

    2016-03-01

    Full Text Available For over decade, automotive industry originated lean concept has been successfully implemented in healthcare systems as a management method and philosophy with main focus on elimination of all types of wastes and looses in all tasks and processes so that time, materials, resources and medical procedures could be realized as effectively as it is possible. As main result lean concept implementation ensured to healthcare organizations to focus on their main core function and dedicate more time and efforts to patients without additional costs for them or healthcare system. However, lean implementation in healthcare could be much more difficult than in standard industrial environment and there are significant number of examples of lean in healthcare projects that failed to gain any measurable results and sustainable benefits from it. This paper presents review of some of the most successful implementations of lean tools and principles in healthcare organizations.

  2. Standard Review Plan Update and Development Program. Implementing Procedures Document

    Energy Technology Data Exchange (ETDEWEB)

    1992-05-01

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

  3. Pretreatment of Latent Prints for Laser Development.

    Science.gov (United States)

    Menzel, E R

    1989-06-01

    The pretreatment procedures for laser detection of latent fingerprints is reviewed. The general features of laser detection and the operational aspects of the examination of physical evidence for laser fingerprint detection are enumerated in the initial sections. The literature review is divided into various pretreatment approaches. Cited studies prior to 1981 are primarily concerned with the demonstration of the viability of laser fingerprint detection, whereas work post-1981 addresses issues of compatibility with the traditional methods of fingerprint development, examination of difficult surfaces, and the routine implementation of laser detection by law enforcement agencies. Related topics of research, review articles, conference reports, case examinations, the research support climate, and future trends are also briefly addressed. Copyright © 1989 Central Police University.

  4. Standard Review Plan Maintenance Program implementing procedures document

    International Nuclear Information System (INIS)

    1996-11-01

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

  5. Effectiveness of multifaceted implementation strategies for the implementation of back and neck pain guidelines in health care : A systematic review

    NARCIS (Netherlands)

    Suman, Arnela; Dikkers, Marije F.; Schaafsma, Frederieke G.; van Tulder, Maurits W.; Anema, Johannes R.

    2016-01-01

    Background: For the optimal use of clinical guidelines in daily practice, mere distribution of guidelines and materials is not enough, and active implementation is needed. This review investigated the effectiveness of multifaceted implementation strategies compared to minimal, single, or no

  6. Enhanced biogas production from rice straw with various pretreatment : a review

    OpenAIRE

    Fahriya Puspita Sari; Budiyono Budiyono

    2014-01-01

    Rice straw is one of organic material that can be used for sustainable production of bioenergy and biofuels such as biogas (about 50-75% CH4 and 25-50% CO2). Out of all bioconversion technologies for biogas production, anaerobic digestion (AD) is a most cost-effective bioconversion technology that has been implemented worldwide for commercial production of electricity, heat, and compressed natural gas (CNG) from organic materials. However, the utilization of rice straw for biogas production v...

  7. Critical factors for EIA implementation: literature review and research options.

    Science.gov (United States)

    Zhang, Jie; Kørnøv, Lone; Christensen, Per

    2013-01-15

    After decades of development, the gap between expectations of Environment Impact Assessments (EIA) and their practical performance remains significant. Research has been done to identify the critical factors for an effective implementation of EIA. However, this research, to a large extent, has not been cumulated and analysed comprehensively according to the stages of the EIA process. This paper contributes to the critical review of the literature on EIA implementation and effectiveness by cumulating mainly empirical findings in an implementation theoretical perspective. It focuses on the links between different critical factors and how they relate to different stages in the EIA and thus influence the decision making process. After reviewing 33 refereed journal articles published between 1999 and 2011, we identified 203 notions of critical factors. Of these, 102 related to different stages defined in our comprehensive EIA implementation model, and 101 were identified as general factors related to the whole EIA system. The number of notions of stage factors and general factors is thus about equal. An overlap between stage factors and general factors was found, which demonstrates that critical factors function differently in different cases. The function of the critical factors is complex and it is difficult to determine contingencies and causations. In the sources we examined, there is evidently an imbalance between in-depth empirical research and general knowledge, and the paper offers some suggestions for future research. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Telepathology Impacts and Implementation Challenges: A Scoping Review.

    Science.gov (United States)

    Meyer, Julien; Paré, Guy

    2015-12-01

    Telepathology is a particular form of telemedicine that fundamentally alters the way pathology services are delivered. Prior reviews in this area have mostly focused on 2 themes, namely technical feasibility issues and diagnosis accuracy. To synthesize the literature on telepathology implementation challenges and broader organizational and societal impacts and to propose a research agenda to guide future efforts in this domain. Two complementary databases were systematically searched: MEDLINE (PubMed) and ABI/INFORM (ProQuest). Peer-reviewed articles and conference proceedings were considered. The final sample consisted of 159 papers published between 1992 and 2013. This review highlights the diversity of telepathology networks and the importance of considering these distinctions when interpreting research findings. Various network structures are associated with different benefits. Although the dominant rationale in single-site projects is financial, larger centralized and decentralized telepathology networks are targeting a more diverse set of benefits, including extending access to pathology to a whole region, achieving substantial economies of scale in workforce and equipment, and improving quality by standardizing care. Importantly, our synthesis reveals that the nature and scale of encountered implementation challenges also varies depending on the network structure. In smaller telepathology networks, organizational concerns are less prominent, and implementers are more focused on usability issues. As the network scope widens, organizational and legal issues gain prominence.

  9. Non-enzymatic pretreatment of nerve agent (soman) poisoning: a brief state-of-the-art review.

    Science.gov (United States)

    van Helden, Herman P M; Joosen, Marloes J A; Philippens, Ingrid H C

    2011-09-25

    The rapid onset of toxic signs following nerve agent intoxication and the apprehension that current therapy (atropine, oxime, diazepam) may not prevent brain damage, requires supportive pretreatment. Since the current pretreatment drug pyridostigmine fails in protecting brain-AChE, more effective pretreatment is necessary. A main focus of present-day pretreatment research is on bioscavengers, another is on centrally active reversible AChE-inhibitors combined with drugs showing anti-cholinergic, anti-glutamatergic, neuroprotective and non-sedating GABA-ergic activity. Strategies aimed at improving efficacy of pharmacological pretreatment will briefly be discussed. Galantamine, given as a pretreatment or stand-alone therapy, emerged as one of the best medical countermeasures against nerve agent poisoning in guinea pigs. Other preclinical studies demonstrated effective pretreatment consisting of physostigmine combined with procyclidine, scopolamine or bupropion (all single injections), against nerve agent poisoning in guinea pigs. A long sign-free pretreatment with physostigmine (Alzet pump), combined with single injection of procyclidine just before soman poisoning, enhanced the efficacy of a post-poisoning therapy consisting of 3 autoinjector equivalents of HI-6, atropine and diazepam, considerably. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Non-enzymatic pretreatment of nerve agent (soman) poisoning: A brief state-of-the-art review

    NARCIS (Netherlands)

    Helden, H.P.M. van; Joosen, M.J.A.; Philippens, I.H.C.H.M.

    2011-01-01

    The rapid onset of toxic signs following nerve agent intoxication and the apprehension that current therapy (atropine, oxime, diazepam) may not prevent brain damage, requires supportive pretreatment. Since the current pretreatment drug pyridostigmine fails in protecting brain-AChE, more effective

  11. Real-Time Pretreatment Review Limits Unacceptable Deviations on a Cooperative Group Radiation Therapy Technique Trial: Quality Assurance Results of RTOG 0933

    Energy Technology Data Exchange (ETDEWEB)

    Gondi, Vinai, E-mail: vgondi@chicagocancer.org [Cadence Brain Tumor Center and CDH Proton Center, Warrenville, Illinois (United States); University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin (United States); Cui, Yunfeng [Duke University School of Medicine, Durham, North Carolina (United States); Mehta, Minesh P. [University of Maryland School of Medicine, Baltimore, Maryland (United States); Manfredi, Denise [Radiation Therapy Oncology Group—RTQA, Philadelphia, Pennsylvania (United States); Xiao, Ying; Galvin, James M. [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Rowley, Howard [University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin (United States); Tome, Wolfgang A. [Montefiore Medical Center and Institute for Onco-Physics, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States)

    2015-03-01

    Purpose: RTOG 0933 was a phase II trial of hippocampal avoidance during whole brain radiation therapy for patients with brain metastases. The results demonstrated improvement in short-term memory decline, as compared with historical control individuals, and preservation of quality of life. Integral to the conduct of this trial were quality assurance processes inclusive of pre-enrollment credentialing and pretreatment centralized review of enrolled patients. Methods and Materials: Before enrolling patients, all treating physicians and sites were required to successfully complete a “dry-run” credentialing test. The treating physicians were credentialed based on accuracy of magnetic resonance imaging–computed tomography image fusion and hippocampal and normal tissue contouring, and the sites were credentialed based on protocol-specified dosimetric criteria. Using the same criteria, pretreatment centralized review of enrolled patients was conducted. Physicians enrolling 3 consecutive patients without unacceptable deviations were permitted to enroll further patients without pretreatment review, although their cases were reviewed after treatment. Results: In all, 113 physicians and 84 sites were credentialed. Eight physicians (6.8%) failed hippocampal contouring on the first attempt; 3 were approved on the second attempt. Eight sites (9.5%) failed intensity modulated radiation therapy planning on the first attempt; all were approved on the second attempt. One hundred thirteen patients were enrolled in RTOG 0933; 100 were analyzable. Eighty-seven cases were reviewed before treatment; 5 (5.7%) violated the eligibility criteria, and 21 (24%) had unacceptable deviations. With feedback, 18 cases were approved on the second attempt and 2 cases on the third attempt. One patient was treated off protocol. Twenty-two cases were reviewed after treatment; 1 (4.5%) violated the eligibility criteria, and 5 (23%) had unacceptable deviations. Conclusions: Although >95% of the

  12. ASSESSING SMART GRIDS IMPLEMENTATION PROJECTS: A SYSTEMATIC REVIEW

    Directory of Open Access Journals (Sweden)

    De Oliveira, G. A.

    2015-06-01

    Full Text Available The electric grid has not changed its’ structural conception, technology, tactics and topologies since its’ large-scale utilization. The usage of information and communication technologies along with the existing grid could make them more efficient, safe, dynamic and flexible, optimizing its’ operation and control, besides providing new market models. However, this new concept, called “smart grids” (SG, comprehends several actors of the electrical system, which have conflicting interests, what hinders project implementation, besides the inherent difficulty in integrating new technologies in different regional contexts. Therefore, it is essential to identify metrics and key-factors of success to create models that allow the comprehensive assessment of this kind of project, once the SG implementation is still in an early stage all over the world. This paper addresses this subject through a systematic literature review, aiming at defining a set of implementation key-factors and compare existing assessment models of SG projects. The main conclusions of this systematic review are that there is significate heterogeneity concerning the complexity level of the key-factors and the assessment models found; and despite that each project has its’ own goals and needs, these key-factors must be comprehensive and better characterized in their analysis depth. Finally, a tighter integration among stakeholders should be promoted in different levels (strategic, tactical, and operational, in order to align the understanding around this subject.

  13. Planning and implementing school oral health programs: A scoping review

    Directory of Open Access Journals (Sweden)

    Kuldeep Singh Shekhawat

    2016-01-01

    Full Text Available Introduction: Most school oral health programs (SOHPs focus on either oral health education or preventive aspects of oral health. This scoping review emphasizes the significance of the knowledge application to design and implement SOHP which is more industrious and result oriented. Aim: To highlight, those school dental health programs which have approached the school oral health from all possible planes, i.e., education, prevention, treatment needs, and follow-up. Materials and Methods: Document 11 of WHO information series on school health for planning the intervention was utilized to obtain the initial benchmark for “best practices.” Electronic database MEDLINE, Cochrane central register of controlled trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, and SCOPUS were searched. Our search strategy included a 3 staged extraction. The first based on the title, the second was based on abstracts and the third stage was based on the full text. Hand search of the key journals was also done. Results: A total of four studies were finally selected and studied to indicate the best practices of the programs. Conclusion: Public health dentistry should now focus on SOHP planning and implementation in terms of management. We need to expand our horizons beyond clinical outcome and short-term goals to accumulate knowledge.

  14. Issues and Opportunities on Implementing an Online Faculty Review System.

    Science.gov (United States)

    Erstad, Brian L; Oxnam, Maliaca G; Miller, Tom P; Draugalis, JoLaine R

    2018-04-01

    Intensifying accountability pressures have led to an increased attention to assessments of teaching, but teaching generally represents only a portion of faculty duties. Less attention has been paid to how evaluations of faculty members can be used to gather data on teaching, research, clinical work, and outreach to integrate clinical and academic contributions and fill in information gaps in strategic areas such as technology transfer and commercialization where universities are being pressed to do more. Online reporting systems can enable departments to gather comprehensive data on faculty activities that can be aggregated for accreditation assessments, program reviews, and strategic planning. As detailed in our case study of implementing such a system at a research university, online annual reviews can also be used to publicize faculty achievements, to document departmental achievements, foster interdisciplinary and community collaborations, recognize service contributions (and disparities), and provide a comprehensive baseline for salary and budgetary investments.

  15. Optimization of infobutton design and Implementation: A systematic review.

    Science.gov (United States)

    Teixeira, Miguel; Cook, David A; Heale, Bret S E; Del Fiol, Guilherme

    2017-10-01

    Infobuttons are clinical decision tools embedded in the electronic health record that attempt to link clinical data with context sensitive knowledge resources. We systematically reviewed technical approaches that contribute to improved infobutton design, implementation and functionality. We searched databases including MEDLINE, EMBASE, and the Cochrane Library database from inception to March 1, 2016 for studies describing the use of infobuttons. We selected full review comparative studies, usability studies, and qualitative studies examining infobutton design and implementation. We abstracted usability measures such as user satisfaction, impact, and efficiency, as well as prediction accuracy of infobutton content retrieval algorithms and infobutton adoption/interoperability. We found 82 original research studies on infobuttons. Twelve studies met criteria for detailed abstraction. These studies investigated infobutton interoperability (1 study); tools to help tailor infobutton functionality (1 study); interventions to improve user experience (7 studies); and interventions to improve content retrieval by improving prediction of relevant knowledge resources and information needs (3 studies). In-depth interviews with implementers showed the Health Level Seven (HL7) Infobutton standard to be simple and easy to implement. A usability study demonstrated the feasibility of a tool to help medical librarians tailor infobutton functionality. User experience studies showed that access to resources with which users are familiar increased user satisfaction ratings; and that links to specific subsections of drug monographs increased information seeking efficiency. However, none of the user experience improvements led to increased usage uptake. Recommender systems based on machine learning algorithms outperformed hand-crafted rules in the prediction of relevant resources and clinicians' information needs in a laboratory setting, but no studies were found using these techniques

  16. The Oxford Implementation Index: a new tool for incorporating implementation data into systematic reviews and meta-analyses.

    Science.gov (United States)

    Montgomery, Paul; Underhill, Kristen; Gardner, Frances; Operario, Don; Mayo-Wilson, Evan

    2013-08-01

    This article presents a new tool that helps systematic reviewers to extract and compare implementation data across primary trials. Currently, systematic review guidance does not provide guidelines for the identification and extraction of data related to the implementation of the underlying interventions. A team of systematic reviewers used a multistaged consensus development approach to develop this tool. First, a systematic literature search on the implementation and synthesis of clinical trial evidence was performed. The team then met in a series of subcommittees to develop an initial draft index. Drafts were presented at several research conferences and circulated to methodological experts in various health-related disciplines for feedback. The team systematically recorded, discussed, and incorporated all feedback into further revisions. A penultimate draft was discussed at the 2010 Cochrane-Campbell Collaboration Colloquium to finalize its content. The Oxford Implementation Index provides a checklist of implementation data to extract from primary trials. Checklist items are organized into four domains: intervention design, actual delivery by trial practitioners, uptake of the intervention by participants, and contextual factors. Systematic reviewers piloting the index at the Cochrane-Campbell Colloquium reported that the index was helpful for the identification of implementation data. The Oxford Implementation Index provides a framework to help reviewers assess implementation data across trials. Reviewers can use this tool to identify implementation data, extract relevant information, and compare features of implementation across primary trials in a systematic review. The index is a work-in-progress, and future efforts will focus on refining the index, improving usability, and integrating the index with other guidance on systematic reviewing. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Mini-review of the geotechnical parameters of municipal solid waste: Mechanical and biological pre-treated versus raw untreated waste.

    Science.gov (United States)

    Petrovic, Igor

    2016-09-01

    The most viable option for biostabilisation of old sanitary landfills, filled with raw municipal solid waste, is the so-called bioreactor landfill. Even today, bioreactor landfills are viable options in many economically developing countries. However, in order to reduce the biodegradable component of landfilled waste, mechanical and biological treatment has become a widely accepted waste treatment technology, especially in more prosperous countries. Given that mechanical and biological treatment alters the geotechnical properties of raw waste material, the design of sanitary landfills which accepts mechanically and biologically treated waste, should be carried out with a distinct set of geotechnical parameters. However, under the assumption that 'waste is waste', some design engineers might be tempted to use geotechnical parameters of untreated raw municipal solid waste and mechanical and biological pre-treated municipal solid waste interchangeably. Therefore, to provide guidelines for use and to provide an aggregated source of this information, this mini-review provides comparisons of geotechnical parameters of mechanical and biological pre-treated waste and raw untreated waste at various decomposition stages. This comparison reveals reasonable correlations between the hydraulic conductivity values of untreated and mechanical and biological pre-treated municipal solid waste. It is recognised that particle size might have a significant influence on the hydraulic conductivity of both municipal solid waste types. However, the compression ratios and shear strengths of untreated and pre-treated municipal solid waste do not show such strong correlations. Furthermore, another emerging topic that requires appropriate attention is the recovery of resources that are embedded in old landfills. Therefore, the presented results provide a valuable tool for engineers designing landfills for mechanical and biological pre-treated waste or bioreactor landfills for untreated raw

  18. Implementation plan for WRAP Module 1 operational readiness review

    International Nuclear Information System (INIS)

    Irons, L.G.

    1994-01-01

    The Waste Receiving and Processing Module 1 (WRAP 1) will be used to receive, sample, treat, and ship contact-handled (CH) transuranic (TRU), low-level waste (LLW), and low-level mixed waste (LLMW) to storage and disposal sites both on the Hanford site and off-site. The primary mission of WRAP 1 is to characterize and certify CH waste in 55-gallon and 85-gallon drums; and its secondary function is to certify CH waste standard waste boxes (SWB) and boxes of similar size for disposal. The WRAP 1 will provide the capability for examination (including x-ray, visual, and contents sampling), limited treatment, repackaging, and certification of CH suspect-TRU waste in 55-gallon drums retrieved from storage, as well as newly generated CH LLW and CH TRU waste drums. The WRAP 1 will also provide examination (X-ray and visual only) and certification of CH LLW and CH TRU waste in small boxes. The decision to perform an Operational Readiness Review (ORR) was made in accordance with WHC-CM-5-34, Solid Waste Disposal Operations Administration, Section 1.4, Operational Readiness Activities. The ORR will ensure plant and equipment readiness, management and personnel readiness, and management programs readiness for the initial startup of the facility. This implementation plan is provided for defining the conduct of the WHC ORR

  19. Implementing electronic health records in hospitals : a systematic literature review

    NARCIS (Netherlands)

    Boonstra, A.; Versluis, Arie; Vos, J.F.J.

    2014-01-01

    Background: The literature on implementing Electronic Health Records (EHR) in hospitals is very diverse. The objective of this study is to create an overview of the existing literature on EHR implementation in hospitals and to identify generally applicable findings and lessons for implementers.

  20. Implementing Student Peer Review: Opportunity versus Change Management

    Science.gov (United States)

    Pharo, Emma; De Salas, Kristy

    2009-01-01

    This paper reflects on the implementation of a peer-assessment innovation in a large first-year geography unit. While the innovation had been carefully researched, difficulties in the implementation drew the authors' attention to the need for more change management to be built into the design and development. Focusing specifically on the teacher…

  1. Implementation and Validation of PACS Integrated Peer Review for Discrepancy Recording of Radiology Reporting

    NARCIS (Netherlands)

    Olthof, A. W.; van Ooijen, P. M. A.

    The purpose of this work is to demonstrate the possibility of implementation of a PACS-integrated peer review system based on RADPEER T classification providing a step-wise implementation plan utilizing features already present in the standard PACS implementation and without the requirement of

  2. Radiotherapy options for localized prostate cancer based upon pretreatment serum prostate-specific antigen levels and biochemical control: A comprehensive review of the literature

    International Nuclear Information System (INIS)

    Vicini, Frank A.; Horwitz, Eric M.; Kini, Vijay R.; Stromberg, Jannifer S.; Martinez, Alvaro A.

    1998-01-01

    Purpose: To review all the available radiotherapy (RT) literature on localized prostate cancer treatment where serum prostate-specific antigen (PSA) levels were used to both stratify patients and evaluate outcome and determine if any conclusions can be reached regarding an optimal radiotherapeutic management for this disease. Methods and Materials: A MEDLINE search was conducted to obtain all articles in English on prostate cancer treatment employing RT from 1986-1997. Studies were considered eligible for review only if they met all the following criteria: 1) pretreatment PSA values were recorded and grouped for subsequent evaluation, 2) posttreatment PSA values were continuously monitored, 3) definitions of biochemical control were stated, and 4) the median follow-up was given. Results: Of the 246 articles identified, only 20 met the inclusion criteria; 4 using conformal external beam RT, 8 using conventional external beam RT, and 8 using interstitial brachytherapy (4 using a permanent implant alone, 3 combining external beam RT with a permanent implant, and 1 combining a conformal temporary interstitial implant boost with external beam RT). No studies using neutrons (with or without external beam RT) or androgen deprivation (combined with external beam RT) were identified where patients were stratified by pretreatment PSA levels. Results for all therapies were extremely variable with the 3-5-year rates of biochemical control for patients with pretreatment PSA levels ≤4 ng/ml ranging from 48 to 100%, for PSA levels >4 and ≤10 ng/ml ranging from 44 to 90%, for PSA levels >10 and ≤20 ng/ml ranging from 27 to 89%, and for PSA levels >20 ranging from 14 to 89%. The median Gleason score, T-stage, definition of biochemical control, and follow-up were substantially different from series to series. No RT option consistently produced superior results. Conclusions: When data are reviewed from studies using serum PSA levels to stratify patients and to evaluate

  3. Implementation of improvement strategies in palliative care: an integrative review

    NARCIS (Netherlands)

    Riet Paap, J.C. van; Vernooij-Dassen, M.; Sommerbakk, R.; Moyle, W.; Hjermstad, M.J.; Leppert, W.; Vissers, K.; Engels, Y.

    2015-01-01

    BACKGROUND: The European population is ageing, and as a consequence, an increasing number of patients are in need of palliative care, including those with dementia. Although a growing number of new insights and best practices in palliative care have been published, they are often not implemented in

  4. IMPLEMENTING NDN USING SDN: A REVIEW ON METHODS AND APPLICATIONS

    Directory of Open Access Journals (Sweden)

    Shiva Rowshanrad

    2016-11-01

    Full Text Available In recent years many claims about the limitations of todays’ network architecture, its lack of flexibility and ability to response to ongoing changes and increasing users demands. In this regard, new network architectures are proposed. Software Defined Networking (SDN is one of these new architectures which centralizes the control of network by separating control plane from data plane. This separation leads to intelligence, flexibility and easier control in computer networks. One of the advantages of this framework is the ability to implement and test new protocols and architectures in actual networks without any concern of interruption.Named Data Networking (NDN is another paradigm for future network architecture. With NDN the network becomes aware of the content that is providing, rather than just transferring it among end-points. NDN attracts researchers’ attention and known as the potential future of networking and internet. Providing NDN functionalities over SDN is an important requirement to enable the innovation and optimization of network resources. In this paper first we describe about SDN and NDN, and then we introduce methods for implementing NDN using SDN. We also point out the advantages and applications of implementing NDN over SDN.

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  6. Cochrane Qualitative and Implementation Methods Group guidance paper 5: methods for integrating qualitative and implementation evidence within intervention effectiveness reviews.

    Science.gov (United States)

    Harden, Angela; Thomas, James; Cargo, Margaret; Harris, Janet; Pantoja, Tomas; Flemming, Kate; Booth, Andrew; Garside, Ruth; Hannes, Karin; Noyes, Jane

    2017-12-11

    The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method evidence from process evaluations. Despite a proliferation of methods for the synthesis of qualitative research, less attention has focused on how to integrate these syntheses within intervention effectiveness reviews. In this article, we report updated guidance from the group on approaches, methods, and tools, which can be used to integrate the findings from quantitative studies evaluating intervention effectiveness with those from qualitative studies and process evaluations. We draw on conceptual analyses of mixed methods systematic review designs and the range of methods and tools that have been used in published reviews that have successfully integrated different types of evidence. We outline five key methods and tools as devices for integration which vary in terms of the levels at which integration takes place; the specialist skills and expertise required within the review team; and their appropriateness in the context of limited evidence. In situations where the requirement is the integration of qualitative and process evidence within intervention effectiveness reviews, we recommend the use of a sequential approach. Here, evidence from each tradition is synthesized separately using methods consistent with each tradition before integration takes place using a common framework. Reviews which integrate qualitative and process evaluation evidence alongside quantitative evidence on intervention effectiveness in a systematic way are rare. This guidance aims to support review teams to achieve integration and we encourage further development through reflection and formal testing. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Preparation, review, and approval of implementation plans for nuclear safety requirements

    International Nuclear Information System (INIS)

    1994-10-01

    This standard describes an acceptable method to prepare, review, and approve implementation plans for DOE Nuclear Safety requirements. DOE requirements are identified in DOE Rules, Orders, Notices, Immediate Action Directives, and Manuals

  8. A Review of Implementing ADC in RFID Sensor

    Directory of Open Access Journals (Sweden)

    M. Zurita

    2016-01-01

    Full Text Available The general considerations to design a sensor interface for passive RFID tags are discussed. This way, power and timing constraints imposed by ISO/IEC 15693 and ISO/IEC 14443 standards to HF RFID tags are explored. A generic multisensor interface is proposed and a survey analysis on the most suitable analog-to-digital converters for passive RFID sensing applications is reported. The most appropriate converter type and architecture are suggested. At the end, a specific sensor interface for carbon nanotube gas sensors is proposed and a brief discussion about its implemented circuits and preliminary results is made.

  9. Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update

    Directory of Open Access Journals (Sweden)

    Jamie Ross

    2016-10-01

    Full Text Available Abstract Background There is a significant potential for e-health to deliver cost-effective, quality health care, and spending on e-health systems by governments and healthcare systems is increasing worldwide. However, there remains a tension between the use of e-health in this way and implementation. Furthermore, the large body of reviews in the e-health implementation field, often based on one particular technology, setting or health condition make it difficult to access a comprehensive and comprehensible summary of available evidence to help plan and undertake implementation. This review provides an update and re-analysis of a systematic review of the e-health implementation literature culminating in a set of accessible and usable recommendations for anyone involved or interested in the implementation of e-health. Methods MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library were searched for studies published between 2009 and 2014. Studies were included if they were systematic reviews of the implementation of e-health. Data from included studies were synthesised using the principles of meta-ethnography, and categorisation of the data was informed by the Consolidated Framework for Implementation Research (CFIR. Results Forty-four reviews mainly from North America and Europe were included. A range of e-health technologies including electronic medical records and clinical decision support systems were represented. Healthcare settings included primary care, secondary care and home care. Factors important for implementation were identified at the levels of the following: the individual e-health technology, the outer setting, the inner setting and the individual health professionals as well as the process of implementation. Conclusion This systematic review of reviews provides a synthesis of the literature that both acknowledges the multi-level complexity of e-health implementation and provides an accessible and useful guide for those

  10. Techniques to aid the implementation of novel clinical information systems: a systematic review.

    Science.gov (United States)

    Kelay, Tanika; Kesavan, Sujatha; Collins, Ruth E; Kyaw-Tun, Jimmy; Cox, Benita; Bello, Fernando; Kneebone, Roger L; Sevdalis, Nick

    2013-01-01

    This systematic review identifies and evaluates techniques that aid the implementation of novel clinical information systems (CIS) within healthcare. We searched electronic databases (MEDLINE, EMBASE, PsycINFO and HMIC Health Management Information Consortium). Desktop reviews for all potentially eligible studies were also conducted via reference lists and forward citation searches. 14,198 abstracts were identified through the initial electronic search. 63 articles were retained following title and abstract reviews, and submitted for full text evaluation. Of these, 18 papers met eligibility criteria. The 5 techniques that emerged from the review and that can assist CIS implementation were: system piloting, eliciting acceptance, use of simulation, training and education, and provision of incentives. These techniques were evaluated with a range of study endpoints (including system utilisation, clinical effectiveness, user satisfaction, attitudes towards system training, and attitudes towards implementation). Consideration of the clinical context in which the CIS was implemented was a consistent theme in the evidence-base. Although some evidence is available for the effectiveness of the 5 implementation techniques found in this review, the variable endpoints and the non-comparable study designs mean that the evidence-base needs further developing. We discuss the potential role of simulation and clinical leadership, particularly in relation to surgeons, in CIS implementation and we propose practical advice for CIS implementation and evaluation within hospital settings. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  11. Benefits and implementation of home hemodialysis: A narrative review

    Directory of Open Access Journals (Sweden)

    Ayman Karkar

    2015-01-01

    Full Text Available Home hemodialysis (HD is a modality of renal replacement therapy that can be safely and independently performed at home by end-stage renal disease (ESRD patients. Home HD can be performed at the convenience of the patients on a daily basis, every other day and overnight (nocturnal. Despite the great and many perceived benefits of home HD, including the significant improvements in health outcomes and resource utilization, the adoption of home HD has been limited; lack or inadequate pre-dialysis education and training constitute a major barrier. The lack of self-confidence and/or self-efficacy to manage own therapy, lack of family and/or social support, fear of machine and cannulation of blood access and worries of possible catastrophic events represent other barriers for the implementation of home HD besides inadequate competence and/or expertise in caring for home HD patients among renal care providers (nephrologists, dialysis nurses, educators. A well-studied, planned and prepared and carefully implemented central country program supported by adequate budget can play a positive role in overcoming the challenges to home HD. Healthcare authorities, with the increasingly financial and logistic demands and the relatively higher mortality and morbidity rates of the conventional in-center HD, should tackle home HD as an attractive and cost-effective modality with more freedom, quality of life and improvement of clinical outcomes for the ESRD patients.

  12. Barriers and facilitators to the implementation of orthodontic mini implants in clinical practice: a systematic review

    NARCIS (Netherlands)

    Meursinge Reynders, Reint; Ronchi, Laura; Ladu, Luisa; Di Girolamo, Nicola; de Lange, Jan; Roberts, Nia; Mickan, Sharon

    2016-01-01

    Numerous surveys have shown that orthodontic mini implants (OMIs) are underused in clinical practice. To investigate this implementation issue, we conducted a systematic review to (1) identify barriers and facilitators to the implementation of OMIs for all potential stakeholders and (2) quantify

  13. 77 FR 71145 - Approval and Promulgation of Implementation Plans; New Mexico; New Source Review (NSR...

    Science.gov (United States)

    2012-11-29

    .... EPA's policy is that all comments received will be included in the public docket without change and... AGENCY 40 CFR Part 52 Approval and Promulgation of Implementation Plans; New Mexico; New Source Review...) State Implementation Plan (SIP) for New Mexico. Among the changes, EPA is proposing to approve are the...

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  15. Book Review: Mentoring and coaching: Tools and techniques for implementation

    Directory of Open Access Journals (Sweden)

    Fiona Donald

    2007-10-01

    Full Text Available Mentoring and coaching: Tools and techniques for implementation. Meyer, M., & Fourie, L. (2004. Randburg: Knowres Publishing. This book is aimed at providing practical guidelines for people involved in mentoring and coaching. Given the need for skills development, employee involvement and change management in South Africa, mentoring and coaching offer a method of transforming the way in which organisations train their employees, manage performance and accelerate employee career development. Further, it can be used to transfer knowledge from people with the most experience to those with less knowledge. As a result it can be a useful tool in achieving employment equity. Written by South African authors, the book is tailored to organisations in this environment where issues such as diversity place additional challenges for mentoring and coaching processes. The book is easy to read and includes a number of issues to consider as well as check lists in each of its ten chapters.

  16. Tailoring the Systems Engineering Technical Review Implementation Within Naval Acquisition

    Science.gov (United States)

    2017-09-01

    they can become a computer guru by buying the latest and greatest product that a salesperson can talk them into, and don’t seem to realize that all...thinks they can become a computer guru by buying the latest and greatest product that a salesperson can talk them into, and don’t seem to realize that...adjudication process, and when stakeholders feel the review is ready to be closed. 8 The program had metrics set to meet threshold and objective criteria 9

  17. Implementation and Validation of PACS Integrated Peer Review for Discrepancy Recording of Radiology Reporting.

    Science.gov (United States)

    Olthof, A W; van Ooijen, P M A

    2016-09-01

    The purpose of this work is to demonstrate the possibility of implementation of a PACS-integrated peer review system based on RADPEER™ classification providing a step-wise implementation plan utilizing features already present in the standard PACS implementation and without the requirement of additional software development. Furthermore, we show the usage and effects of the system during the first 30 months of usage. To allow fast and easy implementation into the daily workflow the key-word feature of the PACS was used. This feature allows to add a key-word to an imaging examination for easy searching in the PACS database (e.g. by entering keywords for different kinds of pathology). For peer review we implemented a keyword structure including a code for each of the existing RADPEER™ scoring language terms and a keyword with the phrase "second reading" followed by the name of the individual radiologist. The use of the short-keys to enter the codes in relation to the peer review was a simple to use solution. During the study 599 reports were peer reviewed. The active participation in this study of the radiologists varies and ranges from 3 to 327 reviews per radiologist. The number of peer review is highest in CT and CR. There are no significant technical obstacles to implement a PACS-integrated RADPEER™ -system based on key-words allowing easy integration of peer review into the daily routine without the requirement of additional software. Peer review implemented in a non-random setting based on relevant priors could already help in increasing the quality of radiological reporting and serve as continuing education among peers. Decisiveness, tact and trust are needed to promote use of the system and collaborative discussion of the results by radiologist.

  18. An Evaluative Review of School Accreditation Implementation Program in Indonesian Contexts

    Science.gov (United States)

    Haryati, Sri

    2014-01-01

    This paper critically reviews and evaluates the implementation of School Accreditation Program for the period of 2013 with a particular reference to Central Java Schools, consisting of Kindergarten (TK) Elementary School (SD), Junior High School (SMP) and Senior High School (SMA) (Note 1). The aim of the review is to see to what extent they can…

  19. A review of the National pharmacovigilance system in Malta - implementing and operating a pharmacovigilance management system.

    Science.gov (United States)

    Tanti, Amy; Micallef, Benjamin; Serracino-Inglott, Anthony; Borg, John-Joseph

    2017-01-01

    Regulatory authorities have a legal mandate to implement and maintain a Pharmacovigilance System designed to monitor the safety of authorised medicinal products and detect any change to their risk-benefit balance. Areas covered: This review maps the implementation of pharmacovigilance activities in Malta since accession in the EU in mid 2004 and discusses the challenges the Maltese Regulator encountered while setting up adequate and effective systems to fulfil its legal mandate. Areas reviewed are those around ADR reporting, promotion and safety communications including rapid alerts and recalls, direct healthcare professional communications, risk minimisation measures and safety circulars and quality systems. Expert opinion: Within a ten year period, 3 EU directives on pharmacovigilance were implemented by our agency. Despite limitations to resources, based on a prioritised implementation, the legislation provisions are now fully operational with a good level of sustainability. Lessons learnt from this process are discussed in this review. The coming years will involve strengthening and consolidation of existing processes.

  20. Erlotinib or gefitinib for the treatment of relapsed platinum pretreated non-small cell lung cancer and ovarian cancer: a systematic review.

    Science.gov (United States)

    Murphy, Mark; Stordal, Britta

    2011-06-01

    Platinum-based chemotherapy is the standard of care for ovarian cancer and non-small cell lung cancer (NSCLC). However, resistance to platinum agents invariably develops. Targeted therapies, such as tyrosine kinase inhibitors (TKIs), have great potential here as they exert their anti-tumour effect via alternative mechanisms to platinum-based drugs and as such may remain unaffected by emergent resistance to platinum. A systematic review was conducted to investigate whether two EGFR-TKIs, erlotinib and gefitinib, have efficacy in the platinum-resistance setting. Preclinical studies of platinum-resistant cancer cell lines, which had been subsequently treated with EGFR-TKIs, were sought to establish proof-of-concept. Clinical trials reporting administration of EGFR-TKIs to ovarian cancer and NSCLC patients relapsed after therapy with platinum drugs were investigated to determine sensitivity of these cohorts to EGFR-TKI treatment. The role of EGFR mutation, copy number and protein expression on response to EGFR-TKIs after failure of platinum chemotherapy were also investigated. Preclinical models of platinum-resistant cancer were found which display a spectrum of cross-resistance profiles to EGFR-TKIs. Sensitivity to EGFR-TKIs is dependent on the activation of the EGFR pathway or EGFR interacting proteins such as HER-2. EGFR-TKIs show favourable response rates in platinum-pretreated NSCLC, 11.14% and 15.25% for 150mg/day erlotinib and 250mg/day gefitinib, respectively. These response rates significantly improve in patients of Asian descent (28.3% and 29.17%, respectively) and patients with EGFR activation mutations (41.6% and 63.89%, respectively) or increased copy number (33.3% and 45.45%, respectively). Gefitinib significantly outperformed erlotinib and should therefore be the EGFR-TKI of choice in platinum-pretreated relapsed NSCLC. In contrast, response rates are very poor to both erlotinib and gefitinib in platinum pretreated ovarian cancer, 0-5.9% and they should

  1. Requirements for ethics committee review for studies submitted to Implementation Science.

    Science.gov (United States)

    Eccles, Martin P; Weijer, Charles; Mittman, Brian

    2011-03-31

    The requirement for ethics review of studies submitted to Implementation Science has been unclear. Therefore, in this editorial, we set out our requirements for ethics committee review of experimental and non-experimental studies. For any study that meets the criteria of human subject research (which includes research on healthcare providers), irrespective of study design, we will require proof of either satisfactory ethics committee review or of the granting of an official exemption or waiver.

  2. Biofuel implementation agendas. A review of Task 39 Member Countries

    International Nuclear Information System (INIS)

    Van Neeft, J.; Van Thuijl, E.; Wismeijer, R.; Mabee, W.

    2007-01-01

    Biofuels for use in the transportation sector have been produced on a significant scale since the 1970's, using a variety of technologies. The biofuels widely available today are predominantly sugar- and starch-based bioethanol, and oilseed- and waste oil-based biodiesel, although new technologies under development may allow the use of lignocellulosic feedstocks. Measures to promote the use of biofuels include renewable fuel mandates, tax incentives, and direct funding for capital projects or fleet upgrades. This paper provides a review of the policies behind the successful establishment of the biofuel industry in countries around the world. The impact of direct funding programs and excise tax exemptions are examined using the United States as a case study. It is found that the success of five major bioethanol producing states (Illinois, Iowa, Nebraska, South Dakota, and Minnesota) is closely related to the presence of funding designed to support the industry in its start-up phase. The study concludes that successful policy interventions can take many forms, but that success is equally dependent upon external factors which include biomass availability, an active industry, and competitive energy prices

  3. The Role and Impact of Critical Review as Perceived by an Implementer

    International Nuclear Information System (INIS)

    Thegerstroem, Claes; Laarouchi Engstroem, Saida; Olsson, Olle

    2006-01-01

    The quality and success of a nuclear waste management programme is based on the amalgamation of the interests of a wide number of stakeholders, integration of many different scientific disciplines, and merging of scientific, technical, ethical and social issues. In this process, a broad and structured review of all aspects of the program is necessary and we find the process with submission and review by stakeholders, regulators and government every third year very useful. High-quality critical review of is always a real benefit to the implementer - as it gives the implementer the possibility to see where improvements can be made. However, a close dialogue and a dynamic reviewing process, where questions are raised throughout the process, are essential in order to optimize the quality of the final applications. Naturally, critical review should not be used for pushing specific general research interests or issues that belong to the political arena rather than nuclear waste management itself. Moreover, critical review provides additional insight and promotes confidence by the general public. However, sometimes the public might be confused and have difficulties in judging the importance and relevance of critical comments. The implementer and regulatory authorities have a special duty to provide an overall perspective of safety-related issues. Even if critical review is valuable, the implementer can not only rely on this. The implementers' own internal quality assurance practise, internal review process as well as its overall safety culture is all crucial. Indeed, a successful management of radio-active waste, including operational aspects as well as siting process, starts with the implementers' own wish to perform state-of-the art-work both in terms of technology and overall approach

  4. Pretreatment Engineering Platform Phase 1 Final Test Report

    Energy Technology Data Exchange (ETDEWEB)

    Kurath, Dean E.; Hanson, Brady D.; Minette, Michael J.; Baldwin, David L.; Rapko, Brian M.; Mahoney, Lenna A.; Schonewill, Philip P.; Daniel, Richard C.; Eslinger, Paul W.; Huckaby, James L.; Billing, Justin M.; Sundar, Parameshwaran S.; Josephson, Gary B.; Toth, James J.; Yokuda, Satoru T.; Baer, Ellen BK; Barnes, Steven M.; Golovich, Elizabeth C.; Rassat, Scot D.; Brown, Christopher F.; Geeting, John GH; Sevigny, Gary J.; Casella, Amanda J.; Bontha, Jagannadha R.; Aaberg, Rosanne L.; Aker, Pamela M.; Guzman-Leong, Consuelo E.; Kimura, Marcia L.; Sundaram, S. K.; Pires, Richard P.; Wells, Beric E.; Bredt, Ofelia P.

    2009-12-23

    Pacific Northwest National Laboratory (PNNL) was tasked by Bechtel National Inc. (BNI) on the River Protection Project, Hanford Tank Waste Treatment and Immobilization Plant (RPP-WTP) project to conduct testing to demonstrate the performance of the WTP Pretreatment Facility (PTF) leaching and ultrafiltration processes at an engineering-scale. In addition to the demonstration, the testing was to address specific technical issues identified in Issue Response Plan for Implementation of External Flowsheet Review Team (EFRT) Recommendations - M12, Undemonstrated Leaching Processes.( ) Testing was conducted in a 1/4.5-scale mock-up of the PTF ultrafiltration system, the Pretreatment Engineering Platform (PEP). Parallel laboratory testing was conducted in various PNNL laboratories to allow direct comparison of process performance at an engineering-scale and a laboratory-scale. This report presents and discusses the results of those tests.

  5. Dissemination and implementation research in dementia care: a systematic scoping review and evidence map.

    Science.gov (United States)

    Lourida, Ilianna; Abbott, Rebecca A; Rogers, Morwenna; Lang, Iain A; Stein, Ken; Kent, Bridie; Thompson Coon, Jo

    2017-07-14

    The need to better understand implementing evidence-informed dementia care has been recognised in multiple priority-setting partnerships. The aim of this scoping review was to give an overview of the state of the evidence on implementation and dissemination of dementia care, and create a systematic evidence map. We sought studies that addressed dissemination and implementation strategies or described barriers and facilitators to implementation across dementia stages and care settings. Twelve databases were searched from inception to October 2015 followed by forward citation and grey literature searches. Quantitative studies with a comparative research design and qualitative studies with recognised methods of data collection were included. Titles, abstracts and full texts were screened independently by two reviewers with discrepancies resolved by a third where necessary. Data extraction was performed by one reviewer and checked by a second. Strategies were mapped according to the ERIC compilation. Eighty-eight studies were included (30 quantitative, 34 qualitative and 24 mixed-methods studies). Approximately 60% of studies reported implementation strategies to improve practice: training and education of professionals (94%), promotion of stakeholder interrelationships (69%) and evaluative strategies (46%) were common; financial strategies were rare (15%). Nearly 70% of studies reported barriers or facilitators of care practices primarily within residential care settings. Organisational factors, including time constraints and increased workload, were recurrent barriers, whereas leadership and managerial support were often reported to promote implementation. Less is known about implementation activities in primary care and hospital settings, or the views and experiences of people with dementia and their family caregivers. This scoping review and mapping of the evidence reveals a paucity of robust evidence to inform the successful dissemination and implementation of

  6. Harnessing implementation science to improve care quality and patient safety: a systematic review of targeted literature.

    Science.gov (United States)

    Braithwaite, Jeffrey; Marks, Danielle; Taylor, Natalie

    2014-06-01

    Getting greater levels of evidence into practice is a key problem for health systems, compounded by the volume of research produced. Implementation science aims to improve the adoption and spread of research evidence. A linked problem is how to enhance quality of care and patient safety based on evidence when care settings are complex adaptive systems. Our research question was: according to the implementation science literature, which common implementation factors are associated with improving the quality and safety of care for patients? We conducted a targeted search of key journals to examine implementation science in the quality and safety domain applying PRISMA procedures. Fifty-seven out of 466 references retrieved were considered relevant following the application of exclusion criteria. Included articles were subjected to content analysis. Three reviewers extracted and documented key characteristics of the papers. Grounded theory was used to distil key features of the literature to derive emergent success factors. Eight success factors of implementation emerged: preparing for change, capacity for implementation-people, capacity for implementation-setting, types of implementation, resources, leverage, desirable implementation enabling features, and sustainability. Obstacles in implementation are the mirror image of these: for example, when people fail to prepare, have insufficient capacity for implementation or when the setting is resistant to change, then care quality is at risk, and patient safety can be compromised. This review of key studies in the quality and safety literature discusses the current state-of-play of implementation science applied to these domains. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  7. Implementation of a journal peer reviewer stratification system based on quality and reliability.

    Science.gov (United States)

    Green, Steven M; Callaham, Michael L

    2011-02-01

    Before starting this study, Annals of Emergency Medicine had a large and unwieldy reviewer pool that demonstrated substantial variability in quality and reliability. We hypothesize that a tiered reviewer stratification system might enable our journal editors to target the bulk of their review invitations to our better reviewers and thus improve our efficiency. In 2003, we instituted a 3-tiered hierarchic classification for our reviewers and stratified them within these categories according to predefined criteria for reviewer quality and reliability. Our approximately 50 editors then targeted the bulk of their review invitations to the top performance tier. Comparing 2009 data with 2002 (the year before the system), we found fewer late reviews (13% versus 32%) and fewer reviewers not used in a given year (28% versus 59%). More top-tier reviewer invitations led to an on-time review (48% versus 37%) in 2009 compared with 2002. Editors have found the system to be simple and easy to use. No serious problems have been identified. Implementation of a tiered system stratifying journal peer reviewers by quality and reliability was readily accomplished by Annals and has appeared to improve the efficiency of our peer review. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  8. The effectiveness of clinical guideline implementation strategies--a synthesis of systematic review findings.

    Science.gov (United States)

    Prior, Mathew; Guerin, Michelle; Grimmer-Somers, Karen

    2008-10-01

    To establish the effectiveness of clinical guideline implementation strategies. Data sources/study setting Systematic reviews in full text, English language, 1987-2007, reporting any measure of clinical process change or cost-benefit analysis. Overview of secondary evidence Independent critical appraisal using AMSTAR, primary author undertaking all data extraction using a purpose-built form. Principal findings We identified 144 potential papers, from which 33 systematic reviews were included. These reflected 714 primary studies involving 22 512 clinicians, in a range of health care settings. Implementation strategies were varied, rarely comparable, with variable outcomes. Effective implementation strategies included multifaceted interventions, interactive education and clinical reminder systems. Didactic education and passive dissemination strategies were ineffective. Cost-effectiveness studies were rare. Successful guideline implementation strategies should be multifaceted, and actively engage clinicians throughout the process.

  9. Facilitators and barriers of implementing and delivering social prescribing services: a systematic review.

    Science.gov (United States)

    Pescheny, Julia Vera; Pappas, Yannis; Randhawa, Gurch

    2018-02-07

    Social Prescribing is a service in primary care that involves the referral of patients with non-clinical needs to local services and activities provided by the third sector (community, voluntary, and social enterprise sector). Social Prescribing aims to promote partnership working between the health and the social sector to address the wider determinants of health. To date, there is a weak evidence base for Social Prescribing services. The objective of the review was to identify factors that facilitate and hinder the implementation and delivery of SP services based in general practice involving a navigator. We searched eleven databases, the grey literature, and the reference lists of relevant studies to identify the barriers and facilitators to the implementation and delivery of Social Prescribing services in June and July 2016. Searches were limited to literature written in English. No date restrictions were applied. Findings were synthesised narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. Eight studies were included in the review. The synthesis identified a range of factors that facilitate and hinder the implementation and delivery of SP services. Facilitators and barriers were related to: the implementation approach, legal agreements, leadership, management and organisation, staff turnover, staff engagement, relationships and communication between partners and stakeholders, characteristics of general practices, and the local infrastructure. The quality of most included studies was poor and the review identified a lack of published literature on factors that facilitate and hinder the implementation and delivery of Social Prescribing services. The review identified a range of factors that facilitate and hinder the implementation and delivery of Social Prescribing services. Findings of this review provide an insight for commissioners, managers, and providers

  10. Implementing Dementia Care Mapping as a practice development tool in dementia care services: a systematic review.

    Science.gov (United States)

    Surr, Claire A; Griffiths, Alys W; Kelley, Rachael

    2018-01-01

    Dementia Care Mapping (DCM) is an observational tool set within a practice development process. Following training in the method, DCM is implemented via a cyclic process of briefing staff, conducting mapping observations, data analysis and report preparation, feedback to staff and action planning. Recent controlled studies of DCM's efficacy have found heterogeneous results, and variability in DCM implementation has been indicated as a potential contributing factor. This review aimed to examine the primary research evidence on the processes and the barriers and facilitators to implementing DCM as a practice development method within formal dementia care settings. PUBMED, PsycINFO, CINAHL, The Cochrane Library-Cochrane reviews, HMIC (Ovid), Web of Science and Social Care Online were searched using the term "Dementia Care Mapping". Inclusion criterion was primary research studies in any formal dementia care settings where DCM was used as a practice development tool and which included discussion/critique of the implementation processes. Assessment of study quality was conducted using the Mixed Methods Appraisal Tool. Twelve papers were included in the review, representing nine research studies. The papers included discussion of various components of the DCM process, including mapper selection and preparation; mapping observations; data analysis, report writing and feedback; and action planning. However, robust evidence on requirements for successful implementation of these components was limited. Barriers and facilitators to mapping were also discussed. The review found some consensus that DCM is more likely to be successfully implemented if the right people are selected to be trained as mappers, with appropriate mapper preparation and ongoing support and with effective leadership for DCM within the implementing organization/unit and in organizations that already have a person-centered culture or ethos. Future development of the DCM tool should consider ways to save on

  11. [Lessons learned in the implementation of interoperable National Health Information Systems: a systematic review].

    Science.gov (United States)

    Ovies-Bernal, Diana Paola; Agudelo-Londoño, Sandra M

    2014-01-01

    Identify shared criteria used throughout the world in the implementation of interoperable National Health Information Systems (NHIS) and provide validated scientific information on the dimensions affecting interoperability. This systematic review sought to identify primary articles on the implementation of interoperable NHIS published in scientific journals in English, Portuguese, or Spanish between 1990 and 2011 through a search of eight databases of electronic journals in the health sciences and informatics: MEDLINE (PubMed), Proquest, Ovid, EBSCO, MD Consult, Virtual Health Library, Metapress, and SciELO. The full texts of the articles were reviewed, and those that focused on technical computer aspects or on normative issues were excluded, as well as those that did not meet the quality criteria for systematic reviews of interventions. Of 291 studies found and reviewed, only five met the inclusion criteria. These articles reported on the process of implementing an interoperable NHIS in Brazil, China, the United States, Turkey, and the Semiautonomous Region of Zanzíbar, respectively. Five common basic criteria affecting implementation of the NHIS were identified: standards in place to govern the process, availability of trained human talent, financial and structural constraints, definition of standards, and assurance that the information is secure. Four dimensions affecting interoperability were defined: technical, semantic, legal, and organizational. The criteria identified have to be adapted to the actual situation in each country and a proactive approach should be used to ensure that implementation of the interoperable NHIS is strategic, simple, and reliable.

  12. Integrative review of implementation strategies for translation of research-based evidence by nurses.

    Science.gov (United States)

    Wuchner, Staci S

    2014-01-01

    The purpose of this review was to synthesize and critique experimental and/or quasi-experimental research that has evaluated implementation strategies for translation of research-based evidence into nursing practice. Successfully implementing evidence-based research can improve patient outcomes. Identifying successful implementation strategies is imperative to move research-based evidence into practice. As implementation science gains popularity, it is imperative to understand the strategies that most effectively translate research-based evidence into practice. The review used the CINAHL and MEDLINE (Ovid) databases. Articles were included if they were experimental and/or quasi-experimental research designs, were written in English, and measured nursing compliance to translation of research-based evidence. An independent review was performed to select and critique the included articles. A wide array of interventions were completed, including visual cues, audit and feedback, educational meetings and materials, reminders, outreach, and leadership involvement. Because of the complex multimodal nature of the interventions and the variety of research topics, comparison across interventions was difficult. Many difficulties exist in determining what implementation strategies are most effective for translation of research-based evidence into practice by nurses. With these limited findings, further research is warranted to determine which implementation strategies most successfully translate research-based evidence into practice.

  13. Transactive Energy A Review of State of The Art and Implementation

    DEFF Research Database (Denmark)

    Liu, Zhaoxi; Wu, Qiuwei; Huang, Shaojun

    2017-01-01

    operations are in demand so that the flexibility of the responsive assets in the grid can be further explored. Transactive control, considered as one of the most novel distributed control approaches for power system operations, has been extensively discussed and studied around the world in recent years....... This paper provides a bibliographical review on the researches and implementation of the transactive energy concepts and transactive control techniques in power systems. The ideas of transactive control are introduced mainly according to the transactive energy framework proposed by the GridWise Architecture...... Council. The implementation pilots and research studies on transactive control applications in power systems are reviewed subsequently....

  14. A literature review for large-scale health information system project planning, implementation and evaluation.

    Science.gov (United States)

    Sligo, Judith; Gauld, Robin; Roberts, Vaughan; Villa, Luis

    2017-01-01

    Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators.

    Science.gov (United States)

    Vlaeyen, Ellen; Stas, Joke; Leysens, Greet; Van der Elst, Elisa; Janssens, Elise; Dejaeger, Eddy; Dobbels, Fabienne; Milisen, Koen

    2017-05-01

    To identify the barriers and facilitators for fall prevention implementation in residential care facilities. Systematic review. Review registration number on PROSPERO: CRD42013004655. Two independent reviewers systematically searched five databases (i.e. MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science) and the reference lists of relevant articles. This systematic review was conducted in line with the Center for Reviews and Dissemination Handbook and reported according to the PRISMA guideline. Only original research focusing on determinants of fall prevention implementation in residential care facilities was included. We used the Mixed Method Appraisal Tool for quality appraisal. Thematic analysis was performed for qualitative data; quantitative data were analyzed descriptively. To synthesize the results, we used the framework of Grol and colleagues that describes six healthcare levels wherein implementation barriers and facilitators can be identified. We found eight relevant studies, identifying 44 determinants that influence implementation. Of these, 17 were facilitators and 27 were barriers. Results indicated that the social and organizational levels have the greatest number of influencing factors (9 and 14, respectively), whereas resident and economical/political levels have the least (3 and 4, respectively). The most cited facilitators were good communication and facility equipment availability, while staff feeling overwhelmed, helpless, frustrated and concerned about their ability to control fall management, staffing issues, limited knowledge and skills (i.e., general clinical skill deficiencies, poor fall management skills or lack of computer skills); and poor communication were the most cited barriers. Successful implementation of fall prevention depends on many factors across different healthcare levels. The focus of implementation interventions, however, should be on modifiable barriers and facilitators such as communication, knowledge, and skills

  16. A Literature Review: The Effect of Implementing Technology in a High School Mathematics Classroom

    Science.gov (United States)

    Murphy, Daniel

    2016-01-01

    This study is a literature review to investigate the effects of implementing technology into a high school mathematics classroom. Mathematics has a hierarchical structure in learning and it is essential that students get a firm understanding of mathematics early in education. Some students that miss beginning concepts may continue to struggle with…

  17. Implementation of Web 2.0 services in academic, medical and research libraries: a scoping review.

    Science.gov (United States)

    Gardois, Paolo; Colombi, Nicoletta; Grillo, Gaetano; Villanacci, Maria C

    2012-06-01

    Academic, medical and research libraries frequently implement Web 2.0 services for users. Several reports notwithstanding, characteristics and effectiveness of services are unclear. To find out: the Web 2.0 services implemented by medical, academic and research libraries; study designs, measures and types of data used in included articles to evaluate effectiveness; whether the identified body of literature is amenable to a systematic review of results. Scoping review mapping the literature on the topic. Searches were performed in 19 databases. research articles in English, Italian, German, French and Spanish (publication date ≥ 2006) about Web 2.0 services for final users implemented by academic, medical and research libraries. Reviewers' agreement was measured by Cohen's kappa. From a data set of 6461 articles, 255 (4%) were coded and analysed. Conferencing/chat/instant messaging, blogging, podcasts, social networking, wikis and aggregators were frequently examined. Services were mainly targeted at general academic users of English-speaking countries. Data prohibit a reliable estimate of the relative frequency of implemented Web 2.0 services. Case studies were the prevalent design. Most articles evaluated different outcomes using diverse assessment methodologies. A systematic review is recommended to assess the effectiveness of such services. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  18. 78 FR 28007 - Submission for Review: Federal Employees' Group Life Insurance (FEGLI) Implementation...

    Science.gov (United States)

    2013-05-13

    ... From the Federal Register Online via the Government Publishing Office OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Federal Employees' Group Life Insurance (FEGLI) Implementation Questionnaire for Tribal Employers AGENCY: U.S. Office of Personnel Management. ACTION: 60-Day Notice and...

  19. Results of Review of the Implementation of Public Law 98-94 for Air Force Retirees

    National Research Council Canada - National Science Library

    1993-01-01

    ... of P.L. 98-94 was not fully implemented in a timely manner. We also believe there was no intentional disregard of the law by management at the Defense Finance and Accounting Service-Denver Center. Scope of Review...

  20. Parent-Implemented Language Interventions for Children with a Developmental Delay: A Systematic Review

    NARCIS (Netherlands)

    van den Os, D.; Jongmans, M.J.; Volman, M.J.M.; Lauteslager, P.

    2017-01-01

    Young children with a developmental delay (DD) show significant delays in communication and language development. Although several parent-implemented language intervention programs have been developed to facilitate the communication and language abilities of children with a DD, no systematic review

  1. Implementation of Blended Learning in Higher Learning Institutions: A Review of the Literature

    Science.gov (United States)

    Ma'arop, Amrien Hamila; Embi, Mohamed Amin

    2016-01-01

    While many educational premises including higher learning institutions favor blended learning over traditional approach and merely online learning, some academicians are still apprehensive about teaching in blended learning. The aim of this review is to synthesize the available evidence in the literature on challenges faced in implementing blended…

  2. A bibliographic review of public health dissemination and implementation research output and citation rates

    Directory of Open Access Journals (Sweden)

    Luke Wolfenden

    2016-12-01

    Systematic reviews, randomized controlled trials and cohort studies were the most frequently cited study designs. The study suggests that publications that had the greatest academic impact (highest citation rates made up only a small proportion of overall public health dissemination and implementation research output.

  3. A bibliographic review of public health dissemination and implementation research output and citation rates.

    Science.gov (United States)

    Wolfenden, Luke; Milat, Andrew J; Lecathelinais, Christophe; Skelton, Eliza; Clinton-McHarg, Tara; Williams, Christopher; Wiggers, John; Chai, Li Kheng; Yoong, Sze Lin

    2016-12-01

    The aim of this study was to describe the research output and citation rates (academic impact) of public health dissemination and implementation research according to research design and study type. A cross sectional bibliographic study was undertaken in 2013. All original data-based studies and review articles focusing on dissemination and implementation research that had been published in 10 randomly selected public health journals in 2008 were audited. The electronic database 'Scopus' was used to calculate 5-year citation rates for all included publications. Of the 1648 publications examined, 216 were original data-based research or literature reviews focusing on dissemination and implementation research. Of these 72% were classified as descriptive/epidemiological, 26% were intervention and just 1.9% were measurement research. Cross-sectional studies were the most common study design (47%). Reviews, randomized trials, non-randomized trials and decision/cost-effectiveness studies each represented between 6 and 10% of all output. Systematic reviews, randomized controlled trials and cohort studies were the most frequently cited study designs. The study suggests that publications that had the greatest academic impact (highest citation rates) made up only a small proportion of overall public health dissemination and implementation research output.

  4. Methods for pretreating biomass

    Science.gov (United States)

    Balan, Venkatesh; Dale, Bruce E; Chundawat, Shishir; Sousa, Leonardo

    2017-05-09

    A method for pretreating biomass is provided, which includes, in a reactor, allowing gaseous ammonia to condense on the biomass and react with water present in the biomass to produce pretreated biomass, wherein reactivity of polysaccharides in the biomass is increased during subsequent biological conversion as compared to the reactivity of polysaccharides in biomass which has not been pretreated. A method for pretreating biomass with a liquid ammonia and recovering the liquid ammonia is also provided. Related systems which include a biochemical or biofuel production facility are also disclosed.

  5. Evaluating the impact of prescription drug monitoring program implementation: a scoping review.

    Science.gov (United States)

    Finley, Erin P; Garcia, Ashley; Rosen, Kristen; McGeary, Don; Pugh, Mary Jo; Potter, Jennifer Sharpe

    2017-06-20

    Prescription drug monitoring programs (PDMPs) have been implemented in 49 out of 50 states in an effort to reduce opioid-related misuse, abuse, and mortality, yet the literature evaluating the impact of PDMP implementation remains limited. We conducted a scoping review to: (1) describe available evidence regarding impact of PDMPs in the U.S.; and (2) propose a conceptual model to inform future PDMP implementation and evaluation efforts. Scoping systematic review following Arksey and O'Malley's (2005) methodology. We identified 11 relevant studies based on inclusion criteria using a PubMed database search of English-language studies published 1/1/2000-5/31/16. Data were extracted and thematic analysis conducted to synthesize results. Extant evidence for the impact of PDMPs as an opioid risk mitigation tool remains mixed. Thematic analysis revealed four domains of opioid-related outcomes frequently examined in original studies evaluating PDMP implementation: (1) opioid prescribing; (2) opioid diversion and supply; (3) opioid misuse; and (4) opioid-related morbidity and mortality. An evaluation framework incorporating these domains is presented that highlights significant gaps in empirical research across each of these domains. Evidence for the impact of state-level PDMPs remains mixed. We propose a conceptual model for evaluating PDMP implementation toward the goals of clarifying PDMP mechanisms of impact, identifying characteristics of PDMPs associated with best outcomes, and maximizing the utility of PDMP policy and implementation to reduce opioid-related public health burden.

  6. Techniques and practices for pretreatment of low and intermediate level solid and liquid radioactive wastes

    International Nuclear Information System (INIS)

    1987-01-01

    An overall waste management strategy generally includes several components: pretreatment, treatment, conditioning, transport and disposal. Benefits of pretreatment are improved safety, lower radiation exposures and significantly lower costs in subsequent waste management operations. This publication reviews current practices in the pretreatment of wastes in different countries and may assist the specialist in selection of appropriate pretreatment techniques

  7. Pretreatment of woody biomass for biofuel production: energy efficiency, technologies, and recalcitrance

    Science.gov (United States)

    J.Y. Zhu; Xuejun Pan; Ronald S. Jr. Zalesny

    2010-01-01

    This mini review discusses several key technical issues associated with cellulosic ethanol production from woody biomass: energy consumption for woody biomass pretreatment, pretreatment energy efficiency, woody biomass pretreatment technologies, and quantification of woody biomass recalcitrance. Both total sugar yield and pretreatment energy efficiency, defined as the...

  8. Woody biomass pretreatment for cellulosic ethanol production : technology and energy consumption evaluation

    Science.gov (United States)

    Junyong Zhu; X.J. Pan

    2010-01-01

    This review presents a comprehensive discussion of the key technical issues in woody biomass pretreatment: barriers to efficient cellulose saccharification, pretreatment energy consumption, in particular energy consumed for wood-size reduction, and criteria to evaluate the performance of a pretreatment. A post-chemical pretreatment size-reduction approach is proposed...

  9. The Society for Implementation Research Collaboration Instrument Review Project: a methodology to promote rigorous evaluation.

    Science.gov (United States)

    Lewis, Cara C; Stanick, Cameo F; Martinez, Ruben G; Weiner, Bryan J; Kim, Mimi; Barwick, Melanie; Comtois, Katherine A

    2015-01-08

    Identification of psychometrically strong instruments for the field of implementation science is a high priority underscored in a recent National Institutes of Health working meeting (October 2013). Existing instrument reviews are limited in scope, methods, and findings. The Society for Implementation Research Collaboration Instrument Review Project's objectives address these limitations by identifying and applying a unique methodology to conduct a systematic and comprehensive review of quantitative instruments assessing constructs delineated in two of the field's most widely used frameworks, adopt a systematic search process (using standard search strings), and engage an international team of experts to assess the full range of psychometric criteria (reliability, construct and criterion validity). Although this work focuses on implementation of psychosocial interventions in mental health and health-care settings, the methodology and results will likely be useful across a broad spectrum of settings. This effort has culminated in a centralized online open-access repository of instruments depicting graphical head-to-head comparisons of their psychometric properties. This article describes the methodology and preliminary outcomes. The seven stages of the review, synthesis, and evaluation methodology include (1) setting the scope for the review, (2) identifying frameworks to organize and complete the review, (3) generating a search protocol for the literature review of constructs, (4) literature review of specific instruments, (5) development of an evidence-based assessment rating criteria, (6) data extraction and rating instrument quality by a task force of implementation experts to inform knowledge synthesis, and (7) the creation of a website repository. To date, this multi-faceted and collaborative search and synthesis methodology has identified over 420 instruments related to 34 constructs (total 48 including subconstructs) that are relevant to implementation

  10. Challenges associated with the implementation of the nursing process: A systematic review

    Science.gov (United States)

    Zamanzadeh, Vahid; Valizadeh, Leila; Tabrizi, Faranak Jabbarzadeh; Behshid, Mojghan; Lotfi, Mojghan

    2015-01-01

    Background: Nursing process is a scientific approach in the provision of qualified nursing cares. However, in practice, the implementation of this process is faced with numerous challenges. With the knowledge of the challenges associated with the implementation of the nursing process, the nursing processes can be developed appropriately. Due to the lack of comprehensive information on this subject, the current study was carried out to assess the key challenges associated with the implementation of the nursing process. Materials and Methods: To achieve and review related studies on this field, databases of Iran medix, SID, Magiran, PUBMED, Google scholar, and Proquest were assessed using the main keywords of nursing process and nursing process systematic review. The articles were retrieved in three steps including searching by keywords, review of the proceedings based on inclusion criteria, and final retrieval and assessment of available full texts. Results: Systematic assessment of the articles showed different challenges in implementation of the nursing process. Intangible understanding of the concept of nursing process, different views of the process, lack of knowledge and awareness among nurses related to the execution of process, supports of managing systems, and problems related to recording the nursing process were the main challenges that were extracted from review of literature. Conclusions: On systematically reviewing the literature, intangible understanding of the concept of nursing process has been identified as the main challenge in nursing process. To achieve the best strategy to minimize the challenge, in addition to preparing facilitators for implementation of nursing process, intangible understanding of the concept of nursing process, different views of the process, and forming teams of experts in nursing education are recommended for internalizing the nursing process among nurses. PMID:26257793

  11. Adaptive radiotherapy strategies for pelvic tumors - a systematic review of clinical implementations

    DEFF Research Database (Denmark)

    Thörnqvist, Sara; Hysing, Liv B; Tuomikoski, Laura

    2016-01-01

    Med. For each tumor site, the identified papers were screened independently by two researches for selection of studies describing all processes of an ART workflow: treatment monitoring and evaluation, decision and execution of adaptations. Both brachytherapy and external beam studies were eligible for review......, but increases workload and thereby challenges clinical implementation. This paper reviews strategies and workflows for clinical and in silico implemented ART for prostate, bladder, gynecological (gyne) and ano-rectal cancers. MATERIAL AND METHODS: Initial identification of papers was based on searches in Pub....... RESULTS: The review consisted of 43 clinical studies and 51 in silico studies. For prostate, 1219 patients were treated with offline re-planning, mainly to adapt prostate motion relative to bony anatomy. For gyne 1155 patients were treated with online brachytherapy re-planning while 25 ano-rectal cancer...

  12. Effective implementation of research into practice: an overview of systematic reviews of the health literature

    Directory of Open Access Journals (Sweden)

    Fraser Alec

    2011-06-01

    Full Text Available Abstract Background The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. Findings A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. Conclusions This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials.

  13. Pretreatment of microbial sludges

    Science.gov (United States)

    Rivard, Christopher J.; Nagle, Nicholas J.

    1995-01-01

    Methods are described for pretreating microbial sludges to break cells and disrupt organic matter. One method involves the use of sonication, and another method involves the use of shear forces. The pretreatment of sludge enhances bioconversion of the organic fraction. This allows for efficient dewatering of the sludge and reduces the cost for final disposal of the waste.

  14. Assessing Fidelity of Implementation (FOI) for School-Based Mindfulness and Yoga Interventions: A Systematic Review.

    Science.gov (United States)

    Gould, Laura Feagans; Dariotis, Jacinda K; Greenberg, Mark T; Mendelson, Tamar

    2016-02-01

    As school-based mindfulness and yoga programs gain popularity, the systematic study of fidelity of program implementation ( FOI ) is critical to provide a more robust understanding of the core components of mindfulness and yoga interventions, their potential to improve specified teacher and student outcomes, and our ability to implement these programs consistently and effectively. This paper reviews the current state of the science with respect to inclusion and reporting of FOI in peer-reviewed studies examining the effects of school-based mindfulness and/or yoga programs targeting students and/or teachers implemented in grades kindergarten through twelve (K-12) in North America. Electronic searches in PsychInfo and Web of Science from their inception through May 2014, in addition to hand searches of relevant review articles, identified 312 publications, 48 of which met inclusion criteria. Findings indicated a relative paucity of rigorous FOI. Fewer than 10% of studies outlined potential core program components or referenced a formal theory of action, and fewer than 20% assessed any aspect of FOI beyond participant dosage. The emerging nature of the evidence base provides a critical window of opportunity to grapple with key issues relevant to FOI of mindfulness-based and yoga programs, including identifying essential elements of these programs that should be faithfully implemented and how we might develop rigorous measures to accurately capture them. Consideration of these questions and suggested next steps are intended to help advance the emerging field of school-based mindfulness and yoga interventions.

  15. Organizational issues in the implementation and adoption of health information technology innovations: an interpretative review.

    Science.gov (United States)

    Cresswell, Kathrin; Sheikh, Aziz

    2013-05-01

    Implementations of health information technologies are notoriously difficult, which is due to a range of inter-related technical, social and organizational factors that need to be considered. In the light of an apparent lack of empirically based integrated accounts surrounding these issues, this interpretative review aims to provide an overview and extract potentially generalizable findings across settings. We conducted a systematic search and critique of the empirical literature published between 1997 and 2010. In doing so, we searched a range of medical databases to identify review papers that related to the implementation and adoption of eHealth applications in organizational settings. We qualitatively synthesized this literature extracting data relating to technologies, contexts, stakeholders, and their inter-relationships. From a total body of 121 systematic reviews, we identified 13 systematic reviews encompassing organizational issues surrounding health information technology implementations. By and large, the evidence indicates that there are a range of technical, social and organizational considerations that need to be deliberated when attempting to ensure that technological innovations are useful for both individuals and organizational processes. However, these dimensions are inter-related, requiring a careful balancing act of strategic implementation decisions in order to ensure that unintended consequences resulting from technology introduction do not pose a threat to patients. Organizational issues surrounding technology implementations in healthcare settings are crucially important, but have as yet not received adequate research attention. This may in part be due to the subjective nature of factors, but also due to a lack of coordinated efforts toward more theoretically-informed work. Our findings may be used as the basis for the development of best practice guidelines in this area. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. Implementing Dementia Care Mapping as a practice development tool in dementia care services: a systematic review

    Directory of Open Access Journals (Sweden)

    Surr CA

    2018-01-01

    Full Text Available Claire A Surr, Alys W Griffiths, Rachael Kelley Centre for Dementia Research, School of Health and Community Studies, Leeds Beckett University, Leeds, UK Abstract: Dementia Care Mapping (DCM is an observational tool set within a practice development process. Following training in the method, DCM is implemented via a cyclic process of briefing staff, conducting mapping observations, data analysis and report preparation, feedback to staff and action planning. Recent controlled studies of DCM’s efficacy have found heterogeneous results, and variability in DCM implementation has been indicated as a potential contributing factor. This review aimed to examine the primary research evidence on the processes and the barriers and facilitators to implementing DCM as a practice development method within formal dementia care settings. PUBMED, PsycINFO, CINAHL, The Cochrane Library-Cochrane reviews, HMIC (Ovid, Web of Science and Social Care Online were searched using the term “Dementia Care Mapping”. Inclusion criterion was primary research studies in any formal dementia care settings where DCM was used as a practice development tool and which included discussion/critique of the implementation processes. Assessment of study quality was conducted using the Mixed Methods Appraisal Tool. Twelve papers were included in the review, representing nine research studies. The papers included discussion of various components of the DCM process, including mapper selection and preparation; mapping observations; data analysis, report writing and feedback; and action planning. However, robust evidence on requirements for successful implementation of these components was limited. Barriers and facilitators to mapping were also discussed. The review found some consensus that DCM is more likely to be successfully implemented if the right people are selected to be trained as mappers, with appropriate mapper preparation and ongoing support and with effective leadership for

  17. Effectiveness of implementation strategies for clinical guidelines to community pharmacy: a systematic review.

    Science.gov (United States)

    Watkins, Kim; Wood, Helen; Schneider, Carl R; Clifford, Rhonda

    2015-10-29

    The clinical role of community pharmacists is expanding, as is the use of clinical guidelines in this setting. However, it is unclear which strategies are successful in implementing clinical guidelines and what outcomes can be achieved. The aim of this systematic review is to synthesise the literature on the implementation of clinical guidelines to community pharmacy. The objectives are to describe the implementation strategies used, describe the resulting outcomes and to assess the effectiveness of the strategies. A systematic search was performed in six electronic databases (Medline, EMBASE, CINAHL, Web of Science, Informit, Cochrane Library) for relevant articles. Studies were included if they reported on clinical guidelines implementation strategies in the community pharmacy setting. Two researchers completed the full-search strategy, data abstraction and quality assessments, independently. A third researcher acted as a moderator. Quality assessments were completed with three validated tools. A narrative synthesis was performed to analyse results. A total of 1937 articles were retrieved and the titles and abstracts were screened. Full-text screening was completed for 36 articles resulting in 19 articles (reporting on 22 studies) included for review. Implementation strategies were categorised according to a modified version of the EPOC taxonomy. Educational interventions were the most commonly utilised strategy (n = 20), and computerised decision support systems demonstrated the greatest effect (n = 4). Most studies were multifaceted and used more than one implementation strategy (n = 18). Overall outcomes were moderately positive (n = 17) but focused on process (n = 22) rather than patient (n = 3) or economic outcomes (n = 3). Most studies (n = 20) were rated as being of low methodological quality and having low or very low quality of evidence for outcomes. Studies in this review did not generally have a well thought

  18. Implementation strategies for health systems in low-income countries: an overview of systematic reviews.

    Science.gov (United States)

    Pantoja, Tomas; Opiyo, Newton; Lewin, Simon; Paulsen, Elizabeth; Ciapponi, Agustín; Wiysonge, Charles S; Herrera, Cristian A; Rada, Gabriel; Peñaloza, Blanca; Dudley, Lilian; Gagnon, Marie-Pierre; Garcia Marti, Sebastian; Oxman, Andrew D

    2017-09-12

    A key function of health systems is implementing interventions to improve health, but coverage of essential health interventions remains low in low-income countries. Implementing interventions can be challenging, particularly if it entails complex changes in clinical routines; in collaborative patterns among different healthcare providers and disciplines; in the behaviour of providers, patients or other stakeholders; or in the organisation of care. Decision-makers may use a range of strategies to implement health interventions, and these choices should be based on evidence of the strategies' effectiveness. To provide an overview of the available evidence from up-to-date systematic reviews about the effects of implementation strategies for health systems in low-income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on alternative implementation strategies and informing refinements of the framework for implementation strategies presented in the overview. We searched Health Systems Evidence in November 2010 and PDQ-Evidence up to December 2016 for systematic reviews. We did not apply any date, language or publication status limitations in the searches. We included well-conducted systematic reviews of studies that assessed the effects of implementation strategies on professional practice and patient outcomes and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the review findings. Two overview authors independently screened reviews, extracted data and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence) and assessments of the relevance of findings to low-income countries. We identified 7272 systematic reviews and included 39 of them in this overview. An additional four

  19. 75 FR 57220 - Rule To Implement the 1997 8-Hour Ozone National Ambient Air Quality Standard: New Source Review...

    Science.gov (United States)

    2010-09-20

    ... National Ambient Air Quality Standard: New Source Review Anti-Backsliding Provisions for Former 1-Hour... ``Proposed Rule to Implement the 1997 8-Hour Ozone National Ambient Air Quality Standard: New Source Review... AGENCY 40 CFR Part 51 RIN 2060-AP30 Rule To Implement the 1997 8-Hour Ozone National Ambient Air Quality...

  20. Interventions to Support System-level Implementation of Health Promoting Schools: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Jessie-Lee D. McIsaac

    2016-02-01

    Full Text Available Health promoting schools (HPS is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation barriers and support uptake of a HPS approach. This study comprised a scoping review to identify, summarise and disseminate the range of research to support the uptake of a HPS approach across school systems. Two reviewers screened and extracted data according to inclusion/exclusion criteria. Relevant studies were identified using a multi-phased approach including searching electronic bibliographic databases of peer reviewed literature, hand-searching reference lists and article recommendations from experts. In total, 41 articles met the inclusion criteria for the review, representing studies across nine international school systems. Overall, studies described policies that provided high-level direction and resources within school jurisdictions to support implementation of a HPS approach. Various multifaceted organizational and professional interventions were identified, including strategies to enable and restructure school environments through education, training, modelling and incentives. A systematic realist review of the literature may be warranted to identify the types of intervention that work best for whom, in what circumstance to create healthier schools and students.

  1. Interventions to Support System-level Implementation of Health Promoting Schools: A Scoping Review.

    Science.gov (United States)

    McIsaac, Jessie-Lee D; Hernandez, Kimberley J; Kirk, Sara F L; Curran, Janet A

    2016-02-06

    Health promoting schools (HPS) is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation barriers and support uptake of a HPS approach. This study comprised a scoping review to identify, summarise and disseminate the range of research to support the uptake of a HPS approach across school systems. Two reviewers screened and extracted data according to inclusion/exclusion criteria. Relevant studies were identified using a multi-phased approach including searching electronic bibliographic databases of peer reviewed literature, hand-searching reference lists and article recommendations from experts. In total, 41 articles met the inclusion criteria for the review, representing studies across nine international school systems. Overall, studies described policies that provided high-level direction and resources within school jurisdictions to support implementation of a HPS approach. Various multifaceted organizational and professional interventions were identified, including strategies to enable and restructure school environments through education, training, modelling and incentives. A systematic realist review of the literature may be warranted to identify the types of intervention that work best for whom, in what circumstance to create healthier schools and students.

  2. Interventions to Support System-level Implementation of Health Promoting Schools: A Scoping Review

    Science.gov (United States)

    McIsaac, Jessie-Lee D.; Hernandez, Kimberley J.; Kirk, Sara F.L.; Curran, Janet A.

    2016-01-01

    Health promoting schools (HPS) is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation barriers and support uptake of a HPS approach. This study comprised a scoping review to identify, summarise and disseminate the range of research to support the uptake of a HPS approach across school systems. Two reviewers screened and extracted data according to inclusion/exclusion criteria. Relevant studies were identified using a multi-phased approach including searching electronic bibliographic databases of peer reviewed literature, hand-searching reference lists and article recommendations from experts. In total, 41 articles met the inclusion criteria for the review, representing studies across nine international school systems. Overall, studies described policies that provided high-level direction and resources within school jurisdictions to support implementation of a HPS approach. Various multifaceted organizational and professional interventions were identified, including strategies to enable and restructure school environments through education, training, modelling and incentives. A systematic realist review of the literature may be warranted to identify the types of intervention that work best for whom, in what circumstance to create healthier schools and students. PMID:26861376

  3. Towards ICF implementation in menopause healthcare: a systematic review of ICF application in Switzerland.

    OpenAIRE

    Zangger, Martina; Poethig, Dagmar; Meissner, Florian; von Wolff, Michael; Stute, Petra

    2017-01-01

    AIMS OF THE STUDY To present a systematic literature review on the application and degree of implementation of the International Classification of Functioning, Disability and Health (ICF) across different health conditions and regions in Switzerland in order to develop an ICF classification of the climacteric syndrome in the medium term. METHODS A systematic literature search was conducted through Embase and Medline covering the period between 2011 and August 2016. Inclusion crite...

  4. A qualitative systematic review of studies using the normalization process theory to research implementation processes

    OpenAIRE

    McEvoy, Rachel; Ballini, Luciana; Maltoni, Susanna; O’Donnell, Catherine A; Mair, Frances S; MacFarlane, Anne

    2014-01-01

    Background There is a well-recognized need for greater use of theory to address research translational gaps. Normalization Process Theory (NPT) provides a set of sociological tools to understand and explain the social processes through which new or modified practices of thinking, enacting, and organizing work are implemented, embedded, and integrated in healthcare and other organizational settings. This review of NPT offers readers the opportunity to observe how, and in what areas, a particul...

  5. Alarming increase in pretreatment HIV drug resistance in children living in sub-Saharan Africa: a systematic review and meta-analysis.

    Science.gov (United States)

    Boerma, R S; Sigaloff, K C E; Akanmu, A S; Inzaule, S; Boele van Hensbroek, M; Rinke de Wit, T F; Calis, J C

    2017-02-01

    Children have an augmented risk of pretreatment HIV drug resistance (PDR) due to exposure to antiretroviral drugs for the prevention of mother-to-child transmission (PMTCT). Paediatric data are essential to evaluate the effectiveness of the restricted number of paediatric regimens currently available, but these data are scarce. We conducted a systematic review of the literature on PDR in children (median age ≤12 years) in sub-Saharan Africa. We separately extracted the proportion of children with PDR for children with and without prior PMTCT exposure, used random-effects meta-analysis to pool proportions and used meta-regression to assess subgroup differences. We included 19 studies representing 2617 children from 13 countries. The pooled PDR prevalence was 42.7% (95% CI 26.2%-59.1%) among PMTCT-exposed children and 12.7% (95% CI 6.7%-18.7%) among PMTCT-unexposed children (P = 0.004). The PDR prevalence in PMTCT-unexposed children increased from 0% in 2004 to 26.8% in 2013 (P = 0.009). NNRTI mutations were detected in 32.4% (95% CI 18.7%-46.1%) of PMTCT-exposed children and in 9.7% (95% CI 4.6%-14.8%) of PMTCT-unexposed children; PI mutations were uncommon (<2.5%). PDR was more common in children aged <3 years compared with children aged ≥3 years [40.9% (95% CI 27.6%-54.3%) versus 17.6% (95% CI 8.9%-26.3%), respectively (P = 0.025)]. The PDR prevalence in African children is high and rapidly increasing. Even in PMTCT-unexposed children, the most recent reports indicate that PDR is present in up to a third of children starting first-line therapy. Our data underscore the importance of initiating PI-based first-line ART in young children (<3 years of age) and suggest that older children may also benefit from this approach. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Systematic review of the implementation of simulation training in surgical residency curriculum.

    Science.gov (United States)

    Kurashima, Yo; Hirano, Satoshi

    2017-07-01

    We reviewed the literature regarding the specific methods and strategies for implementing simulation-based training into the modern surgical residency curriculum. Residency programs are still struggling with how best to implement it into their curricula from a practical viewpoint. A systematic review was performed using Ovid MEDLINE, EMBASE, PubMed, PsycINFO, Web of Science, and other resources for studies involving the use of simulation for technical skills training in the surgical residency curriculum. Studies were selected based on the integration of simulation into the curriculum and/or a description of the details of implementation and the resources required. In total, 2533 unique citations were retrieved based on this search, and 31 articles met the inclusion criteria. Most simulators were focused on laparoscopic procedures, and training occurred most often in a skills lab. The assessment of skills consisted mostly of speed of task completion. Only 4 studies addressed issues of cost, and 6 programs mentioned human resources without any mention of skills center personnel or administrative support. All of the studies described the nature of the simulation training, but very few commented on how it was actually implemented and what was needed from organizational, administrative and logistical perspectives.

  7. Attitudes, implementation and practice of family presence during resuscitation (FPDR): a quantitative literature review.

    Science.gov (United States)

    Porter, Jo; Cooper, Simon J; Sellick, Ken

    2013-01-01

    To undertake a review of the quantitative research literature, to determine emergency staff and public attitudes, to support the implementation and practice of family presence during resuscitation in the emergency department. FPDR although endorsed by numerous resuscitation councils, cardiac, trauma and emergency associations, continues to be topical, the extent to which it is implemented and practiced remains unclear. A review of the quantitative studies published between 1992 and October 2011 was undertaken using the following databases: CINAHL, Ovid Medline, PSYCHINFO, Pro-Quest, Theses Database, Cochrane, and Google Scholar search engine. The primary search terms were 'family presence', and 'resuscitation'. The final studies included in this paper were appraised using the Critical Appraisal Skills Programme criteria. Fourteen studies were included in this literature review. These included quantitative descriptive designs, pre and post-test designs and one randomized controlled trial (RCT). The studies were divided into three main research areas; investigation of emergency staff attitudes and opinions, family and general public attitudes, and four papers evaluating family presence programs in the emergency department. Studies published prior to 2000 were included in the background. FPDR in the emergency department is well recognised and documented among policy makers, the extent in which it is implemented and practiced remains unclear. Further research is needed to assess how emergency staff are educated and trained in order to facilitate family presence during resuscitation attempts. Copyright © 2012. Published by Elsevier Ltd.

  8. Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues.

    Science.gov (United States)

    Farmanova, Elina; Bonneville, Luc; Bouchard, Louise

    2018-01-01

    Organizational health literacy is described as an organization-wide effort to transform organization and delivery of care and services to make it easier for people to navigate, understand, and use information and services to take care of their health. Several health literacy guides have been developed to assist healthcare organizations with this effort, but their content has not been systematically reviewed to understand the scope and practical implications of this transformation. The objective of this study was to review (1) theories and frameworks that inform the concept of organizational health literacy, (2) the attributes of organizational health literacy as described in the guides, (3) the evidence for the effectiveness of the guides, and (4) the barriers and facilitators to implementing organizational health literacy. Drawing on a metanarrative review method, 48 publications were reviewed, of which 15 dealt with the theories and operational frameworks, 20 presented health literacy guides, and 13 addressed guided implementation of organizational health literacy. Seven theories and 9 operational frameworks have been identified. Six health literacy dimensions and 9 quality-improvement characteristics were reviewed for each health literacy guide. Evidence about the effectiveness of health literacy guides is limited at this time, but experiences with the guides were positive. Thirteen key barriers (conceived also as facilitators) were identified. Further development of organizational health literacy requires a strong and a clear connection between its vision and operationalization as an implementation strategy to patient-centered care. For many organizations, becoming health literate will require multiple, simultaneous, and radical changes. Organizational health literacy has to make sense from clinical and financial perspectives in order for organizations to embark on such transformative journey.

  9. Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues

    Science.gov (United States)

    Bonneville, Luc; Bouchard, Louise

    2018-01-01

    Organizational health literacy is described as an organization-wide effort to transform organization and delivery of care and services to make it easier for people to navigate, understand, and use information and services to take care of their health. Several health literacy guides have been developed to assist healthcare organizations with this effort, but their content has not been systematically reviewed to understand the scope and practical implications of this transformation. The objective of this study was to review (1) theories and frameworks that inform the concept of organizational health literacy, (2) the attributes of organizational health literacy as described in the guides, (3) the evidence for the effectiveness of the guides, and (4) the barriers and facilitators to implementing organizational health literacy. Drawing on a metanarrative review method, 48 publications were reviewed, of which 15 dealt with the theories and operational frameworks, 20 presented health literacy guides, and 13 addressed guided implementation of organizational health literacy. Seven theories and 9 operational frameworks have been identified. Six health literacy dimensions and 9 quality-improvement characteristics were reviewed for each health literacy guide. Evidence about the effectiveness of health literacy guides is limited at this time, but experiences with the guides were positive. Thirteen key barriers (conceived also as facilitators) were identified. Further development of organizational health literacy requires a strong and a clear connection between its vision and operationalization as an implementation strategy to patient-centered care. For many organizations, becoming health literate will require multiple, simultaneous, and radical changes. Organizational health literacy has to make sense from clinical and financial perspectives in order for organizations to embark on such transformative journey. PMID:29569968

  10. Lessons learnt from implementation of the International Health Regulations: a systematic review

    Science.gov (United States)

    Allen, Lisa G; Cifuentes, Sara; Dye, Christopher; Nagata, Jason M

    2018-01-01

    Abstract Objective To respond to the World Health Assembly call for dissemination of lessons learnt from countries that have begun implementing the International Health Regulations, 2005 revision; IHR (2005). Methods In November 2015, we conducted a systematic search of the following online databases and sources: PubMed®, Embase®, Global Health, Scopus, World Health Organization (WHO) Global Index Medicus, WHO Bulletin on IHR Implementation and the International Society for Disease Surveillance. We included identified studies and reports summarizing national experience in implementing any of the IHR (2005) core capacities or their components. We excluded studies that were theoretical or referred to IHR (1969). Qualitative systematic review methodology, including meta-ethnography, was used for qualitative synthesis. Findings We analysed 51 articles from 77 countries representing all WHO Regions. The meta-syntheses identified a total of 44 lessons learnt across the eight core capacities of IHR (2005). Major themes included the need to mobilize and sustain political commitment; to adapt global requirements based on local sociocultural, epidemiological, health system and economic contexts; and to conduct baseline and follow-up assessments to monitor the status of IHR (2005) implementation. Conclusion Although experiences of IHR (2005) implementation covered a wide global range, more documentation from Africa and Eastern Europe is needed. We did not find specific areas of weakness in monitoring IHR (2005); sustained monitoring of all core capacities is required to ensure effective systems. These lessons learnt could be adapted by countries in the process of meeting IHR (2005) requirements. PMID:29403114

  11. A qualitative systematic review of studies using the normalization process theory to research implementation processes

    Science.gov (United States)

    2014-01-01

    Background There is a well-recognized need for greater use of theory to address research translational gaps. Normalization Process Theory (NPT) provides a set of sociological tools to understand and explain the social processes through which new or modified practices of thinking, enacting, and organizing work are implemented, embedded, and integrated in healthcare and other organizational settings. This review of NPT offers readers the opportunity to observe how, and in what areas, a particular theoretical approach to implementation is being used. In this article we review the literature on NPT in order to understand what interventions NPT is being used to analyze, how NPT is being operationalized, and the reported benefits, if any, of using NPT. Methods Using a framework analysis approach, we conducted a qualitative systematic review of peer-reviewed literature using NPT. We searched 12 electronic databases and all citations linked to six key NPT development papers. Grey literature/unpublished studies were not sought. Limitations of English language, healthcare setting and year of publication 2006 to June 2012 were set. Results Twenty-nine articles met the inclusion criteria; in the main, NPT is being applied to qualitatively analyze a diverse range of complex interventions, many beyond its original field of e-health and telehealth. The NPT constructs have high stability across settings and, notwithstanding challenges in applying NPT in terms of managing overlaps between constructs, there is evidence that it is a beneficial heuristic device to explain and guide implementation processes. Conclusions NPT offers a generalizable framework that can be applied across contexts with opportunities for incremental knowledge gain over time and an explicit framework for analysis, which can explain and potentially shape implementation processes. This is the first review of NPT in use and it generates an impetus for further and extended use of NPT. We recommend that in future

  12. Implementation strategies for health systems in low-income countries: an overview of systematic reviews

    Science.gov (United States)

    Pantoja, Tomas; Opiyo, Newton; Lewin, Simon; Paulsen, Elizabeth; Ciapponi, Agustín; Wiysonge, Charles S; Herrera, Cristian A; Rada, Gabriel; Peñaloza, Blanca; Dudley, Lilian; Gagnon, Marie-Pierre; Garcia Marti, Sebastian; Oxman, Andrew D

    2017-01-01

    Background A key function of health systems is implementing interventions to improve health, but coverage of essential health interventions remains low in low-income countries. Implementing interventions can be challenging, particularly if it entails complex changes in clinical routines; in collaborative patterns among different healthcare providers and disciplines; in the behaviour of providers, patients or other stakeholders; or in the organisation of care. Decision-makers may use a range of strategies to implement health interventions, and these choices should be based on evidence of the strategies' effectiveness. Objectives To provide an overview of the available evidence from up-to-date systematic reviews about the effects of implementation strategies for health systems in low-income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on alternative implementation strategies and informing refinements of the framework for implementation strategies presented in the overview. Methods We searched Health Systems Evidence in November 2010 and PDQ-Evidence up to December 2016 for systematic reviews. We did not apply any date, language or publication status limitations in the searches. We included well-conducted systematic reviews of studies that assessed the effects of implementation strategies on professional practice and patient outcomes and that were published after April 2005. We excluded reviews with limitations important enough to compromise the reliability of the review findings. Two overview authors independently screened reviews, extracted data and assessed the certainty of evidence using GRADE. We prepared SUPPORT Summaries for eligible reviews, including key messages, 'Summary of findings' tables (using GRADE to assess the certainty of the evidence) and assessments of the relevance of findings to low-income countries. Main results We identified 7272 systematic reviews and included 39 of

  13. Implementation of a reimbursed medication review program: Corporate and pharmacy level strategies.

    Science.gov (United States)

    MacKeigan, Linda D; Ijaz, Nadine; Bojarski, Elizabeth A; Dolovich, Lisa

    In 2006, the Ontario drug plan greatly reduced community pharmacy reimbursement for generic drugs. In exchange, a fee-for-service medication review program was introduced to help patients better understand their medication therapy and ensure that medications were taken as prescribed. A qualitative study of community pharmacy implementation strategies was undertaken to inform a mixed methods evaluation of the program. To describe strategies used by community pharmacies to implement a government-funded medication review service. Key informant interviews were conducted with pharmacy corporate executives and managers, as well as independent pharmacy owners. All pharmacy corporations in the province were approached; owners were purposively sampled from the registry of the pharmacist licensing body to obtain diversity in pharmacy attributes; and pharmacy managers were identified through a mix of snowball and registry sampling. Thematic qualitative coding and analysis were applied to interview transcripts. 42 key informants, including 14 executives, 15 managers/franchisees, and 11 owners, participated. The most common implementation strategy was software adaptation to flag eligible patients and to document the service. Human resource management (task shifting to technicians and increasing the technician complement), staff training, and patient identification and recruitment processes were widely mentioned. Motivational strategies including service targets and financial incentives were less frequent but controversial. Strategies typically unfolded over time, and became multifaceted. Apart from the use of targets in chain pharmacies only, strategies were similar across pharmacy ownership types. Ontario community pharmacies appeared to have done little preplanning of implementation strategies. Strategies focused on service efficiency and quantity, rather than quality. Unlike other jurisdictions, many managers supported the use of targets as motivators, and very few reported

  14. Implementing Head and Neck Contouring Peer Review without Pathway Delay: The On-demand Approach.

    Science.gov (United States)

    Fong, C; Sanghera, P; Good, J; Nightingale, P; Hartley, A

    2017-12-01

    Peer review of contour volume is a priority in the radiotherapy treatment quality assurance process for head and neck cancer. It is essential that incorporation of peer review activity does not introduce additional delays. An on-demand peer review process was piloted to assess the feasibility and efficiency of this approach, as compared with a historic scheduled weekly approach. Between November 2016 and April 2017 four head and neck clinicians in one centre took part in an on-demand peer review process. Cases were of radical or adjuvant intent of any histology and submitted on a voluntary basis. The outcome of contour peer review would be one of unchanged (UC), unchanged with variation or discretion noted (UV), minor change (M) or significant change (S). The time difference between the completion of the on-demand peer review was compared with the time difference to a hypothetical next Monday or Tuesday weekly peer review meeting. The time taken to review each case was also documented in the latter period of the pilot project. In total, 62 cases underwent peer review. Peer review on-demand provided dosimetrists with an average of an extra two working days available per case to meet treatment start dates. The proportion of cases with outcomes UC, UV, M and S were 45%, 16%, 26% and 13%, respectively. The mean peer review time spent per case was 17 min (12 cases). The main reason for S was discrepancy in imaging interpretation (4/8 cases). A lower proportion of oropharyngeal cases were submitted and had S outcomes. A higher proportion of complex cases, e.g. sinonasal/nasopharynx location or previous downstaging chemotherapy had S outcomes. The distribution of S outcomes appears to be similar regardless of clinician experience. The level of peer review activity among individuals differed by workload and job timetable. On-demand peer review of the head and neck contour volume is feasible, reduces delay to the start of dosimetry planning and bypasses the logistical

  15. 42 CFR 435.136 - State agency implementation requirements for one-time notice and annual review system.

    Science.gov (United States)

    2010-10-01

    ...-time notice and annual review system. 435.136 Section 435.136 Public Health CENTERS FOR MEDICARE... agency implementation requirements for one-time notice and annual review system. An agency must— (a...) Establish an annual review system to identify individuals who meet the requirements of § 435.135 (a) or (c...

  16. Implementing the 4D cycle of appreciative inquiry in health care: a methodological review.

    Science.gov (United States)

    Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra

    2013-06-01

    To examine and critique how the phases of the 4D cycle (Discovery, Dream, Design, and Destiny) of appreciative inquiry are implemented in a healthcare context. Appreciative inquiry is a theoretical research perspective, an emerging research methodology and a world view that builds on action research, organizational learning, and organizational change. Increasing numbers of articles published provide insights and learning into its theoretical and philosophical underpinnings. Many articles describe appreciative inquiry and the outcomes of their studies; however, there is a gap in the literature examining the approaches commonly used to implement the 4D cycle in a healthcare context. A methodological review following systematic principles. A methodological review was conducted including articles from the inception of appreciative inquiry in 1986 to the time of writing this review in November, 2011. Key database searches included CINAHL, Emerald, MEDLINE, PubMed, PsycINFO, and Scopus. A methodological review following systematic principles was undertaken. Studies were included if they described in detail the methods used to implement the 4D cycle of appreciative inquiry in a healthcare context. Nine qualitative studies met the inclusion criteria. Results highlighted that appreciative inquiry application is unique and varied between studies. The 4D phases were not rigid steps and were adapted to the setting and participants. Overall, participant enthusiasm and commitment were highlighted suggesting appreciative inquiry was mostly positively perceived by participants. Appreciative inquiry provides a positive way forward shifting from problems to solutions offering a new way of practicing in health care and health research. © 2012 Blackwell Publishing Ltd.

  17. Implementing Calibrated Peer Review (CPR) in a Large-lecture Science Course

    Science.gov (United States)

    Ward, A. S.; Bettis, E. A., III; Russell, J. E.; Van Horne, S.; Sipola, M.; Rocheford, M. K.; Colombo, M. R.

    2014-12-01

    Assessing writing assignments and providing students the opportunity to meaningfully revise the assignments are challenging for instructors of large enrollment science classes. We included two individual writing assignments and peer assessments as part of course assessment for a large Introduction to Environmental Science course. In order to facilitate the assessment, Calibrated Peer Review (CPR), a web-based application developed by UCLA that enables frequent writing assignments in any discipline and with any class size, was adopted. The CPR assignment process involved four steps: submitting a writing assignment, calibrating each student's review skills, reviewing peers' writing, and assessing one's own writing assignment (self-assessment). A rubric was provided to guide students through each writing assignment and the same rubric was used in calibration, review, and self-assessment scoring. Once the instructors uploaded the writing prompts, rubrics, sample writings and answer keys into the CPR system, the CPR software fully directed all student activity (writing assignment submission, calibrations, reviews, and self-assessment). Students were able to view their results within the CPR program, including their self-calibration scores, reviewing scores, peers' ratings and feedback, total earned scores, and self-assessment scores. Surveys independently administered at the conclusion of the CPR assignments indicated that sixty to seventy-five percent of the students perceived that CPR was helpful in their learning, improved their writing and evaluation skills, and that the process of reviewing other students' essays and their own essays was more helpful than the comments received from peers. These survey results are in agreement with the well-established educational research literature that shows the benefits of peer review and peer assessment to student learning. Our experience with CPR in a large enrollment science course indicates that thoughtful planning of the

  18. Pretreatment techniques for biofuels and biorefineries

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Zhen (ed.) [Chinese Academy of Sciences, Kunming, YN (China). Xishuangbanna Tropical Botonical Garden

    2013-02-01

    The first book focused on pretreatment techniques for biofuels contributed by the world's leading experts. Extensively covers the different types of biomass, various pretreatment approaches and methods that show the subsequent production of biofuels and chemicals. In addition to traditional pretreatment methods, novel techniques are also introduced and discussed. An accessible reference work for students, researchers, academicians and industrialists in biorefineries. This book includes 19 chapters contributed by the world's leading experts on pretreatment methods for biomass. It extensively covers the different types of biomass (e.g. molasses, sugar beet pulp, cheese whey, sugarcane residues, palm waste, vegetable oil, straws, stalks and wood), various pretreatment approaches (e.g. physical, thermal, chemical, physicochemical and biological) and methods that show the subsequent production of biofuels and chemicals such as sugars, ethanol, extracellular polysaccharides, biodiesel, gas and oil. In addition to traditional methods such as steam, hot-water, hydrothermal, diluted-acid, organosolv, ozonolysis, sulfite, milling, fungal and bacterial, microwave, ultrasonic, plasma, torrefaction, pelletization, gasification (including biogas) and liquefaction pretreatments, it also introduces and discusses novel techniques such as nano and solid catalysts, organic electrolyte solutions and ionic liquids. This book offers a review of state-of-the-art research and provides guidance for the future paths of developing pretreatment techniques of biomass for biofuels, especially in the fields of biotechnology, microbiology, chemistry, materials science and engineering. It intends to provide a systematic introduction of pretreatment techniques. It is an accessible reference work for students, researchers, academicians and industrialists in biorefineries.

  19. Stakeholders' opinions on the implementation of Child Death Review in the Netherlands.

    Science.gov (United States)

    Gijzen, Sandra; L'Hoir, Monique P; Boere-Boonekamp, Magda M; Need, Ariana

    2016-04-21

    The death of a child is an enormous tragedy for both the family and others involved. A child's death appeals to everyone's responsibility to take measures to prevent similar deaths in the future. Child Death Review (CDR) is an interagency approach in which a child's death is systematically analyzed by a multidisciplinary team. The aim of CDR is to identify avoidable factors that give direction to prevention and to improve death statistics. CDR is not yet implemented in the Netherlands. The purpose of this study is to determine Dutch stakeholders' opinions regarding the facilitating and impeding factors in the implementation of CDR in the Netherlands. Four focus groups were conducted: three with professionals who are involved in children's deaths and one with parents who have lost a child under the age of 2 years. The recorded discussions were transcribed and analyzed using Atlas ti. The facilitating and impeding factors were measured using the measurement instrument for determinants of innovations (MIDI). The MIDI identifies facilitating and impeding determinants associated with the innovation, user, organization and social-political context. Improvement of the quality of (health) care and obtaining a clear explanation for the child's death (user and innovation) were identified as benefits of CDR. The emotional burden for professionals and parents and the time implications were considered to be drawbacks of CDR (user and innovation). The multidisciplinary approach (innovation), parental consent and the use of anonimyzed data (user) were considered as facilitators to implementation. Insufficient information (innovation), potential legal consequences for professionals and organizations (user), insufficient ratification by organizations (organization) and confidentiality (social-political context) were identified as impeding implementation. The determinants identified as facilitating and the recommendations provided to overcome the barriers can be used as input for

  20. Barriers in the Implementation of Health Information Systems: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Florin STAMATIAN

    2013-12-01

    Full Text Available Context. A well-developed health information system which is implemented according to present standards allows a healthcare quality increase. Our study aims at providing an overview of the barriers which were encountered in the process of implementing the health information systems by reviewing the literature connected to Europe and the United States of America. Methodology. We searched within five databases (Cochrane Library, Google Scholar, PubMed, ScienceDirect and Scopus for the exact phrase ‘implementation health information system’ along with the name of each European country/USA state. Relevance was then tested by scanning titles and abstracts. The third and final step involved assessing all the articles in order to set their relevance and a data extraction tool was created, containing the name of the state/country that the article reports data on, the article citation and the challenges identified. Results. The barriers identified were classified in four major categories: technical, organizational, behavioral/human and financial. Seemingly, Europe (41 articles and USA (20 articles are facing the same issues in the implementation of a health information system. No major difference between EU and non-EU countries was found after our analysis with regards to the identified barriers. Discussion. Even if recommendations and solutions are continuously being developed in order to solve these barriers, the implementation of a new health information system must be very detailed in order to face all these problems. Additionally, further research is required in order to evaluate their impact on the successful implementation of a health information system.

  1. Parent implemented early intervention for young children with autism spectrum disorder: a systematic review.

    Science.gov (United States)

    McConachie, Helen; Diggle, Tim

    2007-02-01

    Recent estimates concerning the prevalence of autism spectrum disorder (ASD) suggest that at least one in 200 children is affected. This group of children and families have important service needs. The involvement of parents in implementing intervention strategies designed to help their autistic children has long been accepted as helpful. The potential benefits are increased skills and reduced stress for parents as well as children. This research review focused on interventions for children aged 1-6 years, and was carried out using systematic methodology: a comprehensive search of psychological, educational and biomedical databases, as well as bibliographies and reference lists of key articles, contact with experts in the field, and hand search of key journals. Only studies which involved a concurrent element of control were included. The review found very few studies that had adequate research design from which to draw conclusions about the effectiveness of parent-implemented early intervention. Both randomized and controlled studies tended to suggest that parent training leads to improved child communicative behaviour, increased maternal knowledge of autism, enhanced maternal communication style and parent child interaction, and reduced maternal depression. It seems that parent training can successfully contribute to intervention for young children with ASD. However, the review highlights the need for improved research in this area.

  2. Implementation, validation and review of a critical values list in a cardiac emergency room

    Directory of Open Access Journals (Sweden)

    Dilênia de Oliveira Cipriano Torres

    2014-10-01

    Full Text Available Introduction: Laboratory critical values (CV can indicate threatening conditions that require rapid clinical intervention. The aim of this study was to implement, validate and review a critical values list (CVL at Pronto-Socorro Cardiológico de Pernambuco - Universidade de Pernambuco (PROCAPE-UPE. Method: This study was conducted between 2011 and 2013. To formulate the CVL, laboratory tests performed at PROCAPE were analyzed and compared with those of the Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC and the College of American Pathologists (CAP. A draft CVL was validated by physicians; staff training and the standard operating procedure were developed covering the entire clinical analysis laboratory, in order to formalize the procedure of critical result reporting. The CVL was updated every six months. Results: Changes were made in CV intervals for the measurement of total serum calcium, serum sodium, serum potassium, the international normalized ratio (INR and total leukocyte count. Thyroid-stimulating hormone (TSH was also included in the CVL. In the pediatric CVL, dosages of serum sodium and INR were included, and a change in the value of serum potassium was made. Thus, periodic reviews of CVL allowed greater adequacy to the needs of the study population and avoided overloading the notification process. Conclusion: Clinical laboratories must be responsible for the implementation, validation and review of their CVL to ensure patients’ health.

  3. Pretreatment of woody biomass for biofuel production: energy efficiency, technologies, and recalcitrance.

    Science.gov (United States)

    Zhu, J Y; Pan, Xuejun; Zalesny, Ronald S

    2010-07-01

    This mini review discusses several key technical issues associated with cellulosic ethanol production from woody biomass: energy consumption for woody biomass pretreatment, pretreatment energy efficiency, woody biomass pretreatment technologies, and quantification of woody biomass recalcitrance. Both total sugar yield and pretreatment energy efficiency, defined as the total sugar recovery divided by total energy consumption for pretreatment, should be used to evaluate the performance of a pretreatment process. A post-chemical pretreatment wood size-reduction approach was proposed to significantly reduce energy consumption. The review also emphasizes using a low liquid-to-wood ratio (L/W) to reduce thermal energy consumption for any thermochemical/physical pretreatment in addition to reducing pretreatment temperature.

  4. Review: Effectiveness of implementation strategies to increase physical activity uptake during and after cancer treatment.

    Science.gov (United States)

    IJsbrandy, C; Ottevanger, P B; Tsekou Diogeni, M; Gerritsen, W R; van Harten, W H; Hermens, R P M G

    2018-02-01

    The purpose of this review was to assess the effectiveness of different strategies to implement physical activity during and after cancer treatment. We searched for studies containing strategies to implement physical activity in cancer care that meet the inclusion criteria of the Cochrane EPOC group. The primary outcome was physical activity uptake. We expressed the effectiveness of the strategies as the percentage of studies with improvement. Nine studies met the inclusion criteria. Patient groups doing physical activities via an implementation strategy had better outcomes than those receiving usual care: 83% of the studies showed improvement. Strategies showing significant improvement compared to usual care employed healthcare professionals to provide individual counselling or advice for exercise or interactive elements such as audit and feedback systems. When comparing the different strategies 1) interactive elements or 2) elements tailored to the needs of the patients had better physical activity uptake. Implementation strategies containing individual and interactive elements, tailored to the individual needs of patients, are more successful in improving physical activity uptake. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  5. Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: A literature review

    Directory of Open Access Journals (Sweden)

    Vincent M. Kiberu

    2017-01-01

    Full Text Available Background: Most developing countries, including Uganda, have embraced the use of e-Health and m-Health applications as a means to improve primary healthcare delivery and public health for their populace. In Uganda, the growth in the information and communications technology industry has benefited the rural communities and also created opportunities for new innovations, and their application into healthcare has reported positive results, especially in the areas of disease control and prevention through disease surveillance. However, most are mere proof-of-concepts, only demonstrated in use within a small context and lack sustainability. This study reviews the literature to understand e-Health’s current implementation status within Uganda and documents the barriers and opportunities to sustainable e-Health intervention programmes in Uganda.Methods: A structured literature review of e-Health in Uganda was undertaken between May and December 2015 and was complemented with hand searching and a document review of grey literature in the form of policy documents and reports obtained online or from the Ministry of Health’s Resource Centre.Results: The searches identified a total of 293 resources of which 48 articles met the inclusion criteria of being in English and describing e-Health implementation in Uganda. These were included in the study and were examined in detail.Conclusion: Uganda has trialled several e-Health and m-Health solutions to address healthcare challenges. Most were donor funded, operated in silos and lacked sustainability. Various barriers have been identified. Evidence has shown that e-Health implementations in Uganda have lacked prior planning stages that the literature notes as essential, for example strategy and need readiness assessment. Future research should address these shortcomings prior to introduction of e-Health innovations.

  6. Variation in Research Designs Used to Test the Effectiveness of Dissemination and Implementation Strategies: A Review

    Directory of Open Access Journals (Sweden)

    Stephanie Mazzucca

    2018-02-01

    Full Text Available BackgroundThe need for optimal study designs in dissemination and implementation (D&I research is increasingly recognized. Despite the wide range of study designs available for D&I research, we lack understanding of the types of designs and methodologies that are routinely used in the field. This review assesses the designs and methodologies in recently proposed D&I studies and provides resources to guide design decisions.MethodsWe reviewed 404 study protocols published in the journal Implementation Science from 2/2006 to 9/2017. Eligible studies tested the efficacy or effectiveness of D&I strategies (i.e., not effectiveness of the underlying clinical or public health intervention; had a comparison by group and/or time; and used ≥1 quantitative measure. Several design elements were extracted: design category (e.g., randomized; design type [e.g., cluster randomized controlled trial (RCT]; data type (e.g., quantitative; D&I theoretical framework; levels of treatment assignment, intervention, and measurement; and country in which the research was conducted. Each protocol was double-coded, and discrepancies were resolved through discussion.ResultsOf the 404 protocols reviewed, 212 (52% studies tested one or more implementation strategy across 208 manuscripts, therefore meeting inclusion criteria. Of the included studies, 77% utilized randomized designs, primarily cluster RCTs. The use of alternative designs (e.g., stepped wedge increased over time. Fewer studies were quasi-experimental (17% or observational (6%. Many study design categories (e.g., controlled pre–post, matched pair cluster design were represented by only one or two studies. Most articles proposed quantitative and qualitative methods (61%, with the remaining 39% proposing only quantitative. Half of protocols (52% reported using a theoretical framework to guide the study. The four most frequently reported frameworks were Consolidated Framework for Implementing Research and RE

  7. Meausures of organizational characteristics associated with adoption and/or implementation of innovations: A systematic review.

    Science.gov (United States)

    Allen, Jennifer D; Towne, Samuel D; Maxwell, Annette E; DiMartino, Lisa; Leyva, Bryan; Bowen, Deborah J; Linnan, Laura; Weiner, Bryan J

    2017-08-23

    This paper identifies and describes measures of constructs relevant to the adoption or implementation of innovations (i.e., new policies, programs or practices) at the organizational-level. This work is intended to advance the field of dissemination and implementation research by aiding scientists in the identification of existing measures and highlighting methodological issues that require additional attention. We searched for published studies (1973-2013) in 11 bibliographic databases for quantitative, empirical studies that presented outcome data related to adoption and/or implementation of an innovation. Included studies had to assess latent constructs related to the "inner setting" of the organization, as defined by the Consolidated Framework for Implementation Research. Of the 76 studies included, most (86%) were cross sectional and nearly half (49%) were conducted in health care settings. Nearly half (46%) involved implementation of evidence-based or "best practice" strategies; roughly a quarter (26%) examined use of new technologies. Primary outcomes most often assessed were innovation implementation (57%) and adoption (34%); while 4% of included studies assessed both outcomes. There was wide variability in conceptual and operational definitions of organizational constructs. The two most frequently assessed constructs included "organizational climate" and "readiness for implementation." More than half (55%) of the studies did not articulate an organizational theory or conceptual framework guiding the inquiry; about a third (34%) referenced Diffusion of Innovations theory. Overall, only 46% of articles reported psychometric properties of measures assessing latent organizational characteristics. Of these, 94% (33/35) described reliability and 71% (25/35) reported on validity. The lack of clarity associated with construct definitions, inconsistent use of theory, absence of standardized reporting criteria for implementation research, and the fact that few

  8. Understanding effects in reviews of implementation interventions using the Theoretical Domains Framework.

    Science.gov (United States)

    Little, Elizabeth A; Presseau, Justin; Eccles, Martin P

    2015-06-17

    Behavioural theory can be used to better understand the effects of behaviour change interventions targeting healthcare professional behaviour to improve quality of care. However, the explicit use of theory is rarely reported despite interventions inevitably involving at least an implicit idea of what factors to target to implement change. There is a quality of care gap in the post-fracture investigation (bone mineral density (BMD) scanning) and management (bisphosphonate prescription) of patients at risk of osteoporosis. We aimed to use the Theoretical Domains Framework (TDF) within a systematic review of interventions to improve quality of care in post-fracture investigation. Our objectives were to explore which theoretical factors the interventions in the review may have been targeting and how this might be related to the size of the effect on rates of BMD scanning and osteoporosis treatment with bisphosphonate medication. A behavioural scientist and a clinician independently coded TDF domains in intervention and control groups. Quantitative analyses explored the relationship between intervention effect size and total number of domains targeted, and as number of different domains targeted. Nine randomised controlled trials (RCTs) (10 interventions) were analysed. The five theoretical domains most frequently coded as being targeted by the interventions in the review included "memory, attention and decision processes", "knowledge", "environmental context and resources", "social influences" and "beliefs about consequences". Each intervention targeted a combination of at least four of these five domains. Analyses identified an inverse relationship between both number of times and number of different domains coded and the effect size for BMD scanning but not for bisphosphonate prescription, suggesting that the more domains the intervention targeted, the lower the observed effect size. When explicit use of theory to inform interventions is absent, it is possible to

  9. Shared care in mental illness: A rapid review to inform implementation

    Directory of Open Access Journals (Sweden)

    Kelly Brian J

    2011-11-01

    Full Text Available Abstract Background While integrated primary healthcare for the management of depression has been well researched, appropriate models of primary care for people with severe and persistent psychotic disorders are poorly understood. In 2010 the NSW (Australia Health Department commissioned a review of the evidence on "shared care" models of ambulatory mental health services. This focussed on critical factors in the implementation of these models in clinical practice, with a view to providing policy direction. The review excluded evidence about dementia, substance use and personality disorders. Methods A rapid review involving a search for systematic reviews on The Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects (DARE. This was followed by a search for papers published since these systematic reviews on Medline and supplemented by limited iterative searching from reference lists. Results Shared care trials report improved mental and physical health outcomes in some clinical settings with improved social function, self management skills, service acceptability and reduced hospitalisation. Other benefits include improved access to specialist care, better engagement with and acceptability of mental health services. Limited economic evaluation shows significant set up costs, reduced patient costs and service savings often realised by other providers. Nevertheless these findings are not evident across all clinical groups. Gains require substantial cross-organisational commitment, carefully designed and consistently delivered interventions, with attention to staff selection, training and supervision. Effective models incorporated linkages across various service levels, clinical monitoring within agreed treatment protocols, improved continuity and comprehensiveness of services. Conclusions "Shared Care" models of mental health service delivery require attention to multiple levels (from organisational to individual

  10. Strategies for guideline implementation in primary care focusing on patients with cardiovascular disease: a systematic review.

    Science.gov (United States)

    Unverzagt, Susanne; Oemler, Matthias; Braun, Kristin; Klement, Andreas

    2014-06-01

    Guidelines should reduce inappropriate practice and improve the efficiency of treatment. Not only methodological quality but also acceptance and successful implementation in daily practice are crucial for the benefit on patients. Focusing on cardiovascular diseases (CVD), it is still unclear which implementation strategy can improve physician adherence to the recommendations of guidelines in primary care. We conducted a systematic review on randomized controlled trials about guideline implementation strategies on CVD. Medline, Embase, CENTRAL, conference proceedings and registers of ongoing studies were searched. Eighty-four trials met our predefined inclusion criteria, of them 54 trials compared unimodal strategies and 30 multimodal strategies to usual care. Concerning unimodal strategies, 15 trials investigated provider reminder systems, 3 audit and feedback, 15 provider education, 4 patient education, 5 promotion of self-management and 14 organizational change. The strongest benefit of a unimodal implementation strategy was found due to organizational change (odds ratio 1.96; 95% CI 1.4 to 2.75), followed by patient education, provider education and provider reminder systems. Trials on the efficacy of audit and feedback and patient self-management showed differing results or small advantages in terms of physician adherence. Multimodal interventions showed almost similar effect measures and ranking of strategies. The use of implementation strategies for the distribution of guidelines on CVD can be convincingly effective on physician adherence, regardless whether based on a unimodal or multimodal design. Three distinct strategies should be well considered in such an attempt: organizational changes in the primary care team, patient education and provider education. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Regulatory mechanisms for absenteeism in the health sector: a systematic review of strategies and their implementation

    Science.gov (United States)

    Kisakye, Angela N; Tweheyo, Raymond; Ssengooba, Freddie; Pariyo, George W; Rutebemberwa, Elizeus; Kiwanuka, Suzanne N

    2016-01-01

    Background A systematic review was undertaken to identify regulatory mechanisms aimed at mitigating health care worker absenteeism, to describe where and how they have been implemented as well as their possible effects. The goal was to propose potential policy options for managing the problem of absenteeism among human resources for health in low- and middle-income countries. Mechanisms described in this review are at the local workplace and broader national policy level. Methods A comprehensive online search was conducted on EMBASE, CINAHL, PubMed, Google Scholar, Google, and Social Science Citation Index using MEDLINE search terms. Retrieved studies were uploaded onto reference manager and screened by two independent reviewers. Only publications in English were included. Data were extracted and synthesized according to the objectives of the review. Results Twenty six of the 4,975 published articles retrieved were included. All were from high-income countries and covered all cadres of health workers. The regulatory mechanisms and possible effects include 1) organizational-level mechanisms being reported as effective in curbing absenteeism in low- and middle-income countries (LMICs); 2) prohibition of private sector activities in LMICs offering benefits but presenting a challenge for the government to monitor the health workforce; 3) contractual changes from temporary to fixed posts having been associated with no reduction in absenteeism and not being appropriate for LMICs; 4) multifaceted work interventions being implemented in most settings; 5) the possibility of using financial and incentive regulatory mechanisms in LMICs; 6) health intervention mechanisms reducing absenteeism when integrated with exercise programs; and 7) attendance by legislation during emergencies being criticized for violating human rights in the United States and not being effective in curbing absenteeism. Conclusion Most countries have applied multiple strategies to mitigate health care

  12. Review of extended burnup research, development and implementation in the United States

    International Nuclear Information System (INIS)

    Lang, P.M.

    1984-01-01

    This paper reviews the results to date of the various research and development projects on burnup extension of LWR fuel being sponsored by the author's organizations. These projects include a large number of test assembly irradiations in power reactors, both of current-design fuel and of several advanced designs. The burnups attained to date are tabulated and the status of postirradiation examination of these assemblies is reviewed. Current U.S. thinking on the implications of these results on possible fuel life limiting phenomena is presented, together with discussion and prioritization of further work to be done. The further work under discussion includes, in addition to other advanced designs and life limiting effects, economic studies to determine optimum burnups under present and projected future cost structures and the design of desirable extended burnup fuel cycles for power reactors. These include low leakage fuel management, improved burnable absorbers to control power distributions, extended cycle lengths, and practical transitions toward extended burnup. Results of recent studies on the impacts of extended burnup on the external fuel cycle operations of fuel fabrication, fresh fuel storage, spent fuel storage, and spent fuel transportation are briefly reviewed. The majority of U.S. utilities have already made positive decisions to implement at least a first step of burnup extension in their operating reactors. The results of a recent survey of such implementation are presented, with estimates of percentage of reactors going to burnup extension and of average and maximum increases in burnups now committed. The discussion of these results includes review of various utility motivations, both for restraint and for pressing forward with burnup extension. A summary of burnup extensions already achieved is also included. (author)

  13. Regulatory mechanisms for absenteeism in the health sector: a systematic review of strategies and their implementation.

    Science.gov (United States)

    Kisakye, Angela N; Tweheyo, Raymond; Ssengooba, Freddie; Pariyo, George W; Rutebemberwa, Elizeus; Kiwanuka, Suzanne N

    2016-01-01

    A systematic review was undertaken to identify regulatory mechanisms aimed at mitigating health care worker absenteeism, to describe where and how they have been implemented as well as their possible effects. The goal was to propose potential policy options for managing the problem of absenteeism among human resources for health in low- and middle-income countries. Mechanisms described in this review are at the local workplace and broader national policy level. A comprehensive online search was conducted on EMBASE, CINAHL, PubMed, Google Scholar, Google, and Social Science Citation Index using MEDLINE search terms. Retrieved studies were uploaded onto reference manager and screened by two independent reviewers. Only publications in English were included. Data were extracted and synthesized according to the objectives of the review. Twenty six of the 4,975 published articles retrieved were included. All were from high-income countries and covered all cadres of health workers. The regulatory mechanisms and possible effects include 1) organizational-level mechanisms being reported as effective in curbing absenteeism in low- and middle-income countries (LMICs); 2) prohibition of private sector activities in LMICs offering benefits but presenting a challenge for the government to monitor the health workforce; 3) contractual changes from temporary to fixed posts having been associated with no reduction in absenteeism and not being appropriate for LMICs; 4) multifaceted work interventions being implemented in most settings; 5) the possibility of using financial and incentive regulatory mechanisms in LMICs; 6) health intervention mechanisms reducing absenteeism when integrated with exercise programs; and 7) attendance by legislation during emergencies being criticized for violating human rights in the United States and not being effective in curbing absenteeism. Most countries have applied multiple strategies to mitigate health care worker absenteeism. The success of these

  14. GREET Pretreatment Module

    Energy Technology Data Exchange (ETDEWEB)

    Adom, Felix K. [Argonne National Lab. (ANL), Argonne, IL (United States). Energy Systems Division; Dunn, Jennifer B. [Argonne National Lab. (ANL), Argonne, IL (United States). Energy Systems Division; Han, Jeongwoo [Argonne National Lab. (ANL), Argonne, IL (United States). Energy Systems Division

    2014-09-01

    A wide range of biofuels and biochemicals can be produced from cellulosic biomass via different pretreatment technologies that yield sugars. Process simulations of dilute acid and ammonia fiber expansion pretreatment processes and subsequent hydrolysis were developed in Aspen Plus for four lignocellulosic feedstocks (corn stover, miscanthus, switchgrass, and poplar). This processing yields sugars that can be subsequently converted to biofuels or biochemical. Material and energy consumption data from Aspen Plus were then compiled in a new Greenhouses Gases, Regulated Emissions, and Energy Use in Transportation (GREETTM) pretreatment module. The module estimates the cradle-to-gate fossil energy consumption (FEC) and greenhouse gas (GHG) emissions associated with producing fermentable sugars. This report documents the data and methodology used to develop this module and the cradle-to-gate FEC and GHG emissions that result from producing fermentable sugars.

  15. Development and implementation of online National Board Dental Examination Review Courses.

    Science.gov (United States)

    Gadbury-Amyot, Cynthia C; Austin, Kylie Siruta; Overman, Pamela R

    2013-12-01

    Failure on the National Board Dental Examination (NBDE) Parts I and II has troubling consequences for dental students, faculty members, and school administrators. Since the NBDE is a high-stakes exam for all involved, it is important to determine effective strategies to help students prepare. The purpose of this article is to describe the development and implementation of online NBDE Parts I and II Review Courses by the faculty and administration at the University of Missouri-Kansas City School of Dentistry. The courses are taught by faculty members who are content experts. By utilizing distance technology, students in any geographic location can review the material at the time, place, and pace that are most convenient. Early outcomes show that 592 students from thirty-two states have participated in the courses since they were first offered in 2010-11. In post-course evaluations, students report that participation in the courses encouraged them to spend more time preparing for the exam and that the associated PowerPoint slides/handouts provided structure for their review. The literature suggests that multiple modalities are most effective in preparing for the NBDE. These online review courses can serve as a beneficial component of a student's preparation regimen.

  16. Operational readiness review implementation plan for K Basin sludge water system

    International Nuclear Information System (INIS)

    IRWIN, R.M.

    2003-01-01

    This Implementation Plan (IP) has been prepared consistent with the requirements of U.S. Department of Energy (DOE) Order 425.1B, ''Startup and Restart of Nuclear Facilities'', and DOE-STD-3006-2000, ''Planning and Conduct of Operational Readiness Reviews'' (ORR) (DOE 2002). The scope of the DOE ORR is described in the RL ''Plan of Action, K Basin Sludge Water System'' (Veitenheimer 2003), prepared by DOE project line management and approved by the RL Manager, the designated Approval Authority, on March 20, 2003. The scope of the contractor ORR is described in the contractor ''Plan of Action for the K Basins Sludge Water System Operational Readiness Review'' (FH 2002a) which was prepared by Spent Nuclear Fuel (SNF) Project line management and approved by the DOE Richland Operations Office (RL) Manager on December 19, 2002. DOE Order 425.1B indicates that the Secretarial Officer is the Authorization Authority when substantial modifications are made to a Hazard Category 2 nuclear facility. This Authorization Authority has been delegated to the RL Manager by memorandum from Jessie Hill Roberson, dated February 5, 2003 (Roberson 2003). This IP provides the overall approach and guidelines for performance of the DOE ORR. Appendix A contains the Criteria and Review Approach Documents (CRAD), which define the review objectives and criteria as well as the approach for assessing each objective. ORR results will be published in a final report, as discussed in Section 9.4

  17. Implementing early mobilisation in the intensive care unit: An integrative review.

    Science.gov (United States)

    Phelan, Sonja; Lin, Frances; Mitchell, Marion; Chaboyer, Wendy

    2018-01-01

    The intensive care unit provides complex care for critically ill patients. Consequently, due to the nature of critical illness and the therapies administered in intensive care, patients are often on prolonged periods of bed rest with limited mobility. It has been recognised that mobilising critically ill patients is beneficial to patients' recovery, however implementing early mobility as a standard of care remains challenging in practice. To identify the key factors that underpin successful implementation and sustainability of early mobilisation in adult intensive care units. Integrative Review. A systematic search strategy guided by SPICE framework (Setting, Perspective, Intervention, Comparison, Evaluation) was used to formulate the research question, identify study inclusion and exclusion criteria, and guide the database search strategy. Computerised databases were searched from August-September 2016. Quality improvement articles that identified project implementation of early mobilisation of mechanically ventilated adult intensive care patients were included. After screening the articles, extracting project data and completing summary tables, critical appraisal of the quality improvement projects was completed using the Quality Improvement Minimum Quality Criteria Set. A modified version of the Cochrane Effective Practice and Organisation of Care taxonomy was used to synthesise the multifaceted implementation strategies the projects utilised to help bring about changes in clinician behaviour. Thirteen articles, reflecting 12 projects meeting the inclusion criteria were included in the final analysis. Eleven projects were conducted in the United States, and one in the United Kingdom. Quality scores ranged from 6 to 15. A formal framework to guide the quality improvement process was used in 9 projects. The three most frequently used groups of implementation strategies were educational meetings, clinical practice guidelines and tailored interventions. Managing the

  18. A Decade of Implementing Water Services Reform in Zambia: Review of Outcomes, Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Horman Chitonge

    2011-10-01

    Full Text Available Zambia has been implementing water sector reforms for the past two decades. These reforms initiated major changes in the organisation and management of water supply services starting from the 1990s culminating in the full-scale commercialisation of water services in major cities and towns. This paper reviews the outcomes of implementing these reforms, focusing on the results of the commercialisation of water services in the last 10 years. Data presented in this paper show that there have been positive developments, but many serious challenges as well. Evidence from the review of the past 10 years suggests that much progress has been made in areas related to management and operation performance, while little success has been recorded in core areas such as expanding the network, service coverage, hours of service, and reducing the affordability burden, especially among lower-income households. The key challenge for the water services sector is to find a workable infrastructural development funding formula that will make it possible to sustain and build on the foundation laid over the past decade.

  19. Advanced musculoskeletal physiotherapists in post arthroplasty review clinics: a state wide implementation program evaluation.

    Science.gov (United States)

    Harding, Paula; Burge, Angela; Walter, Kerrie; Shaw, Bridget; Page, Carolyn; Phan, Uyen; Terrill, Desiree; Liew, Susan

    2018-03-01

    To evaluate outcomes following a state-wide implementation of post arthroplasty review (PAR) clinics for patients following total hip and knee arthroplasty, led by advanced musculoskeletal physiotherapists in collaboration with orthopaedic specialists. A prospective observational study analysed data collected by 10 implementation sites (five metropolitan and five regional/rural centres) between September 2014 and June 2015. The Victorian Innovation and Reform Impact Assessment Framework was used to assess efficiency, effectiveness (access to care, safety and quality, workforce capacity, utilisation of skill sets, patient and workforce satisfaction) and sustainability (stakeholder engagement, succession planning and availability of ongoing funding). 2362 planned occasions of service (OOS) were provided for 2057 patients. Reduced patient wait times from referral to appointment were recorded and no adverse events occurred. Average cost savings across 10 sites was AUD$38 per OOS (Baseline $63, PAR clinic $35), representing a reduced pathway cost of 44%. Average annual predicted total value of increased orthopaedic specialist capacity was $11,950 per PAR clinic (range $6149 to $23,400). The Australian Orthopaedic Association review guidelines were met (8/10 sites, 80%) and patient-reported outcome measures were introduced as routine clinical care. High workforce and patient satisfaction were expressed. Eighteen physiotherapists were trained creating a sustainable workforce. Eight sites secured ongoing funding. The PAR clinics delivered a safe, cost-efficient model of care that improved patient access and quality of care compared to traditional specialist-led workforce models. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  20. Maternal and perinatal death inquiry and response project implementation review in India.

    Science.gov (United States)

    Dikid, Tanzin; Gupta, Madhu; Kaur, Manmeet; Goel, Sonu; Aggarwal, Arun Kumar; Caravotta, Jorge

    2013-04-01

    Profile of maternal deaths in selected districts of four Indian states was studied to examine the regional differences in non-biological causal factors (socioeconomic and sociocultural) in maternal mortality and to examine the method and completeness of implementation of Maternal and Perinatal Death Inquiry and Response (MAPEDIR) process. An integrated qualitative and quantitative method was used to study the MAPEDIR process in selected districts of four states in India, through the use of standardized questionnaire for key informant interviews, participant observation checklist, analysis of verbal autopsy questionnaire, and maternal death reports. A comparison of Profile's maternal deaths investigated showed that women died between 25 and 27 years of age. Half of the women died at home because of inability to afford transport (Delay II) and treatment costs. One third of the deaths had occurred in a health facility (Delay III) because of lack of specialists, equipments or blood. Two thirds of the delays (Delay I) were in seeking medical care. Review of the implementation process of MAPEDIR highlighted that the social audit review model is a unique field based collaborative initiative comprising of stakeholders from various sector in order to improve maternal health programming by reducing maternal mortality. MAPEDIR has been able to identify socio-cultural, economic and health care systems related determinants of maternal deaths. Standardization the mechanism for information data sharing at district, sub-district and village level can maximize the use of available evidence for advocacy and policy shifts by developing policies and interventions suited to local needs.

  1. Implementation of algorithms based on support vector machine (SVM for electric systems: topic review

    Directory of Open Access Journals (Sweden)

    Jefferson Jara Estupiñan

    2016-06-01

    Full Text Available Objective: To perform a review of implementation of algorithms based on support vectore machine applied to electric systems. Method: A paper search is done mainly on Biblio­graphic Indexes (BI and Bibliographic Bases with Selection Committee (BBSC about support vector machine. This work shows a qualitative and/or quan­titative description about advances and applications in the electrical environment, approaching topics such as: electrical market prediction, demand predic­tion, non-technical losses (theft, alternative energy source and transformers, among others, in each work the respective citation is done in order to guarantee the copy right and allow to the reader a dynamic mo­vement between the reading and the cited works. Results: A detailed review is done, focused on the searching of implemented algorithms in electric sys­tems and innovating application areas. Conclusion: Support vector machines have a lot of applications due to their multiple benefits, however in the electric energy area; they have not been tota­lly applied, this allow to identify a promising area of researching.

  2. The relationship between organizational culture and implementation of clinical practice guidelines: a narrative review.

    Science.gov (United States)

    Dodek, Peter; Cahill, Naomi E; Heyland, Daren K

    2010-01-01

    The context in which critical care providers work has been shown to be associated with adherence to recommendations of clinical practice guidelines (CPGs). Consideration of contextual factors such as organizational culture may therefore be important when implementing guidelines. Organizational culture has been defined simply as "how things are around here" and encompasses leadership, communication, teamwork, conflict resolution, and other domains. This narrative review highlights the results of recent quantitative and qualitative studies, including studies on adherence to nutrition guidelines in the critical care setting, which demonstrate that elements of organizational culture, such as leadership support, interprofessional collaboration, and shared beliefs about the utility of guidelines, influence adherence to guideline recommendations. Outside nutrition therapy, there is emerging evidence that strategies focusing on organizational change (eg, revision of professional roles, interdisciplinary teams, integrated care delivery, computer systems, and continuous quality improvement) can favorably influence professional performance and patient outcomes. Consequently, future interventions aimed at implementing nutrition guidelines should aim to measure and take into account organizational culture, in addition to considering the characteristics of the patient, provider, and guideline. Further high quality, multimethod studies are required to improve our understanding of how culture influences guideline implementation, and which organizational change strategies might be most effective in optimizing nutrition therapy.

  3. HIV Self-Testing: a Review of Current Implementation and Fidelity.

    Science.gov (United States)

    Estem, Kristecia S; Catania, Joseph; Klausner, Jeffrey D

    2016-04-01

    Oral HIV self-testing is an innovative and potentially high-impact means to increase HIV-case identification globally. As a screening test, oral HIV self-testing offers the potential for increased adoption through greater convenience and privacy, and the potential to increase the proportion of the population who test regularly. Research on how best to translate the innovation of oral self-testing to high-risk populations is underway. Currently only one oral HIV self-test kit is FDA-approved (OraQuick In-Home HIV Test) and available for retail sale. In the present report we review recent studies on the dissemination, adoption, and implementation of oral HIV testing. Prior work has focused primarily on adoption, but recent studies have begun to identify methods for improving dissemination and problems associated with self-implementation. At present a major barrier to wider adoption is the relatively high retail cost of the oral HIV test kit. Significant but minor barriers are represented by overly complex instructional materials for some population segments, and dissemination programs of unknown efficacy. Theoretical and practical suggestions for conducting research on dissemination, adoption, and implementation of oral HIV testing are discussed.

  4. Mandatory influenza vaccination for all healthcare personnel: a review on justification, implementation and effectiveness.

    Science.gov (United States)

    Wang, Tiffany L; Jing, Ling; Bocchini, Joseph A

    2017-10-01

    As healthcare-associated influenza is a serious public health concern, this review examines legal and ethical arguments supporting mandatory influenza vaccination policies for healthcare personnel, implementation issues and evidence of effectiveness. Spread of influenza from healthcare personnel to patients can result in severe harm or death. Although most healthcare personnel believe that they should be vaccinated against seasonal influenza, the Centers for Disease Control and Prevention (CDC) report that only 79% of personnel were vaccinated during the 2015-2016 season. Vaccination rates were as low as 44.9% in institutions that did not promote or offer the vaccine, compared with rates of more than 90% in institutions with mandatory vaccination policies. Policies that mandate influenza vaccination for healthcare personnel have legal and ethical justifications. Implementing such policies require multipronged approaches that include education efforts, easy access to vaccines, vaccine promotion, leadership support and consistent communication emphasizing patient safety. Mandatory influenza vaccination for healthcare personnel is a necessary step in protecting patients. Patients who interact with healthcare personnel are often at an elevated risk of complications from influenza. Vaccination is the best available strategy for protecting against influenza and evidence shows that institutional policies and state laws can effectively increase healthcare personnel vaccination rates, decreasing the risk of transmission in healthcare settings. There are legal and ethical precedents for institutional mandatory influenza policies and state laws, although successful implementation requires addressing both administrative and attitudinal barriers.

  5. Evaluation of lean manufacturing implementation: review of the proceedings of the NMPE

    Directory of Open Access Journals (Sweden)

    Olga Maria Formigoni Carvalho Walter

    2012-08-01

    Full Text Available Through a review of the proceedings of the National Meeting of Production Engineering (NMPE over the past 10 years, this article aims to identify the profile of Brazilian research regarding methods that assess the implementation of Lean Manufacturing (LM, proposing a classification for the methods analyzed. We identified 28 articles that specifically address the assessment of the implementation of LM, which accounts for 16 evaluation methods because some methods have been found in more than one article. The results show that the type of research most widely used is the case study. Lean practices more addressed are: Quality Tools, Multifunctional Teams, Quick-Changeover Techniques, Continuous Improvement and Visual Control. The presence of the researcher was found more than half of the studies analyzed. Less than half showed the full data collection instrument. Moreover most of the papers evaluate the LM industry, specifically on the shop floor. This article will be useful both to researchers and to professionals in Production Engineering interested in evaluating the progress of LM implementation, because it shows the profile of all the methods presented in NMIE, which reflects the progress in the Brazilian research on the subject.

  6. A systematic review of core implementation components in team ball sport injury prevention trials.

    Science.gov (United States)

    O'Brien, James; Finch, Caroline F

    2014-10-01

    Recently, the use of specific exercise programmes to prevent musculoskeletal injuries in team ball sports has gained considerable attention, and the results of large-scale, randomised controlled trials have supported their efficacy. To enhance the translation of these interventions into widespread use, research trials must be reported in a way that allows the players, staff and policymakers associated with sports teams to implement these interventions effectively. In particular, information is needed on core implementation components, which represent the essential and indispensable aspects of successful implementation. To assess the extent to which team ball sport injury prevention trial reports have reported the core implementation components of the intervention, the intervention target and the use of any delivery agents (ie, staff or other personnel delivering the intervention). To summarise which specific types of intervention, intervention target and delivery agents are reported. To develop consensus between reviewers on the reporting of these components. Six electronic databases were systematically searched for English-language, peer-reviewed papers on injury prevention exercise programme (IPEP) trials in team ball sports. The reporting of all eligible trials was assessed by two independent reviewers. The reporting of the three core implementation components were coded as 'yes', 'no' or 'unclear'. For cases coded as 'yes', the specific types of interventions, intervention targets and delivery agents were extracted and summarised. The search strategy identified 52 eligible trials. The intervention and the intervention target were reported in all 52 trials. The reporting of 25 trials (48%) specified the use of delivery agents, the reporting of three trials (6%) specified not using delivery agents, and in the reporting of the remaining 24 trials (46%) the use of delivery agents was unclear. The reported intervention type was an IPEP alone in 43 trials (83

  7. A systematic review of team formulation in clinical psychology practice: Definition, implementation, and outcomes.

    Science.gov (United States)

    Geach, Nicole; Moghaddam, Nima G; De Boos, Danielle

    2017-10-03

    Team formulation is promoted by professional practice guidelines for clinical psychologists. However, it is unclear whether team formulation is understood/implemented in consistent ways - or whether there is outcome evidence to support the promotion of this practice. This systematic review aimed to (1) synthesize how team formulation practice is defined and implemented by practitioner psychologists and (2) analyse the range of team formulation outcomes in the peer-reviewed literature. Seven electronic bibliographic databases were searched in June 2016. Eleven articles met inclusion criteria and were quality assessed. Extracted data were synthesized using content analysis. Descriptions of team formulation revealed three main forms of instantiation: (1) a structured, consultation approach; (2) semi-structured, reflective practice meetings; and (3) unstructured/informal sharing of ideas through routine interactions. Outcome evidence linked team formulation to a range of outcomes for staff teams and service users, including some negative outcomes. Quality appraisal identified significant issues with evaluation methods; such that, overall, outcomes were not well-supported. There is weak evidence to support the claimed beneficial outcomes of team formulation in practice. There is a need for greater specification and standardization of 'team formulation' practices, to enable a clearer understanding of any relationships with outcomes and implications for best-practice implementations. Under the umbrella term of 'team formulation', three types of practice are reported: (1) highly structured consultation; (2) reflective practice meetings; and (3) informal sharing of ideas. Outcomes linked to team formulation, including some negative outcomes, were not well evidenced. Research using robust study designs is required to investigate the process and outcomes of team formulation practice. © 2017 The British Psychological Society.

  8. Developing a framework for implementing intensive care unit diaries: a focused review of the literature.

    Science.gov (United States)

    Beg, Muna; Scruth, Elizabeth; Liu, Vincent

    2016-11-01

    Intensive care unit diaries have been shown to improve post-critical illness recovery, however, prior reports of diary implementation are heterogeneous. We sought to construct a common framework for designing and implementing Intensive Care Unit diaries based on prior studies. We conducted a focused review of the literature regarding intensive care diaries based on a systematic search of several databases. Two reviewers assessed 56 studies and data were abstracted from a total of 25 eligible studies conducted between 1990 and 2014. We identified key information regarding the development, design, and implementation of the journals. We then grouped elements that appeared consistently across these studies within three main categories: (1) diary target populations; (2) diary format and content; and (3) the manner of diary return and follow-up. Most studies were conducted in European countries in adult intensive care units and targeted patients in both medical and surgical units. The timing of diary initiation was based on the elapsed length of stay or duration of mechanical ventilation. We categorised diary format and content as: entry content, authors, use of standardised headings, type of language, initiation, frequency of entries, and physical location of diaries. Diaries were hand written and many studies found that photographs were an essential element in ICU diaries. We categorised the manner of diary return and follow-up. The context in which intensive care unit diaries were returned were felt to be important factors in improving the use of diaries in recovery. In conclusion, we describe a common framework for the future development of intensive care unit diaries that revolves around the target population for the diaries, their format and content, and the timing of their use. Future studies should address how these elements impact the mechanisms by which intensive are diaries exert beneficial effects. Copyright © 2016 Australian College of Critical Care Nurses

  9. Implementing managed alcohol programs in hospital settings: A review of academic and grey literature.

    Science.gov (United States)

    Brooks, Hannah L; Kassam, Shehzad; Salvalaggio, Ginetta; Hyshka, Elaine

    2018-01-18

    People with severe alcohol use disorders are at increased risk of poor acute-care outcomes, in part due to difficulties maintaining abstinence from alcohol while hospitalised. Managed alcohol programs (MAP), which administer controlled doses of beverage alcohol to prevent withdrawal and stabilise drinking patterns, are one strategy for increasing adherence to treatment, and improving health outcomes for hospital inpatients with severe alcohol use disorders. Minimal research has examined the implementation of MAPs in hospital settings. We conducted a scoping review to describe extant literature on MAPs in community settings, as well as the therapeutic provision of alcohol to hospital inpatients, to assess the feasibility of implementing formal MAPs in hospital settings and identify knowledge gaps requiring further study. Four academic and 10 grey literature databases were searched. Evidence was synthesised using quantitative and qualitative approaches. Forty-two studies met review inclusion criteria. Twenty-eight examined the administration of alcohol to hospital inpatients, with most reporting positive outcomes related to prevention or treatment of alcohol withdrawal. Fourteen studies examined MAPs in the community and reported that they help stabilise drinking patterns, reduce alcohol-related harms and facilitate non-judgemental health and social care. MAPs in the community have been well described and research has documented effective provision of alcohol in hospital settings for addressing withdrawal. Implementing MAPs as a harm reduction approach in hospital settings is potentially feasible. However, there remains a need to build off extant literature and develop and evaluate standardised MAP protocols tailored to acute-care settings. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  10. Life Cycle Assessment (ISO 14040) implementation in foods of animal and plant origin: review.

    Science.gov (United States)

    Arvanitoyannis, Ioannis S; Kotsanopoulos, Konstantinos V; Veikou, Agapi

    2014-01-01

    The importance of environmental protection has been recently upgraded due to the continuously increasing environmental pollution load. Life Cycle Assessment (LCA), wellknown as ISO 14040, has been repeatedly shown to be a useful and powerful tool for assessing the environmental performance of industrial processes, both in the European and American continents as well as in many Asian countries (such as Japan and China). To the best of our knowledge, almost no information is provided in relation to LCA implementation in Africa apart from an article related to Egypt. Although food industries are not considered to be among the most heavily polluting ones, for some like olive oil, wine, dairy, and meat processing, their impact on the environment is a heavy burden. The introduction of LCA aimed at identifying both inputs and outputs to find out which are the most detrimental to the environment in terms of water/energy consumption and solid/liquid and gas releases. In this review, a thorough coverage of literature was made in an attempt to compare the implementation of LCA to a variety of products of both plant and animal origin. It was concluded that there is a high number of subsystems suggested for the same product, thereby, occasionally leading to confusion. An idea toward solving the problem is to proceed to some sort of standardization by means of several generic case studies of LCA implementation, similarly to what had happened in the case of Hazard Analysis and Critical Control Points (HACCP) implementation in the United States, Canada, Australia, United Kingdom, and other countries.

  11. Chemical leasing--a review of implementation in the past decade.

    Science.gov (United States)

    Moser, Frank; Jakl, Thomas

    2015-04-01

    In the past decade, research on innovative business models to manage the risk of chemical substances has sought to provide solutions to achieve the goals of the World Summit on Sustainable Development of 2002, which called for a renewal of the commitment to the sound management of chemicals and of hazardous wastes throughout their life cycle and set the ambitious goal, by 2020, to use and produce chemicals in ways that do not lead to significant adverse effects on human health and the environment. Chemical Leasing is an innovative business model that shows a great potential to become a global model for sustainable development within chemical management. This paper provides a review of the current standings of literature regarding the implementation of Chemical Leasing in the past decade. In doing so, the paper highlights the potential of this business model to serve as an approach for dematerializing production processes and managing the risks of chemicals at all levels. More in detail, it provides an outline of how Chemical Leasing has supported the alignment and implementation of the objectives of chemicals policy-makers and industry regarding the production and use of chemicals and analyses to what extent Chemical Leasing contributes to the implementation of a number of voluntary global initiatives, such as Cleaner Production, Sustainable Chemistry and Corporate Social Responsibility. This paper provides a systematic analysis of the gaps identified in literature regarding the implementation of Chemical Leasing business models. Based on this analysis, specific aspects in the field of Chemical Leasing are recommended to be further elaborated in order to increase the understanding and applicability of the business model.

  12. Regulatory mechanisms for absenteeism in the health sector: a systematic review of strategies and their implementation

    Directory of Open Access Journals (Sweden)

    Kisakye AN

    2016-11-01

    Full Text Available Angela N Kisakye,1 Raymond Tweheyo,1 Freddie Ssengooba,1 George W Pariyo,2 Elizeus Rutebemberwa,1 Suzanne N Kiwanuka1 1Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda; 2Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Background: A systematic review was undertaken to identify regulatory mechanisms aimed at mitigating health care worker absenteeism, to describe where and how they have been implemented as well as their possible effects. The goal was to propose potential policy options for managing the problem of absenteeism among human resources for health in low- and middle-income countries. Mechanisms described in this review are at the local workplace and broader national policy level. Methods: A comprehensive online search was conducted on EMBASE, CINAHL, PubMed, Google Scholar, Google, and Social Science Citation Index using MEDLINE search terms. Retrieved studies were uploaded onto reference manager and screened by two independent reviewers. Only publications in English were included. Data were extracted and synthesized according to the objectives of the review. Results: Twenty six of the 4,975 published articles retrieved were included. All were from high-income countries and covered all cadres of health workers. The regulatory mechanisms and possible effects include 1 organizational-level mechanisms being reported as effective in curbing absenteeism in low- and middle-income countries (LMICs; 2 prohibition of private sector activities in LMICs offering benefits but presenting a challenge for the government to monitor the health workforce; 3 contractual changes from temporary to fixed posts having been associated with no reduction in absenteeism and not being appropriate for LMICs; 4 multifaceted work interventions being implemented in most settings; 5 the possibility of using financial and incentive regulatory mechanisms

  13. The implementation of the Plan Esperanza and response to the imPACT Review.

    Science.gov (United States)

    Vidaurre, Tatiana; Santos, Carlos; Gómez, Henry; Sarria, Gustavo; Amorin, Edgar; López, Marga; Regalado, Roxana; Manrique, Javier; Tarco, Duniska; Ayestas, Carlos; Calderón, Mónica; Mas, Luis; Neciosup, Silvia; Salazar, Miriam; Chávez, Juan Carlos; Ubillus, Milward; Limache, Abel; Ubillus, José Carlos; Navarro, Jeannie; Sarwal, Kavita; Sutcliffe, Simon; Gutiérrez-Aguado, Alfonso; Silva, Marianela; Mena, Amalia; Guillén, María Eugenia; Castañeda, Carlos; Abugattas, Julio

    2017-10-01

    Following the implementation of the National Cancer Prevention and Control Results-based Budget Programme (PpR Cancer-024) in 2011, the Peruvian Government approved the Plan Esperanza-a population-based national cancer control plan-in 2012. Legislation that ensured full government-supported funding for people who were otherwise unable to access or afford care and treatment accompanied the Plan. In 2013, the Ministry of Health requested an integrated mission of the Programme of Action for Cancer Therapy (imPACT) report to strengthen cancer control in Peru. The imPACT Review, which was executed in 2014, assessed Peru's achievements in cancer control, and areas for improvement, including cancer control planning, further development of population-based cancer registration, increased prevention, early diagnosis, treatment and palliative care, and the engagement and participation of civil society in the health-care system. This Series paper gives a brief history of the development of the Plan Esperanza, describes the innovative funding model that supports it, and summarises how funds are disseminated on the basis of disease, geography, and demographics. An overview of the imPACT Review, and the government's response in the context of the Plan Esperanza, is provided. The development and execution of the Plan Esperanza and the execution of and response to the imPACT Review demonstrates the Peruvian Government's commitment to fighting cancer across the country, including in remote and urban areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-02-01

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

  15. Readiness factors for lean implementation in healthcare settings--a literature review.

    Science.gov (United States)

    Al-Balushi, S; Sohal, A S; Singh, P J; Al Hajri, A; Al Farsi, Y M; Al Abri, R

    2014-01-01

    The purpose of this paper is to determine the readiness factors that are critical to the application and success of lean operating principles in healthcare organizations through a review of relevant literature. A comprehensive review of literature focussing on lean and lean healthcare was conducted. Leadership, organizational culture, communication, training, measurement, and reward systems are all commonly attributed readiness factors throughout general change management and lean literature. However, directly related to the successful implementation of lean in healthcare is that a setting is able to authorize a decentralized management style and undertake an end-to-end process view. These can be particularly difficult initiatives for complex organizations such as healthcare settings. The readiness factors identified are based on a review of the published literature. The external validity of the findings could be enhanced if tested using an empirical study. The readiness factors identified will enable healthcare practitioners to be better prepared as they begin their lean journeys. Sustainability of the lean initiative will be at stake if these readiness factors are not addressed. To the best of the knowledge, this is the first paper that provides a consolidated list of key lean readiness factors that can guide practice, as well as future theory and empirical research.

  16. Advances in aluminum pretreatment

    Energy Technology Data Exchange (ETDEWEB)

    Sudour, Michel; Maintier, Philippe [PPG Industries France, 3 Z.A.E. Les Dix Muids, B.P. 89, F-59583 Marly (France); Simpson, Mark [PPG Industries Inc., 1200 Piedmont Troy, Michigan 48083 (United States); Quaglia, Paolo [PPG Industries Italia, Via Garavelli 21, I-15028 Quattordio (Italy)

    2004-07-01

    As automotive manufacturers continue to look for ways to reduce vehicle weight, aluminum is finding more utility as a body panel component. The substitution of cold-rolled steel and zinc-coated substrates with aluminum has led to new challenges in vehicle pretreatment. As a result, changes to traditional pretreatment chemistries and operating practices are necessary in order to produce an acceptable coating on aluminum body panels. These changes result in increased sludging and other undesirable characteristics. In addition to the chemistry changes, there are also process-related problems to consider. Many existing automotive pretreatment lines simply were not designed to handle aluminum and its increased demands on filtration and circulation equipment. To retrofit such a system is capital intensive and in addition to requiring a significant amount of downtime, may not be totally effective. Thus, the complexities of pre-treating aluminum body panels have actually had a negative effect on efforts to introduce more aluminum into new vehicle design programs. Recent research into ways of reducing the negative effects has led to a new understanding of the nature of zinc phosphate bath -aluminum interactions. Many of the issues associated with the pretreatment of aluminum have been identified and can be mitigated with only minor changes to the zinc phosphate bath chemistry. The use of low levels of soluble Fe ions, together with free fluoride, has been shown to dramatically improve the efficiency of a zinc phosphate system processing aluminum. Appearance of zinc phosphate coatings, coating weights and sludge are all benefited by this chemistry change. (authors)

  17. A systematic review of factors that shape implementation of mass drug administration for lymphatic filariasis in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Adam Silumbwe

    2017-05-01

    Full Text Available Abstract Background Understanding factors surrounding the implementation process of mass drug administration for lymphatic filariasis (MDA for LF elimination programmes is critical for successful implementation of similar interventions. The sub-Saharan Africa (SSA region records the second highest prevalence of the disease and subsequently several countries have initiated and implemented MDA for LF. Systematic reviews have largely focused on factors that affect coverage and compliance, with less attention on the implementation of MDA for LF activities. This review therefore seeks to document facilitators and barriers to implementation of MDA for LF in sub-Saharan Africa. Methods A systematic search of databases PubMed, Science Direct and Google Scholar was conducted. English peer-reviewed publications focusing on implementation of MDA for LF from 2000 to 2016 were considered for analysis. Using thematic analysis, we synthesized the final 18 articles to identify key facilitators and barriers to MDA for LF programme implementation. Results The main factors facilitating implementation of MDA for LF programmes were awareness creation through innovative community health education programmes, creation of partnerships and collaborations, integration with existing programmes, creation of morbidity management programmes, motivation of community drug distributors (CDDs through incentives and training, and management of adverse effects. Barriers to implementation included the lack of geographical demarcations and unregistered migrations into rapidly urbanizing areas, major disease outbreaks like the Ebola virus disease in West Africa, delayed drug deliveries at both country and community levels, inappropriate drug delivery strategies, limited number of drug distributors and the large number of households allocated for drug distribution. Conclusion Mass drug administration for lymphatic filariasis elimination programmes should design their implementation

  18. A systematic review of factors that shape implementation of mass drug administration for lymphatic filariasis in sub-Saharan Africa.

    Science.gov (United States)

    Silumbwe, Adam; Zulu, Joseph Mumba; Halwindi, Hikabasa; Jacobs, Choolwe; Zgambo, Jessy; Dambe, Rosalia; Chola, Mumbi; Chongwe, Gershom; Michelo, Charles

    2017-05-22

    Understanding factors surrounding the implementation process of mass drug administration for lymphatic filariasis (MDA for LF) elimination programmes is critical for successful implementation of similar interventions. The sub-Saharan Africa (SSA) region records the second highest prevalence of the disease and subsequently several countries have initiated and implemented MDA for LF. Systematic reviews have largely focused on factors that affect coverage and compliance, with less attention on the implementation of MDA for LF activities. This review therefore seeks to document facilitators and barriers to implementation of MDA for LF in sub-Saharan Africa. A systematic search of databases PubMed, Science Direct and Google Scholar was conducted. English peer-reviewed publications focusing on implementation of MDA for LF from 2000 to 2016 were considered for analysis. Using thematic analysis, we synthesized the final 18 articles to identify key facilitators and barriers to MDA for LF programme implementation. The main factors facilitating implementation of MDA for LF programmes were awareness creation through innovative community health education programmes, creation of partnerships and collaborations, integration with existing programmes, creation of morbidity management programmes, motivation of community drug distributors (CDDs) through incentives and training, and management of adverse effects. Barriers to implementation included the lack of geographical demarcations and unregistered migrations into rapidly urbanizing areas, major disease outbreaks like the Ebola virus disease in West Africa, delayed drug deliveries at both country and community levels, inappropriate drug delivery strategies, limited number of drug distributors and the large number of households allocated for drug distribution. Mass drug administration for lymphatic filariasis elimination programmes should design their implementation strategies differently based on specific contextual factors to

  19. Implementation of the Integrated Electronic Patient Portal in the Pediatric Population: A Systematic Review.

    Science.gov (United States)

    Bush, Ruth A; Connelly, Cynthia D; Fuller, Martha; Pérez, Alexa

    2015-08-10

    This study assessed the current state of knowledge regarding the use of the integrated electronic health record (EHR) patient portal for pediatric clinical care. A systematic examination of the research on implementation, utilization, and evaluation of the integrated EHR patient portal among pediatric patients has not been previously conducted. Therefore, the purpose of the present study was to systematically review existing research on the state of the science, describe the way others have defined the patient portal, and examine pediatric patient portal utilization. Covering a period from 1992 to 2014 a literature search was conducted on four electronic databases. Only articles in English were reviewed. Studies were included if they reported the use of a patient portal integrated with an electronic health record and captured pediatric medial encounters. Qualitative or quantitative studies of any design were eligible as long as they focused on patients (or parents) who access their health records through an electronic portal tied to an EHR and reported measures of satisfaction, attitudes on use, barriers and facilitators, adherence, or clinical and health outcomes. Content analysis of each article was performed independently by at least two authors using an extraction grid of study qualities, and quality and relevance of the studies were also assessed. Of a total of 189 potentially relevant publications identified, 31 full-text publications were obtained after screening titles and abstracts. After a full review, 11 publications corresponding to seven studies met the inclusion criteria. The methodological approaches included cross-sectional surveys, retrospective analysis, qualitative studies, and usability testing. In general, feedback was positive. The most frequent negative comments about the portal reflected concern about teenager interaction with the portal and how that might affect communication among patient, parent, and provider. Some users were frustrated

  20. Nonhazardous Urine Pretreatment Method

    Science.gov (United States)

    Akse, James R.; Holtsnider, John T.

    2012-01-01

    A method combines solid phase acidification with two non-toxic biocides to prevent ammonia volatilization and microbial proliferation. The safe, non-oxidizing biocide combination consists of a quaternary amine and a food preservative. This combination has exhibited excellent stabilization of both acidified and unacidified urine. During pretreatment tests, composite urine collected from donors was challenged with a microorganism known to proliferate in urine, and then was processed using the nonhazardous urine pre-treatment method. The challenge microorganisms included Escherichia coli, a common gram-negative bacteria; Enterococcus faecalis, a ureolytic gram-positive bacteria; Candida albicans, a yeast commonly found in urine; and Aspergillus niger, a problematic mold that resists urine pre-treatment. Urine processed in this manner remained microbially stable for over 57 days. Such effective urine stabilization was achieved using non-toxic, non-oxidizing biocides at higher pH (3.6 to 5.8) than previous methods in use or projected for use aboard the International Space Station (ISS). ISS urine pretreatment methods employ strong oxidants including ozone and hexavalent chromium (Cr(VI)), a carcinogenic material, under very acidic conditions (pH = 1.8 to 2.4). The method described here offers a much more benign chemical environment than previous pretreatment methods, and will lower equivalent system mass (ESM) by reducing containment volume and mass, system complexity, and crew time needed to handle pre-treatment chemicals. The biocides, being non-oxidizing, minimize the potential for chemical reactions with urine constituents to produce volatile, airborne contaminants such as cyanogen chloride. Additionally, the biocides are active under significantly less acidic conditions than those used in the current system, thereby reducing the degree of required acidification. A simple flow-through solid phase acidification (SPA) bed is employed to overcome the natural buffering

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

    Science.gov (United States)

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

    2016-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan; Zheng, Nina; Fridley, David

    2012-02-28

    Appliance energy efficiency standards and labeling (S&L) programs have been important policy tools for regulating the efficiency of energy-using products for over 40 years and continue to expand in terms of geographic and product coverage. The most common S&L programs include mandatory minimum energy performance standards (MEPS) that seek to push the market for efficient products, and energy information and endorsement labels that seek to pull the market. This study seeks to review and compare some of the earliest and most well-developed S&L programs in three countries and one region: the U.S. MEPS and ENERGY STAR, Australia MEPS and Energy Label, European Union MEPS and Ecodesign requirements and Energy Label and Japanese Top Runner programs. For each program, key elements of S&L programs are evaluated and comparative analyses across the programs undertaken to identify best practice examples of individual elements as well as cross-cutting factors for success and lessons learned in international S&L program development and implementation. The international review and comparative analysis identified several overarching themes and highlighted some common factors behind successful program elements. First, standard-setting and programmatic implementation can benefit significantly from a legal framework that stipulates a specific timeline or schedule for standard-setting and revision, product coverage and legal sanctions for non-compliance. Second, the different MEPS programs revealed similarities in targeting efficiency gains that are technically feasible and economically justified as the principle for choosing a standard level, in many cases at a level that no product on the current market could reach. Third, detailed survey data such as the U.S. Residential Energy Consumption Survey (RECS) and rigorous analyses provide a strong foundation for standard-setting while incorporating the participation of different groups of stakeholders further strengthen the process

  3. Barriers and enablers of kangaroo mother care implementation from a health systems perspective: a systematic review.

    Science.gov (United States)

    Chan, Grace; Bergelson, Ilana; Smith, Emily R; Skotnes, Tobi; Wall, Stephen

    2017-12-01

    Kangaroo Mother Care (KMC) is an evidence-based intervention that reduces neonatal morbidity and mortality. However, adoption among health systems has varied. Understanding the interaction between health system functions-leadership, financing, healthcare workers (HCWs), technologies, information and research, and service delivery-and KMC is essential to understanding KMC adoption. We present a systematic review of the barriers and enablers of KMC implementation from the perspective of health systems, with a focus on HCWs and health facilities. Using the search terms 'kangaroo mother care', 'skin to skin (STS) care' and 'kangaroo care', we searched Embase, Scopus, Web of Science, Pubmed, and World Health Organization Regional Databases. Reports and hand searched references from publications were also included. Screening and data abstraction were conducted by two independent reviewers using standardized forms. A conceptual model to assess KMC adoption themes was developed using NVivo software. Our search strategy yielded 2875 studies. We included 86 studies with qualitative data on KMC implementation from the perspective of HCWs and/or facilities. Six themes emerged on barriers and enablers to KMC adoption: buy-in and bonding; social support; time; medical concerns; training; and cultural norms. Analysis of interactions between HCWs and facilities yielded further barriers and enablers in the areas of training, communication, and support. HCWs and health facilities serve as two important adopters of Kangaroo Mother Care within a health system. The complex components of KMC lead to multifaceted barriers and enablers to integration, which inform facility, regional, and country-level recommendations for increasing adoption. Further research of methods to promote context-specific adoption of KMC at the health systems level is needed. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  4. Standardized Patients in Clinical Psychology and Psychotherapy: a Scoping Review of Barriers and Facilitators for Implementation.

    Science.gov (United States)

    Kühne, Franziska; Ay, Destina Sevde; Otterbeck, Mara Jasmin; Weck, Florian

    2018-02-08

    The use of simulated and standardized patients (SP) is widely accepted in the medical field and, from there, is beginning to disseminate into clinical psychology and psychotherapy. The purpose of this study was therefore to systematically review barriers and facilitators that should be considered in the implementation of SP interventions specific to clinical psychology and psychotherapy. Following current guidelines, a scoping review was conducted. The literature search focused on the MEDLINE, PsycINFO and Web of Science databases, including Dissertation Abstracts International. After screening for titles and abstracts, full texts were screened independently and in duplicate according to our inclusion criteria. For data extraction, a pre-defined form was piloted and used. Units of meaning with respect to barriers and facilitators were extracted and categorized inductively using content-analysis techniques. From the results, a matrix of interconnections and a network graph were compiled. The 41 included publications were mainly in the fields of psychiatry and mental health nursing, as well as in training and education. The detailed category system contrasts four supercategories, i.e., which organizational and economic aspects to consider, which persons to include as eligible SPs, how to develop adequate scenarios, and how to authentically and consistently portray mental health patients. Publications focused especially on the interrelation between authenticity and consistency of portrayals, on how to evoke empathy in learners, and on economic and training aspects. A variety of recommendations for implementing SP programs, from planning to training, monitoring, and debriefing, is provided, for example, ethical screening of and ongoing support for SPs.

  5. A comprehensive review on the implementation of the biorefinery concept in biodiesel production plants

    Directory of Open Access Journals (Sweden)

    Christian David Botero Gutiérrez

    2017-09-01

    Full Text Available Biodiesel is a promising alternative to petroleum diesel and its production from various generations of feedstocks by using different technologies has been constantly growing globally. However, in spite of such large scale of production, serious considerations should be taken into account to ensure the long-term sustainability of biodiesel production. This issue becomes more of concern given the fact that some generations of feedstocks used for biodiesel production are in clear conflict with food security. The concept of biorefinery has been at the center of attention with an aim to address these challenges by promoting an integral use of biomass to allow the production of multiple products along with biodiesel. Such implementation has been extensively studied over the last years and is expected to lead to economic, environmental, and social advantages over individual processes. The current review first presented an overview on biodiesel, its different feedstocks, and production technologies. Subsequently, the biorefinery concept and its correct implementation was technically discussed. Biodiesel production under the biorefinery scheme was also presented. Finally, techno-economic analysis of biodiesel production under the biorefinery concept by considering palm oil-based biorefinery as case study was investigated.

  6. Insulin pump therapy in the perioperative period: a review of care after implementation of institutional guidelines.

    Science.gov (United States)

    Boyle, Mary E; Seifert, Karen M; Beer, Karen A; Mackey, Patricia; Schlinkert, Richard T; Stearns, Joshua D; Cook, Curtiss B

    2012-09-01

    An institutional policy was previously established for patients with diabetes on insulin pump therapy undergoing elective surgical procedures. Electronic medical records were reviewed to assess documentation of insulin pump status and glucose monitoring during preoperative, intraoperative, and postanesthesia care unit (PACU) phases of care. Twenty patients with insulin pumps underwent 23 procedures from March 1 to December 31, 2011. Mean (standard deviation) age was 58 (13) years, mean diabetes duration was 28 (17) years, and mean duration of insulin pump therapy was 7 (6) years. Nearly all cases (86%) during the preoperative phase had the presence of the device documented--an improvement over the 64% noted in data collected before the policy. Intraoperatively, 13 cases (61%) had the presence of the pump documented, which was higher than the 28% before implementation of the policy. However, documentation of pump status was found in only 38% in the PACU and was actually less than the 60% documented previously. Over 90% of cases had glucose checked in the preoperative area and the PACU, and only 60% had it checked intraoperatively, which was nearly identical to the percentages seen before policy implementation. No adverse events occurred when insulin pump therapy was continued. Although some processes still require improvement, preliminary data suggest that the policy for perioperative management of insulin pumps has provided useful structure for care of these cases. The data thus far indicate that insulin pump therapy can be continued safely during the perioperative period. © 2012 Diabetes Technology Society.

  7. Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review

    Directory of Open Access Journals (Sweden)

    Hage Eveline

    2013-01-01

    Full Text Available Abstract Background An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers whether this is so for rural communities. This review identifies the critical implementation factors and, following the change model of Pettigrew and Whipp, classifies them in terms of “context”, “process”, and “content”. Through this lens, we analyze the empirical findings found in the literature to address the question: How do context, process, and content factors of e-Health implementation influence its adoption in rural communities? Methods We conducted a systematic literature review. This review included papers that met six inclusion and exclusion criteria and had sufficient methodological quality. Findings were categorized in a classification matrix to identify promoting and restraining implementation factors and to explore whether any interactions between context, process, and content affect adoption. Results Of the 5,896 abstracts initially identified, only 51 papers met all our criteria and were included in the review. We distinguished five different perspectives on rural e-Health implementation in these papers. Further, we list the context, process, and content implementation factors found to either promote or restrain rural e-Health adoption. Many implementation factors appear repeatedly, but there are also some contradictory results. Based on a further analysis of the papers’ findings, we argue that interaction effects between context, process, and content elements of change may explain these contradictory results. More specifically, three themes that appear crucial in e-Health implementation in rural communities surfaced: the dual effects of geographical isolation, the targeting of underprivileged groups, and the

  8. Biomass shock pretreatment

    Science.gov (United States)

    Holtzapple, Mark T.; Madison, Maxine Jones; Ramirez, Rocio Sierra; Deimund, Mark A.; Falls, Matthew; Dunkelman, John J.

    2014-07-01

    Methods and apparatus for treating biomass that may include introducing a biomass to a chamber; exposing the biomass in the chamber to a shock event to produce a shocked biomass; and transferring the shocked biomass from the chamber. In some aspects, the method may include pretreating the biomass with a chemical before introducing the biomass to the chamber and/or after transferring shocked biomass from the chamber.

  9. Microwave pretreatment of switchgrass for bioethanol production

    Science.gov (United States)

    Keshwani, Deepak Radhakrishin

    Lignocellulosic materials are promising alternative feedstocks for bioethanol production. These materials include agricultural residues, cellulosic waste such as newsprint and office paper, logging residues, and herbaceous and woody crops. However, the recalcitrant nature of lignocellulosic biomass necessitates a pretreatment step to improve the yield of fermentable sugars. The overall goal of this dissertation is to expand the current state of knowledge on microwave-based pretreatment of lignocellulosic biomass. Existing research on bioenergy and value-added applications of switchgrass is reviewed in Chapter 2. Switchgrass is an herbaceous energy crop native to North America and has high biomass productivity, potentially low requirements for agricultural inputs and positive environmental impacts. Based on results from test plots, yields in excess of 20 Mg/ha have been reported. Environmental benefits associated with switchgrass include the potential for carbon sequestration, nutrient recovery from run-off, soil remediation and provision of habitats for grassland birds. Published research on pretreatment of switchgrass reported glucose yields ranging from 70-90% and xylose yields ranging from 70-100% after hydrolysis and ethanol yields ranging from 72-92% after fermentation. Other potential value-added uses of switchgrass include gasification, bio-oil production, newsprint production and fiber reinforcement in thermoplastic composites. Research on microwave-based pretreatment of switchgrass and coastal bermudagrass is presented in Chapter 3. Pretreatments were carried out by immersing the biomass in dilute chemical reagents and exposing the slurry to microwave radiation at 250 watts for residence times ranging from 5 to 20 minutes. Preliminary experiments identified alkalis as suitable chemical reagents for microwave-based pretreatment. An evaluation of different alkalis identified sodium hydroxide as the most effective alkali reagent. Under optimum pretreatment

  10. Design and implementation of Metta, a metasearch engine for biomedical literature retrieval intended for systematic reviewers.

    Science.gov (United States)

    Smalheiser, Neil R; Lin, Can; Jia, Lifeng; Jiang, Yu; Cohen, Aaron M; Yu, Clement; Davis, John M; Adams, Clive E; McDonagh, Marian S; Meng, Weiyi

    2014-01-01

    Individuals and groups who write systematic reviews and meta-analyses in evidence-based medicine regularly carry out literature searches across multiple search engines linked to different bibliographic databases, and thus have an urgent need for a suitable metasearch engine to save time spent on repeated searches and to remove duplicate publications from initial consideration. Unlike general users who generally carry out searches to find a few highly relevant (or highly recent) articles, systematic reviewers seek to obtain a comprehensive set of articles on a given topic, satisfying specific criteria. This creates special requirements and challenges for metasearch engine design and implementation. We created a federated search tool that is connected to five databases: PubMed, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials. Retrieved bibliographic records were shown online; optionally, results could be de-duplicated and exported in both BibTex and XML format. The query interface was extensively modified in response to feedback from users within our team. Besides a general search track and one focused on human-related articles, we also added search tracks optimized to identify case reports and systematic reviews. Although users could modify preset search options, they were rarely if ever altered in practice. Up to several thousand retrieved records could be exported within a few minutes. De-duplication of records returned from multiple databases was carried out in a prioritized fashion that favored retaining citations returned from PubMed. Systematic reviewers are used to formulating complex queries using strategies and search tags that are specific for individual databases. Metta offers a different approach that may save substantial time but which requires modification of current search strategies and better indexing of randomized controlled trial articles. We envision Metta as one piece of a multi-tool pipeline that will assist

  11. Strategies for implementing school-located influenza vaccination of children: a systematic literature review.

    Science.gov (United States)

    Cawley, John; Hull, Harry F; Rousculp, Matthew D

    2010-04-01

    The Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccinations for all children 6 months to 18 years of age, which includes school-aged children. Influenza immunization programs may benefit schools by reducing absenteeism. A systematic literature review of PubMed, PsychLit, and Dissertation Abstracts available as of January 7, 2008, was conducted for school-located vaccinations, using search words "School Health Services" and "Immunization Programs"; limited to "Child" (6-12 years) and "Adolescent" (13-18 years) for PubMed and "mass or universal" and (immuniz(*) or immunis(*) or vaccin(*)) and (school or Child or Adolescen(*)) for PsychLit and Dissertation Abstracts. Fifty-nine studies met the criteria for review. Strategies such as incentives, education, the design of the consent form, and follow-up can increase parental consent and number of returned forms. Minimizing out-of-pocket cost, offering both the intramuscular (shot) and intranasal (nasal spray) vaccination, and using reminders can increase vaccination coverage among those whose parents consented. Finally, organization, communication, and planning can minimize the logistical challenges. Schools-based vaccination programs are a promising option for achieving the expanded ACIP recommendation; school-located vaccination programs are feasible and effective. Adhering to lessons from the peer-reviewed scientific literature may help public health officials and schools implement the expanded recommendation to provide the greatest benefit for the lowest cost. Given the potential benefits of the expanded recommendation, both directly to the vaccinated children and indirectly to the community, prospective, well-controlled trials to establish the cost-effectiveness of specific vaccination strategies should be high priorities for future research.

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

    Science.gov (United States)

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

    2018-02-03

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

  13. Implementing communication and decision-making interventions directed at goals of care: a theory-led scoping review.

    Science.gov (United States)

    Cummings, Amanda; Lund, Susi; Campling, Natasha; May, Carl R; Richardson, Alison; Myall, Michelle

    2017-10-06

    To identify the factors that promote and inhibit the implementation of interventions that improve communication and decision-making directed at goals of care in the event of acute clinical deterioration. A scoping review was undertaken based on the methodological framework of Arksey and O'Malley for conducting this type of review. Searches were carried out in Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) to identify peer-reviewed papers and in Google to identify grey literature. Searches were limited to those published in the English language from 2000 onwards. Inclusion and exclusion criteria were applied, and only papers that had a specific focus on implementation in practice were selected. Data extracted were treated as qualitative and subjected to directed content analysis. A theory-informed coding framework using Normalisation Process Theory (NPT) was applied to characterise and explain implementation processes. Searches identified 2619 citations, 43 of which met the inclusion criteria. Analysis generated six themes fundamental to successful implementation of goals of care interventions: (1) input into development; (2) key clinical proponents; (3) training and education; (4) intervention workability and functionality; (5) setting and context; and (6) perceived value and appraisal. A broad and diverse literature focusing on implementation of goals of care interventions was identified. Our review recognised these interventions as both complex and contentious in nature, making their incorporation into routine clinical practice dependent on a number of factors. Implementing such interventions presents challenges at individual, organisational and systems levels, which make them difficult to introduce and embed. We have identified a series of factors that influence successful implementation and our analysis has distilled key learning points, conceptualised as a set of propositions, we consider relevant to implementing other complex

  14. Should consultation recording use be a practice standard? A systematic review of the effectiveness and implementation of consultation recordings.

    Science.gov (United States)

    Rieger, Kendra L; Hack, Thomas F; Beaver, Kinta; Schofield, Penelope

    2017-11-25

    To conduct a systematic review of the effectiveness of consultation recordings and identify factors contributing to their successful implementation in health-care settings. A systematic review was conducted for quantitative studies examining the effectiveness of consultation recordings in health care. Two independent reviewers assessed the relevance and quality of retrieved quantitative studies by using standardized criteria. Study findings were examined to determine consultation recording effectiveness and to identify barriers and facilitators to implementation. A supplementary review of qualitative evidence was performed to further explicate implementation factors. Of the 3373 articles retrieved in the quantitative search, 26 satisfied the standardized inclusion criteria (12 randomized controlled trials, 1 quasi-experiment, and 13 cross-sectional studies). Most patients found consultation recordings beneficial. Statistically significant evidentiary support was found for the beneficial impact of consultation recordings on the following patient reported outcomes: knowledge, perception of being informed, information recall, decision-making factors, anxiety, and depression. Implementation barriers included strength of evidence concerns, patient distress, impact of the recording on consultation quality, clinic procedures, medico-legal issues, and resource costs. Facilitators included comfort with being recorded, clinical champions, legal strategies, efficient recording procedures, and a positive consultation recording experience. Consultation recordings are valuable to patients and positively associated with patient-reported outcomes. Successful integration of consultation recording use into clinical practice requires an administratively supported, systematic approach to addressing implementation factors. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Bevacizumab Demonstrates Prolonged Disease Stabilization in Patients with Heavily Pretreated Metastatic Renal Cell Carcinoma: A Case Series and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Nicole M. Agostino

    2010-01-01

    Full Text Available There are now a variety of therapies approved for the treatment of metastatic renal cell carcinoma (RCC. These include the immunotherapeutics, alfa-interferon, and interleukin-2, and agents that target the vascular endothelial growth factor receptor (VEGFR via its tyrosine kinase, such as sorafenib, sunitinib, and pazopanib, or the mammalian target of rapamycin (mTOR, such as temsirolimus and everolimus. Bevacizumab, a monoclonal antibody directed against the ligand, VEGF, has shown activity against RCC as a single agent in patients who had failed prior cytokine therapy and as first line therapy in combination with interferon. The activity of bevacizumab in patients who had received and failed prior therapy has not been described. We report our experience in 4 patients with metastatic RCC who had failed prior cytokine, TKI, and mTOR inhibitors who were treated with bevacizumab as single agent therapy. These heavily pretreated patients sustained very prolonged periods of stable disease (median of 12 months with very little toxicity and excellent quality of life. The activity of this agent in patients who had failed prior therapies directed against the VEGFR and mTOR suggests that therapy targeting the ligand, VEGF, is still a viable approach in these patients and deserves further study.

  16. A Framework on the Critical Success Factors of E-Learning Implementation in Higher Education: A Review of the Literature

    OpenAIRE

    Sujit K. Basak; Marguerite Wotto; Paul Bélanger

    2016-01-01

    This paper presents a conceptual framework on the critical success factors of e-learning implementation in higher education, derived from an in-depth survey of literature review. The aim of this study was achieved by identifying critical success factors that affect for the successful implementation of e-learning. The findings help to articulate issues that are related to e-learning implementation in both formal and non-formal higher education and in this way contribute to the development of p...

  17. Implementation of the Crisis Resolution Team model in adult mental health settings: a systematic review.

    Science.gov (United States)

    Wheeler, Claire; Lloyd-Evans, Brynmor; Churchard, Alasdair; Fitzgerald, Caroline; Fullarton, Kate; Mosse, Liberty; Paterson, Bethan; Zugaro, Clementina Galli; Johnson, Sonia

    2015-04-08

    Crisis Resolution Teams (CRTs) aim to offer an alternative to hospital admission during mental health crises, providing rapid assessment, home treatment, and facilitation of early discharge from hospital. CRTs were implemented nationally in England following the NHS Plan of 2000. Single centre studies suggest CRTs can reduce hospital admissions and increase service users' satisfaction: however, there is also evidence that model implementation and outcomes vary considerably. Evidence on crucial characteristics of effective CRTs is needed to allow team functioning to be optimised. This review aims to establish what evidence, if any, is available regarding the characteristics of effective and acceptable CRTs. A systematic review was conducted. MEDLINE, Embase, PsycINFO, CINAHL and Web of Science were searched to November 2013. A further web-based search was conducted for government and expert guidelines on CRTs. We analysed studies separately as: comparing CRTs to Treatment as Usual; comparing two or more CRT models; national or regional surveys of CRT services; qualitative studies of stakeholders' views regarding best practice in CRTs; and guidelines from government and expert organisations regarding CRT service delivery. Quality assessment and narrative synthesis were conducted. Statistical meta-analysis was not feasible due to the variety of design of retrieved studies. Sixty-nine studies were included. Studies varied in quality and in the composition and activities of the clinical services studied. Quantitative studies suggested that longer opening hours and the presence of a psychiatrist in the team may increase CRTs' ability to prevent hospital admissions. Stakeholders emphasised communication and integration with other local mental health services; provision of treatment at home; and limiting the number of different staff members visiting a service user. Existing guidelines prioritised 24-hour, seven-day-a-week CRT service provision (including psychiatrist and

  18. Knowledge Management Implementation and the Tools Utilized in Healthcare for Evidence-Based Decision Making: A Systematic Review

    OpenAIRE

    Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

    2017-01-01

    Background Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Methods Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: “Healthcar...

  19. Benefits and challenges of EMR implementations in low resource settings: a state-of-the-art review.

    Science.gov (United States)

    Jawhari, Badeia; Ludwick, Dave; Keenan, Louanne; Zakus, David; Hayward, Robert

    2016-09-06

    The intent of this review is to discover the types of inquiry and range of objectives and outcomes addressed in studies of the impacts of Electronic Medical Record (EMR) implementations in limited resource settings in sub-Saharan Africa. A state-of-the-art review characterized relevant publications from bibliographic databases and grey literature repositories through systematic searching, concept-mapping, relevance and quality filter optimization, methods and outcomes categorization and key article analysis. From an initial population of 749 domain articles published before February 2015, 32 passed context and methods filters to merit full-text analysis. Relevant literature was classified by type (e.g., secondary, primary), design (e.g., case series, intervention), focus (e.g., processes, outcomes) and context (e.g., location, organization). A conceptual framework of EMR implementation determinants (systems, people, processes, products) was developed to represent current knowledge about the effects of EMRs in resource-constrained settings and to facilitate comparisons with studies in other contexts. This review provides an overall impression of the types and content of health informatics articles about EMR implementations in sub-Saharan Africa. Little is known about the unique effects of EMR efforts in slum settings. The available reports emphasize the complexity and impact of social considerations, outweighing product and system limitations. Summative guides and implementation toolkits were not found but could help EMR implementers. The future of EMR implementation in sub-Saharan Africa is promising. This review reveals various examples and gaps in understanding how EMR implementations unfold in resource-constrained settings; and opportunities for new inquiry about how to improve deployments in those contexts.

  20. Factors influencing the implementation of fall-prevention programmes: a systematic review and synthesis of qualitative studies

    Directory of Open Access Journals (Sweden)

    Child Sue

    2012-09-01

    Full Text Available Abstract Background More than a third of people over the age of 65 years fall each year. Falling can lead to a reduction in quality of life, mortality, and a risk of prolonged hospitalisation. Reducing and preventing falls has become an international health priority. To help understand why research evidence has often not been translated into changes in clinical practice, we undertook a systematic review and synthesis of qualitative research in order to identify what factors serve as barriers and facilitators to the successful implementation of fall-prevention programmes. Methods We conducted a review of literature published between 1980 and January 2012 for qualitative research studies that examined barriers and facilitators to the effective implementation of fall-prevention interventions among community-dwelling older people and healthcare professionals. Two reviewers independently screened studies for inclusion, extracted data, and assessed methodological quality according to predefined criteria. Findings were synthesised using meta-ethnography. Results Of the 5010 articles identified through database searching, 19 were included in the review. Analysis of the 19 studies revealed limited information about the mechanisms by which barriers to implementation of fall-prevention interventions had been overcome. Data synthesis produced three overarching concepts: (1 practical considerations, (2 adapting for community, and (3 psychosocial. A line of argument synthesis describes the barriers and facilitators to the successful implementation of fall-prevention programmes. These concepts show that the implementation of fall-prevention programmes is complex and multifactorial. This is the first systematic review and synthesis of qualitative studies to examine factors influencing the implementation of fall-prevention programmes from the perspectives of both the healthcare professional and the community-dwelling older person. Conclusions The current

  1. PCA safety data review after clinical decision support and smart pump technology implementation.

    Science.gov (United States)

    Prewitt, Judy; Schneider, Susan; Horvath, Monica; Hammond, Julia; Jackson, Jason; Ginsberg, Brian

    2013-06-01

    Medication errors account for 20% of medical errors in the United States with the largest risk at prescribing and administration. Analgesics or opioids are frequently used medications that can be associated with patient harm when prescribed or administered improperly. In an effort to decrease medication errors, Duke University Hospital implemented clinical decision support via computer provider order entry (CPOE) and "smart pump" technology, 2/2008, with the goal to decrease patient-controlled analgesia (PCA) adverse events. This project evaluated PCA safety events, reviewing voluntary report system and adverse drug events via surveillance (ADE-S), on intermediate and step-down units preimplementation and postimplementation of clinical decision support via CPOE and PCA smart pumps for the prescribing and administration of opioids therapy in the adult patient requiring analgesia for acute pain. Voluntary report system and ADE-S PCA events decreased based upon 1000 PCA days; ADE-S PCA events per 1000 PCA days decreased 22%, from 5.3 (pre) to 4.2 (post) (P = 0.09). Voluntary report system events decreased 72%, from 2.4/1000 PCA days (pre) to 0.66/1000 PCA days (post) and was statistically significant (P PCA events between time periods in both the ADE-S and voluntary report system data, thus supporting the recommendation of clinical decision support via CPOE and PCA smart pump technology.

  2. Towards ICF implementation in menopause healthcare: a systematic review of ICF application in Switzerland.

    Science.gov (United States)

    Zangger, Martina; Poethig, Dagmar; Meissner, Florian; von Wolff, Michael; Stute, Petra

    2017-12-28

    To present a systematic literature review on the application and degree of implementation of the International Classification of Functioning, Disability and Health (ICF) across different health conditions and regions in Switzerland in order to develop an ICF classification of the climacteric syndrome in the medium term. A systematic literature search was conducted through Embase and Medline covering the period between 2011 and August 2016. Inclusion criteria were the term ICF in title or abstract and Switzerland as the workplace of the first author. Identified publications were analysed as descriptive statistics. A total of 83 articles were included in the analysis. Forty-seven different first authors from 24 different institutions were identified. The majority of publications were from Swiss Paraplegic Research (68.7%) and focused on neurology (31.3%). Forty-six cohort studies were identified. In most of them, the ICF was used to set up a general language for comparing patients' information (82.9%). Only one paper from the medical specialty gynaecology was identified; this was on breast cancer. No paper on the menopause was found. In Switzerland, the ICF is actively used in various areas of healthcare, especially in the field of neurology and rehabilitation. There is a need for ICF core sets in other medical fields, such as menopause healthcare, in order to accomplish the goal of the European Menopause and Andropause Society, which is a healthcare model for healthy menopause and aging.

  3. Lean Six Sigma Strategy at Work: Ups, Downs and Lessons Learned From Implementation - A Literature Review

    Directory of Open Access Journals (Sweden)

    Georgiana CIOANĂ

    2015-06-01

    Full Text Available Research work on Lean, Six Sigma and Lean Six Sigma has become increasingly present in the literature in the field of operations management and business excellence and has extended to other areas as the need for process improvement is more prominent. Whether it analyzes theoretical aspects regarding the development and the evolution of the two methodologies or of the most recent merge between the two, known as Lean Six Sigma strategy or simply Lean Sigma, or it presents results of studies undertaken in different industry or service sectors, the knowledge provided by the articles, books or studies currently available is vital to all researchers, specialists in the field and to all businesses. In this consideration we propose a detailed review of the most significant findings drawn from studies concerning the evaluation of the performance of Lean Six Sigma strategy as pure theory or as evidence from organizations performed in the time-frame 2003 to 2014 that seeks to underline the lessons learned from implementation and to question what is to be done in future researches.

  4. Implementation of guiding layers of surface acoustic wave devices: A review.

    Science.gov (United States)

    Xu, Zhangliang; Yuan, Yong J

    2018-01-15

    The purpose of overviewing research and development status of dependable, efficient, and portable and miniaturized surface acoustic wave (SAW) is to propose practical devices for biosensing and medical diagnosis. SAW Love-mode sensors fortunately have a great deal of attention during last two decades. Several periodic structure models of SAW devices were reviewed, especially interdigital transducers (IDTs), wave guiding layers, patterned-ZnO. SAW devices based on such periodic wave guiding layers and patterned-ZnO were demonstrated with superior performance, much better than conventional SAW devices. Both 2D and 3D models of phononic-crystal-based SAW devices can be respectively fabricated by an array of periodic cylindrical holes and pillars, which allowed SAW devices to have both higher Q-factor and GHz-level frequency. Ring waveguide and spherical SAW devices would have potential applications and implementation in biosensing. ZnO is one of attractive guiding-layer materials. Its nanostructures, such as nanowires, nanorods and nanofibers provided with excellent properties, will make nanoscaled SAW devices contribute to be much more sensitive in biosensors. A range of applications based on SAW and ZnO guiding-layer would be therefore expected among of immunochemical analysis, in-situ virus or bacteria determination, microfluidic automation, and cell manipulation. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Systematic review of the cost-effectiveness of implementing guidelines on low back pain management in primary care

    DEFF Research Database (Denmark)

    Jensen, Cathrine Elgaard; Jensen, Martin Bach; Riis, Allan

    2016-01-01

    be included in a comparison with a Danish implementation study to establish which strategy procures most value for money. DESIGN: Systematic review. DATA SOURCES: The search was conducted in Embase, PubMed, Cochrane Library, NHS Economic Evaluation Database, Scopus, CINAHL and EconLit. No restrictions were...

  6. Implementation factors and their effect on e-Health service adoption in rural communities : a systematic literature review

    NARCIS (Netherlands)

    Hage, M.L.; Roo, J.P.; van Offenbeek, M.A.G.; Boonstra, A.

    2013-01-01

    Background: An ageing population is seen as a threat to the quality of life and health in rural communities, and it is often assumed that e-Health services can address this issue. As successful e-Health implementation in organizations has proven difficult, this systematic literature review considers

  7. Health Informatics in Developing Countries: Going beyond Pilot Practices to Sustainable Implementations: A Review of the Current Challenges.

    Science.gov (United States)

    Luna, Daniel; Almerares, Alfredo; Mayan, John Charles; González Bernaldo de Quirós, Fernán; Otero, Carlos

    2014-01-01

    Information technology is an essential tool to improve patient safety and the quality of care, and to reduce healthcare costs. There is a scarcity of large sustainable implementations in developing countries. The objective of this paper is to review the challenges faced by developing countries to achieve sustainable implementations in health informatics and possible ways to address them. In this non-systematic review of the literature, articles were searched using the keywords medical informatics, developing countries, implementation, and challenges in PubMed, LILACS, CINAHL, Scopus, and EMBASE. The authors, after reading the literature, reached a consensus to classify the challenges into six broad categories. The authors describe the problems faced by developing countries arising from the lack of adequate infrastructure and the ways these can be bypassed; the fundamental need to develop nationwide e-Health agendas to achieve sustainable implementations; ways to overcome public uncertainty with respect to privacy and security; the difficulties shared with developed countries in achieving interoperability; the need for a trained workforce in health informatics and existing initiatives for its development; and strategies to achieve regional integration. Central to the success of any implementation in health informatics is knowledge of the challenges to be faced. This is even more important in developing countries, where uncertainty and instability are common. The authors hope this article will assist policy makers, healthcare managers, and project leaders to successfully plan their implementations and make them sustainable, avoiding unexpected barriers and making better use of their resources.

  8. Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems.

    Science.gov (United States)

    Gooch, Phil; Roudsari, Abdul

    2011-01-01

    There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation 'challenge' themes. One hundred and eight relevant studies were selected for review. Twenty-five underlying 'challenge' themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings.

  9. Barriers to advance care planning at the end of life: an explanatory systematic review of implementation studies.

    Directory of Open Access Journals (Sweden)

    Susi Lund

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

  10. The nursing work of hospital-based clinical practice guideline implementation: an explanatory systematic review using Normalisation Process Theory.

    Science.gov (United States)

    May, Carl; Sibley, Andrew; Hunt, Katherine

    2014-02-01

    To investigate the dynamics of nurses' work in implementing Clinical Practice Guidelines. Hybrid: systematic review techniques used to identify qualitative studies of clinical guideline implementation; theory-led and structured analysis of textual data. CINAHL, CSA Illumina, EMBASE, MEDLINE, PsycINFO, and Sociological Abstracts. Systematic review of qualitative studies of the implementation of Clinical Practice Guidelines, analysed using Directed Content Analysis, and interpreted in the light of Normalisation Process Theory. Seven studies met the inclusion criteria of the review. These revealed that clinical practice guidelines are disposed to normalisation when: (a) They are associated with activities that practitioners can make workable in practice, and practitioners are able to integrate it into their collective workflow. (b) When they are differentiated from existing clinical practice by its proponents, and when claims of differentiation are regarded as legitimate by their potential users. (c) When they are associated with an emergent community of practice, and when members of that community of practice enrol each other into group processes that specify their engagement with it. (d) When they are associated with improvements in the collective knowledge of its users, and when users are able to integrate the application of that knowledge into their individual workflow. And, (e) when nurses can minimise disruption to behaviour norms and agreed professional roles, and mobilise structural and cognitive resources in ways that build shared commitments across professional boundaries. This review demonstrates the feasibility and benefits of theory-led review of studies of nursing practice, and proposes a dynamic model of implementation. Normalisation Process Theory supports the analysis of nursing work. It characterises mechanisms by which work is made coherent and meaningful, is formed around sets of relational commitments, is enacted and contextualised, and is

  11. Implementation and evaluation of a peer review process for advanced practice nurses in a university hospital setting.

    Science.gov (United States)

    Bergum, Shelly K; Canaan, Talitha; Delemos, Christi; Gall, Elizabeth Funke; McCracken, Bonnie; Rowen, Dave; Salvemini, Steve; Wiens, Kimberly

    2017-07-01

    Over the past decade, implementation of the peer review process for the development of the advanced practice nurse (APN) has been emphasized. However, little exists in the literature regarding APN peer review. The peer review process is intended to help demonstrate competency of care, enhance quality improvement measures, and foster the professional growth of the APN. APNs serving on a professional governance council within a university teaching hospital developed a model of peer review for APNs. Nine months after the tool was implemented, an anonymous follow-up survey was conducted. A follow-up request was sent 4 weeks later to increase the number of respondents. Likert scales were used to elicit subjective data regarding the process. Of 81 APNs who participated in the survey, more than half (52%) felt that the process would directly improve their professional practice. Survey results show that the peer review process affected APN professional practice positively. Additional research might include pathways for remediation and education of staff, evaluation of alternate methods to improve application to clinical practice, and collection of outcome data. The models presented provide a foundation for future refinement to accommodate different APN practice settings. ©2017 American Association of Nurse Practitioners.

  12. R&D implementation in a department of laboratory medicine and pathology: a systematic review based on pharmaceutical companies.

    Science.gov (United States)

    Feulefack, Joseph; Sergi, Consolato

    2015-01-01

    A systematic literature review on pharmaceutical companies may be a tool for guiding some procedures of R&D implementation in a department of Laboratory Medicine and Pathology. The use of pharmaceutical companies for this specific analysis arises from less variability of standards than healthcare facilities. In this qualitative and quantitative analysis, we focused on three useful areas of implementation, including R&D productivity, commercialization strategies, and expenditures determinants of pharmaceutical companies. Studies and reports of online databases from 1965 to 2014 were reviewed according to specific search terms. Initially, 218 articles and reports were found and examined, but only 91 were considered appropriate and used for further analysis.  We identified some suggested implementation strategies relevant for marketing to enhance companies' own R&D strategies; such as reliability of companies on "sourcing-in" R&D facilities and "think-tank" events. Regardless of the study and of the country, cash flow and profitability always positively influenced R&D expenditure, while sales and firm size did not. We consider that handling R&D determinants should require caution. It seems critical that implementation of R&D systems is directly related with productivity, if it reflects dual embodiment of efficiency and effectiveness. Scrutinizing the determinants of R&D expenditures emphasizes significant factors that are worth to highlight when planning an R&D investment strategy. Although there is no receipt fitting every situation, we think that health care plan makers may find relevant data in this systematic review in creating an initial implementation framework.

  13. Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review.

    Science.gov (United States)

    Salloum, Ramzi G; Shenkman, Elizabeth A; Louviere, Jordan J; Chambers, David A

    2017-11-23

    One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE) is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science. We conducted a systematic literature search (up to December 2016) of the English literature to identify and describe the use of DCEs in engaging stakeholders as an implementation strategy. We searched the following electronic databases: MEDLINE, Econlit, PsychINFO, and the CINAHL using mesh terms. Studies were categorized according to application type, stakeholder(s), healthcare setting, and implementation outcome. Seventy-five publications were selected for analysis in this systematic review. Studies were categorized by application type: (1) characterizing demand for therapies and treatment technologies (n = 32), (2) comparing implementation strategies (n = 22), (3) incentivizing workforce participation (n = 11), and (4) prioritizing interventions (n = 10). Stakeholders included providers (n = 27), patients (n = 25), caregivers (n = 5), and administrators (n = 2). The remaining studies (n = 16) engaged multiple stakeholders (i.e., combination of patients, caregivers, providers, and/or administrators). The following implementation outcomes were discussed: acceptability (n = 75), appropriateness (n = 34), adoption (n = 19), feasibility (n = 16), and fidelity (n = 3). The number of DCE studies engaging stakeholders as an implementation strategy has been increasing over the past decade. As DCEs are more widely used as a

  14. Development, implementation and evaluation of a peer review of teaching (PRoT) initiative in nursing education.

    Science.gov (United States)

    Mager, Diana R; Kazer, Meredith W; Conelius, Jaclyn; Shea, Joyce; Lippman, Doris T; Torosyan, Roben; Nantz, Kathryn

    2014-06-03

    For many years, an area of research in higher education has been emerging around the development and implementation of fair and effective peer evaluation programs. Recently, a new body of knowledge has developed regarding the development and implementation of fair and effective peer evaluation programs resulting in formative and summative evaluations. The purpose of this article is to describe the development, implementation, and evaluation of a peer review of teaching (PRoT) program for nursing faculty, initiated at one small comprehensive university in the northeastern United States. Pairs of nursing faculty evaluated each other's teaching, syllabi, and course materials after collaborating in a pre-evaluation conference to discuss goals of the classroom visit. Qualitative data gathered in post project focus groups revealed that faculty found their modified PRoT process to be a mutually beneficial experience that was more useful, flexible and collegial, and less stressful than their previous evaluation process.

  15. Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review

    Directory of Open Access Journals (Sweden)

    Leduc Yvan

    2011-04-01

    Full Text Available Abstract Background Electronic health record (EHR implementation is currently underway in Canada, as in many other countries. These ambitious projects involve many stakeholders with unique perceptions of the implementation process. EHR users have an important role to play as they must integrate the EHR system into their work environments and use it in their everyday activities. Users hold valuable, first-hand knowledge of what can limit or contribute to the success of EHR implementation projects. A comprehensive synthesis of EHR users' perceptions is key to successful future implementation. This systematic literature review was aimed to synthesize current knowledge of the barriers and facilitators influencing shared EHR implementation among its various users. Methods Covering a period from 1999 to 2009, a literature search was conducted on nine electronic databases. Studies were included if they reported on users' perceived barriers and facilitators to shared EHR implementation, in healthcare settings comparable to Canada. Studies in all languages with an empirical study design were included. Quality and relevance of the studies were assessed. Four EHR user groups were targeted: physicians, other health care professionals, managers, and patients/public. Content analysis was performed independently by two authors using a validated extraction grid with pre-established categorization of barriers and facilitators for each group of EHR users. Results Of a total of 5,695 potentially relevant publications identified, 117 full text publications were obtained after screening titles and abstracts. After review of the full articles, 60 publications, corresponding to 52 studies, met the inclusion criteria. The most frequent adoption factors common to all user groups were design and technical concerns, ease of use, interoperability, privacy and security, costs, productivity, familiarity and ability with EHR, motivation to use EHR, patient and health

  16. Implementing family involvement in the treatment of patients with psychosis: a systematic review of facilitating and hindering factors

    OpenAIRE

    Eassom, Erica; Giacco, Domenico; Dirik, Aysegul; Priebe, Stefan

    2014-01-01

    Objective To synthesise the evidence on implementing family involvement in the treatment of patients with psychosis with a focus on barriers, problems and facilitating factors. Design Systematic review of studies evaluating the involvement of families in tripartite communication between health professionals, ‘families’ (or other unpaid carers) and adult patients, in a single-family context. A theoretical thematic analysis approach and thematic synthesis were used. Data sources A systematic el...

  17. A systematic review of the outcomes of educational interventions relevant to nurses with simultaneous strategies for guideline implementation.

    Science.gov (United States)

    Häggman-Laitila, Arja; Mattila, Lea-Riitta; Melender, Hanna-Leena

    2017-02-01

    To systematically review the literature on the outcomes of educational interventions relevant to nurses with regard to guideline implementation. Previous reviews on interventions to implement guidelines have focused on particular clinical problems, but only one included nursing studies. A systematic review based on the procedure of the Centre for Reviews and Dissemination. We searched for papers published from 1 January 2008 to 26 February 2015 using the Cochrane, CINAHL and PubMed MEDLINE databases and paper references were searched manually. Quality appraisal was conducted with tools developed by Thomas et al.(Worldviews on Evidence-based Nursing, 1, 2004, 176) and National Heart, Lung, and Blood Institute. Data were analysed with qualitative content analysis and narrative synthesis. The data included 13 studies based on a quasi-experimental study design of 13 different educational interventions, described according to their development and realisation, learning content and teaching and learning methods. Seven interventions were supported by simultaneous strategies, 12 studies reported statistically significant outcomes for the interventions on at least one measurement area and six studies reported improvements in the quality of patient care. Interventions with multi-dimensional content, teaching and learning methods produced several good outcomes. Guidelines were implemented in a heterogeneous way and the interventions were delivered once and mainly on a local basis. In the future, we need to test these interventions in different nursing contexts, measure the outcomes on patient care and carry out randomised controlled trials on their effectiveness. It is important to standardise interventions, as this will allow them to be replicated and compared. Educational interventions to implement guidelines could be beneficial in enhancing nurses' evidence-based decision-making and care practice. The combination of teaching and learning methods proved useful, and

  18. The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review.

    Science.gov (United States)

    Sarkies, Mitchell N; Bowles, Kelly-Ann; Skinner, Elizabeth H; Haas, Romi; Lane, Haylee; Haines, Terry P

    2017-11-14

    It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors. An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data. After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles) met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles) were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A unidirectional, hierarchal flow was described from (1

  19. The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review

    Directory of Open Access Journals (Sweden)

    Mitchell N. Sarkies

    2017-11-01

    Full Text Available Abstract Background It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors. Methods An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data. Results After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A

  20. ACC/AHA Special Report: Clinical Practice Guideline Implementation Strategies: A Summary of Systematic Reviews by the NHLBI Implementation Science Work Group: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

    Science.gov (United States)

    Chan, Wiley V; Pearson, Thomas A; Bennett, Glen C; Cushman, William C; Gaziano, Thomas A; Gorman, Paul N; Handler, Joel; Krumholz, Harlan M; Kushner, Robert F; MacKenzie, Thomas D; Sacco, Ralph L; Smith, Sidney C; Stevens, Victor J; Wells, Barbara L; Castillo, Graciela; Heil, Susan K R; Stephens, Jennifer; Vann, Julie C Jacobson

    2017-02-28

    In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines. This systematic review was conducted on 4 critical questions, each focusing on the adoption and effectiveness of 4 intervention strategies: (1) reminders, (2) educational outreach visits, (3) audit and feedback, and (4) provider incentives. A scoping review of the Rx for Change database of systematic reviews was used to identify promising guideline implementation interventions aimed at providers. Inclusion and exclusion criteria were developed a priori for each question, and the published literature was initially searched up to 2012, and then updated with a supplemental search to 2015. Two independent reviewers screened the returned citations to identify relevant reviews and rated the quality of each included review. Audit and feedback and educational outreach visits were generally effective in improving both process of care (15 of 21 reviews and 12 of 13 reviews, respectively) and clinical outcomes (7 of 12 reviews and 3 of 5 reviews, respectively). Provider incentives showed mixed effectiveness for improving both process of care (3 of 4 reviews) and clinical outcomes (3 reviews equally distributed between generally effective, mixed, and generally ineffective). Reminders showed mixed effectiveness for improving process of care outcomes (27 reviews with 11 mixed and 3 generally ineffective results) and were generally ineffective for clinical outcomes (18 reviews with 6 mixed and 9 generally ineffective results). Educational outreach visits (2 of 2

  1. The Perception of Malaysian Architects towards the Implementation of Green Roofs: A Review of Practices, Methodologies and Future Research

    Directory of Open Access Journals (Sweden)

    Zahir M.H. Md.

    2014-01-01

    Full Text Available The implementation of green roofs or vegetated roof as a sustainable tool to mitigate the Urban Heat Island effect is relatively new in Malaysia. Although it has not been tested on an urban scale, many research findings have indicated that green roofs can contribute towards enhancing the environmental and aesthetical quality of the built environment. It was hypothesized that the low application of green roofs in the Malaysian construction industry is due to the lack of awareness, understanding and experience in its benefits especially among building practitioners. As a result, this research was initiated to determine the perception and understanding of Malaysian architects in green roofs implementation issues, as well as to identify their level of acceptance and readiness. This paper reviews practices and different research approaches in understanding the factors that influence architect’s perception towards the implementation of green roofs in the Malaysian construction industry. Architects were chosen as the only respondents due to their intensive involvement in the conceptualisation, planning, design and construction stage of a built environment project. Extensive literature review was conducted to explore past experiences in green roof implementation and to develop the theoretical framework for this research.

  2. Leaders' experiences and perceptions implementing activity-based funding and pay-for-performance hospital funding models: A systematic review.

    Science.gov (United States)

    Baxter, Pamela E; Hewko, Sarah J; Pfaff, Kathryn A; Cleghorn, Laura; Cunningham, Barbara J; Elston, Dawn; Cummings, Greta G

    2015-08-01

    Providing cost-effective, accessible, high quality patient care is a challenge to governments and health care delivery systems across the globe. In response to this challenge, two types of hospital funding models have been widely implemented: (1) activity-based funding (ABF) and (2) pay-for-performance (P4P). Although health care leaders play a critical role in the implementation of these funding models, to date their perspectives have not been systematically examined. The purpose of this systematic review was to gain a better understanding of the experiences of health care leaders implementing hospital funding reforms within Organisation for Economic Cooperation and Development countries. We searched literature from 1982 to 2013 using: Medline, EMBASE, CINAHL, Academic Search Complete, Academic Search Elite, and Business Source Complete. Two independent reviewers screened titles, abstracts and full texts using predefined criteria. We included 2 mixed methods and 12 qualitative studies. Thematic analysis was used in synthesizing results. Five common themes and multiple subthemes emerged. Themes include: pre-requisites for success, perceived benefits, barriers/challenges, unintended consequences, and leader recommendations. Irrespective of which type of hospital funding reform was implemented, health care leaders described a complex process requiring the following: organizational commitment; adequate infrastructure; human, financial and information technology resources; change champions and a personal commitment to quality care. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Barriers and facilitators to implementing family support and education in Early Psychosis Intervention programmes: A systematic review.

    Science.gov (United States)

    Selick, Avra; Durbin, Janet; Vu, Nhi; O'Connor, Karen; Volpe, Tiziana; Lin, Elizabeth

    2017-10-01

    Family support is a core component of the Early Psychosis Intervention (EPI) model, yet it continues to have relatively low rates of implementation in practice. This paper reports results of a literature review on facilitators and barriers to delivering family interventions in EPI programmes. A search was conducted of 4 electronic databases, Medline, EMBASE, PsycINFO and Joanna Briggs, from 2000 to 2015 using terms related to early onset psychosis, family work and implementation. Four thousand four hundred and two unique studies were identified, 7 of which met inclusion criteria. Barriers and facilitators were coded and aggregated to higher-level themes using a consensus approach. Five of 7 studies examined structured multifamily psychoeducation. Uptake by families was affected by: family/client interest and readiness to participate; ability to access supports; and support needs/preferences. Implementation by programmes was affected by staff access to training and resources to provide family support. A key finding across the identified studies was that families have different needs and preferences regarding the timing, length, intensity and content of the intervention. One size does not fit all and many families do not require the intensive psychoeducational programmes typically provided. The reviewed literature suggests that flexible, tiered approaches to care may better meet family needs and increase rates of uptake of family support. However, more research is needed on the effectiveness of different models of family support in early psychosis and how they can be successfully implemented. © 2017 John Wiley & Sons Australia, Ltd.

  4. Systematic review of qualitative literature on occupational health and safety legislation and regulatory enforcement planning and implementation.

    Science.gov (United States)

    MacEachen, Ellen; Kosny, Agnieszka; Ståhl, Christian; O'Hagan, Fergal; Redgrift, Lisa; Sanford, Sarah; Carrasco, Christine; Tompa, Emile; Mahood, Quenby

    2016-01-01

    The ability of occupational health and safety (OHS) legislation and regulatory enforcement to prevent workplace injuries and illnesses is contingent on political, economic, and organizational conditions. This systematic review of qualitative research articles considers how OHS legislation and regulatory enforcement are planned and implemented. A comprehensive search of peer-reviewed, English-language articles published between 1990 and 2013 yielded 11 947 articles. We identified 34 qualitative articles as relevant, 18 of which passed our quality assessment and proceeded to meta-ethnographic synthesis. The synthesis yielded four main themes: OHS regulation formation, regulation challenges, inspector organization, and worker representation in OHS. It illuminates how OHS legislation can be based on normative suppositions about worker and employer behavior and shaped by economic and political resources of parties. It also shows how implementation of OHS legislation is affected by "general duty" law, agency coordination, resourcing of inspectorates, and ability of workers to participate in the system. The review identifies methodological gaps and identifies promising areas for further research in "grey" zones of legislation implementation.

  5. Implementing the Free Water Protocol does not Result in Aspiration Pneumonia in Carefully Selected Patients with Dysphagia: A Systematic Review.

    Science.gov (United States)

    Gillman, Anna; Winkler, Renata; Taylor, Nicholas F

    2017-06-01

    The Frazier Free Water Protocol was developed with the aim of providing patients with dysphagia an option to consume thin (i.e. unthickened) water in-between mealtimes. A systematic review was conducted of research published in peer-reviewed journals. An electronic search of the EMBASE, CINAHL and MEDLINE databases was completed up to July 2016. A total of 8 studies were identified for inclusion: 5 randomised controlled trials, 2 cohort studies with matched cases and 1 single group pre-post intervention prospective study. A total of 215 rehabilitation inpatients and 30 acute patients with oropharyngeal dysphagia who required thickened fluids or were to remain 'nil by mouth', as determined by bedside swallow assessment and/or videofluoroscopy/fiberoptic endoscopic evaluation of swallowing, were included. Meta-analyses of the data from the rehabilitation studies revealed (1) low-quality evidence that implementing the protocol did not result in increased odds of having lung complications and (2) low-quality evidence that fluid intake may increase. Patients' perceptions of swallow-related quality of life appeared to improve. This review has found that when the protocol is closely adhered to and patients are carefully selected using strict exclusion criteria, including an evaluation of their cognition and mobility, adult rehabilitation inpatients with dysphagia to thin fluids can be offered the choice of implementing the Free Water Protocol. Further research is required to determine if the Free Water Protocol can be implemented in settings other than inpatient rehabilitation.

  6. Five years after implementation: A review of the Irish Mental Health Act 2001.

    LENUS (Irish Health Repository)

    Ramsay, Hugh

    2013-01-01

    The Mental Health Act 2001 (MHA 2001) was implemented in November 2006. Since that time, there has been considerable research into its impact, including the impact on service provision, use of coercive practices and the perceptions by key stakeholders. Our objective is to present a summary of research into the MHA 2001 since its implementation in the Irish state in the context of international standards and practice.

  7. Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK

    Directory of Open Access Journals (Sweden)

    Pearson Mark

    2012-10-01

    Full Text Available Abstract Background School-based interventions and campaigns are used to promote health and address a wide variety of public health problems. Schools are considered to be key sites for the implementation of health promotion programmes for their potential to reach the whole population in particular age-groups and instil healthy patterns of behavior early in life. However, evidence for the effectiveness of school-based health promotion interventions is highly variable. Systematic reviews of the evidence of school-based interventions tend to be highly problem- or intervention- specific, thereby missing potential generic insights into implementation and effectiveness of such programmes across problems. Methods/design A realist systematic review will be undertaken to explain how, why and in what circumstances schools can provide feasible settings for effective health promotion programmes in the United Kingdom (UK. The review will be conducted in two phases. Phase 1 will identify programme theories about implementation (ideas about what enables or inhibits effective health promotion to be delivered in a school setting. Phase 2 will test the programme theories so that they can be challenged, endorsed and/or refined. A Review Advisory Group of education and health professionals will be convened to help identify and choose potential programme theories, provide a ‘reality check’ on the clarity and explanatory strength of the mechanisms to be tested, and help shape the presentation of findings to be usable by practitioners and decision-makers. Review findings will be disseminated through liaison with decision-makers, and voluntary and professional groups in the fields of education and health.

  8. The current state of Lean implementation in health care: literature review.

    Science.gov (United States)

    Poksinska, Bozena

    2010-01-01

    The purpose of this article is to discuss the current state of implementation of Lean production in health care. The study focuses on the definition of Lean in health care and implementation process, barriers, challenges, enablers, and outcomes of implementing Lean production methods in health care. A comprehensive search of the literature concerning the implementation of Lean production in health care was used to generate a synthesis of the literature around the chosen research questions. Lean production in health care is mostly used as a process improvement approach and focuses on 3 main areas: (1) defining value from the patient point of view, (2) mapping value streams, and (3) eliminating waste in an attempt to create continuous flow. Value stream mapping is the most frequently applied Lean tool in health care. The usual implementation steps include conducting Lean training, initiating pilot projects, and implementing improvements using interdisciplinary teams. One of the barriers is lack of educators and consultants who have their roots in the health care sector and can provide support by sharing experience and giving examples from real-life applications of Lean in health care. The enablers of Lean in health care seem not to be different from the enablers of any other change initiative. The outcomes can be divided into 2 broad areas: the performance of the health care system and the development of employees and work environment.

  9. PROJECT W-551 INTERIM PRETREATMENT SYSTEM TECHNOLOGY SELECTION SUMMARY DECISION REPORT AND RECOMMENDATION

    Energy Technology Data Exchange (ETDEWEB)

    CONRAD EA

    2008-08-12

    This report provides the conclusions of the tank farm interim pretreatment technology decision process. It documents the methodology, data, and results of the selection of cross-flow filtration and ion exchange technologies for implementation in project W-551, Interim Pretreatment System. This selection resulted from the evaluation of specific scope criteria using quantitative and qualitative analyses, group workshops, and technical expert personnel.

  10. PROJECT W-551 INTERIM PRETREATMENT SYSTEM TECHNOLOGY SELECTION SUMMARY DECISION REPORT AND RECOMMENDATION

    International Nuclear Information System (INIS)

    CONRAD EA

    2008-01-01

    This report provides the conclusions of the tank farm interim pretreatment technology decision process. It documents the methodology, data, and results of the selection of cross-flow filtration and ion exchange technologies for implementation in project W-551, Interim Pretreatment System. This selection resulted from the evaluation of specific scope criteria using quantitative and qualitative analyses, group workshops, and technical expert personnel

  11. Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework.

    Science.gov (United States)

    Iwelunmor, Juliet; Blackstone, Sarah; Veira, Dorice; Nwaozuru, Ucheoma; Airhihenbuwa, Collins; Munodawafa, Davison; Kalipeni, Ezekiel; Jutal, Antar; Shelley, Donna; Ogedegebe, Gbenga

    2016-03-23

    Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions implemented in sub-Saharan Africa are sustained. The purpose of this study was to conduct a systematic review of empirical literature to explore how health interventions implemented in SSA are sustained. We searched MEDLINE, Biological Abstracts, CINAHL, Embase, PsycInfo, SCIELO, Web of Science, and Google Scholar for available research investigating the sustainability of health interventions implemented in sub-Saharan Africa. We also used narrative synthesis to examine factors whether positive or negative that may influence the sustainability of health interventions in the region. The search identified 1819 citations, and following removal of duplicates and our inclusion/exclusion criteria, only 41 papers were eligible for inclusion in the review. Twenty-six countries were represented in this review, with Kenya and Nigeria having the most representation of available studies examining sustainability. Study dates ranged from 1996 to 2015. Of note, majority of these studies (30 %) were published in 2014. The most common framework utilized was the sustainability framework, which was discussed in four of the studies. Nineteen out of 41 studies (46 %) reported sustainability outcomes focused on communicable diseases, with HIV and AIDS represented in majority of the studies, followed by malaria. Only 21 out of 41 studies had clear definitions of sustainability. Community ownership and mobilization were recognized by many of the reviewed studies as crucial facilitators for intervention sustainability, both early on and after intervention implementation, while social and ecological conditions as well as societal upheavals were barriers that influenced the sustainment

  12. Teaching Lifelong Research Skills in Residency: Implementation and Outcome of a Systematic Review and Meta-Analysis Course.

    Science.gov (United States)

    Himelhoch, Seth; Edwards, Sarah; Ehrenreich, Mark; Luber, M Philip

    2015-09-01

    There is rising concern that fundamental scientific principles critical to lifelong learning and scientific literacy are not sufficiently addressed during residency. We describe the development, implementation, and evaluation of a systematic review and meta-analysis course designed to improve residents' research literacy. We developed and implemented a novel, interactive, web-enhanced course for third-year psychiatry residents to provide the theoretical and methodological tools for conducting and reporting systematic reviews and meta-analyses. The course is based on Bloom's learning model, and established criteria for reporting systematic reviews and meta-analyses. Eight sequential learning objectives were linked to 8 well-specified assignments, with the objectives designed to build on one another and lead to the creation of a scientific manuscript. From 2010-2014, 54 third-year psychiatry residents (19 unique groups) successfully completed the course as part of a graduation requirement. The majority rated the course as being good or very good, and participants reported a statistically significant increase in their confidence to conduct systematic reviews (χ(2) = 23.3, P learning experience, which enhances residents' research skills and academic productivity in a feasible and sustainable approach.

  13. Woody biomass pretreatment for cellulosic ethanol production: Technology and energy consumption evaluation.

    Science.gov (United States)

    Zhu, J Y; Pan, X J

    2010-07-01

    This review presents a comprehensive discussion of the key technical issues in woody biomass pretreatment: barriers to efficient cellulose saccharification, pretreatment energy consumption, in particular energy consumed for wood-size reduction, and criteria to evaluate the performance of a pretreatment. A post-chemical pretreatment size-reduction approach is proposed to significantly reduce mechanical energy consumption. Because the ultimate goal of biofuel production is net energy output, a concept of pretreatment energy efficiency (kg/MJ) based on the total sugar recovery (kg/kg wood) divided by the energy consumption in pretreatment (MJ/kg wood) is defined. It is then used to evaluate the performances of three of the most promising pretreatment technologies: steam explosion, organosolv, and sulfite pretreatment to overcome lignocelluloses recalcitrance (SPORL) for softwood pretreatment. The present study found that SPORL is the most efficient process and produced highest sugar yield. Other important issues, such as the effects of lignin on substrate saccharification and the effects of pretreatment on high-value lignin utilization in woody biomass pretreatment, are also discussed. Published by Elsevier Ltd.

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

    Science.gov (United States)

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

    2015-04-09

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

  15. Atrial fibrillation screening in pharmacies using an iPhone ECG: a qualitative review of implementation.

    Science.gov (United States)

    Lowres, Nicole; Krass, Ines; Neubeck, Lis; Redfern, Julie; McLachlan, Andrew J; Bennett, Alexandra A; Freedman, S Ben

    2015-12-01

    Atrial fibrillation guidelines advocate screening to identify undiagnosed atrial fibrillation. Community pharmacies may provide an opportunistic venue for such screening. To explore the experience of implementing an atrial fibrillation screening service from the pharmacist's perspective including: the process of study implementation; the perceived benefits; the barriers and enablers; and the challenges for future sustainability of atrial fibrillation screening within pharmacies. Setting Interviews were conducted face-to-face in the pharmacy or via telephone, according to pharmacist preference. The 'SEARCH-AF study' screened 1000 pharmacy customers aged ≥65 years using an iPhone electrocardiogram, identifying 1.5 % with undiagnosed atrial fibrillation. Nine pharmacists took part in semi-structured interviews. Interviews were transcribed in full and thematically analysed. Qualitative analysis of the experience of implementing an AF screening service from the pharmacist's perspective. Four broad themes relating to service provision were identified: (1) interest and engagement in atrial fibrillation screening by pharmacists, customers, and doctors with the novel, easy-to-use electrocardiogram technology serving as an incentive to undergo screening and an education tool for pharmacists to use with customers; (2) perceived benefits to the pharmacist including increased job satisfaction, improvement in customer relations and pharmacy profile by fostering enhanced customer care and the educational role of pharmacists; (3) implementation barriers including managing workflow, and enablers such as personal approaches for recruitment, and allocating time to discuss screening process and fears; and, (4) potential for sustainable future implementation including remuneration linked to government or pharmacy incentives, combined cardiovascular screening, and automating sections of risk-assessments using touch-screen technology. Atrial fibrillation screening in pharmacies is well

  16. Low Maintenance Water Treatment for Heating and Cooling Systems: Review of Technologies and Guidelines for Implementation

    National Research Council Canada - National Science Library

    Smothers, Kent W; Drozdz, Susan A; Hock, Vincent F

    2007-01-01

    .... To be "smart buyers" of these products, Army installations require periodic technology reviews to stay informed about advances and new capabilities of water treatment products available in the marketplace...

  17. Oral health care in older people in long term care facilities: a systematic review of implementation strategies.

    Science.gov (United States)

    Weening-Verbree, L; Huisman-de Waal, G; van Dusseldorp, L; van Achterberg, T; Schoonhoven, L

    2013-04-01

    Oral hygiene is necessary to maintain oral health and quality of life. However, the oral hygiene and the oral health care of older people in long term care facilities are poor. This indicates that care is not in compliance with the available guidelines and protocols, and stresses the importance of a clear evidence-based implementation strategy to improve oral health care. The aim of this study is to review implementation strategies used to promote or improve oral health care for older people in long term care facilities from the perspective of behaviour change, to code strategy content at the level of determinants, and to explore their effectiveness. Systematic review of literature. The digital databases of the Cochrane Library, PubMed and Cinahl have been searched up to September 2011 for relevant articles. After a systematic selection process, included studies were quality assessed by three researchers. We extracted the study characteristics using the EPOC Data Collection Checklist and Data Abstraction Form. Strategy content was extracted and coded by using the Coding Manual for Behavioural Change Techniques. This manual groups the behaviour change techniques under relevant behavioural determinants. Twenty studies were included in this review. Implementation strategies were delivered by dental hygienists or dentists. Oral health care was performed by nurses and nurse assistants in all studies. All studies addressed knowledge, mostly operationalized as one educational session. Knowledge was most often combined with interventions addressing self efficacy. Implementation strategies aimed at knowledge (providing general information), self-efficacy (modelling) or facilitation of behaviour (providing materials to facilitate behaviour) were most often identified as successful in improving oral health. Knowledge, self-efficacy and facilitation of behaviour are determinants that are often addressed in implementation strategies for successful improvement of oral health

  18. Knowledge Management Implementation and the Tools Utilized in Healthcare for Evidence-Based Decision Making: A Systematic Review.

    Science.gov (United States)

    Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

    2017-09-01

    Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare". It was found that utilization of knowledge management in healthcare is encouraging. There exist numbers of opportunities for knowledge management implementation, though there are some barriers as well. Some of the opportunities that can transform healthcare are advances in health information and communication technology, clinical decision support systems, electronic health record systems, communities of practice and advanced care planning. Providing the right knowledge at the right time, i.e., at the point of decision making by implementing knowledge management in healthcare is paramount. To do so, it is very important to use appropriate tools for knowledge management and user-friendly system because it can significantly improve the quality and safety of care provided for patients both at hospital and home settings.

  19. 75 FR 78883 - Implementation of Additional Changes From the Annual Review of the Entity List

    Science.gov (United States)

    2010-12-17

    ... located in Canada, Egypt, Germany, Hong Kong, Israel, Kuwait, Lebanon, Malaysia, South Korea, Singapore..., Malaysia, South Korea, Singapore, and the United Kingdom. The second rule, published today, implements the... effect under the International Emergency Economic Powers Act. Rulemaking Requirements 1. This rule has...

  20. Implementation of intersectoral community approaches targeting childhood obesity: a systematic review

    NARCIS (Netherlands)

    van der Kleij, R.; Coster, N.; Verbiest, M.; van Assema, P.; Paulussen, T.; Reis, R.; Crone, M.

    2015-01-01

    The implementation of intersectoral community approaches targeting childhood obesity (IACO) is considered challenging. To help overcome these challenges, an overview of the evidence to date is needed. We searched four databases to identify papers that reported on the determinants of successful

  1. Teacher Competencies for the Implementation of Collaborative Learning in the Classroom: A Framework and Research Review

    Science.gov (United States)

    Kaendler, Celia; Wiedmann, Michael; Rummel, Nikol; Spada, Hans

    2015-01-01

    This article describes teacher competencies for implementing collaborative learning in the classroom. Research has shown that the effectiveness of collaborative learning largely depends on the quality of student interaction. We therefore focus on what a "teacher" can do to foster student interaction. First, we present a framework that…

  2. A Literature Review of Indexing and Searching Techniques Implementation in Educational Search Engines

    Science.gov (United States)

    El Guemmat, Kamal; Ouahabi, Sara

    2018-01-01

    The objective of this article is to analyze the searching and indexing techniques of educational search engines' implementation while treating future challenges. Educational search engines could greatly help in the effectiveness of e-learning if used correctly. However, these engines have several gaps which influence the performance of e-learning…

  3. 77 FR 35862 - Approval and Promulgation of Implementation Plans; State of Florida: New Source; Review...

    Science.gov (United States)

    2012-06-15

    ...: Final rule. SUMMARY: EPA is taking final action to approve changes to the Florida State Implementation... taking final action to approve changes to the Florida SIP such that it is consistent with federal.... EPA notes that Florida's October 19, 2007, SIP submission makes clarifying changes to rule 62-212.400...

  4. The Essence Of Government Shares Subscription A Review The Implementation Of State-Owned Enterprises

    Directory of Open Access Journals (Sweden)

    Urbanisasi

    2015-08-01

    Full Text Available The purpose of this study was to determine and explain the mechanisms and the implementation of government share subscription in the implementation of SOEs legal standing of the government shares subscription in the implementation of the state budget that separated in the implementation of SOEs and its legal implications of state loss or not and also legal accountability for losses arising out of shares subscription of SOE. In this study the authors use normative legal research. The data obtained in this study will be analyzed using qualitative normative method with inductive logic. Results from the study indicate that state shares subscription in the establishment of SOE or limited company with funds derived from State Budget are separated. Thus the government no longer has any authority in the field of civil law as a business entity. A clear separation of the status of country as business and as government organizer carries consequences. With the separation then there is clarity about the concept of the state financial losses. SOE as one form of business entity that aim to make a profit is a separate legal entity and has responsibilities that are separately anyway though formed and capital originating from the state finances and the loss of one transaction or in legal entity cannot be categorized as a state finance loss because the state has functioned as a private legal entity.

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

    Science.gov (United States)

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

    2017-06-21

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

  6. Implementing China's circular economy concept at the regional level: a review of progress in Dalian, China.

    Science.gov (United States)

    Geng, Yong; Zhu, Qinghua; Doberstein, Brent; Fujita, Tsuyoshi

    2009-02-01

    The circular economy (CE) concept was introduced in China to address environmental degradation and resource scarcity associated with rapid economic development. Chosen as a demonstration city, Dalian has implemented the CE strategy as a means of conserving water, materials, energy and land. This paper outlines some of the regional CE initiatives that have been successful to date in Dalian, including those focusing on conserving energy and water resources and others focusing on reduced industrial emissions. The paper details the approach used in implementing the CE concept in Dalian, tracing the foci and goals of the program, and the sectoral approach used to implement a CE. Although Dalian municipality has achieved many successes in implementing a CE, our paper identifies several challenges that, until recently, have held back complete implementation. These include: the lack of incentives for older industries to 'green' their operations, the lack of financial support to expand the CE concept, and a broad-based need for heightened public awareness and participation in CE initiatives. Our paper then identifies several responses by Dalian municipality to overcome these challenges, including pricing and tax reforms that serve as conservation incentives, the provision of financial support for CE promotion through budget reorganization, and the organization of CE training programs. Our paper concludes that, although CE initiatives have been successful in Dalian, more is possible and more is needed before Dalian can be designated a true 'eco-city'. The approach used by Dalian can provide guidance for other Chinese cities, although it is recognized that each city must tailor its own approach for differing contexts and conditions.

  7. Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

    Directory of Open Access Journals (Sweden)

    Thierry Hurlimann

    Full Text Available The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc. contexts.The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise.A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications.The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented.The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these

  8. Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review

    Science.gov (United States)

    Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo

    2017-01-01

    Background The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. Aim The goal of this scoping review is to delineate and “map” the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. Methods A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O’Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. Results The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. Discussion The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this

  9. Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

    Science.gov (United States)

    Hurlimann, Thierry; Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo; Godard, Béatrice

    2017-01-01

    The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues

  10. A Qualitative Assessment of Current CCF Guidance Based on a Review of Safety System Digital Implementation Changes with Evolving Technology

    Energy Technology Data Exchange (ETDEWEB)

    Korsah, Kofi [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Muhlheim, Michael David [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wood, Richard [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-04-01

    The US Nuclear Regulatory Commission (NRC) is initiating a new rulemaking project to develop a digital system common-cause failure (CCF) rule. This rulemaking will review and modify or affirm the NRC's current digital system CCF policy as discussed in the Staff Requirements Memorandum to the Secretary of the Commission, Office of the NRC (SECY) 93-087, Policy, Technical, and Licensing Issues Pertaining to Evolutionary and Advanced Light Water Reactor (ALWR) Designs, and Branch Technical Position (BTP) 7-19, Guidance on Evaluation of Defense-in-Depth and Diversity in Digital Computer-Based Instrumentation and Control Systems, as well as Chapter 7, Instrumentation and Controls, in NRC Regulatory Guide (NUREG)-0800, Standard Review Plan for Review of Safety Analysis Reports for Nuclear Power Plants (ML033580677). The Oak Ridge National Laboratory (ORNL) is providing technical support to the NRC staff on the CCF rulemaking, and this report is one of several providing the technical basis to inform NRC staff members. For the task described in this report, ORNL examined instrumentation and controls (I&C) technology implementations in nuclear power plants in the light of current CCF guidance. The intent was to assess whether the current position on CCF is adequate given the evolutions in digital safety system implementations and, if gaps in the guidance were found, to provide recommendations as to how these gaps could be closed.

  11. GIS-based multicriteria municipal solid waste landfill suitability analysis: a review of the methodologies performed and criteria implemented.

    Science.gov (United States)

    Demesouka, O E; Vavatsikos, A P; Anagnostopoulos, K P

    2014-04-01

    Multicriteria spatial decision support systems (MC-SDSS) have emerged as an integration of the geographical information systems (GIS) and multiple criteria decision analysis (MCDA) methods. GIS-based MCDA allows the incorporation of conflicting objectives and decision maker (DM) preferences into spatial decision models. During recent decades, a variety of research articles have been published regarding the implementation of methods and/or tools in a variety of real-world case studies. The article discusses, in detail, the criteria and methods that are implemented in GIS-based landfill siting suitability analysis and especially the exclusionary and non-exclusionary criteria that can be considered when selecting sites for municipal solid waste (MSW) landfills. This paper reviews 36 seminal articles in which the evaluation of candidate landfill sites is conducted using MCDA methods. After a brief description of the main components of a MC-SDSS and the applied decision rules, the review focuses on the criteria incorporated into the decision models. The review provides a comprehensive guide to the landfill siting analysis criteria, providing details regarding the utilization methods, their decision or exclusionary nature and their monotonicity.

  12. A Qualitative Assessment of Current CCF Guidance Based on a Review of Safety System Digital Implementation Changes with Evolving Technology

    International Nuclear Information System (INIS)

    Korsah, Kofi; Muhlheim, Michael David; Wood, Richard

    2016-01-01

    The US Nuclear Regulatory Commission (NRC) is initiating a new rulemaking project to develop a digital system common-cause failure (CCF) rule. This rulemaking will review and modify or affirm the NRC's current digital system CCF policy as discussed in the Staff Requirements Memorandum to the Secretary of the Commission, Office of the NRC (SECY) 93-087, Policy, Technical, and Licensing Issues Pertaining to Evolutionary and Advanced Light Water Reactor (ALWR) Designs, and Branch Technical Position (BTP) 7-19, Guidance on Evaluation of Defense-in-Depth and Diversity in Digital Computer-Based Instrumentation and Control Systems, as well as Chapter 7, Instrumentation and Controls, in NRC Regulatory Guide (NUREG)-0800, Standard Review Plan for Review of Safety Analysis Reports for Nuclear Power Plants (ML033580677). The Oak Ridge National Laboratory (ORNL) is providing technical support to the NRC staff on the CCF rulemaking, and this report is one of several providing the technical basis to inform NRC staff members. For the task described in this report, ORNL examined instrumentation and controls (I&C) technology implementations in nuclear power plants in the light of current CCF guidance. The intent was to assess whether the current position on CCF is adequate given the evolutions in digital safety system implementations and, if gaps in the guidance were found, to provide recommendations as to how these gaps could be closed.

  13. Effectiveness of implementation strategies in improving physician adherence to guideline recommendations in heart failure: a systematic review protocol.

    Science.gov (United States)

    Van Spall, Harriette G C; Shanbhag, Deepti; Gabizon, Itzhak; Ibrahim, Quazi; Graham, Ian D; Harlos, Karen; Haynes, R Brian; Connolly, Stuart J

    2016-03-31

    The uptake of Clinical Practice Guideline (CPG) recommendations that improve outcomes in heart failure (HF) remains suboptimal. We will conduct a systematic review to identify implementation strategies that improve physician adherence to class I recommendations, those with clear evidence that benefits outweigh the risks. We will use American, Canadian and European HF guidelines as our reference. We will conduct a literature search in the databases of MEDLINE, EMBASE, HEALTHSTAR, CINAHL, Cochrane Library, Campbell Collaboration, Joanna Briggs Institute Evidence Based Practice, Centre for Reviews and Dissemination and Evidence Based Practice Centres. We will include prospective studies evaluating implementation interventions aimed at improving uptake of class I CPG recommendations in HF. We will extract data in duplicate. We will classify interventions according to their level of application (ie, provider, organisation, systems level) and common underlying characteristics (eg, education, decision-support, financial incentives) using the Cochrane Effective Practice and Organisation of Care Taxonomy. We will assess the impact of the intervention on adherence to the CPGs. Outcomes will include proportion of eligible patients who were: prescribed a CPG-recommended pharmacological treatment; referred for device consideration; provided self-care education at discharge; and provided left ventricular function assessment. We will include clinical outcomes such as hospitalisations, readmissions and mortality, if data is available. We will identify the common elements of successful and failing interventions, and examine the context in which they were applied, using the Process Redesign contextual framework. We will synthesise the results narratively and, if appropriate, will pool results for meta-analysis. In this review, we will assess the impact of implementation strategies and contextual factors on physician adherence to HF CPGs. We will explore why some interventions may

  14. A systematic review of qualitative evidence on barriers and facilitators to the implementation of task-shifting in midwifery services.

    Science.gov (United States)

    Colvin, Christopher J; de Heer, Jodie; Winterton, Laura; Mellenkamp, Milagros; Glenton, Claire; Noyes, Jane; Lewin, Simon; Rashidian, Arash

    2013-10-01

    to synthesise qualitative research on task-shifting to and from midwives to identify barriers and facilitators to successful implementation. systematic review of qualitative evidence using a 4-stage narrative synthesis approach. We searched the CINAHL, Medline and the Social Science Citation Index databases. Study quality was assessed and evidence was synthesised using a theory-informed comparative case-study approach. midwifery services in any setting in low-, middle-, and high-income countries. midwives, nurses, doctors, patients, community members, policymakers, programme managers, community health workers, doulas, traditional birth attendants and other stakeholders. task shifting to and from midwives. thirty-seven studies were included. Findings were organised under three broad themes: (1) challenges in defining and defending the midwifery model of care during task shifting, (2) training, supervision and support challenges in midwifery task shifting, and (3) teamwork and task shifting. this is the first review to report implementation factors associated with midwifery task shifting and optimisation. Though task shifting may serve as a powerful means to address the crisis in human resources for maternal and newborn health, it is also a complex intervention that generally requires careful planning, implementation and ongoing supervision and support to ensure optimal and safe impact. The unique character and history of the midwifery model of care often makes these challenges even greater. evidence from the review fed into the World Health Organisation's 'Recommendations for Optimizing Health Worker Roles to Improve Access to Key Maternal and Newborn Health Interventions through Task Shifting' guideline. It is appropriate to consider task shifting interventions to ensure wider access to safe midwifery care globally. Legal protections and liabilities and the regulatory framework for task shifting should be designed to accommodate new task shifted practices. © 2013

  15. Managing across Public­Private Partnerships: A Review of Implementation in China and Australia

    OpenAIRE

    Loo-See Beh

    2015-01-01

    Public-private partnership is about governance in the contemporary public service and public interest in public administration with the participation of private sector in the market economy in establishing strategic partnerships in responsible economic management of public services. This article provides an overview of the implementation of public-private partnerships and how these evidences have been managed across China (including Hong Kong SAR) and Australia. It also depicts the k...

  16. 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

  17. Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review

    Directory of Open Access Journals (Sweden)

    Ramzi G. Salloum

    2017-11-01

    Full Text Available Abstract Background One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science. Methods We conducted a systematic literature search (up to December 2016 of the English literature to identify and describe the use of DCEs in engaging stakeholders as an implementation strategy. We searched the following electronic databases: MEDLINE, Econlit, PsychINFO, and the CINAHL using mesh terms. Studies were categorized according to application type, stakeholder(s, healthcare setting, and implementation outcome. Results Seventy-five publications were selected for analysis in this systematic review. Studies were categorized by application type: (1 characterizing demand for therapies and treatment technologies (n = 32, (2 comparing implementation strategies (n = 22, (3 incentivizing workforce participation (n = 11, and (4 prioritizing interventions (n = 10. Stakeholders included providers (n = 27, patients (n = 25, caregivers (n = 5, and administrators (n = 2. The remaining studies (n = 16 engaged multiple stakeholders (i.e., combination of patients, caregivers, providers, and/or administrators. The following implementation outcomes were discussed: acceptability (n = 75, appropriateness (n = 34, adoption (n = 19, feasibility (n = 16, and fidelity (n = 3. Conclusions The number of DCE studies engaging stakeholders as an implementation strategy has been increasing over the

  18. Application of RF-MEMS-Based Split Ring Resonators (SRRs to the Implementation of Reconfigurable Stopband Filters: A Review

    Directory of Open Access Journals (Sweden)

    Ferran Martín

    2014-12-01

    Full Text Available In this review paper, several strategies for the implementation of reconfigurable split ring resonators (SRRs based on RF-MEMS switches are presented. Essentially three types of RF-MEMS combined with split rings are considered: (i bridge-type RF-MEMS on top of complementary split ring resonators CSRRs; (ii cantilever-type RF-MEMS on top of SRRs; and (iii cantilever-type RF-MEMS integrated with SRRs (or RF-MEMS SRRs. Advantages and limitations of these different configurations from the point of view of their potential applications for reconfigurable stopband filter design are discussed, and several prototype devices are presented.

  19. Application of RF-MEMS-based split ring resonators (SRRs) to the implementation of reconfigurable stopband filters: a review.

    Science.gov (United States)

    Martín, Ferran; Bonache, Jordi

    2014-12-02

    In this review paper, several strategies for the implementation of reconfigurable split ring resonators (SRRs) based on RF-MEMS switches are presented. Essentially three types of RF-MEMS combined with split rings are considered: (i) bridge-type RF-MEMS on top of complementary split ring resonators CSRRs; (ii) cantilever-type RF-MEMS on top of SRRs; and (iii) cantilever-type RF-MEMS integrated with SRRs (or RF-MEMS SRRs). Advantages and limitations of these different configurations from the point of view of their potential applications for reconfigurable stopband filter design are discussed, and several prototype devices are presented.

  20. Tobacco Control Policies in Vietnam: Review on MPOWER Implementation Progress and Challenges.

    Science.gov (United States)

    Minh, Hoang Van; Ngan, Tran Thu; Mai, Vu Quynh; My, Nguyen Thi Tuyet; Chung, Le Hong; Kien, Vu Duy; Anh, Tran Tuan; Ngoc, Nguyen Bao; Giap, Vu Van; Cuong, Nguyen Manh; Manh, Pham Duc; Giang, Kim Bao

    2016-01-01

    In Vietnam, the WHO Framework Convention on Tobacco Control (WHO FCTC) took effect in March 2005 while MPOWER has been implemented since 2008. This paper describes the progress and challenges of implementation of the MPOWER package in Vietnam. We can report that, in term of monitoring, Vietnam is very active in the Global Tobacco Surveillance System, completing two rounds of the Global Adult Tobacco Survey (GATS) and three rounds of the Global Youth Tobacco Survey (GYTS). To protect people from tobacco smoke, Vietnam has issued and enforced a law requiring comprehensive smoking bans at workplaces and public places since 2013. Tobacco advertising and promotion are also prohibited with the exception of points of sale displays of tobacco products. Violations come in the form of promotion girls, corporate social responsibility activities from tobacco manufacturers and packages displayed by retail vendors. Vietnam is one of the 77 countries that require pictorial health warnings to be printed on cigarette packages to warn about the danger of tobacco and the warnings have been implemented effectively. Cigarette tax is 70% of factory price which is equal to less than 45% of retail price and much lower than the recommendation of WHO. However, Vietnam is one of the very few countries that require manufacturers and importers to make "compulsory contributions" at 1-2% of the factory price of cigarettes sold in Vietnam for the establishment of a Tobacco Control Fund (TCF). The TCF is being operated well. In 2015, 67 units of 63 provinces/cities, 22 ministries and political-social organizations and 6 hospitals received funding from TCF to implement a wide range of tobacco control activities. Cessation services have been starting with a a toll-free quit-line but need to be further strengthened. In conclusion, Vietnam has constantly put efforts into the tobacco control field with high commitment from the government, scientists and activists. Though several remarkable achievements

  1. Stakeholders' opinions on the implementation of Child Death Review in the Netherlands

    NARCIS (Netherlands)

    Gijzen, S.; Hoir, M.P. L; Boere-Boonekamp, M.M.; Need, A.

    2016-01-01

    Background The death of a child is an enormous tragedy for both the family and others involved. A child’s death appeals to everyone’s responsibility to take measures to prevent similar deaths in the future. Child Death Review (CDR) is an interagency approach in which a child’s death is

  2. Stakeholders’ opinions on the implementation of Child Death Review in the Netherlands

    NARCIS (Netherlands)

    Knoeff-Gijzen, Sandra; L'Hoir, Monique P.; Boere-Boonekamp, Magdalena M.; Need, Ariana

    2016-01-01

    Background The death of a child is an enormous tragedy for both the family and others involved. A child’s death appeals to everyone’s responsibility to take measures to prevent similar deaths in the future. Child Death Review (CDR) is an interagency approach in which a child’s death is

  3. Implementation of a Quality Assurance Review System for the Scalable Development of Online Courses

    Science.gov (United States)

    Ozdemir, Devrim; Loose, Rich

    2014-01-01

    With the growing demand for quality online education in the US, developing quality online courses and online programs, and more importantly maintaining this quality, have been an inevitable concern for higher education institutes. Current literature on quality assurance in online education mostly focuses on the development of review models and…

  4. 77 FR 7060 - Changes To Implement Post-Grant Review Proceedings

    Science.gov (United States)

    2012-02-10

    ... set by the Director, that sets forth reasons why no post-grant review should be instituted based upon..., that contains or contained at any time-- (A) a claim to a claimed invention that has an effective... with the requirement of 35 U.S.C. 322 that the Board may not consider a petition that fails to meet the...

  5. Strategies for Implementing School-Located Influenza Vaccination of Children: A Systematic Literature Review

    Science.gov (United States)

    Cawley, John; Hull, Harry F.; Rousculp, Matthew D.

    2010-01-01

    Background: The Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccinations for all children 6 months to 18 years of age, which includes school-aged children. Influenza immunization programs may benefit schools by reducing absenteeism. Methods: A systematic literature review of PubMed, PsychLit, and Dissertation Abstracts…

  6. Assessment of Programming Language Learning Based on Peer Code Review Model: Implementation and Experience Report

    Science.gov (United States)

    Wang, Yanqing; Li, Hang; Feng, Yuqiang; Jiang, Yu; Liu, Ying

    2012-01-01

    The traditional assessment approach, in which one single written examination counts toward a student's total score, no longer meets new demands of programming language education. Based on a peer code review process model, we developed an online assessment system called "EduPCR" and used a novel approach to assess the learning of computer…

  7. Implementation and Outcomes of a Faculty-Based, Peer Review Manuscript Writing Workshop.

    Science.gov (United States)

    Kulage, Kristine M; Larson, Elaine L

    2016-01-01

    The publication of scholarly work and research findings is an important expectation for nursing faculty; however, academic writing is often neglected, leaving dissemination through manuscript writing an area of concern for the nursing profession. Writing initiatives have been utilized to promote scholarly dissemination in schools of nursing, but those described in the literature have been primarily non-United States based and student focused. This article describes a faculty-based manuscript writing workshop, assesses participants' impressions, and describes its impact on scholarly output. The workshop is a collaborative learning process utilizing peer review to improve manuscript quality and model behaviors for improving writing and peer-reviewing skills. Seventeen workshop participants including three predoctoral students, 6 postdoctoral fellows, and 8 faculty members completed an anonymous workshop survey (81% response rate). All but 1 of 17 manuscripts reviewed in the workshop are published, accepted, or in the review process. All participants indicated that the workshop was a valuable use of time and would recommend it to colleagues. The greatest reported workshop benefit was its function as an impetus to complete and submit manuscripts. We recommend the manuscript writing workshop model for other schools of nursing seeking ways to expand their scholarly output and create accountability for dissemination through manuscript writing. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. 75 FR 29884 - Implementation of Changes from the 2009 Annual Review of the Entity List

    Science.gov (United States)

    2010-05-28

    ..., Ireland or Taiwan were not included in the 2009 annual review because they were added to the Entity List... Emirates. Entities listed under the destinations of Armenia, Ireland or Taiwan were not included in the.... Notwithstanding any other provision of law, no person is required to respond to nor be subject to a penalty for...

  9. Let the Children Play: Scoping Review on the Implementation and Use of Loose Parts for Promoting Physical Activity Participation.

    Science.gov (United States)

    Houser, Natalie E; Roach, Lindsay; Stone, Michelle R; Turner, Joan; Kirk, Sara F L

    2016-01-01

    Active play has become a critical focus in terms of physical activity participation in young children. Unstructured or child-led play offers children the opportunity to interact with the environment in a range of different ways. Unstructured materials, often called loose parts, encourage child-led play, and therefore may also promote physical activity. The purpose of this scoping review was to determine what is currently known about how loose parts may influence physical activity participation. Following a systematic literature search, a total of 16 articles were retrieved, reviewed and categorized according to: (1) types of loose parts; (2) types of play; and (3) types of thinking. We found that there are currently a range of loose parts being used to support play, but the way in which they are implemented varies and there is a lack of clarity around how they might support the development of active outdoor play and physical literacy skills.

  10. Let the Children Play: Scoping Review on the Implementation and Use of Loose Parts for Promoting Physical Activity Participation

    Directory of Open Access Journals (Sweden)

    Natalie E. Houser

    2016-09-01

    Full Text Available Active play has become a critical focus in terms of physical activity participation in young children. Unstructured or child-led play offers children the opportunity to interact with the environment in a range of different ways. Unstructured materials, often called loose parts, encourage child-led play, and therefore may also promote physical activity. The purpose of this scoping review was to determine what is currently known about how loose parts may influence physical activity participation. Following a systematic literature search, a total of 16 articles were retrieved, reviewed and categorized according to: (1 types of loose parts; (2 types of play; and (3 types of thinking. We found that there are currently a range of loose parts being used to support play, but the way in which they are implemented varies and there is a lack of clarity around how they might support the development of active outdoor play and physical literacy skills.

  11. Promise of combined hydrothermal/chemical and mechanical refining for pretreatment of woody and herbaceous biomass.

    Science.gov (United States)

    Kim, Sun Min; Dien, Bruce S; Singh, Vijay

    2016-01-01

    Production of advanced biofuels from woody and herbaceous feedstocks is moving into commercialization. Biomass needs to be pretreated to overcome the physicochemical properties of biomass that hinder enzyme accessibility, impeding the conversion of the plant cell walls to fermentable sugars. Pretreatment also remains one of the most costly unit operations in the process and among the most critical because it is the source of chemicals that inhibit enzymes and microorganisms and largely determines enzyme loading and sugar yields. Pretreatments are categorized into hydrothermal (aqueous)/chemical, physical, and biological pretreatments, and the mechanistic details of which are briefly outlined in this review. To leverage the synergistic effects of different pretreatment methods, conducting two or more pretreatments consecutively has gained attention. Especially, combining hydrothermal/chemical pretreatment and mechanical refining, a type of physical pretreatment, has the potential to be applied to an industrial plant. Here, the effects of the combined pretreatment (combined hydrothermal/chemical pretreatment and mechanical refining) on energy consumption, physical structure, sugar yields, and enzyme dosage are summarized.

  12. End User and Implementer Experiences of mHealth Technologies for Noncommunicable Chronic Disease Management in Young Adults: Systematic Review.

    Science.gov (United States)

    Slater, Helen; Campbell, Jared M; Stinson, Jennifer N; Burley, Megan M; Briggs, Andrew M

    2017-12-12

    Chronic noncommunicable diseases (NCDs) such as asthma, diabetes, cancer, and persistent musculoskeletal pain impose an escalating and unsustainable burden on young people, their families, and society. Exploring how mobile health (mHealth) technologies can support management for young people with NCDs is imperative. The aim of this study was to identify, appraise, and synthesize available qualitative evidence on users' experiences of mHealth technologies for NCD management in young people. We explored the perspectives of both end users (young people) and implementers (health policy makers, clinicians, and researchers). A systematic review and meta-synthesis of qualitative studies. Eligibility criteria included full reports published in peer-reviewed journals from January 2007 to December 2016, searched across databases including EMBASE, MEDLINE (PubMed), Scopus, and PsycINFO. All qualitative studies that evaluated the use of mHealth technologies to support young people (in the age range of 15-24 years) in managing their chronic NCDs were considered. Two independent reviewers identified eligible reports and conducted critical appraisal (based on the Joanna Briggs Institute Qualitative Assessment and Review Instrument: JBI-QARI). Three reviewers independently, then collaboratively, synthesized and interpreted data through an inductive and iterative process to derive emergent themes across the included data. External validity checking was undertaken by an expert clinical researcher and for relevant content, a health policy expert. Themes were subsequently subjected to a meta-synthesis, with findings compared and contrasted between user groups and policy and practice recommendations derived. Twelve studies met our inclusion criteria. Among studies of end users (N=7), mHealth technologies supported the management of young people with diabetes, cancer, and asthma. Implementer studies (N=5) covered the management of cognitive and communicative disabilities, asthma

  13. Implementing family involvement in the treatment of patients with psychosis: a systematic review of facilitating and hindering factors.

    Science.gov (United States)

    Eassom, Erica; Giacco, Domenico; Dirik, Aysegul; Priebe, Stefan

    2014-10-03

    To synthesise the evidence on implementing family involvement in the treatment of patients with psychosis with a focus on barriers, problems and facilitating factors. Systematic review of studies evaluating the involvement of families in tripartite communication between health professionals, 'families' (or other unpaid carers) and adult patients, in a single-family context. A theoretical thematic analysis approach and thematic synthesis were used. A systematic electronic search was carried out in seven databases, using database-specific search strategies and controlled vocabulary. A secondary manual search of grey literature was performed as well as using forwards and backwards snowballing techniques. A total of 43 studies were included. The majority featured qualitative data (n=42), focused solely on staff perspectives (n=32) and were carried out in the UK (n=23). Facilitating the training and ongoing supervision needs of staff are necessary but not sufficient conditions for a consistent involvement of families. Organisational cultures and paradigms can work to limit family involvement, and effective implementation appears to operate via a whole team coordinated effort at every level of the organisation, supported by strong leadership. Reservations about family involvement regarding power relations, fear of negative outcomes and the need for an exclusive patient-professional relationship may be explored and addressed through mutually trusting relationships. Implementing family involvement carries additional challenges beyond those generally associated with translating research to practice. Implementation may require a cultural and organisational shift towards working with families. Family work can only be implemented if this is considered a shared goal of all members of a clinical team and/or mental health service, including the leaders of the organisation. This may imply a change in the ethos and practices of clinical teams, as well as the establishment of

  14. Implementation of inclusive education for children with intellectual and developmental disabilities in African countries: a scoping review.

    Science.gov (United States)

    Okyere, Christiana; Aldersey, Heather Michelle; Lysaght, Rosemary; Sulaiman, Surajo Kamilu

    2018-04-25

    To advance understanding of practices that support inclusion of children with intellectual and developmental disabilities in inclusive education classrooms in Africa by conducting a review of the extant literature. Five academic databases were searched supplemented by a hand search of key journals and references of included studies. Two authors independently screened studies via a reference manager (Covidence) which allowed for blinding. A third author was consulted in cases of conflict. Thirty articles that provided empirical evidence of inclusive education implementation were included. Eight articles highlighted practices that support inclusion of children with intellectual and developmental disabilities. Using Bronfenbrenner's bioecological framework, findings revealed that inclusive education implementation is influenced by factors on the bio level, micro level, meso level, and macro level. Recommendations for promoting inclusive education implementation are provided. Inclusion goes beyond teachers and requires strong commitment of other stakeholders such as families and governments. To guarantee the smooth inclusion of children with special education needs and particularly with intellectual and developmental disabilities, a set of practices validated through rigorous research as supportive and unique and that can be universal to Africa is wise. Implications for rehabilitation A number of strategies were identified that can improve the classroom inclusion of children with intellectual and developmental disabilities. Development of policies that support such strategies could improve implementation. Inclusion goes beyond teachers. Rehabilitation professionals (i.e. occupational therapists) and educational professionals should partner to identify practical solutions to the challenges of creating inclusive environments for children with special education needs. Committing more resources and time towards the development and implementation of special education

  15. Separations/pretreatment considerations for Hanford privatization phase 2

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, R.D.; McGinnis, C.P.; Welch, T.D.

    1998-05-01

    The Tank Focus Area is funded to develop, demonstrate, and deploy technologies that will assist in the treatment and closure of its nuclear waste tanks. Pretreatment technologies developed to support the privatization effort by the Department of Energy are reviewed. Advancements in evaporation, solid-liquid separation, sludge treatment, solids controls, sodium management, and radionuclide removal are considered.

  16. Advances in paper-based sample pretreatment for point-of-care testing.

    Science.gov (United States)

    Tang, Rui Hua; Yang, Hui; Choi, Jane Ru; Gong, Yan; Feng, Shang Sheng; Pingguan-Murphy, Belinda; Huang, Qing Sheng; Shi, Jun Ling; Mei, Qi Bing; Xu, Feng

    2017-06-01

    In recent years, paper-based point-of-care testing (POCT) has been widely used in medical diagnostics, food safety and environmental monitoring. However, a high-cost, time-consuming and equipment-dependent sample pretreatment technique is generally required for raw sample processing, which are impractical for low-resource and disease-endemic areas. Therefore, there is an escalating demand for a cost-effective, simple and portable pretreatment technique, to be coupled with the commonly used paper-based assay (e.g. lateral flow assay) in POCT. In this review, we focus on the importance of using paper as a platform for sample pretreatment. We firstly discuss the beneficial use of paper for sample pretreatment, including sample collection and storage, separation, extraction, and concentration. We highlight the working principle and fabrication of each sample pretreatment device, the existing challenges and the future perspectives for developing paper-based sample pretreatment technique.

  17. Tank Focus Area pretreatment activities

    International Nuclear Information System (INIS)

    McGinnis, C.P.; Welch, T.D.; Manke, K.L.

    1997-01-01

    Plans call for the high-level wastes to be retrieved from the tanks and immobilized in a stable waste form suitable for long-term isolation. Chemistry and chemical engineering operations are required to retrieve the wastes, to condition the wastes for subsequent steps, and to reduce the costs of the waste management enterprise. Pretreatment includes those processes between retrieval and immobilization, and includes preparation of suitable feed material for immobilization and separations to partition the waste into streams that yield lower life-cycle costs. Some of the technologies being developed by the Tank Focus Area (TFA) to process these wastes are described. These technologies fall roughly into three areas: (1) solid/liquid separation (SLS), (2) sludge pretreatment, and (3) supernate pretreatment

  18. Implementing peer review at an emergency medicine blog: bridging the gap between educators and clinical experts.

    Science.gov (United States)

    Thoma, Brent; Chan, Teresa; Desouza, Natalie; Lin, Michelle

    2015-03-01

    Emergency physicians are leaders in the ''free open-access meducation'' (FOAM) movement. The mandate of FOAM is to create open-access education and knowledge translation resources for trainees and practicing physicians (e.g., blogs, podcasts, and vodcasts). Critics of FOAM have suggested that because such resources can be easily published online without quality control mechanisms, unreviewed FOAM resources may be erroneous or biased. We present a new initiative to incorporate open, expert, peer review into an established academic medical blog. Experts provided either pre- or postpublication reviews that were visible to blog readers. This article outlines the details of this initiative and discusses the potentially transformative impact of this educational innovation.

  19. Implementing a Course Review Process for a Continuous Quality Improvement Model for a Medical School Curriculum.

    Science.gov (United States)

    Ward, Cassandra S; Andrade, Amy; Walker-Winfree, Lena

    2018-01-01

    In 1901, Abraham Flexner, a research scholar at the Carnegie Foundation for the Advancement of Teaching, visited 155 medical schools in the United States and Canada to assess medical education. Flexner's recommendations became the foundation for the Liaison Committee on Medical Education accreditation, a voluntary, peer-reviewed quality assurance process to determine whether a medical education program meets established standards. The Meharry Medical College School of Medicine, a historically Black college/university (HBCU) established the Office of Curriculum Evaluation and Effectiveness in 2013 to ensure the consistent monitoring of the medical education program's compliance with accreditation standards. The motto and logo, LCME 24/7, highlight the school's emphasis on meeting accreditation standards. The school uses the 1994 Plan-Do-Study-Act Cycle for Learning and Improvement for continuous review of course content, outcomes, and evaluations. This process identifies strengths, challenges, and opportunities for innovative steps for continuous quality improvements to the curriculum.

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Explicit and implicit theories of change when designing and implementing preventive ergonomics interventions--a systematic literature review.

    Science.gov (United States)

    Wijk, Katarina; Mathiassen, Svend Erik

    2011-09-01

    In contrast to several previous papers dealing with the structure and effects of ergonomics interventions, this systematic literature review focuses on the theories concerning change processes upon which these interventions--implicitly or explicitly--have been based. In a systematic search of 13 literature databases, 30 peer-reviewed intervention studies published between 2000-2007 were identified that provided sufficient information for the change process theory to be identified. Thirteen studies referred to an explicit theory of change, the most common being participatory theory, while in 17 studies, the change theory could only be discerned indirectly from the described intervention strategy. Twenty-five studies explained the reason for choosing their strategy, with a clear reference to theory or previous research, whereas five provided only a weak background. Four categories of intervention strategies for change were identified: (i) changes targeting the individual, (ii) changes focusing on the work environment, (iii) changes relying on interactions between people, and (iv) structural and organizational changes. A strikingly small proportion of ergonomics intervention studies have explained the theory behind the expected change process. A better awareness of the assumptions about change processes embedded in intervention strategies--whether implicit or explicit--may help in identifying and examining those ideas and processes that promote or restrict successful implementation. Such knowledge, in turn, can contribute to the development of interventions that are thoughtfully designed and effectively implemented.

  2. Programmes for advance distribution of misoprostol to prevent post-partum haemorrhage: a rapid literature review of factors affecting implementation.

    Science.gov (United States)

    Smith, Helen J; Colvin, Christopher J; Richards, Esther; Roberson, Jeffrey; Sharma, Geeta; Thapa, Kusum; Gülmezoglu, A Metin

    2016-02-01

    Recent efforts to prevent post-partum haemorrhage (PPH) in low-income countries have focused on providing women with access to oral misoprostol during home birth. The WHO recommends using lay health workers (LHWs) to administer misoprostol in settings where skilled birth attendants are not available. This review synthesizes current knowledge about the barriers and facilitators affecting implementation of advance community distribution of misoprostol to prevent PPH, where misoprostol may be self-administered or administered by an LHW.We searched for and summarized available empirical evidence, and collected primary data from programme stakeholders about their experiences of programme implementation.We present key outcomes and features of advanced distribution programmes that are in operation or have been piloted globally. We categorized factors influencing implementation into those that operate at the health system level, factors related to the community and policy context and those factors more closely connected to the end user.Debates around advance distribution have centred on the potential risks and benefits of making misoprostol available to pregnant women and community members during pregnancy for administration in the home. However, the risks of advance distribution appear manageable and the benefits of self-administration, especially for women who have little chance of expert care for PPH, are considerable. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  3. Understanding the implementation of interventions to improve the management of chronic kidney disease in primary care: a rapid realist review.

    Science.gov (United States)

    Tsang, Jung Yin; Blakeman, Tom; Hegarty, Janet; Humphreys, John; Harvey, Gill

    2016-04-04

    Chronic kidney disease (CKD) is common and a significant marker of morbidity and mortality. Its management in primary care is essential for maintenance of cardiovascular health, avoidance of acute kidney injury (AKI) and delay in progression to end-stage renal disease. Although many guidelines and interventions have been established, there is global evidence of an implementation gap, including variable identification rates and low patient communication and awareness. The objective of this study is to understand the factors enabling and constraining the implementation of CKD interventions in primary care. A rapid realist review was conducted that involved a primary literature search of three databases to identify existing CKD interventions in primary care between the years 2000 and 2014. A secondary search was performed as an iterative process and included bibliographic and grey literature searches of reference lists, authors and research groups. A systematic approach to data extraction using Normalisation Process Theory (NPT) illuminated key mechanisms and contextual factors that affected implementation. Our primary search returned 710 articles that were narrowed down to 18 relevant CKD interventions in primary care. Our findings suggested that effective management of resources (encompassing many types) was a significant contextual factor enabling or constraining the functioning of mechanisms. Three key intervention features were identified from the many that contributed to successful implementation. Firstly, it was important to frame CKD interventions appropriately, such as within the context of cardiovascular health and diabetes. This enabled buy-in and facilitated an understanding of the significance of CKD and the need for intervention. Secondly, interventions that were compatible with existing practices or patients' everyday lives were readily accepted. In contrast, new systems that could not be integrated were abandoned as they were viewed as inconvenient

  4. The economic promise of developing and implementing dengue vaccines: Evidence from a systematic review.

    Science.gov (United States)

    Endo, Iara C; Ziegelmann, Patricia K; Patel, Anita

    2016-12-07

    Dengue fever is one of the most rapidly advancing viral vector-borne diseases worldwide and vaccine candidates are in the final stages of clinical trials, representing a decisive opportunity to control the disease. To decide whether and where to support the introduction of new vaccines it is crucial to assess costs imposed by the disease and cost-effectiveness of vaccine programmes. To identify economic evidence about dengue fever immunization, by systematic review, to assist future policy decisions and investment. The electronic search stage was conducted on PubMed/Medline, Embase, Web of Science, Global Health, NHS Economic Evaluation Database (NHS EED) and Latin American and Caribbean Health Sciences Literature (LILACS) databases. Searches were restricted to papers published between January 1970 and February 2016. Selected papers were quality assessed using three recognized checklists. Eleven relevant studies were identified and there is economic evidence of a satisfactory quality level, derived through modelling approaches, to conclude that dengue fever vaccines will be economically advantageous when compared to vector preventive strategies, despite uncertainties surrounding vaccine efficacy and costs per vaccine dose. Quality assessment based on checklists showed similar findings and although overall quality was considered satisfactory, there were relevant methodological issues not considered among studies reviewed. Several uncertainties still remain about effectiveness of dengue fever vaccines; however, the reviewed economic evidence suggests that, when available, the vaccine can be economically advantageous at moderate prices. Future research needs to confirm findings from the economic models by using actual costs and effectiveness data. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Implementation Plan for the Hawaii Geothermal Project Environmental Impact Statement (DOE Review Draft:)

    Energy Technology Data Exchange (ETDEWEB)

    None

    1992-09-18

    The US Department of Energy (DOE) is preparing an Environmental Impact Statement (EIS) that identifies and evaluates the environmental impacts associated with the proposed Hawaii Geothermal Project (HGP), as defined by the State of Hawaii in its 1990 proposal to Congress (DBED 1990). The location of the proposed project is shown in Figure 1.1. The EIS is being prepared pursuant to the requirements of the National Environmental Policy Act of 1969 (NEPA), as implemented by the President's Council on Environmental Quality (CEQ) regulations (40 CFR Parts 1500-1508) and the DOE NEPA Implementing Procedures (10 CFR 1021), effective May 26, 1992. The State's proposal for the four-phase HGP consists of (1) exploration and testing of the geothermal resource beneath the slopes of the active Kilauea volcano on the Island of Hawaii (Big Island), (2) demonstration of deep-water power cable technology in the Alenuihaha Channel between the Big Island and Mau, (3) verification and characterization of the geothermal resource on the Big Island, and (4) construction and operation of commercial geothermal power production facilities on the Big Island, with overland and submarine transmission of electricity from the Big Island to Oahu and possibly other islands. DOE prepared appropriate NEPA documentation for separate federal actions related to Phase 1 and 2 research projects, which have been completed. This EIS will consider Phases 3 and 4, as well as reasonable alternatives to the HGP. Such alternatives include biomass coal, solar photovoltaic, wind energy, and construction and operation of commercial geothermal power production facilities on the Island of Hawaii (for exclusive use on the Big Island). In addition, the EIs will consider the reasonable alternatives among submarine cable technologies, geothermal extraction, production, and power generating technologies; pollution control technologies; overland and submarine power transmission routes; sites reasonably suited to

  6. Surface pretreatments for medical application of adhesion

    Directory of Open Access Journals (Sweden)

    Weber Michael

    2003-09-01

    Full Text Available Abstract Medical implants and prostheses (artificial hips, tendono- and ligament plasties usually are multi-component systems that may be machined from one of three material classes: metals, plastics and ceramics. Typically, the body-sided bonding element is bone. The purpose of this contribution is to describe developments carried out to optimize the techniques , connecting prosthesis to bone, to be joined by an adhesive bone cement at their interface. Although bonding of organic polymers to inorganic or organic surfaces and to bone has a long history, there remains a serious obstacle in realizing long-term high-bonding strengths in the in vivo body environment of ever present high humidity. Therefore, different pretreatments, individually adapted to the actual combination of materials, are needed to assure long term adhesive strength and stability against hydrolysis. This pretreatment for metal alloys may be silica layering; for PE-plastics, a specific plasma activation; and for bone, amphiphilic layering systems such that the hydrophilic properties of bone become better adapted to the hydrophobic properties of the bone cement. Amphiphilic layering systems are related to those developed in dentistry for dentine bonding. Specific pretreatment can significantly increase bond strengths, particularly after long term immersion in water under conditions similar to those in the human body. The bond strength between bone and plastic for example can be increased by a factor approaching 50 (pealing work increasing from 30 N/m to 1500 N/m. This review article summarizes the multi-disciplined subject of adhesion and adhesives, considering the technology involved in the formation and mechanical performance of adhesives joints inside the human body.

  7. Business Education for Plastic Surgeons: A Systematic Review, Development, and Implementation of a Business Principles Curriculum in a Residency Program.

    Science.gov (United States)

    Zarrabi, Bahar; Burce, Karen K; Seal, Stella M; Lifchez, Scott D; Redett, Richard J; Frick, Kevin D; Dorafshar, Amir H; Cooney, Carisa M

    2017-05-01

    Rising health care costs, decreasing reimbursement rates, and changes in American health care are forcing physicians to become increasingly business-minded. Both academic and private plastic surgeons can benefit from being educated in business principles. The authors conducted a systematic review to identify existing business curricula and integrated a business principles curriculum into residency training. The authors anonymously surveyed their department regarding perceived importance of business principles and performed a systematic literature review from 1993 to 2013 using PubMed and Embase to identify residency training programs that had designed/implemented business curricula. Subsequently, the authors implemented a formal, quarterly business curriculum. Thirty-two of 36 physicians (88.9 percent; 76.6 percent response rate) stated business principles are either "pretty important" or "very important" to being a doctor. Only 36 percent of faculty and 41 percent of trainees had previous business instruction. The authors identified 434 articles in the systematic review: 29 documented formal business curricula. Twelve topics were addressed, with practice management/administration (n = 22) and systems-based practice (n = 6) being the most common. Four articles were from surgical specialties: otolaryngology (n = 1), general surgery (n = 2), and combined general surgery/plastic surgery (n = 1). Teaching formats included lectures and self-directed learning modules; outcomes and participant satisfaction were reported inconsistently. From August of 2013 to June of 2015, the authors held eight business principles sessions. Postsession surveys demonstrated moderately to extremely satisfied responses in 75 percent or more of resident/fellow respondents (n = 13; response rate, 48.1 percent) and faculty (n = 9; response rate, 45.0 percent). Business principles can be integrated into residency training programs. Having speakers familiar with the physician audience and a

  8. Supervising community health workers in low-income countries – a review of impact and implementation issues

    Directory of Open Access Journals (Sweden)

    Zelee Hill

    2014-05-01

    Full Text Available Background: Community health workers (CHWs are an increasingly important component of health systems and programs. Despite the recognized role of supervision in ensuring CHWs are effective, supervision is often weak and under-supported. Little is known about what constitutes adequate supervision and how different supervision strategies influence performance, motivation, and retention. Objective: To determine the impact of supervision strategies used in low- and middle-income countries and discuss implementation and feasibility issues with a focus on CHWs. Design: A search of peer-reviewed, English language articles evaluating health provider supervision strategies was conducted through November 2013. Included articles evaluated the impact of supervision in low- or middle-income countries using a controlled, pre-/post- or observational design. Implementation and feasibility literature included both peer-reviewed and gray literature. Results: A total of 22 impact papers were identified. Papers were from a range of low- and middle-income countries addressing the supervision of a variety of health care providers. We classified interventions as testing supervision frequency, the supportive/facilitative supervision package, supervision mode (peer, group, and community, tools (self-assessment and checklists, focus (quality assurance/problem solving, and training. Outcomes included coverage, performance, and perception of quality but were not uniform across studies. Evidence suggests that improving supervision quality has a greater impact than increasing frequency of supervision alone. Supportive supervision packages, community monitoring, and quality improvement/problem-solving approaches show the most promise; however, evaluation of all strategies was weak. Conclusion: Few supervision strategies have been rigorously tested and data on CHW supervision is particularly sparse. This review highlights the diversity of supervision approaches that policy

  9. Implementation of the Individual Placement and Support approach for people with mental illness – a systematic review of facilitators and barriers

    DEFF Research Database (Denmark)

    Bonfils, Inge Storgaard; Hansen, Henrik; Stentoft Dalum, Helle

    2015-01-01

    /evaluations and reviews included in the review. Results: Factors influencing the implementation process exist on the contextual, local organizational, cooperation/team and individual level. There is an inherent interdependency between various factors. Key element is the use of fidelity scale and skilled local leadership...

  10. Carbonic Acid Pretreatment of Biomass

    Energy Technology Data Exchange (ETDEWEB)

    G. Peter van Walsum; Kemantha Jayawardhana; Damon Yourchisin; Robert McWilliams; Vanessa Castleberry

    2003-05-31

    This project sought to address six objectives, outlined below. The objectives were met through the completion of ten tasks. 1) Solidify the theoretical understanding of the binary CO2/H2O system at reaction temperatures and pressures. The thermodynamics of pH prediction have been improved to include a more rigorous treatment of non-ideal gas phases. However it was found that experimental attempts to confirm theoretical pH predictions were still off by a factor of about 1.8 pH units. Arrhenius experiments were carried out and the activation energy for carbonic acid appears to be substantially similar to sulfuric acid. Titration experiments have not yet confirmed or quantified the buffering or acid suppression effects of carbonic acid on biomass. 2) Modify the carbonic acid pretreatment severity function to include the effect of endogenous acid formation and carbonate buffering, if necessary. It was found that the existing severity functions serve adequately to account for endogenous acid production and carbonate effects. 3) Quantify the production of soluble carbohydrates at different reaction conditions and severity. Results show that carbonic acid has little effect on increasing soluble carbohydrate concentrations for pretreated aspen wood, compared to pretreatment with water alone. This appears to be connected to the release of endogenous acids by the substrate. A less acidic substrate such as corn stover would derive benefit from the use of carbonic acid. 4) Quantify the production of microbial inhibitors at selected reaction conditions and severity. It was found that the release of inhibitors was correlated to reaction severity and that carbonic acid did not appear to increase or decrease inhibition compared to pretreatment with water alone. 5) Assess the reactivity to enzymatic hydrolysis of material pretreated at selected reaction conditions and severity. Enzymatic hydrolysis rates increased with severity, but no advantage was detected for the use of carbonic

  11. Non-invasive prenatal testing: a review of international implementation and challenges

    Directory of Open Access Journals (Sweden)

    Allyse M

    2015-01-01

    Full Text Available Megan Allyse,1 Mollie A Minear,2 Elisa Berson,3 Shilpa Sridhar,3 Margaret Rote,3 Anthony Hung,3 Subhashini Chandrasekharan4 1Institute for Health and Aging, University of California San Francisco, San Francisco, California, USA, 2Duke Science & Society, Duke University, Durham, NC, USA, 3Trinity College of Arts and Sciences, Duke University, Durham, NC, USA; 4Duke Global Health Institute, Duke University, Durham, NC, USA Abstract: Noninvasive prenatal genetic testing (NIPT is an advance in the detection of fetal chromosomal aneuploidies that analyzes cell-free fetal DNA in the blood of a pregnant woman. Since its introduction to clinical practice in Hong Kong in 2011, NIPT has quickly spread across the globe. While many professional societies currently recommend that NIPT be used as a screening method, not a diagnostic test, its high sensitivity (true positive rate and specificity (true negative rate make it an attractive alternative to the serum screens and invasive tests currently in use. Professional societies also recommend that NIPT be accompanied by genetic counseling so that families can make informed reproductive choices. If NIPT becomes more widely adopted, States will have to implement regulation and oversight to ensure it fits into existing legal frameworks, with particular attention to returning fetal sex information in areas where sex-based abortions are prevalent. Although there are additional challenges for NIPT uptake in the developing world, including the lack of health care professionals and infrastructure, the use of NIPT in low-resource settings could potentially reduce the need for skilled clinicians who perform invasive testing. Future advances in NIPT technology promise to expand the range of conditions that can be detected, including single gene disorders. With these advances come questions of how to handle incidental findings and variants of unknown significance. Moving forward, it is essential that all stakeholders have

  12. 2015 Five-Yearly Review : one last formal step, with the implementation to follow

    CERN Multimedia

    Staff Association

    2015-01-01

    Taking into account the arbitration by the Director General the Staff Council decided that it did not oppose the Management proposals for the 2015 Five-Yearly Review (see Echo 234). Consequently, at the TREF meeting of Thursday 26 November, Management presented its consolidated proposals taking into account the outcome of the arbitration. The Staff Association was invited to express its point of view (the text of our declaration follows). After the Member States’ delegates got satisfactory answers to their questions for clarification, none of the 14 delegations represented opposed the proposals nor were there any abstentions. The Chair of TREF, B. Dormy, will thus report to Finance Committee and Council on 16 and 17 December that TREF recommends that these committees approve the Management proposals. A huge amount of work by many CERN colleagues, representatives of the Management, the Sectors, and the Staff Association has come to a successful conclusion. Now we move into the important implementati...

  13. The adoption and implementation of RFID technologies in healthcare: a literature review.

    Science.gov (United States)

    Yao, Wen; Chu, Chao-Hsien; Li, Zang

    2012-12-01

    Radio Frequency Identification (RFID) technology not only offers tracking capability to locate equipment, supplies and people in real time, but also provides efficient and accurate access to medical data for health professionals. However, the reality of RFID adoption in healthcare is far behind earlier expectation. This study reviews literature on the use of RFID in healthcare/hospitals following a formal innovation-decision framework. We aim to identify the common applications, potential benefits, barriers, and critical success factors. Our study facilitates quick assessment and provides guidance for researchers and practitioners in adopting RFID in medical arenas. Many earlier adopters in healthcare found RFID to be functional and useful in such areas as asset tracking and patient identification. Major barriers to adoption include technological limitations, interference concerns, prohibitive costs, lack of global standards and privacy concerns. Better designed RFID systems with low cost and privacy issues addressed are needed to increase acceptance of RFID in healthcare.

  14. Review of the factors affecting the selection and implementation of waste management technologies

    International Nuclear Information System (INIS)

    1999-08-01

    The objective of this publication is to identify and critically review the factors affecting the selection of waste management strategies and technologies; summarize and discuss the options available, and offer a systematic approach for considering these factors to design, install and operate appropriate technologies for waste streams generated. The scope of this publication includes the management of radioactive waste from all orientations including low and intermediate level waste arising from the production of radionuclides and their application in industry, agriculture, medicine, education and research; waste generated from research reactors, power reactors and from nuclear fuel cycle activities including reprocessing high level waste. Although waste from decommissioning is not specifically addressed, the management of this waste is not significantly different from other types of waste in the same category

  15. An implementation of support vector machine on sentiment classification of movie reviews

    Science.gov (United States)

    Yulietha, I. M.; Faraby, S. A.; Adiwijaya; Widyaningtyas, W. C.

    2018-03-01

    With technological advances, all information about movie is available on the internet. If the information is processed properly, it will get the quality of the information. This research proposes to the classify sentiments on movie review documents. This research uses Support Vector Machine (SVM) method because it can classify high dimensional data in accordance with the data used in this research in the form of text. Support Vector Machine is a popular machine learning technique for text classification because it can classify by learning from a collection of documents that have been classified previously and can provide good result. Based on number of datasets, the 90-10 composition has the best result that is 85.6%. Based on SVM kernel, kernel linear with constant 1 has the best result that is 84.9%

  16. What's the Point?: A Review of Reward Systems Implemented in Gamification Interventions.

    Science.gov (United States)

    Lewis, Zakkoyya H; Swartz, Maria C; Lyons, Elizabeth J

    2016-04-01

    Rewards are commonly used in interventions to change behavior, but they can inhibit development of intrinsic motivation, which is associated with long-term behavior maintenance. Gamification is a novel intervention strategy that may target intrinsic motivation through fun and enjoyment. Before the effects of gamified interventions on motivation can be determined, there must be an understanding of how gamified interventions operationalize rewards, such as point systems. The purpose of this review is to determine the prevalence of different reward types, specifically point systems, within gamified interventions. Electronic databases were searched for relevant articles. Data sources included Medline OVID, Medline PubMed, Web of Science, CINAHL, Cochrane Central, and PsycINFO. Out of the 21 articles retrieved, 18 studies described a reward system and were included in this review. Gamified interventions were designed to target a myriad of clinical outcomes across diverse populations. Rewards included points (n = 14), achievements/badges/medals (n = 7), tangible rewards (n = 7), currency (n = 4), other unspecified rewards (n = 3), likes (n = 2), animated feedback (n = 1), and kudos (n = 1). Rewards, and points in particular, appear to be a foundational component of gamified interventions. Despite their prevalence, authors seldom described the use of noncontingent rewards or how the rewards interacted with other game features. The reward systems relying on tangible rewards and currency may have been limited by inhibited intrinsic motivation. As gamification proliferates, future research should explicitly describe how rewards were operationalized in the intervention and evaluate the effects of gamified rewards on motivation across populations and research outcomes.

  17. SPIE Smart Structures Product Implementation Award: a review of the first ten years

    Science.gov (United States)

    Anderson, Eric H.; Sater, Janet M.

    2007-04-01

    The research field of smart materials and structures has been a distinct entity for two decades. Over the past ten years, the SPIE Industrial and Commercial Applications Conference has presented a Smart Structures Product Implementation Award at its annual symposium. This paper revisits the nine winning entries to date (1998-2007) and updates their status. The paper begins with a brief description of the original and current intent of the award and follows with a short overview of the evolution of smart structures, from research to products. The winning teams and their respective products are then described. The current status of the products is discussed based on publicly available information and input from the respective companies. Note however that it is not the purpose of the paper to rank the product winners in terms of success or sales. The paper concludes with an assessment of the larger trends in productization of smart structures technologies. The application "form" for the award as well as the evaluation criteria and suggestions for improving award application packages can be found in the appendix.

  18. Challenges with the implementation of an Integrated Disease Surveillance and Response (IDSR) system: systematic review of the lessons learned.

    Science.gov (United States)

    Phalkey, Revati K; Yamamoto, Shelby; Awate, Pradip; Marx, Michael

    2015-02-01

    Despite a realistic strategy and availability of resources, multiple challenges still overwhelm countries grappling with the challenges of communicable disease surveillance. The Integrated Disease Surveillance and Response (IDSR) strategy is by far the most pragmatic strategy in resource-poor settings. The objective of this study was to systematically review and document the lessons learned and the challenges identified with the implementation of the IDSR in low- and middle-income countries and to identify the main barriers that contribute to its sub-optimal functioning. A systematic review of literature published in English using Web of Knowledge, PubMed, and databases of the World Health Organization (WHO) and the Centers for Disease Control (CDC) between 1998 and 2012 was undertaken. Additionally, manual reference and grey literature searches were conducted. Citations describing core and support functions or the quality attributes of the IDSR as described by WHO and CDC were included in the review. Thirty-three assessment studies met the inclusion criteria. IDSR strategy has been best adopted and implemented in the WHO-AFRO region. Although significant progress is made in overcoming the challenges identified with vertical disease surveillance strategies, gaps still exist. Mixed challenges with core and support IDSR functions were observed across countries. Main issues identified include non-sustainable financial resources, lack of co-ordination, inadequate training and turnover of peripheral staff, erratic feedback, inadequate supervision from the next level, weak laboratory capacities coupled with unavailability of job aids (case definitions/reporting formats), and poor availability of communication and transport systems particularly at the periphery. Best outcomes in core functions and system attributes were reported when support surveillance functions performed optimally. Apart from technical and technological issues, human resources and the health care

  19. Implementing the EcoDesign Directive in distribution transformers: First impacts review

    Directory of Open Access Journals (Sweden)

    Constantinos Charalampopoulos

    2017-01-01

    Full Text Available Since the commission of the Ecodesign Directive 2005/32/EC and the review of the Directive in 2009, there has been radical change on a multitude of aspects across the grid of electrical products. Because of their high volume sales, significant environmental impact and high potential for improvement, distribution transformers were set as a priority for the Ecodesign Working Period 2009–2011. As of July 2015, the requirements of the Directive affect every unit placed into market. This study addresses the impact that the Ecodesign Directive had on the distribution transformer industry financially, environmentally, and technologically. Data has been collected from various authoritative sources in order to give an inclusive picture of the current situation, and how it may improve by the measures presented. We need to ascertain both the importance of the existing difficulties and the validity of the actions and regulations in effect so far. The purpose of this paper will be considered fulfilled if the reader can clearly understand the current state of the distribution transformer industry, the problems that the Ecodesign Directive attempts to overcome, the methods of solving said problems, and the effects that those solutions can have in the near future.

  20. Review of the Experimental Background and Implementation of Computational Models of the Ocular Lens Microcirculation.

    Science.gov (United States)

    Wu, Ho-Ting D; Donaldson, Paul J; Vaghefi, Ehsan

    2016-01-01

    Our sense of vision is critically dependent on the clarity of the crystalline lens. The most common cause of transparency loss in the lens is age-related nuclear cataract, which is due to accumulative oxidative damage to this tissue. Since the ocular lens is an avascular tissue, it has to maintain its physiological homeostasis and antioxidant levels using a system of water microcirculation. This system has been experimentally imaged in animal lenses using different modalities. Based on these data, computational models have been developed to predict the properties of this system in human lenses and its changes due to aging. Although successful in predicting many aspects of lens fluid dynamics, at least in animal models, these in-silica models still need further improvement to become more accurate and representative of human ocular lens. We have been working on gathering experimental data and simultaneously developing computational models of lens microcirculation for the past decade. This review chronologically looks at the development of data-driven computational foundations of lens microcirculation model, its current state, and future advancement directions. A comprehensive model of lens fluid dynamics is essential to understand the physiological optics of this tissue and ultimately the underlying mechanisms of cataract onset and progression.

  1. How best can we plan & implement HIV prevention? A review of successful evidence based practices & research

    Directory of Open Access Journals (Sweden)

    Vijay Kumar Chattu

    2014-07-01

    Full Text Available Context: Around 2.5 million people become infected with HIV each year and its impact on human life and public health can only be tackled and reversed only by sound prevention strategies. Aim: This paper aims to provide the reader about different types of prevention strategies that are effective and practiced in various countries with special emphasis on evidence for success. It also highlights the importance of to the evidence based medicine& strategies. It describes about the importance of combination prevention, which encompasses complementary behavioral, biomedical and structural prevention strategies. Methods & Materials: Searches for peer reviewed journal articles was conducted using the search engines to gather the information from databases of medicine, health sciences and social sciences. Information for each strategy is organized & presented systematically with detailed discussion. Results: For a successful reduction in HIV transmission, there is a great need for combined effects of radical & sustainable behavioral changes among individuals who are potentially at risk. Second, combination prevention is essential for HIV prevention is neither simple nor simplistic. Reductions in HIV transmission need widespread and sustained efforts. A mix of communication channels are essential to disseminate messages to motivate people to engage in various methods of risk reduction. Conclusions: The effect of behavioral strategies could be increased by aiming for many goals that are achieved by use of multilevel approaches with populations both uninfected and infected with HIV. Combination prevention programs operate on different levels to address the specific, but diverse needs of the populations at risk of HIV infection.

  2. Increasing Coverage of Hepatitis B Vaccination in China: A Systematic Review of Interventions and Implementation Experiences.

    Science.gov (United States)

    Wang, Shengnan; Smith, Helen; Peng, Zhuoxin; Xu, Biao; Wang, Weibing

    2016-05-01

    This study used a system evaluation method to summarize China's experience on improving the coverage of hepatitis B vaccine, especially the strategies employed to improve the uptake of timely birth dosage. Identifying successful methods and strategies will provide strong evidence for policy makers and health workers in other countries with high hepatitis B prevalence.We conducted a literature review included English or Chinese literature carried out in mainland China, using PubMed, the Cochrane databases, Web of Knowledge, China National Knowledge Infrastructure, Wanfang data, and other relevant databases.Nineteen articles about the effectiveness and impact of interventions on improving the coverage of hepatitis B vaccine were included. Strong or moderate evidence showed that reinforcing health education, training and supervision, providing subsidies for facility birth, strengthening the coordination among health care providers, and using out-of-cold-chain storage for vaccines were all important to improving vaccination coverage.We found evidence that community education was the most commonly used intervention, and out-reach programs such as out-of-cold chain strategy were more effective in increasing the coverage of vaccination in remote areas where the facility birth rate was respectively low. The essential impact factors were found to be strong government commitment and the cooperation of the different government departments.Public interventions relying on basic health care systems combined with outreach care services were critical elements in improving the hepatitis B vaccination rate in China. This success could not have occurred without exceptional national commitment.

  3. The design, implementation, and evaluation of online credit nutrition courses: a systematic review.

    Science.gov (United States)

    Cohen, Nancy L; Carbone, Elena T; Beffa-Negrini, Patricia A

    2011-01-01

    To assess how postsecondary online nutrition education courses (ONEC) are delivered, determine ONEC effectiveness, identify theoretical models used, and identify future research needs. Systematic search of database literature. Postsecondary education. Nine research articles evaluating postsecondary ONEC. Knowledge/performance outcomes and student satisfaction, motivation, or perceptions. Systematic search of 922 articles and review of 9 articles meeting search criteria. Little research regarding ONEC marketing/management existed. Studies primarily evaluated introductory courses using email/websites (before 2000), or course management systems (after 2002). None used true experimental designs; just 3 addressed validity or reliability of measures or pilot-tested instruments. Three articles used theoretical models in course design; few used theories to guide evaluations. Four quasi-experimental studies indicated no differences in nutrition knowledge/performance between online and face-to-face learners. Results were inconclusive regarding student satisfaction, motivation, or perceptions. Students can gain knowledge in online as well as in face-to-face nutrition courses, but satisfaction was mixed. More up-to-date investigations on effective practices are warranted, using theories to identify factors that enhance student outcomes, addressing emerging technologies, and documenting ONEC marketing, management, and delivery. Adequate training/support for faculty is needed to improve student experiences and faculty time management. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  4. Evidence-based competencies for improving communication skills in graduate medical education: a review with suggestions for implementation.

    Science.gov (United States)

    Henry, Stephen G; Holmboe, Eric S; Frankel, Richard M

    2013-05-01

    Communicating with patients is arguably the most common and important activity in medical practice, but this activity receives relatively little emphasis in graduate medical education. We propose 12 evidence-based communication competencies that program directors can adopt as a framework for teaching and evaluating residents' communication skills. We review supporting evidence for these competencies and argue that communication should be treated like a procedural skill that must be taught and evaluated by observing real resident-patient interactions. We make practical suggestions for implementing these competencies by addressing three critical components of a competency-based approach to communication skills: patient safety, faculty development, and direct observation of residents. This approach to teaching and assessing communication skills provides a rationale for incorporating routine direct observation into graduate medical education programs and also for designing communication skills training that ensures graduating residents develop the skills needed to provide safe, effective patient care.

  5. Implementing systematic review techniques in chemical risk assessment: Challenges, opportunities and recommendations.

    Science.gov (United States)

    Whaley, Paul; Halsall, Crispin; Ågerstrand, Marlene; Aiassa, Elisa; Benford, Diane; Bilotta, Gary; Coggon, David; Collins, Chris; Dempsey, Ciara; Duarte-Davidson, Raquel; FitzGerald, Rex; Galay-Burgos, Malyka; Gee, David; Hoffmann, Sebastian; Lam, Juleen; Lasserson, Toby; Levy, Len; Lipworth, Steven; Ross, Sarah Mackenzie; Martin, Olwenn; Meads, Catherine; Meyer-Baron, Monika; Miller, James; Pease, Camilla; Rooney, Andrew; Sapiets, Alison; Stewart, Gavin; Taylor, David

    2016-01-01

    Systematic review (SR) is a rigorous, protocol-driven approach designed to minimise error and bias when summarising the body of research evidence relevant to a specific scientific question. Taking as a comparator the use of SR in synthesising research in healthcare, we argue that SR methods could also pave the way for a "step change" in the transparency, objectivity and communication of chemical risk assessments (CRA) in Europe and elsewhere. We suggest that current controversies around the safety of certain chemicals are partly due to limitations in current CRA procedures which have contributed to ambiguity about the health risks posed by these substances. We present an overview of how SR methods can be applied to the assessment of risks from chemicals, and indicate how challenges in adapting SR methods from healthcare research to the CRA context might be overcome. Regarding the latter, we report the outcomes from a workshop exploring how to increase uptake of SR methods, attended by experts representing a wide range of fields related to chemical toxicology, risk analysis and SR. Priorities which were identified include: the conduct of CRA-focused prototype SRs; the development of a recognised standard of reporting and conduct for SRs in toxicology and CRA; and establishing a network to facilitate research, communication and training in SR methods. We see this paper as a milestone in the creation of a research climate that fosters communication between experts in CRA and SR and facilitates wider uptake of SR methods into CRA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Early Child Development and Nutrition: A Review of the Benefits and Challenges of Implementing Integrated Interventions1234

    Science.gov (United States)

    Hurley, Kristen M; Yousafzai, Aisha K; Lopez-Boo, Florencia

    2016-01-01

    Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions. PMID:26980819

  7. Forecasting academic success through implementation of an online prerequisite review tutorials program for first year pharmacy students.

    Science.gov (United States)

    Stamper, Brendan D; Buhler, Amber V; Harrelson, John P; Roberts, Sigrid C; Malhotra, Ashim; Elbarbry, Fawzy A; Rao, Deepa; Karimi, Reza; Turner, R Brigg; Marlow, Catherine; Devaud, Leslie L

    Online prerequisite review (OPR) tutorials were designed and implemented to reinforce foundational scientific material in order to protect in-class time, foster self-directed learning, and ensure all students have similar baseline knowledge. Twenty-one tutorials covering undergraduate prerequisite material were developed by faculty and organized into six core modules, comprising basic biology, chemistry, and physiology topics. A quiz on this material was given on the first day of each course. This score was correlated with the final exam score at course completion. Additional student and faculty feedback was collected through surveys. 2372 quiz-exam pairings were collected over three consecutive fall semesters. A one point increase in the quiz score was associated with a 3.6 point (95% confidence interval 3.1-4.0) higher exam score, as well as a greater probability of passing the exam (Pstudent survey data revealed an overwhelmingly positive perception of the OPR tutorials, and surveyed faculty reported better use of class time and improved student competency and participation. Implementation of OPR tutorials may give faculty more efficient use of class time, and their associated quizzes serve as an early indicator for students at-risk of not passing who are candidates for early interventions. Furthermore, the OPR tutorial design gives it great transferability to biomedical post-graduate programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. HIV policy implementation in two health and demographic surveillance sites in Uganda: findings from a national policy review, health facility surveys and key informant interviews.

    Science.gov (United States)

    McRobie, Ellen; Wringe, Alison; Nakiyingi-Miiro, Jessica; Kiweewa, Francis; Lutalo, Tom; Nakigozi, Gertrude; Todd, Jim; Eaton, Jeffrey William; Zaba, Basia; Church, Kathryn

    2017-04-05

    Successful HIV testing, care and treatment policy implementation is essential for realising the reductions in morbidity and mortality those policies are designed to target. While adoption of new HIV policies is rapid, less is known about the facility-level implementation of new policies and the factors influencing this. We assessed implementation of national policies about HIV testing, treatment and retention at health facilities serving two health and demographic surveillance sites (HDSS) (10 in Kyamulibwa, 14 in Rakai). Ugandan Ministry of Health HIV policy documents were reviewed in 2013, and pre-determined indicators were extracted relating to the content and nature of guidance on HIV service provision. Facility-level policy implementation was assessed via a structured questionnaire administered to in-charge staff from each health facility. Implementation of policies was classified as wide (≥75% facilities), partial (26-74% facilities) or minimal (≤25% facilities). Semi-structured interviews were conducted with key informants (policy-makers, implementers, researchers) to identify factors influencing implementation; data were analysed using the Framework Method of thematic analysis. Most policies were widely implemented in both HDSS (free testing, free antiretroviral treatment (ART), WHO first-line regimen as standard, Option B+). Both had notable implementation gaps for policies relating to retention on treatment (availability of nutritional supplements, support groups or isoniazid preventive therapy). Rakai implemented more policies relating to provision of antiretroviral treatment than Kyamulibwa and performed better on quality of care indicators, such as frequency of stock-outs. Factors facilitating implementation were donor investment and support, strong scientific evidence, low policy complexity, phased implementation and effective planning. Limited human resources, infrastructure and health management information systems were perceived as major

  9. Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person's Pathway.

    LENUS (Irish Health Repository)

    2018-01-25

    We addressed the research question "what factors enable the successful development and implementation of a frail older person\\'s pathway within the acute setting". A rapid realist review (RRR) was conducted by adopting the RAMESES standards. We began with a sample of 232 articles via database searches supplemented with 94 additional records including inputs from a twitter chat and a hospital site visit. Our final sample consisted of 18 documents. Following review and consensus by an expert panel we identified a conceptual model of context-mechanism-(resources)-outcomes. There was overall agreement frailty should be identified at the front door of the acute hospital. Significant challenges identified related to organisational boundaries both within the acute setting and externally, the need to shift outcomes to patient orientated ones, to support staff to sustain the pathway by providing ongoing education and by providing role clarity. RRRs can support research such as the systematic approach to improving care for frail older adults (SAFE) study by producing accounts of what works based on a wide range of sources and innovative engagement with stakeholders. It is evident from our provisional model that numerous factors need to combine and interact to enable and sustain a successful frail older person\\'s pathway.

  10. Enablers and barriers to the implementation of primary health care interventions for Indigenous people with chronic diseases: a systematic review.

    Science.gov (United States)

    Gibson, Odette; Lisy, Karolina; Davy, Carol; Aromataris, Edoardo; Kite, Elaine; Lockwood, Craig; Riitano, Dagmara; McBride, Katharine; Brown, Alex

    2015-05-22

    Access to appropriate, affordable, acceptable and comprehensive primary health care (PHC) is critical for improving the health of Indigenous populations. Whilst appropriate infrastructure, sufficient funding and knowledgeable health care professionals are crucial, these elements alone will not lead to the provision of appropriate care for all Indigenous people. This systematic literature review synthesised international evidence on the factors that enable or inhibit the implementation of interventions aimed at improving chronic disease care for Indigenous people. A systematic review using Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed platform), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Excerpta Medica Database (EMBASE), ATSIHealth, Australian Indigenous HealthInfoNet via Informit Online and Primary Health Care Research and Information Service (PHCRIS) databases was undertaken. Studies were included if they described an intervention for one or more of six chronic conditions that was delivered in a primary health care setting in Australia, New Zealand, Canada or the United States. Attitudes, beliefs, expectations, understandings and knowledge of patients, their families, Indigenous communities, providers and policy makers were of interest. Published and unpublished qualitative and quantitative studies from 1998 to 2013 were considered. Qualitative findings were pooled using a meta-aggregative approach, and quantitative data were presented as a narrative summary. Twenty three studies were included. Meta-aggregation of qualitative data revealed five synthesised findings, related to issues within the design and planning phase of interventions, the chronic disease workforce, partnerships between service providers and patients, clinical care pathways and patient access to services. The available quantitative data supported the qualitative findings. Three key features of enablers and barriers

  11. Pretreatment Solution for Water Recovery Systems

    Science.gov (United States)

    Muirhead, Dean (Inventor)

    2018-01-01

    Chemical pretreatments are used to produce usable water by treating a water source with a chemical pretreatment that contains a hexavalent chromium and an acid to generate a treated water source, wherein the concentration of sulfate compounds in the acid is negligible, and wherein the treated water source remains substantially free of precipitates after the addition of the chemical pretreatment. Other methods include reducing the pH in urine to be distilled for potable water extraction by pretreating the urine before distillation with a pretreatment solution comprising one or more acid sources selected from a group consisting of phosphoric acid, hydrochloric acid, and nitric acid, wherein the urine remains substantially precipitate free after the addition of the pretreatment solution. Another method described comprises a process for reducing precipitation in urine to be processed for water extraction by mixing the urine with a pretreatment solution comprising hexavalent chromium compound and phosphoric acid.

  12. Development of an Implementation Plan Related to Biological Opinion on Operation of the Federal Columbia River Power System ; Step 1: Review and Critique of Implementation Plans.

    Energy Technology Data Exchange (ETDEWEB)

    Neitzel, Duane A.; Bunn, Amoret

    2000-12-01

    The Draft Biological Opinion on Operation of the Federal Columbia River Power System calls for the development of 1- and 5-year implementation plans. These plans will provide the roadmap for planning and subsequent implementation of actions intended to meet specific performance standards (i.e., biological objectives) in a timely manner. To develop implementation plans the key tasks and sequences of steps must be determined. Those responsible for specific tasks must be identified and they must understand what they need to do. There must be assurances that the resources (human, physical, and fiscal) to complete the tasks are available. Motivation and incentive systems should be set up. Systems to coordinate efforts and guide activity must be devised and installed. An information management system must be designed to manage and analyze data and ensure that appropriate data are collected. This will aid managers in assessing whether individual activities or actions are tracking with stated goals and objectives. Training programs to improve managerial and worker capability in making and implementing plans should be designed. Managerial leadership to guide the efforts of all individuals in achieving the goals of the anadromous and resident fish recovery must be developed. It is the entire process of managing fish recovery in relationship to the Biological Opinion that will guide, coordinate, motivate, and control work and determine the effectiveness and efficiency of plan implementation.

  13. Recent Advances in the Application of Inorganic Salt Pretreatment for Transforming Lignocellulosic Biomass into Reducing Sugars.

    Science.gov (United States)

    Loow, Yu-Loong; Wu, Ta Yeong; Tan, Khang Aik; Lim, Yung Shen; Siow, Lee Fong; Jahim, Jamaliah Md; Mohammad, Abdul Wahab; Teoh, Wen Hui

    2015-09-30

    Currently, the transformation of lignocellulosic biomass into value-added products such as reducing sugars is garnering attention worldwide. However, efficient hydrolysis is usually hindered by the recalcitrant structure of the biomass. Many pretreatment technologies have been developed to overcome the recalcitrance of lignocellulose such that the components can be reutilized more effectively to enhance sugar recovery. Among all of the utilized pretreatment methods, inorganic salt pretreatment represents a more novel method and offers comparable sugar recovery with the potential for reducing costs. The use of inorganic salt also shows improved performance when it is integrated with other pretreatment technologies. Hence, this paper is aimed to provide a detailed overview of the current situation for lignocellulosic biomass and its physicochemical characteristics. Furthermore, this review discusses some recent studies using inorganic salt for pretreating biomass and the mechanisms involved during the process. Finally, some prospects and challenges using inorganic salt are highlighted.

  14. Development and evaluation of 'briefing notes' as a novel knowledge translation tool to aid the implementation of sex/gender analysis in systematic reviews: a pilot study.

    Science.gov (United States)

    Doull, Marion; Welch, Vivian; Puil, Lorri; Runnels, Vivien; Coen, Stephanie E; Shea, Beverley; O'Neill, Jennifer; Borkhoff, Cornelia; Tudiver, Sari; Boscoe, Madeline

    2014-01-01

    There is increasing recognition of sex/gender differences in health and the importance of identifying differential effects of interventions for men and women. Yet, to whom the research evidence does or does not apply, with regard to sex/gender, is often insufficiently answered. This is also true for systematic reviews which synthesize results of primary studies. A lack of analysis and reporting of evidence on sex/gender raises concerns about the applicability of systematic reviews. To bridge this gap, this pilot study aimed to translate knowledge about sex/gender analysis (SGA) into a user-friendly 'briefing note' format and evaluate its potential in aiding the implementation of SGA in systematic reviews. Our Sex/Gender Methods Group used an interactive process to translate knowledge about sex/gender into briefing notes, a concise communication tool used by policy and decision makers. The briefing notes were developed in collaboration with three Cochrane Collaboration review groups (HIV/AIDS, Hypertension, and Musculoskeletal) who were also the target knowledge users of the briefing notes. Briefing note development was informed by existing systematic review checklists, literature on sex/gender, in-person and virtual meetings, and consultation with topic experts. Finally, we held a workshop for potential users to evaluate the notes. Each briefing note provides tailored guidance on considering sex/gender to reviewers who are planning or conducting systematic reviews and includes the rationale for considering sex/gender, with examples specific to each review group's focus. Review authors found that the briefing notes provided welcome guidance on implementing SGA that was clear and concise, but also identified conceptual and implementation challenges. Sex/gender briefing notes are a promising knowledge translation tool. By encouraging sex/gender analysis and equity considerations in systematic reviews, the briefing notes can assist systematic reviewers in ensuring the

  15. Review of technical justification of assumptions and methods used by the Environmental Protection Agency for estimating risks avoided by implementing MCLs for radionuclides

    International Nuclear Information System (INIS)

    Morris, S.C.; Rowe, M.D.; Holtzman, S.; Meinhold, A.F.

    1992-11-01

    The Environmental Protection Agency (EPA) has proposed regulations for allowable levels of radioactive material in drinking water (40 CFR Part 141, 56 FR 33050, July 18, 1991). This review examined the assumptions and methods used by EPA in calculating risks that would be avoided by implementing the proposed Maximum Contaminant Levels for uranium, radium, and radon. Proposed limits on gross alpha and beta-gamma emitters were not included in this review

  16. Review of technical justification of assumptions and methods used by the Environmental Protection Agency for estimating risks avoided by implementing MCLs for radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Morris, S.C.; Rowe, M.D.; Holtzman, S.; Meinhold, A.F.

    1992-11-01

    The Environmental Protection Agency (EPA) has proposed regulations for allowable levels of radioactive material in drinking water (40 CFR Part 141, 56 FR 33050, July 18, 1991). This review examined the assumptions and methods used by EPA in calculating risks that would be avoided by implementing the proposed Maximum Contaminant Levels for uranium, radium, and radon. Proposed limits on gross alpha and beta-gamma emitters were not included in this review.

  17. A review of signal processing used in the implementation of the pulse oximetry photoplethysmographic fluid responsiveness parameter.

    Science.gov (United States)

    Addison, Paul S

    2014-12-01

    ΔPOP is a physiological parameter derived from the respiration-induced change in the pulse oximetry plethysmographic (POP) waveform or "pleth." It has been proposed as a proxy for pulse pressure variation used in the determination of the response to intravascular volume expansion in hypovolemic patients. Many studies have now reported on the parameter, and many research groups have constructed algorithms for its computation from the first principles where the implementation details have been described. This review focuses on the signal processing aspects of ΔPOP, as reported in the literature, and aims to provide a comprehensive summary of the wide-ranging algorithmic strategies that have been attempted in its computation. A search was conducted for articles concerning the use of ΔPOP as a fluid responsiveness parameter. In particular, articles concerning the correlation between ΔPOP and pulse pressure variation were targeted. Comments and replies to comments by the authors in which signal processing aspects were discussed were also included in the review. The parameter is first defined, and a history of the early work surrounding pleth-based fluid responsiveness parameters is presented. This is followed by an overview of the signal processing methods used in the reported studies, including details of exclusion criteria, manual filtering (preprocessing), gain change issues, acquisition details, selection of registration periods, averaging methods, physiological influences on the pleth, and comments by the investigators themselves. It is concluded that to develop a robust, fully automated ΔPOP algorithm for use in the clinical environment, more rigorous signal processing is required. Specifically, signals should be evaluated over significant periods of time, with emphasis on the quality and temporal relevance of the information.

  18. Method for pretreating lignocellulosic biomass

    Science.gov (United States)

    Kuzhiyil, Najeeb M.; Brown, Robert C.; Dalluge, Dustin Lee

    2015-08-18

    The present invention relates to a method for pretreating lignocellulosic biomass containing alkali and/or alkaline earth metal (AAEM). The method comprises providing a lignocellulosic biomass containing AAEM; determining the amount of the AAEM present in the lignocellulosic biomass; identifying, based on said determining, the amount of a mineral acid sufficient to completely convert the AAEM in the lignocellulosic biomass to thermally-stable, catalytically-inert salts; and treating the lignocellulosic biomass with the identified amount of the mineral acid, wherein the treated lignocellulosic biomass contains thermally-stable, catalytically inert AAEM salts.

  19. Implementing Assessments of Robotic-Assisted Technical Skill in Urologic Education: A Systematic Review and Synthesis of the Validity Evidence.

    Science.gov (United States)

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

    2018-03-31

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

  20. Provider-initiated testing and counselling programmes in sub-Saharan Africa: a systematic review of their operational implementation.

    Science.gov (United States)

    Roura, Maria; Watson-Jones, Deborah; Kahawita, Tanya M; Ferguson, Laura; Ross, David A

    2013-02-20

    The routine offer of an HIV test during patient-provider encounters is gaining momentum within HIV treatment and prevention programmes. This review examined the operational implementation of provider-initiated testing and counselling (PITC) programmes in sub-Saharan Africa. PUBMED, EMBASE, Global Health, COCHRANE Library and JSTOR databases were searched systematically for articles published in English between January 2000 and November 2010. Grey literature was explored through the websites of international and nongovernmental organizations. Eligibility of studies was based on predetermined criteria applied during independent screening by two researchers. We retained 44 studies out of 5088 references screened. PITC polices have been effective at identifying large numbers of previously undiagnosed individuals. However, the translation of policy guidance into practice has had mixed results, and in several studies of routine programmes the proportion of patients offered an HIV test was disappointingly low. There were wide variations in the rates of acceptance of the test and poor linkage of those testing positive to follow-up assessments and antiretroviral treatment. The challenges encountered encompass a range of areas from logistics, to data systems, human resources and management, reflecting some of the weaknesses of health systems in the region. The widespread adoption of PITC provides an unprecedented opportunity for identifying HIV-positive individuals who are already in contact with health services and should be accompanied by measures aimed at strengthening health systems and fostering the normalization of HIV at community level. The resources and effort needed to do this successfully should not be underestimated.

  1. Does pre-ordering tests enhance the value of the periodic examination? Study Design - Process implementation with retrospective chart review

    Directory of Open Access Journals (Sweden)

    Stroebel Robert J

    2011-09-01

    Full Text Available Abstract Background To evaluate the value of a pre-ordering process for the pro-active scheduling and completion of appropriate preventive and chronic disease monitoring tests prior to a periodic health examination (PHE. Methods A standardized template was developed and used by our nursing staff to identify and schedule appropriate tests prior to the patients PHE. Chart reviews were completed on all 602 PHE visits for a 3-month interval in a primary care setting. A patient satisfaction survey was administered to a convenience sample of the PHE patients. Results Of all the patients with tests pre-ordered, 87.8% completed the tests. All providers in the division used the process, but some evolved from one template to another over time. Most patients (61% preferred to get their tests done prior to their PHE appointment. Many of our patients had abnormal test results. With this process, patients were able to benefit from face-to-face discussion of these results directly with their provider. Conclusions A pre-order process was successfully implemented to improve the value of the PHE visit in an internal medicine primary care practice using a standardized approach that allowed for provider autonomy. The process was accepted by patients and providers and resulted in improved office efficiency through reduced message handling. Completion of routine tests before the PHE office visit can help facilitate face-to-face discussions about abnormal results and subsequent management that otherwise may only occur by telephone.

  2. The Role of Ultrasound in Screening Dense Breasts—A Review of the Literature and Practical Solutions for Implementation

    Directory of Open Access Journals (Sweden)

    Denise Thigpen

    2018-03-01

    Full Text Available Breast cancer is the second leading cause of cancer death in women. Estimates indicate a nearly 40% breast cancer mortality reduction when screening women annually starting at age 40. Although mammography is well known to be a powerful screening tool in the detection of early breast cancer, it is imperfect, particularly for women with dense breasts. In women with dense breast tissue, the sensitivity of mammography is reduced. Additionally, women with dense breasts have an increased risk of developing breast cancer while mammography has a lower sensitivity. Screening ultrasound, both handheld and automated, is effective in detecting mammographically occult cancer in women with dense tissue. Studies have shown that ultrasound significantly increases detection of clinically important, small, largely invasive, node-negative cancers. The purpose of this review article is to summarize the literature to date regarding screening breast ultrasound, emphasizing differences in cancer detection in high risk and intermediate risk women, and to discuss practical ways to implement screening ultrasound in clinical practice, including automated whole breast ultrasound, as a viable solution to the increasing need for additional screening.

  3. A qualitative review of implementer perceptions of the national community-level malaria surveillance system in Southern Province, Zambia.

    Science.gov (United States)

    Lohfeld, Lynne; Kangombe-Ngwenya, Tokozile; Winters, Anna M; Chisha, Zunda; Hamainza, Busiku; Kamuliwo, Mulakwa; Miller, John M; Burns, Matthew; Bridges, Daniel J

    2016-08-08

    Parts of Zambia with very low malaria parasite prevalence and high coverage of vector control interventions are targeted for malaria elimination through a series of interventions including reactive case detection (RCD) at community level. When a symptomatic individual presenting to a community health worker (CHW) or government clinic is diagnostically confirmed as an incident malaria case an RCD response is initiated. This consists of a CHW screening the community around the incident case with rapid diagnostic tests (RDT) and treating positive cases with artemether-lumefantrine (AL, Coartem™) in accordance with national policy. Since its inception in 2011, Zambia's RCD programme has relied on anecdotal feedback from staff to identify issues and possible solutions. In 2014, a systematic qualitative programme review was conducted to determine perceptions around malaria rates, incentives, operational challenges and solutions according to CHWs, their supervisors and district-level managers. A criterion-based sampling framework based on training regime and performance level was used to select nine rural health posts in four districts of Southern Province. Twenty-two staff interviews were completed to produce English or bilingual (CiTonga or Silozi + English) verbatim transcripts, which were then analysed using thematic framework analysis. CHWs, their supervisors and district-level managers strongly credited the system with improving access to malaria services and significantly reducing the number of cases in their area. The main implementation barriers included access (e.g., lack of rain gear, broken bicycles), insufficient number of CHWs for programme coverage, communication (e.g. difficulties maintaining cell phones and "talk time" to transmit data by phone), and inconsistent supply chain (e.g., inadequate numbers of RDT kits and anti-malarial drugs to test and treat uncomplicated cases). This review highlights the importance of a community surveillance system

  4. The rise of multiple imputation: a review of the reporting and implementation of the method in medical research.

    Science.gov (United States)

    Hayati Rezvan, Panteha; Lee, Katherine J; Simpson, Julie A

    2015-04-07

    Missing data are common in medical research, which can lead to a loss in statistical power and potentially biased results if not handled appropriately. Multiple imputation (MI) is a statistical method, widely adopted in practice, for dealing with missing data. Many academic journals now emphasise the importance of reporting information regarding missing data and proposed guidelines for documenting the application of MI have been published. This review evaluated the reporting of missing data, the application of MI including the details provided regarding the imputation model, and the frequency of sensitivity analyses within the MI framework in medical research articles. A systematic review of articles published in the Lancet and New England Journal of Medicine between January 2008 and December 2013 in which MI was implemented was carried out. We identified 103 papers that used MI, with the number of papers increasing from 11 in 2008 to 26 in 2013. Nearly half of the papers specified the proportion of complete cases or the proportion with missing data by each variable. In the majority of the articles (86%) the imputed variables were specified. Of the 38 papers (37%) that stated the method of imputation, 20 used chained equations, 8 used multivariate normal imputation, and 10 used alternative methods. Very few articles (9%) detailed how they handled non-normally distributed variables during imputation. Thirty-nine papers (38%) stated the variables included in the imputation model. Less than half of the papers (46%) reported the number of imputations, and only two papers compared the distribution of imputed and observed data. Sixty-six papers presented the results from MI as a secondary analysis. Only three articles carried out a sensitivity analysis following MI to assess departures from the missing at random assumption, with details of the sensitivity analyses only provided by one article. This review outlined deficiencies in the documenting of missing data and the

  5. Understanding the Attributes of Implementation Frameworks to Guide the Implementation of a Model of Community-based Integrated Health Care for Older Adults with Complex Chronic Conditions: A Metanarrative Review

    Directory of Open Access Journals (Sweden)

    Ann McKillop

    2017-06-01

    Full Text Available Introduction: Many studies have investigated the process of healthcare implementation to understand better how to bridge gaps between recommended practice, the needs and demands of healthcare consumers, and what they actually receive. However, in the implementation of integrated community-based and integrated health care, it is still not well known which approaches work best.  Methods: We conducted a systematic review and metanarrative synthesis of literature on implementation frameworks, theories and models in support of a research programme investigating CBPHC for older adults with chronic health problems. Results: Thirty-five reviews met our inclusion criteria and were appraised, summarised, and synthesised. Five metanarratives emerged 1 theoretical constructs; 2 multiple influencing factors; 3 development of new frameworks; 4 application of existing frameworks; and 5 effectiveness of interventions within frameworks/models. Four themes were generated that exposed the contradictions and synergies among the metanarratives. Person-centred care is fundamental to integrated CBPHC at all levels in the health care delivery system, yet many implementation theories and frameworks neglect this cornerstone.  Discussion: The research identified perspectives central to integrated CBPHC that were missing in the literature. Context played a key role in determining success and in how consumers and their families, providers, organisations and policy-makers stay connected to implementing the best care possible.  Conclusions: All phases of implementation of a new model of CBPHC call for collaborative partnerships with all stakeholders, the most important being the person receiving care in terms of what matters most to them.

  6. Total Productive Maintenance And Role Of Interpretive Structural Modeling And Structural Equation Modeling In Analyzing Barriers In Its Implementation A Literature Review

    Directory of Open Access Journals (Sweden)

    Prasanth S. Poduval

    2015-08-01

    Full Text Available Abstract - The aim of the authors is to present a review of literature of Total Productive Maintenance and the barriers in implementation of Total Productive Maintenance TPM. The paper begins with a brief description of TPM and the barriers in implementation of TPM. Interpretive Structural Modeling ISM and its role in analyzing the barriers in TPM implementation is explained in brief. Applications of ISM in analyzing issues in various fields are highlighted with special emphasis on TPM. The paper moves on to introduction to Structural Equation Modeling SEM and its role in validating ISM in analyzing barriers in implementation of TPM. The paper concludes with a gap analysis from the current literature research that can be carried out and expected outcomes from the proposed research.

  7. Comparison of different pretreatment methods for separation hemicellulose from straw during the lignocellulosic bioethanol production

    Science.gov (United States)

    Eisenhuber, Katharina; Krennhuber, Klaus; Steinmüller, Viktoria; Kahr, Heike; Jäger, Alexander

    2013-04-01

    lead to increasing conversion of hemicellulose to xylose. In contrast, increasing sodium hydroxide concentrations degrade the hemicellulose to unknown derivates. Consequently, almost no sugars from hemicellulose remain for fermentation. The hydrolysis of sulfuric acid pretreated straw results in a maximum glucose concentration of 100 g/kg straw and a xylose concentration of nearly 30 g/kg. Sodium hydroxide pretreated and hydrolyzed straw leads to a maximum glucose concentration of 90 g/kg straw and a xylose concentration of nearly 20 g/kg. In comparison to the two chemical pretreatment methods (sodium hydroxide and sulfuric acid pretreatment), the steam explosion pretreatment (conditions: temperature 190°C, time 20 minutes) results in a higher glucose concentration of about 190 g/kg straw and a xylose concentration of nearly 75 g/kg straw after enzymatic hydrolysis of the dried straw. Because of the small effect the sodium hydroxide pretreatment has on xylose recovery, this method won't be used for separation and conversion of hemicellulose into xylose and arabinose. Although pretreatment with sulfuric acid achieved promising results, further research and economical considerations have to be performed. In conclusion, the steam explosion method is still the state of the art pretreatment method for the production of lignocellulosic biofuels. Alkaline methods destroy most of the xylose part of the sugar fraction and a loss of up to 25 % of the fermentable sugars is not acceptable for a sustainable biofuel production. The acid pretreatment yields high amounts of accessible hemicellulose and cellulose, but the consumption of chemicals for acid pretreatment and neutralization has to be taken into account when considering technical implementation.

  8. Façade insulation retrofitting policy implementation process and its effects on health equity determinants: A realist review

    International Nuclear Information System (INIS)

    Camprubí, Lluís; Malmusi, Davide; Mehdipanah, Roshanak

    2016-01-01

    Fuel poverty and cold housing constitute a significant public health problem. Energy efficiency interventions, such as façade retrofitting, address the problem from a structural and long-term perspective. Despite evidence of the health benefits of insulation, little is known about the political and social contexts that contribute to social inequalities in receiving and experiencing health benefits from these interventions. We used a realist review methodology to better understand the mechanisms that explain how and why variations across different social groups appear in receiving energy efficiency façade retrofitting interventions and in their impact on health determinants. We considered the four stages of the policy implementation framework: public policy approach; policy; receiving intervention and impact on health determinants. We found strong evidence that certain social groups (low-income, renters, elderly) suffering most from fuel poverty, experience more barriers for undertaking a building retrofitting (due to factors such as upfront costs, “presentism” thinking, split incentives, disruption and lack of control), and that some public policies on housing energy efficiency may exacerbate these inequalities. This can be avoided if such policies specifically aim at tackling fuel poverty or social inequities, are completely free to users, target the most affected groups and are adapted to their needs. - Highlights: •Health benefits of housing façade insulation more pronounced in fuel poor groups. •Social groups suffering most from fuel poverty least likely to undergo insulation. •Energy efficiency policies focused solely on CO 2 reduction may increase inequalities. •Split Incentives and “Take-Back” effect show socioeconomic and contextual variability. •Universal policies without targeting increase inequalities in retrofitting uptake.

  9. The characterization of radioactive waste: a critical review of techniques implemented or under development at CEA, France

    Science.gov (United States)

    Pérot, Bertrand; Jallu, Fanny; Passard, Christian; Gueton, Olivier; Allinei, Pierre-Guy; Loubet, Laurent; Estre, Nicolas; Simon, Eric; Carasco, Cédric; Roure, Christophe; Boucher, Lionel; Lamotte, Hervé; Comte, Jérôme; Bertaux, Maïté; Lyoussi, Abdallah; Fichet, Pascal; Carrel, Frédérick

    2018-03-01

    This review paper describes the destructive and non-destructive measurements implemented or under development at CEA, in view to perform the most complete radioactive waste characterization. First, high-energy photon imaging (radiography, tomography) brings essential information on the waste packages, such as density, position and shape of the waste inside the container and in the possible binder, quality of coating and blocking matrices, presence of internal shields or structures, presence of cracks, voids, or other defects in the container or in the matrix, liquids or other forbidden materials, etc. Radiological assessment is then performed using a series of non-destructive techniques such as gamma-ray spectroscopy, which allows characterizing a wide range of radioactive and nuclear materials, passive neutron coincidence counting and active neutron interrogation with the differential die-away technique, or active photon interrogation with high-energy photons (photofission), to measure nuclear materials. Prompt gamma neutron activation analysis (PGNAA) can also be employed to detect toxic chemicals or elements which can greatly influence the above measurements, such as neutron moderators or absorbers. Digital auto-radiography can also be used to detect alpha and beta contaminated waste. These non-destructive assessments can be completed by gas measurements, to quantify the radioactive and radiolysis gas releases, and by destructive examinations such as coring homogeneous waste packages or cutting the heterogeneous ones, in view to perform visual examination and a series of physical, chemical, and radiochemical analyses on samples. These last allow for instance to check the mechanical and containment properties of the package envelop, or of the waste binder, to measure toxic chemicals, to assess the activity of long-lived radionuclides or pure beta emitters, to determine the isotopic composition of nuclear materials, etc.

  10. Implementation of Management by Objective through Open Performance Review and Appraisal System (OPRAS for Teachers in Tanzania

    Directory of Open Access Journals (Sweden)

    Rose Ephraim Matete

    2016-07-01

    Full Text Available Management by Objective through Open Performance Review and Appraisal System (OPRAS was introduced in Tanzania for evaluation of public servants work performance in 2004. The aim of this study was to investigate how teachers perceive the implementation of OPRAS as a mechanism of assessing their work performance and making them accountable for their teaching. The study was mainly qualitative with some aspects of quantitative data. It involved 108 informants, where 90 were the primary school classroom teachers, 10 headteachers, 6 school committee members and 2 district educational officials. The data were collected through questionnaires, interviews, and focus group discussion. Some teachers think if OPRAS contract could well be worked out, it could improve the performance; however, there are those teachers who think OPRAS is impractical and unrealistic to the Tanzanian context where pupils are congested in classrooms with shortage of desks.  During the school visit in both Kinondoni Dar es Salaam and Mbeya City findings indicated that OPRAS had been abandoned as it created hostility between headteachers and teachers. Teachers complained of the expenses involved in duplicating the copies and the time consumed for discussion. I argue in this paper that although evaluation of teachers is important, the adoption of the type of assessment for their work performance has to be considered because of the nature of the field and the complications involved in dealing with human mind. Teaching is a labour-intensive process. Teachers cannot, by means of their teaching, determine how many pupils will pass a given exam and how well they will do in their exams under the OPRAS requirements. Keywords: Management by objectives, OPRAS, performance, teachers

  11. Wash water waste pretreatment system

    Science.gov (United States)

    1977-01-01

    Investigations were completed on wash waters based on each candidate personal cleansing agent. Evaluations of coagulants, antifoam agents, and the effect of promising antifoams on the chemical precipitation were included. Based on these evaluations two candidate soaps as well as their companion antifoam agents were selected for further work. Operating parameters included the effect of soap concentration, ferric chloride concentration, duration of mixing, and pore size of depth filters on the degree of soap removal. The effect of pressure on water flow through filter cartridges and on the rate of decline of water flow was also investigated. The culmination of the program was the recommendation of a pretreatment concept based on chemical precipitation followed by pressure filtration.

  12. New degradation compounds from lignocellulosic biomass pretreatment: routes for formation of potent oligophenolic enzyme inhibitors

    DEFF Research Database (Denmark)

    Rasmussen, H.; Tanner, David Ackland; Sørensen, H. R.

    2017-01-01

    In this study 26 new oligophenol cellulase inhibitors were discovered from wheat straw pretreatment liquors. By consideration of the reaction mechanisms for their formation it is proposed that these oligophenols are formed during hydrothermal biomass pretreatment by pentose self-condensation reac......In this study 26 new oligophenol cellulase inhibitors were discovered from wheat straw pretreatment liquors. By consideration of the reaction mechanisms for their formation it is proposed that these oligophenols are formed during hydrothermal biomass pretreatment by pentose self......-condensation reactions involving aldol condensations, 1,4 additions to α,β unsaturated carbonyl compounds, 3-keto acid decarboxylations and oxidations. Furthermore, pentose reactions with phenolic lignin components are suggested. The identification of the central role of xylose in the reaction routes for oligophenolic...... the way for implementation of new types of reactions that hinder inhibitor formation in lignocellulosic biomass processing....

  13. Evaluation of chemical, thermobaric and thermochemical pre-treatment on anaerobic digestion of high-fat cattle slaughterhouse waste.

    Science.gov (United States)

    Harris, Peter W; Schmidt, Thomas; McCabe, Bernadette K

    2017-11-01

    This work aimed to enhance the anaerobic digestion of fat-rich dissolved air flotation (DAF) sludge through chemical, thermobaric, and thermochemical pre-treatment methods. Soluble chemical oxygen demand was enhanced from 16.3% in the control to 20.84% (thermobaric), 40.82% (chemical), and 50.7% (thermochemical). Pre-treatment altered volatile fatty acid concentration by -64% (thermobaric), 127% (chemical) and 228% (thermochemical). Early inhibition was reduced by 20% in the thermochemical group, and 100% in the thermobaric group. Specific methane production was enhanced by 3.28% (chemical), 8.32% (thermobaric), and 8.49% (thermochemical) as a result of pre-treatment. Under batch digestion, thermobaric pre-treatment demonstrated the greatest improvement in methane yield with respect to degree of pre-treatment applied. Thermobaric pre-treatment was also the most viable for implementation at slaughterhouses, with potential for heat-exchange to reduce pre-treatment cost. Further investigation into long-term impact of pre-treatments in semi-continuous digestion experiments will provide additional evaluation of appropriate pre-treatment options for high-fat slaughterhouse wastewater. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya.

    Science.gov (United States)

    Njoroge, Martin; Zurovac, Dejan; Ogara, Esther A A; Chuma, Jane; Kirigia, Doris

    2017-02-10

    The growth of Information and Communication Technology in Kenya has facilitated implementation of a large number of eHealth projects in a bid to cost-effectively address health and health system challenges. This systematic review aims to provide a situational analysis of eHealth initiatives being implemented in Kenya, including an assessment of the areas of focus and geographic distribution of the health projects. The search strategy involved peer and non-peer reviewed sources of relevant information relating to projects under implementation in Kenya. The projects were examined based on strategic area of implementation, health purpose and focus, geographic location, evaluation status and thematic area. A total of 114 citations comprising 69 eHealth projects fulfilled the inclusion criteria. The eHealth projects included 47 mHealth projects, 9 health information system projects, 8 eLearning projects and 5 telemedicine projects. In terms of projects geographical distribution, 24 were executed in Nairobi whilst 15 were designed to have a national coverage but only 3 were scaled up. In terms of health focus, 19 projects were mainly on primary care, 17 on HIV/AIDS and 11 on maternal and child health (MNCH). Only 8 projects were rigorously evaluated under randomized control trials. This review discovered that there is a myriad of eHealth projects being implemented in Kenya, mainly in the mHealth strategic area and focusing mostly on primary care and HIV/AIDs. Based on our analysis, most of the projects were rarely evaluated. In addition, few projects are implemented in marginalised areas and least urbanized counties with more health care needs, notwithstanding the fact that adoption of information and communication technology should aim to improve health equity (i.e. improve access to health care particularly in remote parts of the country in order to reduce geographical inequities) and contribute to overall health systems strengthening.

  15. Feasibilities of consolidated bioprocessing microbes: from pretreatment to biofuel production.

    Science.gov (United States)

    Parisutham, Vinuselvi; Kim, Tae Hyun; Lee, Sung Kuk

    2014-06-01

    Lignocelluloses are rich sugar treasures, which can be converted to useful commodities such as biofuel with the help of efficient combination of enzymes and microbes. Although several bioprocessing approaches have been proposed, biofuel production from lignocelluloses is limited because of economically infeasible technologies for pretreatment, saccharification and fermentation. Use of consolidated bioprocessing (CBP) microbes is the most promising method for the cost-effective production of biofuels. However, lignocelluloses are obtained from highly diverse environment and hence are heterogeneous in nature. Therefore, it is necessary to develop and integrate tailor-designed pretreatment processes and efficient microbes that can thrive on many different kinds of biomass. In this review, the progress towards the construction of consolidated bioprocessing microbes, which can efficiently convert heterogeneous lignocellulosic biomass to bioenergy, has been discussed; in addition, the potential and constraints of current bioprocessing technologies for cellulosic biofuel production have been discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Pretreatment of the macroalgae Chaetomorpha linum for the production of bioethanol - Comparison of five pretreatment technologies

    DEFF Research Database (Denmark)

    Schultz-Jensen, Nadja; Thygesen, Anders; Thomsen, Sune Tjalfe

    2013-01-01

    -assisted pretreatment (PAP) and ball milling (BM), to determine effects of the pretreatment methods on the conversion of C. linum into ethanol by simultaneous saccharification and fermentation (SSF). WO and BM showed the highest ethanol yield of 44. g ethanol/100. g glucan, which was close to the theoretical ethanol......A qualified estimate for pretreatment of the macroalgae Chaetomorpha linum for ethanol production was given, based on the experience of pretreatment of land-based biomass. C. linum was subjected to hydrothermal pretreatment (HTT), wet oxidation (WO), steam explosion (STEX), plasma...... yield of 57. g ethanol/100. g glucan. A 64% higher ethanol yield, based on raw material, was reached after pretreatment with WO and BM compared with unpretreated C. linum, however 50% of the biomass was lost during WO. Results indicated that the right combination of pretreatment and marine macroalgae...

  17. Organizational- and system-level characteristics that influence implementation of shared decision-making and strategies to address them - a scoping review.

    Science.gov (United States)

    Scholl, Isabelle; LaRussa, Allison; Hahlweg, Pola; Kobrin, Sarah; Elwyn, Glyn

    2018-03-09

    Shared decision-making (SDM) is poorly implemented in routine care, despite being promoted by health policies. No reviews have solely focused on an in-depth synthesis of the literature around organizational- and system-level characteristics (i.e., characteristics of healthcare organizations and of healthcare systems) that may affect SDM implementation. A synthesis would allow exploration of interventions to address these characteristics. The study aim was to compile a comprehensive overview of organizational- and system-level characteristics that are likely to influence the implementation of SDM, and to describe strategies to address those characteristics described in the literature. We conducted a scoping review using the Arksey and O'Malley framework. The search strategy included an electronic search and a secondary search including gray literature. We included publications reporting on projects that promoted implementation of SDM or other decision support interventions in routine healthcare. We screened titles and abstracts, and assessed full texts for eligibility. We used qualitative thematic analysis to identify organizational- and system-level characteristics. After screening 7745 records and assessing 354 full texts for eligibility, 48 publications on 32 distinct implementation projects were included. Most projects (N = 22) were conducted in the USA. Several organizational-level characteristics were described as influencing the implementation of SDM, including organizational leadership, culture, resources, and priorities, as well as teams and workflows. Described system-level characteristics included policies, clinical guidelines, incentives, culture, education, and licensing. We identified potential strategies to influence the described characteristics, e.g., examples how to facilitate distribution of decision aids in a healthcare institution. Although infrequently studied, organizational- and system-level characteristics appear to play a role in the

  18. Online Radiology Reporting with Peer Review as a Learning and Feedback Tool in Radiology; Implementation, Validity, and Student Impressions

    DEFF Research Database (Denmark)

    McEvoy, Fintan; Shen, Nicholas W; Nielsen, Dorte Hald

    2017-01-01

    radiology course. The computer code used to manage the course and deliver images online is reported, and we provide links to the executable files. We tested to see if undergraduate peer review of radiological reports has validity and describe student impressions of the learning process. Peer review scores......Communicating radiological reports to peers has pedagogical value. Students may be uneasy with the process due to a lack of communication and peer review skills or to their failure to see value in the process. We describe a communication exercise with peer review in an undergraduate veterinary...... review scores students received and the student scores obtained in the MCQ examination. The difference in peer review scores received by students grouped according to their level of course performance (high vs. low) was statistically significant (p review...

  19. Integrated analysis of hydrothermal flow through pretreatment

    Directory of Open Access Journals (Sweden)

    Archambault-Leger Veronique

    2012-07-01

    Full Text Available Abstract Background The impact of hydrothermal flowthrough (FT pretreatment severity on pretreatment and solubilization performance metrics was evaluated for three milled feedstocks (corn stover, bagasse, and poplar and two conversion systems (simultaneous saccharification and fermentation using yeast and fungal cellulase, and fermentation by Clostridium thermocellum. Results Compared to batch pretreatment, FT pretreatment consistently resulted in higher XMG recovery, higher removal of non-carbohydrate carbon and higher glucan solubilization by simultaneous saccharification and fermentation (SSF. XMG recovery was above 90% for FT pretreatment below 4.1 severity but decreased at higher severities, particularly for bagasse. Removal of non-carbohydrate carbon during FT pretreatment increased from 65% at low severity to 80% at high severity for corn stover, and from 40% to 70% for bagasse and poplar. Solids obtained by FT pretreatment were amenable to high conversion for all of the feedstocks and conversion systems examined. The optimal time and temperature for FT pretreatment on poplar were found to be 16 min and 210°C. At these conditions, SSF glucan conversion was about 85%, 94% of the XMG was removed, and 62% of the non carbohydrate mass was solubilized. Solubilization of FT-pretreated poplar was compared for C. thermocellum fermentation (10% inoculum, and for yeast-fungal cellulase SSF (5% inoculum, cellulase loading of 5 and 10 FPU/g glucan supplemented with β-glucosidase at 15 and 30 U/g glucan. Under the conditions tested, which featured low solids concentration, C. thermocellum fermentation achieved faster rates and more complete conversion of FT-pretreated poplar than did SSF. Compared to SSF, solubilization by C. thermocellum was 30% higher after 4 days, and was over twice as fast on ball-milled FT-pretreated poplar. Conclusions XMG removal trends were similar between feedstocks whereas glucan conversion trends were significantly

  20. What are the factors of organisational culture in health care settings that act as barriers to the implementation of evidence-based practice? A scoping review.

    Science.gov (United States)

    Williams, Brett; Perillo, Samuel; Brown, Ted

    2015-02-01

    The responsibility to implement evidence-based practice (EBP) in a health care workplace does not fall solely on the individual health care professional. Organisational barriers relate to the workplace setting, administrational support, infrastructure, and facilities available for the retrieval, critique, summation, utilisation, and integration of research findings in health care practices and settings. Using a scoping review approach, the organisational barriers to the implementation of EBP in health care settings were sought. This scoping review used the first five of the six stage methodology developed by Levac et al. (2010). The five stages used are: 1) Identify the research question; 2) identify relevant studies; 3) study selection; 4) charting the data; and 5) collating, summarising and reporting the results. The following databases were searched from January 2004 until February 2014: Medline, EMBASE, EBM Reviews, Google Scholar, The Cochrane Library and CINAHL. Of the 49 articles included in this study, there were 29 cross-sectional surveys, six descriptions of specific interventions, seven literature reviews, four narrative reviews, nine qualitative studies, one ethnographic study and one systematic review. The articles were analysed and five broad organisational barriers were identified. This scoping review sought to map the breadth of information available on the organisational barriers to the use of EBP in health care settings. Even for a health care professional who is motivated and competent in the use of EBP; all of these barriers will impact on their ability to increase and maintain their use of EBP in the workplace. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. [Advances in research on mechanisms of seed pre-treatments.

    Science.gov (United States)

    Liu, Xu; Liu, Juan; Liu, Qian; Gao, Ya Ni; Wang, Quan Zhen

    2016-11-18

    Seeds play a vital role in nature and agro-ecosystems. The success of seed germination and the establishment of a normal seedling determine the propagation and survival of a plant species, but seed vigor is often seriously damaged because of seed aging, dormancy and the deterioration of natural habitat. Thus, exploring methods for improving germination quality is of great significance to ecology and the economy. Based on the latest international reports, seed pre-treatments are the most practical and effective methods for improving plant performance, increasing yields and enhancing stress resistance. This review provided a summary of the current pre-sowing treatment technologies and the physiological and biochemical responses of plants to these methods by addressing gene expression, cytological effects, enzyme system activities, material and energy metabolism, antioxidation mechanisms and signal transduction pathways. We also interpreted the mechanisms of the seed pre-treatment methods from aspects of seed germination acceleration and stress resistance enhancement. The bottleneck in seed pre-treatments at the cytological and molecular levels and the problems involved in their application were also discussed. Thus far, most studies had largely focused on the partial reaction alterations of plant biochemistry and enzyme activities, and they had generally been characterized by a lack of systematic and holistic study for applications to crop production. Finally, we proposed an outlook for further study in an attempt to provide a prospective and scientific reference for plant germplasm conservation, high-efficiency organic agriculture development and ecological environment re-construction.

  2. A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations.

    Science.gov (United States)

    Davies, Philippa; Walker, Anne E; Grimshaw, Jeremy M

    2010-02-09

    There is growing interest in the use of cognitive, behavioural, and organisational theories in implementation research. However, the extent of use of theory in implementation research is uncertain. We conducted a systematic review of use of theory in 235 rigorous evaluations of guideline dissemination and implementation studies published between 1966 and 1998. Use of theory was classified according to type of use (explicitly theory based, some conceptual basis, and theoretical construct used) and stage of use (choice/design of intervention, process/mediators/moderators, and post hoc/explanation). Fifty-three of 235 studies (22.5%) were judged to have employed theories, including 14 studies that explicitly used theory. The majority of studies (n = 42) used only one theory; the maximum number of theories employed by any study was three. Twenty-five different theories were used. A small number of theories accounted for the majority of theory use including PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation), diffusion of innovations, information overload and social marketing (academic detailing). There was poor justification of choice of intervention and use of theory in implementation research in the identified studies until at least 1998. Future research should explicitly identify the justification for the interventions. Greater use of explicit theory to understand barriers, design interventions, and explore mediating pathways and moderators is needed to advance the science of implementation research.

  3. A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations

    Directory of Open Access Journals (Sweden)

    Grimshaw Jeremy M

    2010-02-01

    Full Text Available Abstract Background There is growing interest in the use of cognitive, behavioural, and organisational theories in implementation research. However, the extent of use of theory in implementation research is uncertain. Methods We conducted a systematic review of use of theory in 235 rigorous evaluations of guideline dissemination and implementation studies published between 1966 and 1998. Use of theory was classified according to type of use (explicitly theory based, some conceptual basis, and theoretical construct used and stage of use (choice/design of intervention, process/mediators/moderators, and post hoc/explanation. Results Fifty-three of 235 studies (22.5% were judged to have employed theories, including 14 studies that explicitly used theory. The majority of studies (n = 42 used only one theory; the maximum number of theories employed by any study was three. Twenty-five different theories were used. A small number of theories accounted for the majority of theory use including PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation, diffusion of innovations, information overload and social marketing (academic detailing. Conclusions There was poor justification of choice of intervention and use of theory in implementation research in the identified studies until at least 1998. Future research should explicitly identify the justification for the interventions. Greater use of explicit theory to understand barriers, design interventions, and explore mediating pathways and moderators is needed to advance the science of implementation research.

  4. What are effective strategies for implementing trauma-informed care in youth inpatient psychiatric and residential treatment settings? A realist systematic review.

    Science.gov (United States)

    Bryson, Stephanie A; Gauvin, Emma; Jamieson, Ally; Rathgeber, Melanie; Faulkner-Gibson, Lorelei; Bell, Sarah; Davidson, Jana; Russel, Jennifer; Burke, Sharlynne

    2017-01-01

    Many young people who receive psychiatric care in inpatient or residential settings in North America have experienced various forms of emotional trauma. Moreover, these settings can exacerbate trauma sequelae. Common practices, such as seclusion and restraint, put young people at risk of retraumatization, development of comorbid psychopathology, injury, and even death. In response, psychiatric and residential facilities have embraced trauma-informed care (TIC), an organizational change strategy which aligns service delivery with treatment principles and discrete interventions designed to reduce rates of retraumatization through responsive and non-coercive staff-client interactions. After more than two decades, a number of TIC frameworks and approaches have shown favorable results. Largely unexamined, however, are the features that lead to successful implementation of TIC, especially in child and adolescent inpatient psychiatric and residential settings. Using methods proposed by Pawson et al. (J Health Serv Res Policy 10:21-34, 2005), we conducted a modified five-stage realist systematic review of peer-reviewed TIC literature. We rigorously searched ten electronic databases for peer reviewed publications appearing between 2000 and 2015 linking terms "trauma-informed" and "child*" or "youth," plus "inpatient" or "residential" plus "psych*" or "mental." After screening 693 unique abstracts, we selected 13 articles which described TIC interventions in youth psychiatric or residential settings. We designed a theoretically-based evaluative framework using the active implementation cycles of the National Implementation Research Network (NIRN) to discern which foci were associated with effective TIC implementation. Excluded were statewide mental health initiatives and TIC implementations in outpatient mental health, child welfare, and education settings. Interventions examined included: Attachment, Self-Regulation, and Competency Framework; Six Core Strategies

  5. 77 FR 36964 - Approval and Promulgation of Implementation Plans; Texas; Revisions to the New Source Review (NSR...

    Science.gov (United States)

    2012-06-20

    ... parallel processing, EPA takes final action on the State's proposal if the State's final submission is... the State's February 22, 2012, proposed rulemaking parallel reviewed by EPA for this proposal action... the State's February 22, 2012, proposed parallel rulemaking parallel reviewed by EPA for this proposal...

  6. Understanding Ionic Liquid Pretreatment of Lignocellulosic Biomasses

    Science.gov (United States)

    Pretreatment of biomass is essential for breaking apart highly ordered and crystalline plant cell walls and loosening the lignin and hemicellulose conjugation to cellulose microfibrills, thereby facilitating enzyme accessibility and adsorption and reducing costs of downstream saccharification proces...

  7. Hydrolysis of alkaline pretreated banana peel

    Science.gov (United States)

    Fatmawati, A.; Gunawan, K. Y.; Hadiwijaya, F. A.

    2017-11-01

    Banana peel is one of food wastes that are rich in carbohydrate. This shows its potential as fermentation substrate including bio-ethanol. This paper presented banana peel alkaline pretreatment and enzymatic hydrolysis. The pretreatment was intended to prepare banana peel in order to increase hydrolysis performance. The alkaline pretreatment used 10, 20, and 30% w/v NaOH solution and was done at 60, 70 and 80°C for 1 hour. The hydrolysis reaction was conducted using two commercial cellulose enzymes. The reaction time was varied for 3, 5, and 7 days. The best condition for pretreatment process was one conducted using 30% NaOH solution and at 80°C. This condition resulted in cellulose content of 90.27% and acid insoluble lignin content of 2.88%. Seven-day hydrolysis time had exhibited the highest reducing sugar concentration, which was7.2869 g/L.

  8. Ultrasonic sludge pretreatment under pressure.

    Science.gov (United States)

    Le, Ngoc Tuan; Julcour-Lebigue, Carine; Delmas, Henri

    2013-09-01

    The objective of this work was to optimize the ultrasound (US) pretreatment of sludge. Three types of sewage sludge were examined: mixed, secondary and secondary after partial methanisation ("digested" sludge). Thereby, several main process parameters were varied separately or simultaneously: stirrer speed, total solid content of sludge (TS), thermal operating conditions (adiabatic vs. isothermal), ultrasonic power input (PUS), specific energy input (ES), and for the first time external pressure. This parametric study was mainly performed for the mixed sludge. Five different TS concentrations of sludge (12-36 g/L) were tested for different values of ES (7000-75,000 kJ/kgTS) and 28 g/L was found as the optimum value according to the solubilized chemical oxygen demand in the liquid phase (SCOD). PUS of 75-150 W was investigated under controlled temperature and the "high power input - short duration" procedure was the most effective at a given ES. The temperature increase in adiabatic US application significantly improved SCOD compared to isothermal conditions. With PUS of 150 W, the effect of external pressure was investigated in the range of 1-16 bar under isothermal and adiabatic conditions for two types of sludge: an optimum pressure of about 2 bar was found regardless of temperature conditions and ES values. Under isothermal conditions, the resulting improvement of sludge disintegration efficacy as compared to atmospheric pressure was by 22-67% and 26-37% for mixed and secondary sludge, respectively. Besides, mean particle diameter (D[4,3]) of the three sludge types decreased respectively from 408, 117, and 110 μm to about 94-97, 37-42, and 36-40 μm regardless of sonication conditions, and the size reduction process was much faster than COD extraction. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Interprofessional education for whom? --challenges and lessons learned from its implementation in developed countries and their application to developing countries: a systematic review.

    Directory of Open Access Journals (Sweden)

    Bruno F Sunguya

    Full Text Available BACKGROUND: Evidence is available on the potential efficacy of interprofessional education (IPE to foster interprofessional cooperation, improve professional satisfaction, and improve patient care. While the intention of the World Health Organization (WHO is to implement IPE in all countries, evidence comes from developed countries about its efficiency, challenges, and barriers to planning and implementing IPE. We therefore conducted this review to examine challenges of implementing IPE to suggest possible pathways to overcome the anticipated challenges in developing countries. METHODS: We searched for literatures on IPE in PubMed/MEDLINE, CINAHL, PsycINFO, and ERIC databases. We examined challenges or barriers and initiatives to overcome them so as to suggest methods to solve the anticipated challenges in developing countries. We could not conduct a meta-analysis because of the qualitative nature of the research question and the data; instead we conducted a meta-narrative of evidence. RESULTS: A total of 40 out of 2,146 articles were eligible for analyses in the current review. Only two articles were available from developing countries. Despite the known benefits of IPE, a total of ten challenges or barriers were common based on the retrieved evidence. They included curriculum, leadership, resources, stereotypes and attitudes, variety of students, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Out of ten, three had already been reported in developing countries: IPE curriculum, resource limitations, and stereotypes. CONCLUSION: This study found ten important challenges on implementing IPE. They are curriculum, leadership, resources, stereotypes, students' diversity, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Although only three of them are already experienced in developing countries, the remaining seven are potentially important for developing countries, too. By knowing these

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

    NARCIS (Netherlands)

    Z. Trogrlic (Zoran); M. van der Jagt (Mathieu); J. Bakker (Jan); M.C. Balas (Michele C.); E.W. Ely (Wesley E.); P.H.J. van der Voort (Peter); E. Ista (Erwin)

    2015-01-01

    textabstractIntroduction: Despite recommendations from professional societies and patient safety organizations, the majority of ICU patients worldwide are not routinely monitored for delirium, thus preventing timely prevention and management. The purpose of this systematic review is to summarize

  11. 78 FR 4339 - Approval and Promulgation of Implementation Plans; New Mexico; Revisions to the New Source Review...

    Science.gov (United States)

    2013-01-22

    ..., and conflict with our intentions for the use of SILs to demonstrate compliance with CAA section 163(a... submitted on May 23, 2011, will remain before EPA for review. EPA will revisit these submitted revisions...

  12. The implementation of musculoskeletal injury-prevention exercise programmes in team ball sports: a systematic review employing the RE-AIM framework.

    Science.gov (United States)

    O'Brien, James; Finch, Caroline F

    2014-09-01

    Team ball sports such as soccer, basketball and volleyball have high participation levels worldwide. Musculoskeletal injuries are common in team ball sports and are associated with significant treatment costs, participation loss and long-term negative side effects. The results of recent randomized controlled trials provide support for the protective effect of injury-prevention exercise programmes (IPEPs) in team ball sports, but also highlight that achieving adequate compliance can be challenging. A key process in enhancing the ultimate impact of team ball sport IPEPs is identifying the specific implementation components that influence the adoption, execution and maintenance of these interventions. Despite this, no systematic review focussing on the specific implementation components of team ball sport IPEPs has been conducted. Our objective was to assess the reporting of specific implementation components in the published literature on team ball sport IPEPs using the Reach Efficacy Adoption Implementation Maintenance (RE-AIM) framework. Six electronic databases were systematically searched from inception to December 2012 for papers reporting team ball sport IPEP trials. All eligible papers were independently evaluated by two raters before reaching consensus on the reporting of individual RE-AIM items, using the RE-AIM Model Dimension Items Checklist (RE-AIM MDIC). A total of 60 papers, reporting 52 unique intervention trials, met eligibility criteria. Before consensus, the level of agreement across all trials between reviewers using the RE-AIM MDIC ranged from 81 to 91%. The RE-AIM MDIC dimension of 'efficacy' had the highest level of reporting, with the five individual items in this dimension reported in 19-100% of eligible trials (mean 58%). The RE-AIM MDIC dimension 'maintenance-setting level' had the lowest level of reporting, with none of the four individual items in this dimension reported. For other dimensions, the mean level of reporting and range across

  13. The Role of Therapist Training in the Implementation of Psychosocial Treatments: A Review and Critique with Recommendations

    OpenAIRE

    Herschell, Amy D.; Kolko, David J.; Baumann, Barbara L.; Davis, Abigail C.

    2010-01-01

    Evidence-based treatments (EBT) are underutilized in community settings, where consumers are often seen for treatment. Underutilization of EBTs may be related to a lack of empirically informed and supported training strategies. The goals of this review are to understand the state of the literature for training therapists in psychotherapy skills and to offer recommendations to improve research in this area. Results of this review of 55 studies evaluating six training methods indicate that mult...

  14. [Priorization of facilitators for the implementation of medication review with follow-up service in Spanish community pharmacies through exploratory factor analysis].

    Science.gov (United States)

    Gil, Modesta Inmaculada; Benrimoj, Shalom Isaac; Martínez-Martínez, Fernando; Cardero, Manuel; Gastelurrutia, Miguel Ángel

    2013-01-01

    to prioritize previously identified in Spain facilitators for the implementation of new Pharmaceutical Services that allow designing strategies for the implementation of Medication Review with follow-up (MRFup) service. Exploratory factor analysis (EFA). A draft of a questionnaire was performed based on a previous literature review and following the RAND/UCLA methodology. An expert panel worked with it and generated a definitive questionnaire which, after piloting, was used with a representative sample of pharmacists, owners or staff members, who were working in community pharmacy, using computer-assisted telephone interviewing (CATI) methodology. To understand underlying constructs in the questionnaire an EFA was performed. Different approaches were tested such as principal components factor analysis and principal axis factoring method. The best interpretability was achieved using the Factorization of Principal axis method with Direct Oblimin rotation, which explained the 40.0% of total variance. This produced four factors defined as: «Incentives», «External campaigns», «Expert in MRFup» and «Professionalism of the pharmacist». It can be stated that for implementation and sustainability of MRFup Service it is necessary being paid; also it must be explained to health professional and society in general. Practice of MRFup service demands pharmacists receiving a more clinical education and assuming more responsibilities as health professionals. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  15. Linguistic and review features of peer feedback and their effect on the implementation of changes in academic writing: A corpus based investigation

    Directory of Open Access Journals (Sweden)

    Djuddah A.J. Leijen & Anna Leontjeva

    2012-11-01

    Full Text Available The inclusion of peer feedback activities into the academic writing process has become common practice in higher education. However, while research has shown that students perceive many features of peer feedback to be useful, the actual effectiveness of these features in terms of measurable learning outcomes remains unclear. The aim of this study was to investigate the linguistic and review features of peer feedback and how these might influence peers to accept or reject revision advice offered in the context of academic writing among L2 learners. A corpus-based machine learning approach was employed to test three different algorithms (logistic regression, decision tree, and random forests on three feature models (linguistic, review, and all features to determine which algorithm offered the best predictive results and to determine which feature model most accurately predicts implementation. The results indicated that random forests is the most effective way of modeling the different features. In addition, the feature model containing all features most accurately predicted implementation. The findings further suggest that directive comments and multiple peer comments on the same topic included in the feedback process seem to influence implementation.

  16. Pre-treatment technologies for dark fermentative hydrogen production: Current advances and future directions.

    Science.gov (United States)

    Rafieenia, Razieh; Lavagnolo, Maria Cristina; Pivato, Alberto

    2018-01-01

    Hydrogen is regarded as a clean and non-carbon fuel and it has a higher energy content compared to carbon fuels. Dark fermentative hydrogen production from organic wastes is the most promising technology for commercialization among chemical and biological methods. Using mixed microflora is favored in terms of easier process control and substrate conversion efficiencies instead of pure cultures. However, mixed cultures should be first pre-treated in order to select sporulating hydrogen producing bacteria and suppress non-spore forming hydrogen consumers. Various inoculum pre-treatments have been used to enhance hydrogen production by dark fermentation including heat shock, acid or alkaline treatment, chemical inhibition, aeration, irradiation and inhibition by long chain fatty acids. Regarding substrate pre-treatment, that is performed with the aim of enhanced substrate biodegradability, thermal pre-treatment, pH adjustment using acid or base, microwave irradiation, sonication and biological treatment are the most commonly studied technologies. This article reviews the most investigated pre-treatment technologies applied for either inoculum or substrate prior to dark fermentation, the long-term effects of varying pre-treatment methods and the subsequently feasibility of each method for commercialization. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. 75 FR 56423 - Approval and Promulgation of Implementation Plans; Texas; Revisions to the New Source Review (NSR...

    Science.gov (United States)

    2010-09-15

    ... Phase 1 Implementation Rule in its entirety. South Coast Air Quality Management District, et al., v. EPA... of South Coast Air Quality Management District v. EPA. As a result of this decision, States must... Permit program. Finally, EPA is also disapproving a submitted severable definition of best available...

  18. The relevance of team characteristics and team directed strategies in the implementation of nursing innovations: a literature review.

    NARCIS (Netherlands)

    Holleman, G.J.M.; Poot, E.; Mintjes-de Groot, A.J.; Achterberg, T. van

    2009-01-01

    BACKGROUND: Implementation of innovations is a complex and intensive procedure in which different strategies can be successful. In nursing, strategies often focus on intrinsic motivation, competencies and attitudes of individual nurses while ignoring the social context. Since nurses often work in

  19. The relevance of team characteristics and team directed strategies in the implementation of nursing innovations : A literature review

    NARCIS (Netherlands)

    Theo van Achterberg; Joke Mintjes; G. Holleman; E. Poot

    2009-01-01

    Implementation of innovations is a complex and intensive procedure in which different strategies can be successful. In nursing, strategies often focus on intrinsic motivation, competencies and attitudes of individual nurses while ignoring the social context. Since nurses often work in teams,

  20. Translating knowledge on best practice into improving quality of RRT care: a systematic review of implementation strategies

    NARCIS (Netherlands)

    van der Veer, Sabine N.; Jager, Kitty J.; Nache, Azri M.; Richardson, Donald; Hegarty, Janet; Couchoud, Cécile; de Keizer, Nicolette F.; Tomson, Charles R. V.

    2011-01-01

    Recent studies showed wide variation in the extent to which guidelines and other types of best practice have been implemented as part of routine health care. This is also true for the delivery of renal replacement therapy (RRT) for ESRD patients. Increasing uptake of best practice within such

  1. The implementation of Integrated Disease Surveillance and Response in Uganda: a review of progress and challenges between 2001 and 2007.

    Science.gov (United States)

    Lukwago, Luswa; Nanyunja, Miriam; Ndayimirije, Nestor; Wamala, Joseph; Malimbo, Mugaga; Mbabazi, William; Gasasira, Anne; Nabukenya, Immaculate N; Musenero, Monica; Alemu, Wondimagegnehu; Perry, Helen; Nsubuga, Peter; Talisuna, Ambrose

    2013-01-01

    In 2000 Uganda adopted the Integrated Disease Surveillance and Response (IDSR) strategy, which aims to create a co-ordinated approach to the collection, analysis, interpretation, use and dissemination of surveillance data for guiding decision making on public health actions. We used a monitoring framework recommended by World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC)-Atlanta to evaluate performance of the IDSR core indicators at the national level from 2001 to 2007. To determine the performance of IDSR at district and health facility levels over a 5-year period, we compared the evaluation results of a 2004 surveillance survey with findings from a baseline assessment in 2000. We also examined national-level funding for IDSR implementation during 2000-07. Our findings show improvements in the performance of IDSR, including: (1) improved reporting at the district level (49% in 2001; 85% in 2007); (2) an increase and then decrease in timeliness of reporting from districts to central level; and (3) an increase in analysed data at the local level (from 10% to 47% analysing at least one target disease, P < 0.01). The case fatality rate (CFR) for two target priority diseases (cholera and meningococcal meningitis) decreased during IDSR implementation (cholera: from 7% to 2%; meningitis: from 16% to 4%), most likely due to improved outbreak response. A comparison before and after implementation showed increased funding for IDSR from government and development partners. However, funding support decreased ten-fold from the government budget of 2000/01 through to 2007/08. Per capita input for disease surveillance activities increased from US$0.0046 in 1996-99 to US$0.0215 in 2000-07. Implementation of IDSR was associated with improved surveillance and response efforts. However, decreased budgetary support from the government may be eroding these gains. Renewed efforts from government and other stakeholders are necessary to sustain and

  2. Hanford tank waste simulants specification and their applicability for the retrieval, pretreatment, and vitrification processes

    Energy Technology Data Exchange (ETDEWEB)

    GR Golcar; NG Colton; JG Darab; HD Smith

    2000-04-04

    A wide variety of waste simulants were developed over the past few years to test various retrieval, pretreatment and waste immobilization technologies and unit operations. Experiments can be performed cost-effectively using non-radioactive waste simulants in open laboratories. This document reviews the composition of many previously used waste simulants for remediation of tank wastes at the Hanford reservation. In this review, the simulants used in testing for the retrieval, pretreatment, and vitrification processes are compiled, and the representative chemical and physical characteristics of each simulant are specified. The retrieval and transport simulants may be useful for testing in-plant fluidic devices and in some cases for filtration technologies. The pretreatment simulants will be useful for filtration, Sr/TRU removal, and ion exchange testing. The vitrification simulants will be useful for testing melter, melter feed preparation technologies, and for waste form evaluations.

  3. Hanford tank waste simulants specification and their applicability for the retrieval, pretreatment, and vitrification processes

    International Nuclear Information System (INIS)

    GR Golcar; NG Colton; JG Darab; HD Smith

    2000-01-01

    A wide variety of waste simulants were developed over the past few years to test various retrieval, pretreatment and waste immobilization technologies and unit operations. Experiments can be performed cost-effectively using non-radioactive waste simulants in open laboratories. This document reviews the composition of many previously used waste simulants for remediation of tank wastes at the Hanford reservation. In this review, the simulants used in testing for the retrieval, pretreatment, and vitrification processes are compiled, and the representative chemical and physical characteristics of each simulant are specified. The retrieval and transport simulants may be useful for testing in-plant fluidic devices and in some cases for filtration technologies. The pretreatment simulants will be useful for filtration, Sr/TRU removal, and ion exchange testing. The vitrification simulants will be useful for testing melter, melter feed preparation technologies, and for waste form evaluations

  4. Implementation evaluation of early intensive behavioral intervention programs for children with autism spectrum disorders: A systematic review of studies in the last decade.

    Science.gov (United States)

    Caron, Valérie; Bérubé, Annie; Paquet, Annie

    2017-06-01

    For young children with autism spectrum disorders, one of the choice interventions is Early Intensive Behavioral Intervention. Over the past ten years, its effectiveness has been abundantly evaluated based on various parameters, including the intensity and duration of the intervention. Despite major advances in effectiveness evaluation, data concerning the implementation of the intervention are often described briefly, and the active ingredients of the intervention are but rarely linked to the documented effects. This study aims at reviewing with a systematic method, the studies pertaining to EIBI provided to children with autism spectrum disorders over the past ten years (2005-2015) and at documenting the program implementation components described in the studies, based on Dane and Schneider's (1998) model in accordance with PRISMA guidelines. The results show that, although the variables related to intervention dosage and protocol are relatively well described, the authors do not always consider them in the effects analysis. Furthermore, the majority of the studies did not report information on intervention participation, differentiation or quality. Data concerning the implementation of the intervention are partially described in the articles retained. In this regard, a better description of the intervention provided and a more systematic evaluation of its implementation seem necessary to detect the subtle differences in the effects of the intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The role of therapist training in the implementation of psychosocial treatments: a review and critique with recommendations.

    Science.gov (United States)

    Herschell, Amy D; Kolko, David J; Baumann, Barbara L; Davis, Abigail C

    2010-06-01

    Evidence-based treatments (EBT) are underutilized in community settings, where consumers are often seen for treatment. Underutilization of EBTs may be related to a lack of empirically informed and supported training strategies. The goals of this review are to understand the state of the literature for training therapists in psychotherapy skills and to offer recommendations to improve research in this area. Results of this review of 55 studies evaluating six training methods indicate that multi-component trainings have been studied most often and have most consistently demonstrated positive training outcomes relative to other training methods. Studies evaluating utility of reading, self-directed trainings, and workshops have documented that these methods do not routinely produce positive outcomes. Workshop follow-ups help to sustain outcomes. Little is known about the impact of train-the-trainer methods. Methodological flaws and factors that may influence training outcome and future directions are also reviewed.

  6. KPIs for measuring the sustainability performance of ecodesign implementation into product development and related processes: a systematic literature review

    DEFF Research Database (Denmark)

    Rodrigues, Vinicius Picanco; Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.

    , marketing, procurement etc. in order to develop products with increased environmental performance.The application of ecodesign potentially presents a set of sustainability benefits, such as innovation potential, development of new products and business models, the ability to meet or exceed customer......, many difficulties still surround the implementation and management of ecodesign. The main challenges in embedding ecodesign into PDRP are: (i) the lack of support to select key performance indicators (KPI) to measure how well a company is being successful in ecodesign integration from a product...... development process perspective; and (ii) to quantify the sustainability benefits of ecodesign implementation. Various frameworks for performance measurement systems (PMS) have been proposed, such as the Balanced Scorecard (BSC) and Neely’s “Performance Prism”. The PMS bundles the set of individual indicators...

  7. Measuring the implementation of ecodesign management practices: a review and consolidation of process-oriented performance indicators

    DEFF Research Database (Denmark)

    Rodrigues, Vinicius Picanco; Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.

    2017-01-01

    of ecodesign implementation and management. To enable a systematic and streamlined integration of ecodesign practices into the product development processes, adequate mechanisms are needed to capture and measure performance improvements, and thereby achieve consistent improvements in a company’s efforts...... towards enhanced sustainability performance. In face of this challenge, this paper aims at providing organizations with a set of process-oriented indicators to supporting and enhancing ecodesign implementation and management. This research was grounded on a 2-phase approach to (i) cross......Ecodesign plays an important role in manufacturing companies’ quest for improved sustainability performance. However, many ecodesign efforts are geared towards tackling single-issue discrete improvements, in contrast to operationalizing, measuring and acting upon the consistent improvement...

  8. Review Of Implementation In Bunut Shoes Assistance Program In Order Of Micro, Small And Medium Enterprises Economic In Asahan Regency

    Science.gov (United States)

    Saleh Malawat, M.; Putra, M. Umar Maya

    2018-03-01

    This paper studies the implementation of business opportunities that can improve the revenue of Bunut Shoes Micro, Small and Medium Enterprises. Probit model with E Views 6 program was used to see how far the opportunity of variable efforts to improve the revenue such as education, training, capital assistance, technological procurement of them. The data used was the primary data by conducting a survey using questionnaires to members of them with the observation period from 2013 to 2015. The results showed that all variables of implementation did not have a business opportunity correlation to the increase in revenue and Asahan District Governments are asked to create a creative breakthrough in order to achieve optimal business revenue and cooperate with other private institutions related to increase the business income.

  9. Improving obstetric care in low-resource settings: implementation of facility-based maternal death reviews in five pilot hospitals in Senegal

    Directory of Open Access Journals (Sweden)

    Fournier Pierre

    2009-07-01

    Full Text Available Abstract Background In sub-Saharan Africa, maternal and perinatal mortality and morbidity are major problems. Service availability and quality of care in health facilities are heterogeneous and most often inadequate. In resource-poor settings, the facility-based maternal death review or audit is one of the most promising strategies to improve health service performance. We aim to explore and describe health workers' perceptions of facility-based maternal death reviews and to identify barriers to and facilitators of the implementation of this approach in pilot health facilities of Senegal. Methods This study was conducted in five reference hospitals in Senegal with different characteristics. Data were collected from focus group discussions, participant observations of audit meetings, audit documents and interviews with the staff of the maternity unit. Data were analysed by means of both quantitative and qualitative approaches. Results Health professionals and service administrators were receptive and adhered relatively well to the process and the results of the audits, although some considered the situation destabilizing or even threatening. The main barriers to the implementation of maternal deaths reviews were: (1 bad quality of information in medical files; (2 non-participation of the head of department in the audit meetings; (3 lack of feedback to the staff who did not attend the audit meetings. The main facilitators were: (1 high level of professional qualifications or experience of the data collector; (2 involvement of the head of the maternity unit, acting as a moderator during the audit meetings; (3 participation of managers in the audit session to plan appropriate and realistic actions to prevent other maternal deaths. Conclusion The identification of the barriers to and the facilitators of the implementation of maternal death reviews is an essential step for the future adaptation of this method in countries with few resources. We

  10. Barriers and facilitators to implementation, uptake and sustainability of community-based health insurance schemes in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Fadlallah, Racha; El-Jardali, Fadi; Hemadi, Nour; Morsi, Rami Z; Abou Samra, Clara Abou; Ahmad, Ali; Arif, Khurram; Hishi, Lama; Honein-AbouHaidar, Gladys; Akl, Elie A

    2018-01-29

    Community-based health insurance (CBHI) has evolved as an alternative health financing mechanism to out of pocket payments in low- and middle-income countries (LMICs), particularly in areas where government or employer-based health insurance is minimal. This systematic review aimed to assess the barriers and facilitators to implementation, uptake and sustainability of CHBI schemes in LMICs. We searched six electronic databases and grey literature. We included both quantitative and qualitative studies written in English language and published after year 1992. Two reviewers worked in duplicate and independently to complete study selection, data abstraction, and assessment of methodological features. We synthesized the findings based on thematic analysis and categorized according to the ecological model into individual, interpersonal, community and systems levels. Of 15,510 citations, 51 met the eligibility criteria. Individual factors included awareness and understanding of the concept of CBHI, trust in scheme and scheme managers, perceived service quality, and demographic characteristics, which influenced enrollment and sustainability. Interpersonal factors such as household dynamics, other family members enrolled in the scheme, and social solidarity influenced enrollment and renewal of membership. Community-level factors such as culture and community involvement in scheme development influenced enrollment and sustainability of scheme. Systems-level factors encompassed governance, financial and delivery arrangement. Government involvement, accountability of scheme management, and strong policymaker-implementer relation facilitated implementation and sustainability of scheme. Packages that covered outpatient and inpatient care and those tailored to community needs contributed to increased enrollment. Amount and timing of premium collection was reported to negatively influence enrollment while factors reported as threats to sustainability included facility

  11. Enzymatic hydrolysis of pretreated soybean straw

    International Nuclear Information System (INIS)

    Xu Zhong; Wang Qunhui; Jiang Zhaohua; Yang Xuexin; Ji Yongzhen

    2007-01-01

    In order to produce lactic acid, from agricultural residues such as soybean straw, which is a raw material for biodegradable plastic production, it is necessary to decompose the soybean straw into soluble sugars. Enzymatic hydrolysis is one of the methods in common use, while pretreatment is the effective way to increase the hydrolysis rate. The optimal conditions of pretreatment using ammonia and enzymatic hydrolysis of soybean straw were determined. Compared with the untreated straw, cellulose in straw pretreated by ammonia liquor (10%) soaking for 24 h at room temperature increased 70.27%, whereas hemicellulose and lignin in pretreated straw decreased to 41.45% and 30.16%, respectively. The results of infrared spectra (IR), scanning electron microscope (SEM) and X-ray diffraction (XRD) analysis also showed that the structure and the surface of the straw were changed through pretreatment that is in favor of the following enzymatic hydrolysis. maximum enzymatic hydrolysis rate of 51.22% was achieved at a substrate concentration of 5% (w/v) at 50 deg. C and pH 4.8 using cellulase (50 fpu/g of substrate) for 36 h

  12. 76 FR 42078 - Approval and Promulgation of Implementation Plans; Texas; Revisions to the New Source Review (NSR...

    Science.gov (United States)

    2011-07-18

    ... analysis of the submittals for this definition has found that these changes meet the CAA and 40 CFR Part 51... (71 FR 52698) as part of the Texas SIP. ``Facility'' is defined as ``A discrete or identifiable... reviewing SIP submissions, EPA's role is to approve state choices, provided that they meet the criteria of...

  13. Review of transmission routes of 24 infectious diseases preventable by biosecurity measures and comparison of the implementation of these measures in pig herds in six European countries

    DEFF Research Database (Denmark)

    Filippitzi, M. E.; Kruse, Amanda Brinch; Postma, M.

    2018-01-01

    This study aimed to review the transmission routes of important infectious pig diseases and to translate these into biosecurity measures preventing or reducing the transmission between and within pig herds. Furthermore, it aimed to identify the level of implementation of these measures in different...... European countries and discuss the observed variations to identify potentials for improvement. First, a literature review was performed to show which direct and indirect transmission routes of 24 infectious pig diseases can be prevented through different biosecurity measures. Second, a quantitative...... on biosecurity since 1971 in Denmark. However, the observed pattern may also be attributed to differences in data collection methods. The qualitative analysis identified differences in applied policies, legislation, disease status, pig farm density, farming culture and habits between countries that can be used...

  14. ACC/AHA Special Report: Clinical Practice Guideline Implementation Strategies: A Summary of Systematic Reviews by the NHLBI Implementation Science Work Group: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

    Science.gov (United States)

    Chan, Wiley V; Pearson, Thomas A; Bennett, Glen C; Cushman, William C; Gaziano, Thomas A; Gorman, Paul N; Handler, Joel; Krumholz, Harlan M; Kushner, Robert F; MacKenzie, Thomas D; Sacco, Ralph L; Smith, Sidney C; Stevens, Victor J; Wells, Barbara L

    2017-02-28

    In 2008, the National Heart, Lung, and Blood Institute convened an Implementation Science Work Group to assess evidence-based strategies for effectively implementing clinical practice guidelines. This was part of a larger effort to update existing clinical practice guidelines on cholesterol, blood pressure, and overweight/obesity. Review evidence from the published implementation science literature and identify effective or promising strategies to enhance the adoption and implementation of clinical practice guidelines. This systematic review was conducted on 4 critical questions, each focusing on the adoption and effectiveness of 4 intervention strategies: (1) reminders, (2) educational outreach visits, (3) audit and feedback, and (4) provider incentives. A scoping review of the Rx for Change database of systematic reviews was used to identify promising guideline implementation interventions aimed at providers. Inclusion and exclusion criteria were developed a priori for each question, and the published literature was initially searched up to 2012, and then updated with a supplemental search to 2015. Two independent reviewers screened the returned citations to identify relevant reviews and rated the quality of each included review. Audit and feedback and educational outreach visits were generally effective in improving both process of care (15 of 21 reviews and 12 of 13 reviews, respectively) and clinical outcomes (7 of 12 reviews and 3 of 5 reviews, respectively). Provider incentives showed mixed effectiveness for improving both process of care (3 of 4 reviews) and clinical outcomes (3 reviews equally distributed between generally effective, mixed, and generally ineffective). Reminders showed mixed effectiveness for improving process of care outcomes (27 reviews with 11 mixed and 3 generally ineffective results) and were generally ineffective for clinical outcomes (18 reviews with 6 mixed and 9 generally ineffective results). Educational outreach visits (2 of 2

  15. Temperature Modelling of the Biomass Pretreatment Process

    DEFF Research Database (Denmark)

    Prunescu, Remus Mihail; Blanke, Mogens; Jensen, Jakob M.

    2012-01-01

    In a second generation biorefinery, the biomass pretreatment stage has an important contribution to the efficiency of the downstream processing units involved in biofuel production. Most of the pretreatment process occurs in a large pressurized thermal reactor that presents an irregular temperature...... distribution. Therefore, an accurate temperature model is critical for observing the biomass pretreatment. More than that, the biomass is also pushed with a constant horizontal speed along the reactor in order to ensure a continuous throughput. The goal of this paper is to derive a temperature model...... that captures the environmental temperature differences inside the reactor using distributed parameters. A Kalman filter is then added to account for any missing dynamics and the overall model is embedded into a temperature soft sensor. The operator of the plant will be able to observe the temperature in any...

  16. A review of methods and tools to assess the implementation of government policies to create healthy food environments for preventing obesity and diet-related non-communicable diseases

    OpenAIRE

    Phulkerd, Sirinya; Lawrence, Mark; Vandevijvere, Stefanie; Sacks, Gary; Worsley, Anthony; Tangcharoensathien, Viroj

    2016-01-01

    Background Policies to create healthy food environments are recognized as critical components of efforts to prevent obesity and diet-related non-communicable diseases. There has not been a systematic review of existing methods and tools used to assess the implementation of these government policies. The purpose of this study was to review methods and tools used for assessing the implementation of government policies to create healthy food environments. The study conducted a systematic literat...

  17. Cleanser, Detergent, Personal Care Product Pretreatment Evaluation

    Science.gov (United States)

    Adam, Niklas

    2010-01-01

    The purpose of the Cleanser, Detergent, Personal Care Product, and Pretreatment Evaluation & Selection task is to identify the optimal combination of personal hygiene products, crew activities, and pretreatment strategies to provide the crew with sustainable life support practices and a comfortable habitat. Minimal energy, mass, and crew time inputs are desired to recycle wastewater during long duration missions. This document will provide a brief background on the work this past year supporting the ELS Distillation Comparison Test, issues regarding use of the hygiene products originally chosen for the test, methods and results used to select alternative products, and lessons learned from testing.

  18. Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Diaa Othman

    2012-01-01

    Full Text Available This is a paper reviewing the National Health Service (NHS agenda in relation to the use of Negative Pressure Wound Therapy (NPWT in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients’ satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients’ satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.

  19. Identifying emerging trends for implementing learning technology in special education: a state-of-the-art review of selected articles published in 2008-2012.

    Science.gov (United States)

    Liu, Gi-Zen; Wu, No-Wei; Chen, Yi-Wen

    2013-10-01

    As electronic learning (e-learning) becomes increasingly popular in education worldwide, learning technology (LT) has been applied in various learning environments and activities to promote meaningful, efficient, and effective learning. LT has also been adopted by researchers and teacher-practitioners in the field of special education, but as yet little review-based research has been published. This review research thus carefully examined the trends of LT implementations in special education, providing a comprehensive analysis of 26 studies published in indexed journals in the past five years (2008-2012). Two research questions were addressed: (a) What are the major research aims, methodologies, and outcomes in these studies of implementing LT in the field of special education? and (b) What types of LT are mainly used with special education students, and for what kinds of students? Major findings include that examining the learning effectiveness of LT using was the most common research purpose (75%); researchers primarily relied on experimental studies (46%, 12 studies), followed by interviews and questionnaires (19%, 5 studies). Moreover, the most common use of LT was computer-assisted technology (such as web-based mentoring, educational computer games, laptop computers) in special education; studies investigating the use of LT with mentally disabled students were more than those with physically disabled ones. It is expected that the findings of this work and their implications will serve as valuable references with regard to the use of LT with special education students. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Negative pressure wound therapy literature review of efficacy, cost effectiveness, and impact on patients' quality of life in chronic wound management and its implementation in the United kingdom.

    Science.gov (United States)

    Othman, Diaa

    2012-01-01

    This is a paper reviewing the National Health Service (NHS) agenda in relation to the use of Negative Pressure Wound Therapy (NPWT) in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients' satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients' satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.

  1. Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom

    Science.gov (United States)

    Othman, Diaa

    2012-01-01

    This is a paper reviewing the National Health Service (NHS) agenda in relation to the use of Negative Pressure Wound Therapy (NPWT) in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients' satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients' satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country. PMID:22701169

  2. Diabetes self-management arrangements in Europe: a realist review to facilitate a project implemented in six countries.

    Science.gov (United States)

    Kousoulis, Antonis A; Patelarou, Evridiki; Shea, Sue; Foss, Christina; Ruud Knutsen, Ingrid A; Todorova, Elka; Roukova, Poli; Portillo, Mari Carmen; Pumar-Méndez, María J; Mujika, Agurtzane; Rogers, Anne; Vassilev, Ivaylo; Serrano-Gil, Manuel; Lionis, Christos

    2014-10-02

    Self-management of long term conditions can promote quality of life whilst delivering benefits to the financing of health care systems. However, rarely are the meso-level influences, likely to be of direct relevance to these desired outcomes, systematically explored. No specific international guidelines exist suggesting the features of the most appropriate structure and organisation of health care systems within which to situate self-management approaches and practices. This review aimed to identify the quantitative literature with regard to diabetes self-management arrangements currently in place within the health care systems of six countries (The United Kingdom, The Netherlands, Norway, Spain, Bulgaria, and Greece) and explore how these are integrated into the broader health care and welfare systems in each country. The methodology for a realist review was followed. Publications of interest dating from 2000 to 2013 were identified through appropriate MeSH terms by a systematic search in six bibliographic databases. A search diary was maintained and the studies were assessed for their quality and risk of bias. Following the multi-step search strategy, 56 studies were included in the final review (the majority from the UK) reporting design methods and findings on 21 interventions and programmes for diabetes and chronic disease self-management. Most (11/21, 52%) of the interventions were designed to fit within the context of primary care. The majority (11/21, 52%) highlighted behavioural change as an important goal. Finally, some (5/21, 24%) referred explicitly to Internet-based tools. This review is based on results which are derived from a total of at least 5,500 individuals residing in the six participating countries. It indicates a policy shift towards patient-centred self-management of diabetes in a primary care context. The professional role of diabetes specialist nurses, the need for multidisciplinary approaches and a focus on patient education emerge as

  3. Robotic Telecytology for Remote Cytologic Evaluation without an On-site Cytotechnologist or Cytopathologist: A Tale of Implementation and Review of Constraints.

    Science.gov (United States)

    Sirintrapun, Sahussapont Joseph; Rudomina, Dorota; Mazzella, Allix; Feratovic, Rusmir; Alago, William; Siegelbaum, Robert; Lin, Oscar

    2017-01-01

    The first satellite center to offer interventional radiology procedures at Memorial Sloan Kettering Cancer Center opened in October 2014. Two of the procedures offered, fine needle aspirations and core biopsies, required rapid on-site cytologic evaluation of smears and biopsy touch imprints for cellular content and adequacy. The volume and frequency of such evaluations did not justify hiring on-site cytotechnologists, and therefore, a dynamic robotic telecytology (TC) solution was created. In this technical article, we present a detailed description of our implementation of robotic TC. Pathology devised the remote robotic TC solution after acknowledging that it would not be cost effective to staff cytotechnologists on-site at the satellite location. Sakura VisionTek was selected as our robotic TC solution. In addition to configuration of the dynamic robotic TC solution, pathology realized integrating the technology solution into operations would require a multidisciplinary effort and reevaluation of existing staffing and workflows. Extensively described are the architectural framework and multidisciplinary process re-design, created to navigate the constraints of our technical, cultural, and organizational environment. Also reviewed are the benefits and challenges associated with available desktop sharing solutions, particularly accounting for information security concerns. Dynamic robotic TC is effective for immediate evaluations performed without on-site cytotechnology staff. Our goal is providing an extensive perspective of the implementation process, particularly technical, cultural, and operational constraints. Through this perspective, our template can serve as an extensible blueprint for other centers interested in implementing robotic TC without on-site cytotechnologists.

  4. Effectiveness of Implementing Evidence-based Interventions to Reduce C-spine Image Ordering in the Emergency Department: A Systematic Review.

    Science.gov (United States)

    Desai, Shashwat; Liu, Chaocheng; Kirkland, Scott W; Krebs, Lynette D; Keto-Lambert, Diana; Rowe, Brian H

    2017-12-19

    Appropriate use of imaging for adult patients with cervical spine (C-spine) injuries in the emergency department (ED) is a longstanding issue. Guidance for C-spine ordering exists; however, the effectiveness of the decision support implementation in the ED is not well studied. This systematic review examines the implementation and effectiveness of evidence-based interventions aimed at reducing C-spine imaging in adults presenting to the ED with neck trauma. Six electronic databases and the gray literature were searched. Comparative intervention studies were eligible for inclusion. Two independent reviewers screened for study eligibility, study quality, and extracted data. The change in imaging was reported using individual odds ratios (ORs) with 95% confidence intervals (CIs) using random effects. A total of 990 unique citations were screened for relevance of which six before-after studies and one randomized controlled trial were included. None of the studies were assessed as high quality. Interventions consisted primarily of locally developed guidelines or established clinical decision rules such as the NEXUS or the Canadian C-spine rule. Overall, implementation of interventions aimed at reducing C-spine image ordering resulted in a statistically significant reduction in imaging (OR = 0.69, 95% CI = 0.51-0.93); however, heterogeneity was high (I 2  = 82%). Subgroup analysis revealed no differences between studies that specified enrolling alert and stable patients compared to unspecified trauma (p = 0.81) or between studies employing multifaceted versus nonmultifaceted interventions (p = 0.66). While studies generally provided details on implementation strategies (e.g., teaching sessions, pocket cards, posters, computerized decision support) the effectiveness of these implementation strategies were frequently not reported. There is moderate evidence regarding the effectiveness of interventions to reduce C-spine image ordering in adult patients seen in the

  5. Barriers and Facilitators to the Implementation of Interventions to Prevent Youth Violence in Latin America: A Systematic Review and Qualitative Evidence Synthesis.

    Science.gov (United States)

    Atienzo, Erika E; Kaltenthaler, Eva; Baxter, Susan K

    2016-08-12

    Youth violence in Latin America is an important public health problem. However, the evidence from preventive programs within the region to address this problem is limited. Identifying context-specific factors that facilitate or hinder the success of interventions is necessary to guarantee the successful implementation of new preventive strategies. We present a systematic review and synthesis of qualitative studies to identify factors affecting the implementation of programs to prevent youth violence in Latin America. We searched 10 electronic databases and websites of international institutions. The quality of the studies was assessed using the critical appraisal skills program checklist, while the certainty of the findings of the synthesis was assessed using the certainty of the qualitative evidence approach. We included eight papers describing five programs in Argentina, Venezuela, Peru, El Salvador, and Mexico. Most of the factors affecting the implementation of programs were aspects related to features of the programs and social/political constraints. The synthesis suggests that future programs can benefit from having a multidisciplinary and/or multisectoral approach involving different key players. At the same time, potential strategies for avoiding problems related to such active engagement should be planned via promoting effective channels for communication and supervision. The review also suggests the importance of increasing awareness and motivation toward the problem of youth violence among relevant agencies and stakeholders. While the limited volume and quality of the literature impact on the ability to draw conclusions, the results could be useful for new programs being designed and the ones seeking to be adapted from other contexts. © The Author(s) 2016.

  6. Correlation of Technetium-99m Macroaggregated Albumin and Yttrium-90 Glass Microsphere Biodistribution in Hepatocellular Carcinoma: A Retrospective Review of Pretreatment Single Photon Emission CT and Posttreatment Positron Emission Tomography/CT.

    Science.gov (United States)

    Haste, Paul; Tann, Mark; Persohn, Scott; LaRoche, Thomas; Aaron, Vasantha; Mauxion, Thibault; Chauhan, Nikhil; Dreher, Matthew R; Johnson, Matthew S

    2017-05-01

    To evaluate whether technetium-99 ( 99m Tc)-labeled macroaggregated albumin (MAA) can predict subsequent yttrium-90 ( 90 Y) distribution and imaging response in patients with hepatocellular carcinoma (HCC). Retrospective review was performed of records of 83 patients with HCC who underwent 90 Y glass microsphere radioembolization with 99m Tc-MAA single photon emission computed tomography (SPECT) and 90 Y positron emission tomography (PET)/CT between January 2013 and December 2014. Images were fused to segment the whole liver normal tissue (WLNT) and the largest tumors. Fused images were reviewed and analyzed for comparison of absorbed dose (AD) to tumors and WLNT as calculated from 99m Tc-MAA SPECT and from 90 Y PET/CT, subjective imaging comparison of 99m Tc-MAA SPECT and 90 Y PET for tumors and WLNT, and correlation of tumoral AD with response on follow-up CT. Final analysis included 73 and 63 patients for WLNT and tumor 99m Tc-MAA/ 90 Y correlation, respectively, and 62 patients for AD vs response. 99m Tc-MAA/ 90 Y limit of agreement for each reviewer was viewed as clinically acceptable only for WLNT (-15 to 15 Gy). AD interreviewer variability was clinically acceptable for WLNT but was too broad for tumor. Mean tumor AD for objective response (78%) was 313 Gy vs 234 Gy for nonresponders. No threshold was found between tumor AD and response (P > .1). Catheter mismatch between 99m Tc-MAA and 90 Y had a direct impact on AD mismatch between the 2 image sets. 99m Tc-MAA was found to be a poor surrogate to quantitatively predict subsequent 90 Y AD to hepatocellular tumors. 99m Tc-MAA distribution correlated with 90 Y distribution in the normal hepatic parenchyma. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  7. Recent developments in sample preparation and data pre-treatment in metabonomics research.

    Science.gov (United States)

    Li, Ning; Song, Yi peng; Tang, Huiru; Wang, Yulan

    2016-01-01

    Metabonomics is a powerful approach for biomarker discovery and an effective tool for pinpointing endpoint metabolic effects of external stimuli, such as pathogens and disease development. Due to its wide applications, metabonomics is required to deal with various biological samples of different properties. Hence sample preparation and corresponding data pre-treatment become important factors in ensuring validity of an investigation. In this review, we summarize some recent developments in metabonomics sample preparation and data-pretreatment procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Earthdata Search Client: Usability Review Process, Results, and Implemented Changes, Using Earthdata Search Client as a Case Study

    Science.gov (United States)

    Siarto, Jeff; Reese, Mark; Shum, Dana; Baynes, Katie

    2016-01-01

    User experience and visual design are greatly improved when usability testing is performed on a periodic basis. Design decisions should be tested by real users so that application owners can understand the effectiveness of each decision and identify areas for improvement. It is important that applications be tested not just once, but as a part of a continuing process that looks to build upon previous tests. NASA's Earthdata Search Client has undergone a usability study to ensure its users' needs are being met and that users understand how to use the tool efficiently and effectively. This poster will highlight the process followed for usability study, the results of the study, and what has been implemented in light of the results to improve the application's interface.

  9. Review of transmission routes of 24 infectious diseases preventable by biosecurity measures and comparison of the implementation of these measures in pig herds in six European countries.

    Science.gov (United States)

    Filippitzi, M E; Brinch Kruse, A; Postma, M; Sarrazin, S; Maes, D; Alban, L; Nielsen, L R; Dewulf, J

    2018-04-01

    This study aimed to review the transmission routes of important infectious pig diseases and to translate these into biosecurity measures preventing or reducing the transmission between and within pig herds. Furthermore, it aimed to identify the level of implementation of these measures in different European countries and discuss the observed variations to identify potentials for improvement. First, a literature review was performed to show which direct and indirect transmission routes of 24 infectious pig diseases can be prevented through different biosecurity measures. Second, a quantitative analysis was performed using the Biocheck.UGent™, a risk-based scoring system to evaluate biosecurity in pig herds, to obtain an insight into the implementation of these biosecurity measures. The database contained farm-specific biosecurity data from 574 pig farms in Belgium, Denmark, France, Germany, the Netherlands and Sweden, entered between January 2014 and January 2016. Third, a qualitative analysis based on a review of literature and other relevant information resources was performed for every subcategory of internal and external biosecurity in the Biocheck.UGent™ questionnaire. The quantitative analysis indicated that at the level of internal, external and overall biosecurity, Denmark had a significantly distinct profile with higher external biosecurity scores and less variation than the rest of the countries. This is likely due to a widely used specific pathogen-free (SPF) system with extensive focus on biosecurity since 1971 in Denmark. However, the observed pattern may also be attributed to differences in data collection methods. The qualitative analysis identified differences in applied policies, legislation, disease status, pig farm density, farming culture and habits between countries that can be used for shaping country-specific biosecurity advice to attain improved prevention and control of important pig diseases in European pig farms. © 2017 Blackwell

  10. Fermentation of pretreated corncob hemicellulose hydrolysate to ...

    African Journals Online (AJOL)

    To investigate the effect of unknown fermentation inhibitors in corncob hemicellulose acid hydrolysate processed by pretreatment and detoxification on fermentation, corncob hemicellulose acid hydrolysate and artificially prepared hydrolysate were fermented in parallel by Candida shehatae YHFK-2. The results show that ...

  11. Antibacterial effect of surface pretreatment techniques against ...

    African Journals Online (AJOL)

    (CFU/ml), respectively, among the groups evaluated (P < 0.05). Er:YAG laser irradiation and its combinations with other antibacterial surface pretreatment applications also inhibited the bacterial growth with, respectively, 1444, 406, and 294 CFU/ml bacterial recovery being more efficient than KTP laser irradiation and ozone ...

  12. Antibacterial Effect of Surface Pretreatment Techniques against ...

    African Journals Online (AJOL)

    2018-02-23

    Feb 23, 2018 ... of dentin chips were obtained from the cavity walls, and the number of bacteria recovered was counted. Kruskal–Wallis ... Keywords: Antibacterial effect, cavity surface pretreatment techniques, cavity preparation, dental, dental ... wavelengths for removing oral soft and dental hard tissues without pain relief, ...

  13. Bromine pretreated chitosan for adsorption of lead

    Indian Academy of Sciences (India)

    Pollution by heavy metals like lead (II) is responsible for health hazards and environmental degradation. Adsorption is a prevalent method applied for removal of heavy metal pollutants from water. This study explored adsorption performances of 30% bromine pretreated chitosan for lead (II) abatement from water. Bromine ...

  14. Measuring the Effectiveness of Mentoring as a Knowledge Translation Intervention for Implementing Empirical Evidence: A Systematic Review

    Science.gov (United States)

    Abdullah, Ghadah; Rossy, Dianne; Ploeg, Jenny; Davies, Barbara; Higuchi, Kathryn; Sikora, Lindsey; Stacey, Dawn

    2014-01-01

    Background Mentoring as a knowledge translation (KT) intervention uses social influence among healthcare professionals to increase use of evidence in clinical practice. Aim To determine the effectiveness of mentoring as a KT intervention designed to increase healthcare professionals’ use of evidence in clinical practice. Methods A systematic review was conducted using electronic databases (i.e., MEDLINE, CINAHL), grey literature, and hand searching. Eligible studies evaluated mentoring of healthcare professionals responsible for patient care to enhance the uptake of evidence into practice. Mentoring is defined as (a) a mentor more experienced than mentee; (b) individualized support based on mentee's needs; and (c) involved in an interpersonal relationship as indicated by mutual benefit, engagement, and commitment. Two reviewers independently screened citations for eligibility, extracted data, and appraised quality of studies. Data were analyzed descriptively. Results Of 10,669 citations from 1988 to 2012, 10 studies were eligible. Mentoring as a KT intervention was evaluated in Canada, USA, and Australia. Exposure to mentoring compared to no mentoring improved some behavioral outcomes (one study). Compared to controls or other multifaceted interventions, multifaceted interventions with mentoring improved practitioners’ knowledge (four of five studies), beliefs (four of six studies), and impact on organizational outcomes (three of four studies). There were mixed findings for changes in professionals’ behaviors and impact on practitioners’ and patients’ outcomes: some outcomes improved, while others showed no difference. Linking Evidence to Action Only one study evaluated the effectiveness of mentoring alone as a KT intervention and showed improvement in some behavioral outcomes. The other nine studies that evaluated the effectiveness of mentoring as part of a multifaceted intervention showed mixed findings, making it difficult to determine the added effect

  15. Mental health and public policies implemented in the Northeast of Brazil: A systematic review with meta-analysis.

    Science.gov (United States)

    Januário, Sonilde Saraiva; das Neves Peixoto, Florido Sampaio; Lima, Nádia Nara Rolim; do Nascimento, Vânia Barbosa; de Sousa, Danilo Ferreira; Pereira Luz, Dayse Christina Rodrigues; da Silva, Claúdio Gleidiston Lima; Rolim Neto, Modesto Leite

    2017-02-01

    Studies about mental disorders are very rare in the Northeast of Brazil, especially when psychopathologies in children and adolescents are considered. The consequence is a small availability of data and an absence of a real epidemiological profile. This is a systematic review with meta-analysis, following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol, in the period from 2003 to 2015, using the databases LILACS, SciELO and BVS. The analysis comprised the keywords 'models of primary and secondary healthcare in mental health', 'psychiatric reform' and 'policies and services in mental health', using the Boolean operator '# AND'. Original texts based on secondary data from the Hospital Information System of the Brazilian Unified Health System were also included via the Citizen Electronic Record System, Instituto Brasileiro de Geografia e Estatística, and Ministry of Health. Grey literature was used by means of hand searching. A combined analysis of the strategies mentioned in the analyzed articles shows a combined odds ratio of 1.291 (confidence interval (CI) = 1.054-1.582), thus it demonstrates the efficacy of using such strategies in the elaboration of institutional apparatus in mental health. The p-value of the chi-square distribution resulted in .9753, which does not reject the hypothesis of association between strategies in mental health and possible development of institutional apparatus in mental health. A combined analysis of all strategies mentioned in the analyzed studies shows efficacy of using strategies to elaborate institutional apparatus in mental health.

  16. Biodelignification of lignocellulose substrates: An intrinsic and sustainable pretreatment strategy for clean energy production.

    Science.gov (United States)

    Chandel, Anuj K; Gonçalves, Bruna C M; Strap, Janice L; da Silva, Silvio S

    2015-01-01

    Lignocellulosic biomass (LB) is a promising sugar feedstock for biofuels and other high-value chemical commodities. The recalcitrance of LB, however, impedes carbohydrate accessibility and its conversion into commercially significant products. Two important factors for the overall economization of biofuel production is LB pretreatment to liberate fermentable sugars followed by conversion into ethanol. Sustainable biofuel production must overcome issues such as minimizing water and energy usage, reducing chemical usage and process intensification. Amongst available pretreatment methods, microorganism-mediated pretreatments are the safest, green, and sustainable. Native biodelignifying agents such as Phanerochaete chrysosporium, Pycnoporous cinnabarinus, Ceriporiopsis subvermispora and Cyathus stercoreus can remove lignin, making the remaining substrates amenable for saccharification. The development of a robust, integrated bioprocessing (IBP) approach for economic ethanol production would incorporate all essential steps including pretreatment, cellulase production, enzyme hydrolysis and fermentation of the released sugars into ethanol. IBP represents an inexpensive, environmentally friendly, low energy and low capital approach for second-generation ethanol production. This paper reviews the advancements in microbial-assisted pretreatment for the delignification of lignocellulosic substrates, system metabolic engineering for biorefineries and highlights the possibilities of process integration for sustainable and economic ethanol production.

  17. Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hye Bin; Park, Hee Chul; Park, Won [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); and others

    2012-09-15

    Although anemia is considered to be a contributor to intra-tumoral hypoxia and tumor resistance to ionizing radiation in cancer patients, the impact of pretreatment anemia on local control after neoadjuvant concurrent chemoradiotherapy (NACRT) and surgery for rectal cancer remains unclear. We reviewed the records of 247 patients with locally advanced rectal cancer who were treated with NACRT followed by curative-intent surgery. The patients with anemia before NACRT (36.0%, 89/247) achieved less pathologic complete response (pCR) than those without anemia (p = 0.012). The patients with pretreatment anemia had worse 3-year local control than those without pretreatment anemia (86.0% vs. 95.7%, p = 0.005). Multivariate analysis showed that pretreatment anemia (p = 0.035), pathologic tumor and nodal stage (p = 0.020 and 0.032, respectively) were independently significant factors for local control. Pretreatment anemia had negative impacts on pCR and local control among patients who underwent NACRT and surgery for rectal cancer. Strategies maintaining hemoglobin level within normal range could potentially be used to improve local control in rectal cancer patients.

  18. Negative impact of pretreatment anemia on local control after neoadjuvant chemoradiotherapy and surgery for rectal cancer

    International Nuclear Information System (INIS)

    Lee, Hye Bin; Park, Hee Chul; Park, Won

    2012-01-01

    Although anemia is considered to be a contributor to intra-tumoral hypoxia and tumor resistance to ionizing radiation in cancer patients, the impact of pretreatment anemia on local control after neoadjuvant concurrent chemoradiotherapy (NACRT) and surgery for rectal cancer remains unclear. We reviewed the records of 247 patients with locally advanced rectal cancer who were treated with NACRT followed by curative-intent surgery. The patients with anemia before NACRT (36.0%, 89/247) achieved less pathologic complete response (pCR) than those without anemia (p = 0.012). The patients with pretreatment anemia had worse 3-year local control than those without pretreatment anemia (86.0% vs. 95.7%, p = 0.005). Multivariate analysis showed that pretreatment anemia (p = 0.035), pathologic tumor and nodal stage (p = 0.020 and 0.032, respectively) were independently significant factors for local control. Pretreatment anemia had negative impacts on pCR and local control among patients who underwent NACRT and surgery for rectal cancer. Strategies maintaining hemoglobin level within normal range could potentially be used to improve local control in rectal cancer patients.

  19. Review of disaster management implementation for the community safety in the vicinity of oil and gas field

    International Nuclear Information System (INIS)

    Musa, R. Abdullah; Heni, Siti; Harjanto, Meddy

    2015-01-01

    Sukowati site which is operated by Production Sharing Contract (PSC) Joint Operating Body Pertamina Petrochina East Java (JOB P-PEJ) located at Bojonegoro regency East Java Province. This site is close to densely populated settlements with approximately 6,010 people within a radius less than 600 m. The fluid produced have a dangerous potential to the above mention community, due to accompanying of hydrogen sulphide gas (H2S) with a concentration about 0.6% – 2% from the total gas produced. In 2006, there was incident of gas leak from drilling development well of Sukowati # 5. The incident made the surrounding community panic due to lack of preparedness and awareness. Learning from the incident, the company together with the government and local communities initiated to make improvements through the disaster management system approach. The efforts are carried out in accordance with the 4 (four) periods in a continuous cycle consist of (1) mitigation; (2) preparation; (3) response and (4) recovery. Emergency response drills conducted regularly at least once a year, its main purpose is to find out the results of the implementation of the existing disaster management. The results of the drills showed an increase in public awareness and responsiveness to emergency situations caused by the operational failures of oil and gas exploration and production activities near their settlement

  20. Factors influencing the development and implementation of advanced and consultant radiographer practice - A review of the literature

    International Nuclear Information System (INIS)

    Kelly, Judith; Piper, Keith; Nightingale, Julie

    2008-01-01

    United Kingdom (UK) government policy, which has focused on modernising the NHS and making it more responsive to patients' needs, has, in fact, created significant service demand. The Department of Health (DoH) committed itself to changing and improving the organisation and delivery of health care through professional role development and blurring of traditional professional boundaries. In 2000, the DoH announced an intention to create consultant allied health professional posts to facilitate career development opportunities for expert and experienced staff. There are currently 31 consultant radiographers in the UK who have been appointed to new posts, and 2 trainees. Such posts are created subject to a formal approval panel process as laid down by the DoH. This paper will begin by outlining the current scope of radiographic consultant practice and advanced clinical roles in the UK. Key factors that have facilitated the development and implementation of such roles will then be explored and discussed. It will also consider what specific factors can inhibit innovative change and whether there appears to be any perceived threats to the current momentum of change

  1. Review of disaster management implementation for the community safety in the vicinity of oil and gas field

    Energy Technology Data Exchange (ETDEWEB)

    Musa, R. Abdullah; Heni, Siti [JOB Pertamina Petrochina East Java, Lingkar Pertamina - Soko, Tuban 62372 (Indonesia); Harjanto, Meddy, E-mail: mharja@gmail.com [JOB Pertamina Petrochina East Java, Lingkar Pertamina - Soko, Tuban 62372 (Indonesia); Occupational Health and Safety of Airlangga University, Surabaya 60115 (Indonesia)

    2015-04-24

    Sukowati site which is operated by Production Sharing Contract (PSC) Joint Operating Body Pertamina Petrochina East Java (JOB P-PEJ) located at Bojonegoro regency East Java Province. This site is close to densely populated settlements with approximately 6,010 people within a radius less than 600 m. The fluid produced have a dangerous potential to the above mention community, due to accompanying of hydrogen sulphide gas (H2S) with a concentration about 0.6% – 2% from the total gas produced. In 2006, there was incident of gas leak from drilling development well of Sukowati # 5. The incident made the surrounding community panic due to lack of preparedness and awareness. Learning from the incident, the company together with the government and local communities initiated to make improvements through the disaster management system approach. The efforts are carried out in accordance with the 4 (four) periods in a continuous cycle consist of (1) mitigation; (2) preparation; (3) response and (4) recovery. Emergency response drills conducted regularly at least once a year, its main purpose is to find out the results of the implementation of the existing disaster management. The results of the drills showed an increase in public awareness and responsiveness to emergency situations caused by the operational failures of oil and gas exploration and production activities near their settlement.

  2. Review of disaster management implementation for the community safety in the vicinity of oil and gas field

    Science.gov (United States)

    Musa, R. Abdullah; Harjanto, Meddy; Heni, Siti

    2015-04-01

    Sukowati site which is operated by Production Sharing Contract (PSC) Joint Operating Body Pertamina Petrochina East Java (JOB P-PEJ) located at Bojonegoro regency East Java Province. This site is close to densely populated settlements with approximately 6,010 people within a radius less than 600 m. The fluid produced have a dangerous potential to the above mention community, due to accompanying of hydrogen sulphide gas (H2S) with a concentration about 0.6% - 2% from the total gas produced. In 2006, there was incident of gas leak from drilling development well of Sukowati # 5. The incident made the surrounding community panic due to lack of preparedness and awareness. Learning from the incident, the company together with the government and local communities initiated to make improvements through the disaster management system approach. The efforts are carried out in accordance with the 4 (four) periods in a continuous cycle consist of (1) mitigation; (2) preparation; (3) response and (4) recovery. Emergency response drills conducted regularly at least once a year, its main purpose is to find out the results of the implementation of the existing disaster management. The results of the drills showed an increase in public awareness and responsiveness to emergency situations caused by the operational failures of oil and gas exploration and production activities near their settlement.

  3. Misoprostol for postpartum hemorrhage prevention at home birth: an integrative review of global implementation experience to date

    Science.gov (United States)

    2013-01-01

    Background Hemorrhage continues to be a leading cause of maternal death in developing countries. The 2012 World Health Organization guidelines for the prevention and management of postpartum hemorrhage (PPH) recommend oral administration of misoprostol by community health workers (CHWs). However, there are several outstanding questions about distribution of misoprostol for PPH prevention at home births. Methods We conducted an integrative review of published research studies and evaluation reports from programs that distributed misoprostol at the community level for prevention of PPH at home births. We reviewed methods and cadres involved in education of end-users, drug administration, distribution, and coverage, correct and incorrect usage, and serious adverse events. Results Eighteen programs were identified; only seven reported all data of interest. Programs utilized a range of strategies and timings for distributing misoprostol. Distribution rates were higher when misoprostol was distributed at a home visit during late pregnancy (54.5-96.9%) or at birth (22.5-83.6%), compared to antenatal care (ANC) distribution at any ANC visit (22.5-49.1%) or late ANC visit (21.0-26.7%). Coverage rates were highest when CHWs and traditional birth attendants distributed misoprostol and lower when health workers/ANC providers distributed the medication. The highest distribution and coverage rates were achieved by programs that allowed self-administration. Seven women took misoprostol prior to delivery out of more than 12,000 women who were followed-up. Facility birth rates increased in the three programs for which this information was available. Fifty-one (51) maternal deaths were reported among 86,732 women taking misoprostol: 24 were attributed to perceived PPH; none were directly attributed to use of misoprostol. Even if all deaths were attributable to PPH, the equivalent ratio (59 maternal deaths/100,000 live births) is substantially lower than the reported maternal

  4. Implementation of High Resolution Whole Genome Array CGH in the Prenatal Clinical Setting: Advantages, Challenges, and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Paola Evangelidou

    2013-01-01

    Full Text Available Array Comparative Genomic Hybridization analysis is replacing postnatal chromosomal analysis in cases of intellectual disabilities, and it has been postulated that it might also become the first-tier test in prenatal diagnosis. In this study, array CGH was applied in 64 prenatal samples with whole genome oligonucleotide arrays (BlueGnome, Ltd. on DNA extracted from chorionic villi, amniotic fluid, foetal blood, and skin samples. Results were confirmed with Fluorescence In Situ Hybridization or Real-Time PCR. Fifty-three cases had normal karyotype and abnormal ultrasound findings, and seven samples had balanced rearrangements, five of which also had ultrasound findings. The value of array CGH in the characterization of previously known aberrations in five samples is also presented. Seventeen out of 64 samples carried copy number alterations giving a detection rate of 26.5%. Ten of these represent benign or variables of unknown significance, giving a diagnostic capacity of the method to be 10.9%. If karyotype is performed the additional diagnostic capacity of the method is 5.1% (3/59. This study indicates the ability of array CGH to identify chromosomal abnormalities which cannot be detected during routine prenatal cytogenetic analysis, therefore increasing the overall detection rate. In addition a thorough review of the literature is presented.

  5. Review of techniques for monitoring the healing fracture of bones for implementation in an internally fixated pelvis.

    Science.gov (United States)

    Wong, Lydia Chwang Yuh; Chiu, Wing Kong; Russ, Matthias; Liew, Susan

    2012-03-01

    Sacral fractures from high-impact trauma often cause instability in the pelvic ring structure. Treatment is by internal fixation which clamps the fractured edges together to promote healing. Healing could take up to 12 weeks whereby patients are bedridden to avoid hindrances to the fracture from movement or weight bearing activities. Immobility can lead to muscle degradation and longer periods of rehabilitation. The ability to determine the time at which the fracture is stable enough to allow partial weight-bearing is important to reduce hospitalisation time. This review looks into different techniques used for monitoring the fracture healing of bones which could lead to possible methods for in situ and non-invasive assessment of healing fracture in a fixated pelvis. Traditional techniques being used include radiology and CT scans but were found to be unreliable at times and very subjective in addition to being non in situ. Strain gauges have proven to be very effective for accurate assessment of fracture healing as well as stability for long bones with external fixators but may not be suitable for an internally fixated pelvis. Ultrasound provides in situ monitoring of stiffness recovery but only assesses local fracture sites close to the skin surface and has only been tested on long bones. Vibration analysis can detect non-uniform healing due to its assessment of the overall structure but may suffer from low signal-to-noise ratio due to damping. Impedance techniques have been used to assess properties of non-long bones but recent studies have only been conducted on non-biological materials and more research needs to be done before it can be applicable for monitoring healing in the fixated pelvis. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  6. Individual performance review in hospital practice: the development of a framework and evaluation of doctors' attitudes to its value and implementation.

    Science.gov (United States)

    Trebble, T M; Cruickshank, L; Hockey, P M; Heyworth, N; Powell, T; Clarke, N

    2013-11-01

    Appraisal, or independent performance review (IPR) is used in human resources management in the commercial and public sectors to evaluate the performance of an employee against agreed local organisational expectations and objectives, and to identify their requirements for development and effective management. IPR for NHS consultants may provide essential information for job planning, contribute towards medical appraisal for revalidation, and facilitate productivity and quality improvement. To develop a framework for IPR for consultants, and to determine attitudes on its value, process and content. Information from commercial, public and voluntary sector models and published and other literature sources were used to develop an IPR framework. This was assessed through a three-cycle action research methodology involving qualitative interviews with 22 consultants (predominantly with medical management roles). The domains of the IPR framework included: (1) performance against objectives; (2) behaviour and leadership; (3) talent management; (4) agreed future objectives. A number of themes were identified from the consultant interviews including: ineffective current appraisal systems reflecting a lack of valid performance data and allotted time; a lack of empowerment of medical managers to address performance issues; IPR as a more explicit system, offering value in evaluating doctors performance; and the dependence of successful implementation on the engagement of the Trust executive. IPR may have value for performance evaluation of consultants, contributing toward job planning and complementing medical appraisal. Support by their employing organisation and engagement with medical managers in design and implementation is likely to be essential.

  7. Robotic telecytology for remote cytologic evaluation without an on-site cytotechnologist or cytopathologist: A tale of implementation and review of constraints

    Directory of Open Access Journals (Sweden)

    Sahussapont Joseph Sirintrapun

    2017-01-01

    Full Text Available Background: The first satellite center to offer interventional radiology procedures at Memorial Sloan Kettering Cancer Center opened in October 2014. Two of the procedures offered, fine needle aspirations and core biopsies, required rapid on-site cytologic evaluation of smears and biopsy touch imprints for cellular content and adequacy. The volume and frequency of such evaluations did not justify hiring on-site cytotechnologists, and therefore, a dynamic robotic telecytology (TC solution was created. In this technical article, we present a detailed description of our implementation of robotic TC. Methods: Pathology devised the remote robotic TC solution after acknowledging that it would not be cost effective to staff cytotechnologists on-site at the satellite location. Sakura VisionTek was selected as our robotic TC solution. In addition to configuration of the dynamic robotic TC solution, pathology realized integrating the technology solution into operations would require a multidisciplinary effort and reevaluation of existing staffing and workflows. Results: Extensively described are the architectural framework and multidisciplinary process re-design, created to navigate the constraints of our technical, cultural, and organizational environment. Also reviewed are the benefits and challenges associated with available desktop sharing solutions, particularly accounting for information security concerns. Conclusions: Dynamic robotic TC is effective for immediate evaluations performed without on-site cytotechnology staff. Our goal is providing an extensive perspective of the implementation process, particularly technical, cultural, and operational constraints. Through this perspective, our template can serve as an extensible blueprint for other centers interested in implementing robotic TC without on-site cytotechnologists.

  8. Challenges to the programmatic implementation of ready to use infant formula in the post-earthquake response, Haiti, 2010: a program review.

    Directory of Open Access Journals (Sweden)

    Leisel E Talley

    Full Text Available BACKGROUND AND OBJECTIVES: Following the 2010 earthquake in Haiti, infant and young child feeding was identified as a priority nutrition intervention. A new approach to support breastfeeding mothers and distribute ready-to-use infant formula (RUIF to infants unable to breastfeed was established. The objective of the evaluation was to assess the implementation of infant feeding programs using RUIF in displaced persons camps in Port-au-Prince, Haiti during the humanitarian response. METHODS: A retrospective record review was conducted from April-July, 2010 to obtain data on infants receiving RUIF in 30 baby tents. A standardized data collection form was created based on data collected across baby tents and included: basic demographics, admission criteria, primary caretaker, feeding practices, and admission and follow-up anthropometrics. MAIN FINDINGS: Orphans and abandoned infants were the most frequent enrollees (41% in the program. While the program targeted these groups, it is unlikely that this is a true reflection of population demographics. Despite programmatic guidance, admission criteria were not consistently applied across programs. Thirty-four percent of infants were undernourished (weight for age Z score <-2 at the time of admission. Defaulting accounted for 50% of all program exits and there was no follow-up of these children. Low data quality was a significant barrier. CONCLUSIONS: The design, implementation and magnitude of the 'baby tents' using RUIF was novel in response to infant and young child feeding (IYCF in emergencies and presented multiple challenges that should not be overlooked, including adherence to protocols and the adaption of emergency programs to existing programs. The implementation of IYCF programs should be closely monitored to ensure that they achieve the objectives set by the humanitarian community and national government. IYCF is an often overlooked component of emergency preparedness; however to improve

  9. Challenges to the programmatic implementation of ready to use infant formula in the post-earthquake response, Haiti, 2010: a program review.

    Science.gov (United States)

    Talley, Leisel E; Boyd, Erin

    2013-01-01

    Following the 2010 earthquake in Haiti, infant and young child feeding was identified as a priority nutrition intervention. A new approach to support breastfeeding mothers and distribute ready-to-use infant formula (RUIF) to infants unable to breastfeed was established. The objective of the evaluation was to assess the implementation of infant feeding programs using RUIF in displaced persons camps in Port-au-Prince, Haiti during the humanitarian response. A retrospective record review was conducted from April-July, 2010 to obtain data on infants receiving RUIF in 30 baby tents. A standardized data collection form was created based on data collected across baby tents and included: basic demographics, admission criteria, primary caretaker, feeding practices, and admission and follow-up anthropometrics. Orphans and abandoned infants were the most frequent enrollees (41%) in the program. While the program targeted these groups, it is unlikely that this is a true reflection of population demographics. Despite programmatic guidance, admission criteria were not consistently applied across programs. Thirty-four percent of infants were undernourished (weight for age Z score <-2) at the time of admission. Defaulting accounted for 50% of all program exits and there was no follow-up of these children. Low data quality was a significant barrier. The design, implementation and magnitude of the 'baby tents' using RUIF was novel in response to infant and young child feeding (IYCF) in emergencies and presented multiple challenges that should not be overlooked, including adherence to protocols and the adaption of emergency programs to existing programs. The implementation of IYCF programs should be closely monitored to ensure that they achieve the objectives set by the humanitarian community and national government. IYCF is an often overlooked component of emergency preparedness; however to improve response, generic protocols and pre-emergency training and preparedness should be

  10. Evaluation of the improvement of sonication pre-treatment in the anaerobic digestion of sewage sludge.

    Science.gov (United States)

    Martín, María Ángeles; González, Inmaculada; Serrano, Antonio; Siles, José Ángel

    2015-01-01

    Sewage sludge is a polluting and hazardous waste generated in wastewater treatment plants with severe management problems. The high content in heavy metal, pathogens and micropolluting compounds limit the implementation of the available management methods. Anaerobic digestion could be an interesting treatment method, but must be improved since the biomethanisation of sewage sludge entails low biodegradability and low methane production. A sonication pre-treatment at lab scale is proposed to increase the organic matter solubilisation of sewage sludge and enhance the biomethanisation yield. Sonication time was optimised by analysing the physicochemical characteristics of sewage sludge (both total and soluble fraction) at different pre-treatment times. The pre-treatment time was fixed at 45 min under the study conditions given that the solubilisation of organic matter did not increase significantly at lower sonication times, whereas the concentration of total nitrogen increased markedly at higher times. The volatile fatty acids generation rate was also evaluated for the pre-treatment conditions. The anaerobic digestion of untreated and pre-treated sewage sludge was subsequently compared and promising results were obtained for loads of 1.0 g VS/L (VS, total volatile solids). The methane yield coefficient increased from 88 to 172 mLSTP/g VS (STP, 0 °C, 1 atm) after the pre-treatment, while biodegradability was found to be around 81% (in VS). Moreover, the allowed organic loading rate and methane production rate observed for the sewage sludge reached values of up to 4.1 kg VS/m(3)·d and 1270 LSTP/m(3)·d, respectively. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Pretreatment of Dioscorea zingiberensis for Microbial Transformation

    Directory of Open Access Journals (Sweden)

    Tianxiang Zheng

    2014-09-01

    Full Text Available The influences of five pretreatments on fungal growth and enzyme production during microbial transformation of Dioscorea zingiberensis (DZW were studied. The biomass, α-rhamnase and β-glucosidase activities in the fermentation system were employed in the study to determine how each method affected the efficiency of microbial transformation. The fungal strain grew better on the substrate which contained easily utilized carbon source. While lack of carbon source induced the strain produce more glucosidase. Among five pretreatment methods, complex enzymatic hydrolyzation can remove 84.3% starch and 76.5% fibre from DZW in form of sugar, which resulted in high α-rhamnase activity of 2.89 IU/mL and β-glucosidase activity of 8.17 IU/mL in fermentation broth.

  12. Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person’s Pathway

    Directory of Open Access Journals (Sweden)

    Éidín Ní Shé

    2018-01-01

    Full Text Available We addressed the research question “what factors enable the successful development and implementation of a frail older person’s pathway within the acute setting”. A rapid realist review (RRR was conducted by adopting the RAMESES standards. We began with a sample of 232 articles via database searches supplemented with 94 additional records including inputs from a twitter chat and a hospital site visit. Our final sample consisted of 18 documents. Following review and consensus by an expert panel we identified a conceptual model of context-mechanism-(resources-outcomes. There was overall agreement frailty should be identified at the front door of the acute hospital. Significant challenges identified related to organisational boundaries both within the acute setting and externally, the need to shift outcomes to patient orientated ones, to support staff to sustain the pathway by providing ongoing education and by providing role clarity. RRRs can support research such as the systematic approach to improving care for frail older adults (SAFE study by producing accounts of what works based on a wide range of sources and innovative engagement with stakeholders. It is evident from our provisional model that numerous factors need to combine and interact to enable and sustain a successful frail older person’s pathway.

  13. Antenatal HIV Testing in Sub-Saharan Africa During the Implementation of the Millennium Development Goals: A Systematic Review Using the PEN-3 Cultural Model.

    Science.gov (United States)

    Blackstone, Sarah R; Nwaozuru, Ucheoma; Iwelunmor, Juliet

    2018-01-01

    This study systematically explored the barriers and facilitators to routine antenatal HIV testing from the perspective of pregnant women in sub-Saharan Africa during the implementation period of the Millennium Development Goals. Articles published between 2000 and 2015 were selected after reviewing the title, abstract, and references. Twenty-seven studies published in 11 African countries were eligible for the current study and reviewed. The most common barriers identified include communication with male partners, patient convenience and accessibility, health system and health-care provider issues, fear of disclosure, HIV-related stigma, the burden of other responsibilities at home, and the perception of antenatal care as a "woman's job." Routine testing among pregnant women is crucial for the eradication of infant and child HIV infections. Further understanding the interplay of social and cultural factors, particularly the role of women in intimate relationships and the influence of men on antenatal care seeking behaviors, is necessary to continue the work of the Millennium Development Goals.

  14. Technical Basis of Scaling Relationships for the Pretreatment Engineering Platform

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, William L.; Arm, Stuart T.; Huckaby, James L.; Kurath, Dean E.; Rassat, Scot D.

    2008-07-15

    Pacific Northwest National Laboratory has been tasked by Bechtel National Inc. (BNI) on the River Protection Project-Waste Treatment Plant (RPP-WTP) project to perform research and development activities. The Pretreatment Engineering Platform (PEP) is being designed and constructed as part of a plan to respond to an issue raised by the WTP External Flowsheet Review Team (EFRT) entitled “Undemonstrated Leaching Processes” and numbered M12. The PEP replicates the WTP leaching process using prototypic equipment and control strategies. The approach for scaling PEP performance data to predict WTP performance is critical to the successful resolution of the EFRT issue. This report describes the recommended PEP scaling approach, PEP data interpretation and provides recommendations on test conduct and data requirements.

  15. Pretreatment Capabilities and Benefits of Electrocoagulation

    Science.gov (United States)

    2004-12-01

    4.1.1.2 Oil-Water Emulsions – Mock Solutions ………………… 20 4.1.1.3 Tannin and Humic Acid Mixture – Mock Solutions …….. 35 4.1.1.4 Silt – Mock...water Influent/ effluent water control Industrial wastewater Pre-treatment for drinking water Oil emulsion breaking Medical waste

  16. Hydrothermal pretreatments of macroalgal biomass for biorefineries

    DEFF Research Database (Denmark)

    Ruiz, Héctor A.; Rodríguez-Jasso, Rosa M.; Aguedo, Mario

    2015-01-01

    ecently, macroalgal biomass is gaining wide attention as an alternative in the production of biofuels (as bioetanol and biogas) and compounds with high added value with specific properties (antioxidants, anticoagulants, anti–inflammatories) for applications in food, medical and energy industries...... in accordance with the integrated biorefineries. Furthermore, biorefinery concept requires processes that allow efficient utilization of all components of the biomass. The pretreatment step in a biorefinery is often based on hydrothermal principles of high temperatures in aqueous solution. Therefore...

  17. Waste Separations and Pretreatment Workshop report

    International Nuclear Information System (INIS)

    Cruse, J.M.; Harrington, R.A.; Quadrel, M.J.

    1994-01-01

    This document provides the minutes from the Waste Separations and Pretreatment Workshop sponsored by the Underground Storage Tank-Integrated Demonstration in Salt Lake City, Utah, February 3--5, 1993. The Efficient Separations and Processing-Integrated Program and the Hanford Site Tank Waste Remediation System were joint participants. This document provides the detailed minutes, including responses to questions asked, an attendance list, reproductions of the workshop presentations, and a revised chart showing technology development activities

  18. Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa

    Science.gov (United States)

    2014-01-01

    Background Access to mobile phone technology has rapidly expanded in developing countries. In Africa, mHealth is a relatively new concept and questions arise regarding reliability of the technology used for health outcomes. This review documents strengths, weaknesses, opportunities, and threats (SWOT) of mHealth projects in Africa. Methods A systematic review of peer-reviewed literature on mHealth projects in Africa, between 2003 and 2013, was carried out using PubMed and OvidSP. Data was synthesized using a SWOT analysis methodology. Results were grouped to assess specific aspects of project implementation in terms of sustainability and mid/long-term results, integration to the health system, management process, scale-up and replication, and legal issues, regulations and standards. Results Forty-four studies on mHealth projects in Africa were included and classified as: “patient follow-up and medication adherence” (n = 19), “staff training, support and motivation” (n = 2), “staff evaluation, monitoring and guidelines compliance” (n = 4), “drug supply-chain and stock management” (n = 2), “patient education and awareness” (n = 1), “disease surveillance and intervention monitoring” (n = 4), “data collection/transfer and reporting” (n = 10) and “overview of mHealth projects” (n = 2). In general, mHealth projects demonstrate positive health-related outcomes and their success is based on the accessibility, acceptance and low-cost of the technology, effective adaptation to local contexts, strong stakeholder collaboration, and government involvement. Threats such as dependency on funding, unclear healthcare system responsibilities, unreliable infrastructure and lack of evidence on cost-effectiveness challenge their implementation. mHealth projects can potentially be scaled-up to help tackle problems faced by healthcare systems like poor management of drug stocks, weak surveillance and reporting systems or

  19. Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa.

    Science.gov (United States)

    Aranda-Jan, Clara B; Mohutsiwa-Dibe, Neo; Loukanova, Svetla

    2014-02-21

    Access to mobile phone technology has rapidly expanded in developing countries. In Africa, mHealth is a relatively new concept and questions arise regarding reliability of the technology used for health outcomes. This review documents strengths, weaknesses, opportunities, and threats (SWOT) of mHealth projects in Africa. A systematic review of peer-reviewed literature on mHealth projects in Africa, between 2003 and 2013, was carried out using PubMed and OvidSP. Data was synthesized using a SWOT analysis methodology. Results were grouped to assess specific aspects of project implementation in terms of sustainability and mid/long-term results, integration to the health system, management process, scale-up and replication, and legal issues, regulations and standards. Forty-four studies on mHealth projects in Africa were included and classified as: "patient follow-up and medication adherence" (n = 19), "staff training, support and motivation" (n = 2), "staff evaluation, monitoring and guidelines compliance" (n = 4), "drug supply-chain and stock management" (n = 2), "patient education and awareness" (n = 1), "disease surveillance and intervention monitoring" (n = 4), "data collection/transfer and reporting" (n = 10) and "overview of mHealth projects" (n = 2). In general, mHealth projects demonstrate positive health-related outcomes and their success is based on the accessibility, acceptance and low-cost of the technology, effective adaptation to local contexts, strong stakeholder collaboration, and government involvement. Threats such as dependency on funding, unclear healthcare system responsibilities, unreliable infrastructure and lack of evidence on cost-effectiveness challenge their implementation. mHealth projects can potentially be scaled-up to help tackle problems faced by healthcare systems like poor management of drug stocks, weak surveillance and reporting systems or lack of resources. mHealth in Africa is an innovative approach

  20. Cost comparison for REDC pretreatment project

    International Nuclear Information System (INIS)

    Robinson, S.M.; Homan, F.J.

    1997-06-01

    This analysis has been prepared to support the planned expenditure to provide the Radiochemical Engineering Development Center (REDC) with the capability to pretreat their liquid low-level waste (LLLW) before discharging it to the Oak Ridge National Laboratory (ORNL) LLLW system. Pretreatment will remove most of the radioactivity, particularly the transuranic isotopes and Cs-137 from the waste to be discharged. This will render the supernates that accumulate in the storage tanks low-activity Class B low-level wastes rather than high-activity Class B or Class C wastes. The sludges will be Class C rather than remote-handled transuranic (RH-TRU) wastes. When REDC wastes are commingled with other ORNL LLLW, the present-worth treatment and transport costs are higher by a factor of 1.3 for the no-pretreatment cases. This result is consistent with data from similar studies conducted at other sites. Based on the information presented in this analysis, the recommendation is to proceed with REDC treatment projects

  1. Hot Idea or Hot Air: A Systematic Review of Evidence for Two Widely Marketed Youth Suicide Prevention Programs and Recommendations for Implementation.

    Science.gov (United States)

    Wei, Yifeng; Kutcher, Stan; LeBlanc, John C

    2015-01-01

    Youth suicide is highly related to mental disorders. While communities and schools are marketed to with a plethora of suicide prevention programs, they often lack the capacity to choose evidence-based programs. We conducted a systematic review of two youth suicide prevention programs to help determine if the quality of evidence available justifies their wide spread dissemination. We searched Medline, PsycINFO, EMBASE, CINAHL, the Cochrane Library, Campbell Collaboration SPECTR database, SocIndex, Sociological Abstracts, Social Services Abstracts, ERIC, Social Work Abstracts, Research Library, and Web of Science, for relevant studies. We included studies/systematic reviews/meta-analysis that evaluated the effectiveness, cost-effectiveness, and/or safety of Signs of Suicide (SOS) and Yellow Ribbon (YR) suicide prevention programs that target adolescents. We applied the Office of Justice Program What Works Repository (OJP-R) to evaluate the quality of the included studies as effective, effective with reservation, promising, inconclusive evidence, insufficient evidence, and ineffective. Two SOS studies were ranked as "inconclusive evidence" based on the OJP-R. One SOS study was ranked as having "insufficient evidence" on OJP-R. The YR study was ranked as "ineffective" using OJP-R. We only included studies in peer-reviewed journals in English and therefore may have missed reports in grey literature or non-English publications. We cannot recommend that schools and communities implement either the SOS or YR suicide prevention programs. Purchasers of these programs should be aware that there is no evidence that their use prevents suicide. Academics and organizations should not overstate the positive impacts of suicide prevention interventions when the evidence is lacking.

  2. Pretreatment of Agave americana stalk for enzymatic saccharification.

    Science.gov (United States)

    Yang, Qiang; Pan, Xuejun

    2012-12-01

    Agave americana is one of commonly grown agave species but currently less valuable because its large flower stalk cannot be used for producing alcoholic beverage. In the present study, the stalk was pretreated with dilute acid (DA), sulfite (SPORL), and sodium hydroxide (NaOH) to preliminarily assess its potential as feedstock for bioethanol production. The changes of cell wall components during the pretreatments, enzymatic digestibility of the pretreated stalks, and the adsorption of cellulases on the substrates were investigated. Results indicated that the pretreatments significantly improved the enzymatic digestibility of the agave stalk. SPORL pretreatment gave higher substrate and sugar yields, while NaOH pretreated stalk had better digestibility under the investigated conditions. The better hydrolysability of NaOH-pretreated stalk was attributed to low lignin and hemicellulose content and high affinity to cellulases. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Pilot implementation

    DEFF Research Database (Denmark)

    Hertzum, Morten; Bansler, Jørgen P.; Havn, Erling C.

    2012-01-01

    be difficult to plan and conduct. It is sometimes assumed that pilot implementations are less complicated and risky than ordinary implementations. Pilot implementations are, however, neither prototyping nor small-scale versions of full-scale implementations; they are fundamentally different and have their own...

  4. Development and Evaluation of ‘Briefing Notes’ as a Novel Knowledge Translation Tool to Aid the Implementation of Sex/Gender Analysis in Systematic Reviews: A Pilot Study

    Science.gov (United States)

    Doull, Marion; Welch, Vivian; Puil, Lorri; Runnels, Vivien; Coen, Stephanie E.; Shea, Beverley; O’Neill, Jennifer; Borkhoff, Cornelia; Tudiver, Sari; Boscoe, Madeline

    2014-01-01

    Background There is increasing recognition of sex/gender differences in health and the importance of identifying differential effects of interventions for men and women. Yet, to whom the research evidence does or does not apply, with regard to sex/gender, is often insufficiently answered. This is also true for systematic reviews which synthesize results of primary studies. A lack of analysis and reporting of evidence on sex/gender raises concerns about the applicability of systematic reviews. To bridge this gap, this pilot study aimed to translate knowledge about sex/gender analysis (SGA) into a user-friendly ‘briefing note’ format and evaluate its potential in aiding the implementation of SGA in systematic reviews. Methods Our Sex/Gender Methods Group used an interactive process to translate knowledge about sex/gender into briefing notes, a concise communication tool used by policy and decision makers. The briefing notes were developed in collaboration with three Cochrane Collaboration review groups (HIV/AIDS, Hypertension, and Musculoskeletal) who were also the target knowledge users of the briefing notes. Briefing note development was informed by existing systematic review checklists, literature on sex/gender, in-person and virtual meetings, and consultation with topic experts. Finally, we held a workshop for potential users to evaluate the notes. Results Each briefing note provides tailored guidance on considering sex/gender to reviewers who are planning or conducting systematic reviews and includes the rationale for considering sex/gender, with examples specific to each review group’s focus. Review authors found that the briefing notes provided welcome guidance on implementing SGA that was clear and concise, but also identified conceptual and implementation challenges. Conclusions Sex/gender briefing notes are a promising knowledge translation tool. By encouraging sex/gender analysis and equity considerations in systematic reviews, the briefing notes can

  5. Prognostic Value and Reproducibility of Pretreatment CT Texture Features in Stage III Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Fried, David V.; Tucker, Susan L.; Zhou, Shouhao; Liao, Zhongxing; Mawlawi, Osama; Ibbott, Geoffrey; Court, Laurence E.

    2014-01-01

    Purpose: To determine whether pretreatment CT texture features can improve patient risk stratification beyond conventional prognostic factors (CPFs) in stage III non-small cell lung cancer (NSCLC). Methods and Materials: We retrospectively reviewed 91 cases with stage III NSCLC treated with definitive chemoradiation therapy. All patients underwent pretreatment diagnostic contrast enhanced computed tomography (CE-CT) followed by 4-dimensional CT (4D-CT) for treatment simulation. We used the average-CT and expiratory (T50-CT) images from the 4D-CT along with the CE-CT for texture extraction. Histogram, gradient, co-occurrence, gray tone difference, and filtration-based techniques were used for texture feature extraction. Penalized Cox regression implementing cross-validation was used for covariate selection and modeling. Models incorporating texture features from the 33 image types and CPFs were compared to those with models incorporating CPFs alone for overall survival (OS), local-regional control (LRC), and freedom from distant metastases (FFDM). Predictive Kaplan-Meier curves were generated using leave-one-out cross-validation. Patients were stratified based on whether their predicted outcome was above or below the median. Reproducibility of texture features was evaluated using test-retest scans from independent patients and quantified using concordance correlation coefficients (CCC). We compared models incorporating the reproducibility seen on test-retest scans to our original models and determined the classification reproducibility. Results: Models incorporating both texture features and CPFs demonstrated a significant improvement in risk stratification compared to models using CPFs alone for OS (P=.046), LRC (P=.01), and FFDM (P=.005). The average CCCs were 0.89, 0.91, and 0.67 for texture features extracted from the average-CT, T50-CT, and CE-CT, respectively. Incorporating reproducibility within our models yielded 80.4% (±3.7% SD), 78.3% (±4.0% SD), and 78

  6. Prognostic Value and Reproducibility of Pretreatment CT Texture Features in Stage III Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fried, David V. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, Texas (United States); Tucker, Susan L. [Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zhou, Shouhao [Division of Quantitative Sciences, Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Liao, Zhongxing [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mawlawi, Osama [Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, Texas (United States); Ibbott, Geoffrey [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, Texas (United States); Court, Laurence E., E-mail: LECourt@mdanderson.org [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, Texas (United States)

    2014-11-15

    Purpose: To determine whether pretreatment CT texture features can improve patient risk stratification beyond conventional prognostic factors (CPFs) in stage III non-small cell lung cancer (NSCLC). Methods and Materials: We retrospectively reviewed 91 cases with stage III NSCLC treated with definitive chemoradiation therapy. All patients underwent pretreatment diagnostic contrast enhanced computed tomography (CE-CT) followed by 4-dimensional CT (4D-CT) for treatment simulation. We used the average-CT and expiratory (T50-CT) images from the 4D-CT along with the CE-CT for texture extraction. Histogram, gradient, co-occurrence, gray tone difference, and filtration-based techniques were used for texture feature extraction. Penalized Cox regression implementing cross-validation was used for covariate selection and modeling. Models incorporating texture features from the 33 image types and CPFs were compared to those with models incorporating CPFs alone for overall survival (OS), local-regional control (LRC), and freedom from distant metastases (FFDM). Predictive Kaplan-Meier curves were generated using leave-one-out cross-validation. Patients were stratified based on whether their predicted outcome was above or below the median. Reproducibility of texture features was evaluated using test-retest scans from independent patients and quantified using concordance correlation coefficients (CCC). We compared models incorporating the reproducibility seen on test-retest scans to our original models and determined the classification reproducibility. Results: Models incorporating both texture features and CPFs demonstrated a significant improvement in risk stratification compared to models using CPFs alone for OS (P=.046), LRC (P=.01), and FFDM (P=.005). The average CCCs were 0.89, 0.91, and 0.67 for texture features extracted from the average-CT, T50-CT, and CE-CT, respectively. Incorporating reproducibility within our models yielded 80.4% (±3.7% SD), 78.3% (±4.0% SD), and 78

  7. Pretreatment of Reed by Wet Oxidation and Subsequent Utilization of the Pretreated Fibers for Ethanol Production

    DEFF Research Database (Denmark)

    Szijarto, Nora; Kádár, Zsófia; Varga, Eniko

    2009-01-01

    lignocelluloses usually do. In the present study, wet oxidation was investigated as the pretreatment method to enhance the enzymatic digestibility of reed cellulose to soluble sugars and thus improve the convertibility of reed to ethanol. The most effective treatment increased the digestibility of reed cellulose...... by cellulases more than three times compared to the untreated control. During this wet oxidation, 51.7% of the hemicellulose and 58.3% of the lignin were solubilized, whereas 87.1% of the cellulose remained in the solids. After enzymatic hydrolysis of pretreated fibers from the same treatment, the conversion...... of cellulose to glucose was 82.4%. Simultaneous saccharification and fermentation of pretreated solids resulted in a final ethanol concentration as high as 8.7 g/L, yielding 73% of the theoretical....

  8. Implementation and maintenance of patient navigation programs linking primary care with community-based health and social services: a scoping literature review.

    Science.gov (United States)

    Valaitis, Ruta K; Carter, Nancy; Lam, Annie; Nicholl, Jennifer; Feather, Janice; Cleghorn, Laura

    2017-02-06

    Since the early 90s, patient navigation programs were introduced in the United States to address inequitable access to cancer care. Programs have since expanded internationally and in scope. The goals of patient navigation programs are to: a) link patients and families to primary care services, specialist care, and community-based health and social services (CBHSS); b) provide more holistic patient-centred care; and, c) identify and resolve patient barriers to care. This paper fills a gap in knowledge to reveal what is known about motivators and factors influencing implementation and maintenance of patient navigation programs in primary care that link patients to CBHSS. It also reports on outcomes from these studies to help identify gaps in research that can inform future studies. This scoping literature review involved: i) electronic database searches; ii) a web site search; iii) a search of reference lists from literature reviews; and, iv) author follow up. It included papers from Canada, the United States, the United Kingdom, Australia, New Zealand, and/or Western Europe published between January 1990 and June 2013 if they discussed navigators or navigation programs in primary care settings that linked patients to CBHSS. Of 34 papers, most originated in the United States (n = 29) while the remainder were from the United Kingdom, Canada and Australia. Motivators for initiating navigation programs were to: a) improve delivery of health and social care services; b) support and manage specific health needs or specific population needs, and; c) improve quality of life and wellbeing of patients. Eleven factors were found to influence implementation and maintenance of these patient navigation programs. These factors closely aligned with the Diffusion of Innovation in Service Organizations model, thus providing a theoretical foundation to support them. Various positive outcomes were reported for patients, providers and navigators, as well as the health and social

  9. Physiochemical Characterization of Lignocellulosic Biomass Dissolution by Flowthrough Pretreatment

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Lishi; Pu, Yunqiao; Bowden, Mark; Ragauskas, Arthur J.; Yang, Bin

    2016-01-04

    Comprehensive understanding of biomass solubilization chemistry in aqueous pretreatment such as water-only and dilute acid flowthrough pretreatment is of fundamental importance to achieve the goal of valorizing biomass to fermentable sugars and lignin for biofuels production. In this study, poplar wood was flowthrough pretreated by water-only or 0.05% (w/w) sulfuric acid at different temperatures (220-270 °C), flow rate (25 mL/min), and reaction times (8-90 min), resulting in significant disruption of the lignocellulosic biomass. Ion chromatography (IC), Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD) analysis, and solid state cross-polarization/magic angle spinning (CP/MAS) 13C nuclear magnetic resonance (NMR) spectroscopy were applied to characterize the pretreated biomass whole slurries in order to reveal depolymerization as well as solubilization mechanism and identify unique dissolution structural features during these pretreatments. Results showed temperature-dependent cellulose decrystallization in flowthrough pretreatment. Crystalline cellulose was completely disrupted, and mostly converted to amorphous cellulose and oligomers by water-only operation at 270 °C for 10 min and by 0.05 wt % H2SO4 flowthrough pretreatment at 220 °C for 12 min. Flowthrough pretreatment with 0.05% (w/w) H2SO4 led to a greater disruption of structures in pretreated poplar at a lower temperature compared to water-only pretreatment.

  10. Pretreatment on corn stover with low concentration of formic acid.

    Science.gov (United States)

    Xu, Jian; Thomsen, Mette Hedegaard; Thomsen, Anne Belinda

    2009-08-01

    Bioethanol derived from lignocellulosic biomass has the potential to replace gasoline. Cellulose is naturally recalcitrant to enzymatic attack, and it also surrounded by the matrix of xylan and lignin, which enhances the recalcitrance. Therefore, lignocellulosic materials must be pretreated to make the cellulose easily degraded into sugars and further fermented to ethanol. In this work, hydrothermal pretreatment on corn stover at 195 degrees for 15 min with and without lower concentration of formic acid was compared in terms of sugar recoveries and ethanol fermentation. For pretreatment with formic acid, the overall glucan recovery was 89% and pretreatment without formic acid yielded the recovery of 94%. Compared with glucan, xylan was more sensitive to the pretreatment condition. The lowest xylan recovery of 55% was obtained after pretreatment with formic acid and the highest of 75% found following pretreatment without formic acid. Toxicity tests of liquor parts showed that there were no inhibitions found for both pretreatment conditions. After simultaneous saccharification and fermentation (SSF) of the pretreated corn stover with Baker's yeast, the highest ethanol yield of 76.5% of the theoretical was observed from corn stover pretreated at 195 degrees for 15 min with formic acid.

  11. Development, inter-rater reliability and feasibility of a checklist to assess implementation (Ch-IMP) in systematic reviews: the case of provider-based prevention and treatment programs targeting children and youth.

    Science.gov (United States)

    Cargo, Margaret; Stankov, Ivana; Thomas, James; Saini, Michael; Rogers, Patricia; Mayo-Wilson, Evan; Hannes, Karin

    2015-09-07

    Several papers report deficiencies in the reporting of information about the implementation of interventions in clinical trials. Information about implementation is also required in systematic reviews of complex interventions to facilitate the translation and uptake of evidence of provider-based prevention and treatment programs. To capture whether and how implementation is assessed within systematic effectiveness reviews, we developed a checklist for implementation (Ch-IMP) and piloted it in a cohort of reviews on provider-based prevention and treatment interventions for children and young people. This paper reports on the inter-rater reliability, feasibility and reasons for discrepant ratings. Checklist domains were informed by a framework for program theory; items within domains were generated from a literature review. The checklist was pilot-tested on a cohort of 27 effectiveness reviews targeting children and youth. Two raters independently extracted information on 47 items. Inter-rater reliability was evaluated using percentage agreement and unweighted kappa coefficients. Reasons for discrepant ratings were content analysed. Kappa coefficients ranged from 0.37 to 1.00 and were not influenced by one-sided bias. Most kappa values were classified as excellent (n = 20) or good (n = 17) with a few items categorised as fair (n = 7) or poor (n = 1). Prevalence-adjusted kappa coefficients indicate good or excellent agreement for all but one item. Four areas contributed to scoring discrepancies: 1) clarity or sufficiency of information provided in the review; 2) information missed in the review; 3) issues encountered with the tool; and 4) issues encountered at the review level. Use of the tool demands time investment and it requires adjustment to improve its feasibility for wider use. The case of provider-based prevention and treatment interventions showed relevancy in developing and piloting the Ch-IMP as a useful tool for assessing the extent to

  12. Determining the cost of implementing and operating a remote patient monitoring programme for the elderly with chronic conditions: A systematic review of economic evaluations.

    Science.gov (United States)

    Peretz, Daniel; Arnaert, Antonia; Ponzoni, Norma N

    2018-01-01

    Introduction Remote patient monitoring (RPM) in conjunction with home nursing visits is becoming increasingly popular for the follow-up of patients with chronic conditions and evidence exists that it improves patients' health outcomes. Current cost data is reported inconsistently and often gathered from studies of poor methodological quality, making it difficult for decision-makers who consider implementing this service in their organizations. This study reviewed the cost of RPM programmes targeting elderly patients with chronic conditions. Methods After evaluation against the inclusion and exclusion criteria and appraisal against two criteria which are important for economic evaluations, data from selected studies were extracted and grouped into meaningful cost categories, then adjusted to reflect November 2015 US dollars. Results In the 13 selected studies, the newly-created cost category 'Combined intervention cost' (reflecting equipment purchasing, servicing and monitoring cost) for the various RPM programmes ranged from US$275-US$7963 per patient per year. The three main findings are: (a) RPM programme costs have decreased since 2004 due to cheaper technology; (b) monitoring a single vital sign is likely to be less costly than monitoring multiple vital signs; and (c) programmes targeting hypertension or congestive heart failure are less costly than those targeting respiratory diseases or multiple conditions. Conclusions This review recommends that future studies present their cost data with more granularity, that grouping of costs should be minimized and that any assumptions, such as amortization, should be made explicit. In addition, studies should compare programmes with similar characteristics in terms of type of conditions, number of vital signs monitored, etc. for more generalizable results.

  13. Rheological evaluation of pretreated cladding removal waste

    International Nuclear Information System (INIS)

    McCarthy, D.; Chan, M.K.C.; Lokken, R.O.

    1986-01-01

    Cladding removal waste (CRW) contains concentrations of transuranic (TRU) elements in the 80 to 350 nCi/g range. This waste will require pretreatment before it can be disposed of as glass or grout at Hanford. The CRW will be pretreated with a rare earth strike and solids removal by centrifugation to segregate the TRU fraction from the non-TRU fraction of the waste. The centrifuge centrate will be neutralized with sodium hydroxide. This neutralized cladding removal waste (NCRW) is expected to be suitable for grouting. The TRU solids removed by centrifugation will be vitrified. The goal of the Rheological Evaluation of Pretreated Cladding Removal Waste Program was to evaluate those rheological and transport properties critical to assuring successful handling of the NCRW and TRU solids streams and to demonstrate transfers in a semi-prototypic pumping environment. This goal was achieved by a combination of laboratory and pilot-scale evaluations. The results obtained during these evaluations were correlated with classical rheological models and scaled-up to predict the performance that is likely to occur in the full-scale system. The Program used simulated NCRW and TRU solid slurries. Rockwell Hanford Operations (Rockwell) provided 150 gallons of simulated CRW and 5 gallons of simulated TRU solid slurry. The simulated CRW was neutralized by Pacific Northwest Laboratory (PNL). The physical and rheological properties of the NCRW and TRU solid slurries were evaluated in the laboratory. The properties displayed by NCRW allowed it to be classified as a pseudoplastic or yield-pseudoplastic non-Newtonian fluid. The TRU solids slurry contained very few solids. This slurry exhibited the properties associated with a pseudoplastic non-Newtonian fluid

  14. Energy consumption modeling during dairy sewage pretreatment

    Science.gov (United States)

    Dąbrowski, Wojciech; Żyłka, Radosław; Malinowski, Paweł; Boruszko, Dariusz

    2017-11-01

    The research was conducted in a dairy WWTP located in north-eastern Poland with the average flow of 546 m3d-1 and PE 11500 in 2016. Energy consumption was measured with the help of Lumel 3-phase network parameter transducers installed within the plant. The modeling was conducted based on the quantity and quality of raw sewage, after its screening, averaging and dissolved air flotation. The following parameters were determined: BOD5, COD. N-total and P-total. During the research period. 15 measurement series were carried out. Pollution loads removed in primary treatment varied from 167.0 to 803.5 kgO2d-1 and 1205.9 to 10032 kgO2d-1 for BOD5 and COD respectively. The energy consumption share during dairy pretreatment in relation to the total energy consumption was in the range from 13.8 to 28.5% with the mean value of 18.7% during the research period. Energy consumption indicators relating to removed pollution loads for primary treatment were established with the mean values of 0.74 and 0.83 kWhkg-1d-1 for BOD5 and COD respectively. An attempt was made to determine the influence of raw sewage characteristics and pretreatment efficiency on energy consumption of the object. A model of energy consumption during pretreatment was estimated according to the experimental data obtained in the research period. It was modeled using the linear regression model and principal component analysis.

  15. Energy consumption modeling during dairy sewage pretreatment

    Directory of Open Access Journals (Sweden)

    Dąbrowski Wojciech

    2017-01-01

    Full Text Available The research was conducted in a dairy WWTP located in north-eastern Poland with the average flow of 546 m3d-1 and PE 11500 in 2016. Energy consumption was measured with the help of Lumel 3-phase network parameter transducers installed within the plant. The modeling was conducted based on the quantity and quality of raw sewage, after its screening, averaging and dissolved air flotation. The following parameters were determined: BOD5, COD. N-total and P-total. During the research period. 15 measurement series were carried out. Pollution loads removed in primary treatment varied from 167.0 to 803.5 kgO2d-1 and 1205.9 to 10032 kgO2d-1 for BOD5 and COD respectively. The energy consumption share during dairy pretreatment in relation to the total energy consumption was in the range from 13.8 to 28.5% with the mean value of 18.7% during the research period. Energy consumption indicators relating to removed pollution loads for primary treatment were established with the mean values of 0.74 and 0.83 kWhkg-1d-1 for BOD5 and COD respectively. An attempt was made to determine the influence of raw sewage characteristics and pretreatment efficiency on energy consumption of the object. A model of energy consumption during pretreatment was estimated according to the experimental data obtained in the research period. It was modeled using the linear regression model and principal component analysis.

  16. Enzymatic Hydrolysis of Alkaline Pretreated Coconut Coir

    Directory of Open Access Journals (Sweden)

    Akbarningrum Fatmawati

    2013-06-01

    Full Text Available The purpose of this research is to study the effect of concentration and temperature on the cellulose and lignin content, and the reducing sugars produced in the enzymatic hydrolysis of coconut coir. In this research, the coconut coir is pretreated using 3%, 7%, and 11% NaOH solution at 60oC, 80oC, and 100oC. The pretreated coir were assayed by measuring the amount of cellulose and lignin and then hydrolysed using Celluclast and Novozyme 188 under various temperature (30oC, 40oC, 50oC and pH (3, 4, 5. The hydrolysis results were assayed for the reducing sugar content. The results showed that the alkaline delignification was effective to reduce lignin and to increase the cellulose content of the coir. The best delignification condition was observed at 11% NaOH solution and 100oC which removed 14,53% of lignin and increased the cellulose content up to 50,23%. The best condition of the enzymatic hydrolysis was obtained at 50oC and pH 4 which produced 7,57 gr/L reducing sugar. © 2013 BCREC UNDIP. All rights reservedReceived: 2nd October 2012; Revised: 31st January 2013; Accepted: 6th February 2013[How to Cite: Fatmawati, A., Agustriyanto, R., Liasari, Y. (2013. Enzymatic Hydrolysis of Alkaline Pre-treated Coconut Coir. Bulletin of Chemical Reaction Engineering & Catalysis, 8 (1: 34-39 (doi:10.9767/bcrec.8.1.4048.34-39[Permalink/DOI: http://dx.doi.org/10.9767/bcrec.8.1.4048.34-39] | View in  |

  17. Systematic review of the design, implementation and effectiveness of mass media and nutrition education interventions for infant and young child feeding.

    Science.gov (United States)

    Graziose, Matthew M; Downs, Shauna M; O'Brien, Quentin; Fanzo, Jessica

    2018-02-01

    To systematically review the design, implementation and effectiveness of mass media and nutrition education interventions for improving infant and young child feeding (IYCF) practices and related psychosocial factors. A search of PubMed, Embase and PsycINFO databases, a Google search, and a consultation with experts in the field of IYCF performed in July 2016. Low- and middle-income countries, as defined by the World Bank Group. Eligible studies: included a mass media component (with or without nutrition education); conducted a pre-post evaluation (with or without a control group); assessed IYCF knowledge, attitudes, beliefs and/or practices; and were published in English between 2000 and present. Eighteen unique studies were identified that examined the effect of mass media (types included: television; print; voice and/or SMS (text) messages; radio; megaphones/loudspeakers; videos; social media; songs/dramas) and nutrition education interventions on IYCF practices within thirteen countries. Of these, fifteen studies reported improvements in breast- and/or complementary feeding practices, using indicators recommended by the WHO, and six studies reported improvements in related psychosocial factors. However, little detail was provided on the use of formative research, a formal behaviour change theory and behaviour change techniques. Few studies reported both dose delivered and participants' exposure to the intervention. Despite evidence of effectiveness, few common elements in the design of interventions were identified. Future research should consistently report these details to open the 'black box' of IYCF interventions, identify effective design components and ensure replicability.

  18. Acetic acid pretreatment improves the hardness of cooked potato slices.

    Science.gov (United States)

    Zhao, Wenlin; Shehzad, Hussain; Yan, Shoulei; Li, Jie; Wang, Qingzhang

    2017-08-01

    The effects of acetic acid pretreatment on the texture of cooked potato slices were investigated in this work. Potato slices were pretreated with acetic acid immersion (AAI), distilled water immersion (DWI), or no immersion (NI). Subsequently, the cell wall material of the pretreated samples was isolated and fractioned to evaluate changes in the monosaccharide content and molar mass (MM), and the hardness and microscopic structure of the potato slices in different pretreatments before and after cooking were determined. The results showed that the highest firmness was obtained with more intact structure of the cell wall for cooked potato slices with AAI pretreatment. Furthermore, the MM and sugar ratio demonstrated that the AAI pretreated potato slices contained a higher content of the small molecular polysaccharides of cell walls, especially in the hemicellulose fraction. This work may provide a reference for potato processing. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Impact of pretreatment on colour and texture of watermelon rind

    Science.gov (United States)

    Athmaselvi, K.; Alagusundaram, K.; Kavitha, C.; Arumuganathan, T.

    2012-07-01

    The effect of osmotic dehydration pretreatment on water loss, solid gain, colour and textural change was investigated. Watermelon rind 1 x 1 cm size was immersed in sucrose solution of 40, 50 and 60° Brix after pretreatment with microwave and conventional boiling in water for 1, 3, and 5 min, respectively. Water loss and solid gain increased with the time of cooking and sugar concentration. Microwave pretreated samples showed higher water loss and solid gain. Increase in the time of cooking decreased the brightness of all the samples. Microwave pretreated samples showed higher `b' values than conventionally pretreated ones. There was no significant difference (P≤0.05) in texture profile analysis parameters except for hardness. Hardness decreased with increase in time of cooking and sugar concentration. Second order regression model was developed for water loss and solid gain of microwave and conventional pretreated watermelon rind.

  20. Review

    Indian Academy of Sciences (India)

    Review. J. Astrophys. Astr., Vol. 36, No. 4, December 2015, pp. 433–445. Line Shape Variability in a Sample of AGN with Broad Lines. D. Ilic1,∗, L. ˇC. Popovic1,2 ... ing from. We give here a comparative review of the line shape variability ..... using the mean continuum flux at 5100 Å and the online calculator for luminosity.

  1. Reviews

    Science.gov (United States)

    2004-01-01

    BOOK REVIEWS (99) Complete A-Z Physics Handbook Science Magic in the Kitchen The Science of Cooking Science Experiments You Can Eat WEB WATCH (101) These journal themes are pasta joke Microwave oven Web links CD REVIEW (104) Electricity and Magnetism, KS3 Big Science Comics

  2. Lignocellulosic biomass-Thermal pretreatment with steam: Pretreatment techniques for biofuels and biorefineries

    DEFF Research Database (Denmark)

    Toor, Saqib; Rosendahl, Lasse; Hoffmann, Jessica

    2013-01-01

    technologies; thermal pre-treatment with steam. The Norwegian company CAMBI developed a process for treatment of sludge from waste water treatment plants, and the idea was based on the experience that cooking sludge under pressure at temperature from 150oC to 180oC improved the digestibility and at the same...

  3. The characteristic changes of betung bamboo (Dendrocalamus asper pretreated by fungal pretreatment

    Directory of Open Access Journals (Sweden)

    Widya Fatriasari

    2014-05-01

    Full Text Available Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 The fungal pretreatment effect on chemical structural and morphological changes of Betung Bamboo was evaluated based on its biomass components after being cultivated by white rot fungi, Trametes versicolor. Betung bamboo powder (15 g was exposed to liquid inoculum of white rot fungi and incubated at 270C for 15, 30 and 45 days. The treated samples were then characterized by FT-IR spectroscopy, X-Ray diffraction and SEM-EDS analyses. Cultivation for 30 days with 5 and 10% loadings retained greater selectivity compared to that of the other treatments. FTIR spectra demonstrated that the fungus affected the decreasing of functional group quantities without changing the functional groups. The decrease in intensity at wave number of 1246 cm-1 (guaiacyl of lignin was greater than that at wave number of 1328 cm-1 (deformation combination of syringyl and xylan after fungal treatment. X-ray analysis showed the pretreated samples had a higher crystallinity than the untreated ones which might be due to the cleavage of amorphous fractions of cellulose. The pretreated samples have more fragile than the untreated ones confirmed by SEM. Crystalline allomorph calculated by XRD analysis showed that fungus pretreatment for 30 days has transformed triclinic structure of cellulose to monoclinic structure.

  4. FRACTIONAL CRYSTALLIZATION TESTING WITH INTERIM PRETREATMENT SYSTEM FEEDS

    International Nuclear Information System (INIS)

    HERTING DL

    2008-01-01

    The fractional crystallization process was developed as a pretreatment method for saltcake waste retrieved from Hanford single-shell tanks (SST). The process separates the retrieved SST waste into a high-level waste stream containing the bulk of the radionuclides and a low-activity waste stream containing the bulk of the nonradioactive sodium salts. The Interim Pretreatment System project shifted the focus on pretreatment planning from SST waste to double-shell tank waste

  5. Cellulose conversion of corn pericarp without pretreatment.

    Science.gov (United States)

    Kim, Daehwan; Orrego, David; Ximenes, Eduardo A; Ladisch, Michael R

    2017-12-01

    We report enzyme hydrolysis of cellulose in unpretreated pericarp at a cellulase loading of 0.25FPU/g pericarp solids using a phenol tolerant Aspergillus niger pectinase preparation. The overall protein added was 5mg/g and gave 98% cellulose conversion in 72h. However, for double the amount of enzyme from Trichoderma reesei, which is significantly less tolerant to phenols, conversion was only 16%. The key to achieving high conversion without pretreatment is combining phenol inhibition-resistant enzymes (such as from A. niger) with unground pericarp from which release of phenols is minimal. Size reduction of the pericarp, which is typically carried out in a corn-to-ethanol process, where corn is first ground to a fine powder, causes release of highly inhibitory phenols that interfere with cellulase enzyme activity. This work demonstrates hydrolysis without pretreatment of large particulate pericarp is a viable pathway for directly producing cellulose ethanol in corn ethanol plants. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Biologically Pre-Treated Habitation Waste Water as a Sustainable Green Urine Pre-Treat Solution

    Science.gov (United States)

    Jackson, W. Andrew; Thompson, Bret; Sevanthi, Ritesh; Morse, Audra; Meyer, Caitlin; Callahan, Michael

    2017-01-01

    The ability to recover water from urine and flush water is a critical process to allow long term sustainable human habitation in space or bases on the moon or mars. Organic N present as urea or similar compounds can hydrolyze producing free ammonia. This reaction results in an increase in the pH converting ammonium to ammonia which is volatile and not removed by distillation. The increase in pH will also cause precipitation reactions to occur. In order to prevent this, urine on ISS is combined with a pretreat solution. While use of a pretreatment solution has been successful, there are numerous draw backs including: storage and use of highly hazardous solutions, limitations on water recovery (less than 85%), and production of brine with pore dewatering characteristics. We evaluated the use of biologically treated habitation wastewaters (ISS and early planetary base) to replace the current pretreat solution. We evaluated both amended and un-amended bioreactor effluent. For the amended effluent, we evaluated "green" pretreat chemicals including citric acid and citric acid amended with benzoic acid. We used a mock urine/air separator modeled after the urine collection assembly on ISS. The urine/air separator was challenged continually for >6 months. Depending on the test point, the separator was challenged daily with donated urine and flushed with amended or un-amended reactor effluent. We monitored the pH of the urine, flush solution and residual pH in the urine/air separator after each urine event. We also evaluated solids production and biological growth. Our results support the use of both un-amended and amended bioreactor effluent to maintain the operability of the urine /air separator. The ability to use bioreactor effluent could decrease consumable cost, reduce hazards associated with current pre-treat chemicals, allow other membrane based desalination processes to be utilized, and improve brine characteristics.

  7. Feasibility of Hydrothermal Pretreatment on Maize Silage for Bioethanol Production

    DEFF Research Database (Denmark)

    Xu, Jian; Thomsen, Mette Hedegaard; Thomsen, Anne Belinda

    2010-01-01

    The potential of maize silage as a feedstock to produce bioethanol was evaluated in the present study. The hydrothermal pretreatment with five different pretreatment severity factors (PSF) was employed to pretreat the maize silage and compared in terms of sugar recovery, toxic test, and ethanol...... the liquors from the five conditions were not toxic to the Baker’s yeast. Pretreatment under 195°C for 7 min had the similar PSF with that of 185°C for 15 min, and both gave the higher ethanol concentration of 19.92 and 19.98 g/L, respectively. The ethanol concentration from untreated maize silage was only 7...

  8. Nonhazardous Urine Pretreatment Method for Future Exploration Systems, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — A nonhazardous urine pretreatment system prototype is proposed that will stabilize urine against biological growth or chemical instabilities without using hazardous...

  9. Nonhazardous Urine Pretreatment Method for Future Exploration Systems, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — A novel urine pretreatment that will prevent biological growth or chemical instabilities in urine without using hazardous chemicals is proposed. Untreated urine...

  10. Pretreatment and fermentation strategies to overcome the toxicity of acetic acid in hemicellulosic hydrolysates

    DEFF Research Database (Denmark)

    Mussatto, Solange I.

    Acetic acid is one of the most important toxic compounds present in hemicellulosic hydrolysates. In order to overcome this problem, several strategies were studied for both biomass pretreatment and fermentation steps. Biomass deacetylation by mild alkaline pretreatment or using high pressure CO2...... were considered interesting strategies to selectively remove acetic acid from biomass structure. In addition, the selective removal of acetic acid from biomass as a first step in the whole biomass conversion chain, contribute for the development and implementation of competitive biorefinery platforms...... where acetic acid can also be integrated as a valuable final product. For the fermentation step, it is well known that hemicellulosic hydrolysates usually need to be detoxified prior use as fermentation medium in order to improve the performance of the microorganism to convert sugars in the product...

  11. Net positive energy wastewater treatment plant via thermal pre-treatment of sludge: A theoretical case study.

    Science.gov (United States)

    Farno, Ehsan; Baudez, Jean Christophe; Parthasarathy, Rajarathinam; Eshtiaghi, Nicky

    2017-04-16

    In a wastewater treatment process, energy is mainly used in sludge handling and heating, while energy is recovered by biogas production in anaerobic digestion process. Thermal pre-treatment of sludge can change the energy balance in a wastewater treatment process since it reduces the viscosity and yield stress of sludge and increases the biogas production. In this study, a calculation based on a hypothetical wastewater treatment plant is provided to show the possibility of creating a net positive energy wastewater treatment plant as a result of implementing thermal pre-treatment process before the anaerobic digester. The calculations showed a great energy saving in pumping and mixing of the sludge by thermal pre-treatment of sludge before anaerobic digestion process.

  12. Reviews

    OpenAIRE

    Revista alicantina de estudios ingleses

    1996-01-01

    Contiene: Jan Pilditch, ed. The Critical Response to Katherine Mansfield. Critical Responses in Arts and Letters. 21. Westport, CT: Greenwood Press, 1996 / reviewed by Ana Belén López Pérez; Edith Wharton. Cartas a Morton Fullerton (1907-1931), (Barcelona, Grijalbo Mondadori, 1995). Ed. Marina Premoli. Translation: Esther Gómez / reviewed by Teresa Gómez Reus; Elizabeth Deeds Ermarth. The English Novel in History: 1840-1895. London and New York: Routledge, 1997 / reviewed by Ángel Pé...

  13. Review

    Indian Academy of Sciences (India)

    2017-04-18

    jbiosci. J. Biosci. 42(2), June 2017, 345–353 * Indian Academy of Sciences. 345. DOI: 10.1007/s12038-017-9681-x. Keywords. Angiogenesis; FRG1; FSHD; neuromuscular disorder; RNA biogenesis. Review. Published online: ...

  14. Reviews.

    Science.gov (United States)

    Radcliffe, George; And Others

    1988-01-01

    Reviews three software packages: 1) a package containing 68 programs covering general topics in chemistry; 2) a package dealing with acid-base titration curves and allows for variables to be changed; 3) a chemistry tutorial and drill package. (MVL)

  15. Reviews.

    Science.gov (United States)

    Greenleaf, Floyd; And Others

    1986-01-01

    Reviews eight textbooks, readers, and books. Topics include Latin America, colonial America, the Carolinians, women in French textbooks, the Vikings, the Soviet Union, nineteenth-century Black America, and Ernest Rutherford. (TRS)

  16. Review

    African Journals Online (AJOL)

    , complications are relatively common and this needs to be considered in patient counseling and clinical decision making. Review: Fertility generally returns after renal transplantation. Approximately 74% of pregnancies in kidney transplant ...

  17. Reviews

    OpenAIRE

    Revista alicantina de estudios ingleses

    2000-01-01

    Contiene: Villalba, Estefanía. Claves para interpretar la literatura inglesa. Madrid: Alianza Editorial, 1999,211 p. / reviewed by Eva M. Pérez Rodríguez; Dieter Stein & Rosanna Sornicola (ed.) The Virtues of Language. History in Language, Linguistics and Texts. Number 87. Amsterdam: John Benjamin Pub. Co., 1998 / reviewed by José Manuel Belda Medina; Antonia Sánchez-Macarro and R. Carter (eds.) (1998): Linguistic Choice across Genres: Variation in Spoken and Written English. Amsterd...

  18. Saccharification and ethanol fermentation from cholinium ionic liquid-pretreated bagasse with a different number of post-pretreatment washings.

    Science.gov (United States)

    Ninomiya, Kazuaki; Omote, Sayuri; Ogino, Chiaki; Kuroda, Kosuke; Noguchi, Mana; Endo, Takatsugu; Kakuchi, Ryohei; Shimizu, Nobuaki; Takahashi, Kenji

    2015-01-01

    Choline acetate (ChOAc), a cholinium ionic liquid (IL), was compared with 1-ethyl-3-methylimidazolium acetate (EmimOAc) with regard to biomass pretreatment, inhibition on cellulase and yeast, residuals in pretreated biomass, and saccharification and fermentation of pretreated biomass. Irrespective of ChOAc and EmimOAc, cellulose and hemicellulose saccharification of the IL-pretreated bagasse were over 90% and 60%, respectively. Median effective concentrations (EC50) based on cellulase activity were 32 wt% and 16 wt% for ChOAc and EmimOAc, respectively. The EC50 based on yeast growth were 3.1 wt% and 0.3 wt% for ChOAc and EmimOAc respectively. The residuals in IL-pretreated bagasse were 10% and 23% for ChOAc and EmimOAc, respectively, when washed 2 times after pretreatment. Ethanol yield on a bagasse basis were 60% and 24% for ChOAc and EmimOAc, respectively, in the saccharification and fermentation of IL-pretreated bagasse when washed 2 times. ChOAc-pretreated bagasse could be saccharified and fermented with fewer wash times than EmimOAc-pretreated bagasse. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Glycerol carbonate as green solvent for pretreatment of sugarcane bagasse

    Science.gov (United States)

    2013-01-01

    Background Pretreatment of lignocellulosic biomass is a prerequisite for effective saccharification to produce fermentable sugars. In this study, “green” solvent systems based on acidified mixtures of glycerol carbonate (GC) and glycerol were used to treat sugarcane bagasse and the roles of each solvent in deconstructing biomass were determined. Results Pretreatment of sugarcane bagasse at 90°C for only 30 min with acidified GC produced a solid residue having a glucan digestibility of 90% and a glucose yield of 80%, which were significantly higher than a glucan digestibility of 16% and a glucose yield of 15% obtained for bagasse pretreated with acidified ethylene carbonate (EC). Biomass compositional analyses showed that GC pretreatment removed more lignin than EC pretreatment (84% vs 54%). Scanning electron microscopy (SEM) showed that fluffy and size-reduced fibres were produced from GC pretreatment whereas EC pretreatment produced compact particles of reduced size. The maximal glucan digestibility and glucose yield of GC/glycerol systems were about 7% lower than those of EC/ethylene glycol (EG) systems. Replacing up to 50 wt% of GC with glycerol did not negatively affect glucan digestibility and glucose yield. The results from pretreatment of microcrystalline cellulose (MCC) showed that (1) pretreatment with acidified alkylene glycol (AG) alone increased enzymatic digestibility compared to pretreatments with acidified alkylene carbonate (AC) alone and acidified mixtures of AC and AG, (2) pretreatment with acidified GC alone slightly increased, but with acidified EC alone significantly decreased, enzymatic digestibility compared to untreated MCC, and (3) there was a good positive linear correlation of enzymatic digestibility of treated and untreated MCC samples with congo red (CR) adsorption capacity. Conclusions Acidified GC alone was a more effective solvent for pretreatment of sugarcane bagasse than acidified EC alone. The higher glucose yield obtained

  20. Understanding of alkaline pretreatment parameters for corn stover enzymatic saccharification

    Directory of Open Access Journals (Sweden)

    Chen Ye

    2013-01-01

    Full Text Available Abstract Background Previous research on alkaline pretreatment has mainly focused on optimization of the process parameters to improve substrate digestibility. To achieve satisfactory sugar yield, extremely high chemical loading and enzyme dosages were typically used. Relatively little attention has been paid to reduction of chemical consumption and process waste management, which has proven to be an indispensable component of the bio-refineries. To indicate alkali strength, both alkali concentration in pretreatment solution (g alkali/g pretreatment liquor or g alkali/L pretreatment liquor and alkali loading based on biomass solids (g alkali/g dry biomass have been widely used. The dual approaches make it difficult to compare the chemical consumption in different process scenarios while evaluating the cost effectiveness of this pretreatment technology. The current work addresses these issues through pretreatment of corn stover at various combinations of pretreatment conditions. Enzymatic hydrolysis with different enzyme blends was subsequently performed to identify the effects of pretreatment parameters on substrate digestibility as well as process operational and capital costs. Results The results showed that sodium hydroxide loading is the most dominant variable for enzymatic digestibility. To reach 70% glucan conversion while avoiding extensive degradation of hemicellulose, approximately 0.08 g NaOH/g corn stover was required. It was also concluded that alkali loading based on total solids (g NaOH/g dry biomass governs the pretreatment efficiency. Supplementing cellulase with accessory enzymes such as α-arabinofuranosidase and β-xylosidase significantly improved the conversion of the hemicellulose by 6–17%. Conclusions The current work presents the impact of alkaline pretreatment parameters on the enzymatic hydrolysis of corn stover as well as the process operational and capital investment costs. The high chemical consumption for alkaline

  1. Evaluation of High Solids Alkaline Pretreatment of Rice Straw

    Science.gov (United States)

    Cheng, Yu-Shen; Zheng, Yi; Yu, Chao Wei; Dooley, Todd M.; Jenkins, Bryan M.

    2010-01-01

    Fresh-harvested, air-dried rice straw was pretreated at a water content of 5 g H2O/g straw using sodium hydroxide (NaOH) and compared to pretreatment at 10 g H2O/g straw by hydrated lime (Ca(OH)2). Full factorial experiments including parallel wash-only treatments were completed with both sources of alkali. The experiments were designed to measure the effects of alkaline loading and pretreatment time on delignification and sugar yield upon enzymatic hydrolysis. Reaction temperature was held constant at 95°C for lime pretreatment and 55°C for NaOH pretreatment. The range of delignification was 13.1% to 27.0% for lime pretreatments and was 8.6% to 23.1% for NaOH pretreatments. Both alkaline loading and reaction time had significant positive effects (p delignification under the design conditions, but only alkaline loading had a significant positive effect on enzymatic hydrolysis. Treatment at higher temperature also improved delignification; delignification with water alone ranged from 9.9% to 14.5% for pretreatment at 95°C, but there was little effect observed at 55°C. Post-pretreatment washing of biomass was not necessary for subsequent enzymatic hydrolysis. Maximum glucose yields were 176.3 mg/g dried biomass (48.5% conversion efficiency of total glucose) in lime-pretreated and unwashed biomass and were 142.3 mg/g dried biomass (39.2% conversion efficiency of total glucose) in NaOH-pretreated and unwashed biomass. PMID:20440580

  2. Assessment of technologies for hazardous waste site remediation: Non-treatment technologies and pilot scale facility implementation -- excavation -- storage technology -- safety analysis and review statement

    International Nuclear Information System (INIS)

    Johnson, H.R.; Overbey, W.K. Jr.; Koperna, G.J. Jr.

    1994-02-01

    The purpose of this study is to assess the state-of-the-art of excavation technology as related to environmental remediation applications. A further purpose is to determine which of the excavation technologies reviewed could be used by the US Corp of Engineers in remediating contaminated soil to be excavated in the near future for construction of a new Lock and Dam at Winfield, WV. The study is designed to identify excavation methodologies and equipment which can be used at any environmental remediation site but more specifically at the Winfield site on the Kanawha River in Putnam County, West Virginia. A technical approach was determined whereby a functional analysis was prepared to determine the functions to be conducted during the excavation phase of the remediation operations. A number of excavation technologies were identified from the literature. A set of screening criteria was developed that would examine the utility and ranking of the technologies with respect to the operations that needed to be conducted at the Winfield site. These criteria were performance, reliability, implementability, environmental safety, public health, and legal and regulatory compliance. The Loose Bulk excavation technology was ranked as the best technology applicable to the Winfield site. The literature was also examined to determine the success of various methods of controlling fugitive dust. Depending upon any changes in the results of chemical analyses, or prior remediation of the VOCs from the vadose zone, consideration should be given to testing a new ''Pneumatic Excavator'' which removes the VOCs liberated during the excavation process as they outgas from the soil. This equipment however would not be needed on locations with low levels of VOC emissions

  3. Assessment of technologies for hazardous waste site remediation: Non-treatment technologies and pilot scale facility implementation -- excavation -- storage technology -- safety analysis and review statement. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, H.R.; Overbey, W.K. Jr.; Koperna, G.J. Jr.

    1994-02-01

    The purpose of this study is to assess the state-of-the-art of excavation technology as related to environmental remediation applications. A further purpose is to determine which of the excavation technologies reviewed could be used by the US Corp of Engineers in remediating contaminated soil to be excavated in the near future for construction of a new Lock and Dam at Winfield,