WorldWideScience

Sample records for structural intervention strategies

  1. Structure strategy interventions: Increasing reading comprehension of expository text

    Directory of Open Access Journals (Sweden)

    Bonnie J. F. MEYER

    2011-11-01

    Full Text Available In this review of the literature we examine empirical studies designed to teach the structure strategy to increase reading comprehension of expository texts. First, we review the research that has served as a foundation for many of the studies examining the effects of text structure instruction. Text structures generally can be grouped into six categories: comparison, problem-and solution, causation, sequence, collection, and description. Next, we provide a historical look at research of structure strategyinterventions. Strategy interventions employ modeling, practice, and feedback to teach students how to use text structure strategically and eventually automatically. Finally, we review recent text structure interventions for elementary school students. We present similarities and differences among these studies and applications for instruction. Our review of intervention research suggests that direct instruction, modeling, scaffolding, elaborated feedback, and adaptation of instruction to student performance are keys in teaching students to strategically use knowledge about text structure.

  2. Teacher Strategies and Interventions for Maltreated Children.

    Science.gov (United States)

    Lowenthal, Barbara

    2001-01-01

    Suggests that teachers use classroom strategies (structure and routine, reasonable rules and limits, using appropriate methods of discipline, other positive behavior management techniques) and socio-emotional interventions (development of friendships, appropriate expressions of emotions, anger control, conflict management, and internal sense of…

  3. Strategy intervention for the evolution of fairness.

    Directory of Open Access Journals (Sweden)

    Yanling Zhang

    Full Text Available The 'irrational' preference for fairness has attracted increasing attention. Although previous studies have focused on the effects of spitefulness on the evolution of fairness, they did not consider non-monotonic rejections shown in behavioral experiments. In this paper, we introduce a non-monotonic rejection in an evolutionary model of the Ultimatum Game. We propose strategy intervention to study the evolution of fairness in general structured populations. By sequentially adding five strategies into the competition between a fair strategy and a selfish strategy, we arrive at the following conclusions. First, the evolution of fairness is inhibited by altruism, but it is promoted by spitefulness. Second, the non-monotonic rejection helps fairness overcome selfishness. Particularly for group-structured populations, we analytically investigate how fairness, selfishness, altruism, and spitefulness are affected by population size, mutation, and migration in the competition among seven strategies. Our results may provide important insights into understanding the evolutionary origin of fairness.

  4. ADHD in the Classroom: Effective Intervention Strategies

    Science.gov (United States)

    DuPaul, George J.; Weyandt, Lisa L.; Janusis, Grace M.

    2011-01-01

    School-related difficulties are commonly associated with attention deficit hyperactivity disorder (ADHD). This article describes effective school-based intervention strategies including behavioral interventions, modifications to academic instruction, and home-school communication programs. One overlooked aspect of treatment of children with ADHD…

  5. Attention Deficit Hyperactivity Disorder Intervention: Strategies ...

    African Journals Online (AJOL)

    The need for teachers' intervention strategies has been extensively discussed in this paper with a view of developing an intervention programme in other to promote care and support for the pupils who manifest symptoms of ADHD. It is recommended among other things that teachers' knowledge should be enhanced to ...

  6. attention deficit hyperactivity disorder intervention: strategies

    African Journals Online (AJOL)

    Elizabeth

    attention has been given to the pupils who manifest symptoms of this chronic ... The need for teachers' intervention strategies has been ... symptoms and management strategies. ... The “classroom setting” has difficulty for the ADHD pupils because of .... The ADHD pupil's relationship with others is unpredictable, and s/he is.

  7. Strategies of Intervention with Public Offenders.

    Science.gov (United States)

    Chaneles, Sol, Ed.

    1981-01-01

    Reviews intervention strategies with public offenders, including learning therapy, education, group assertive training, and the use of volunteers. The l0 articles deal with inmates' rights in terms of health care and psychotherapy, and evaluation of social programs, and a psychodrama program description/model. (JAC)

  8. Strategies for reducing police arrest in the context of an HIV prevention programme for female sex workers: evidence from structural interventions in Karnataka, South India.

    Science.gov (United States)

    Bhattacharjee, Parinita; Isac, Shajy; McClarty, Leigh M; Mohan, Haranahalli L; Maddur, Srinath; Jagannath, Sunitha B; Venkataramaiah, Balasubramanya K; Moses, Stephen; Blanchard, James F; Gurnani, Vandana

    2016-01-01

    Female sex workers (FSWs) frequently experience violence in their work environments, violating their basic rights and increasing their vulnerability to HIV infection. Structural interventions addressing such violence are critical components of comprehensive HIV prevention programmes. We describe structural interventions developed to address violence against FSWs in the form of police arrest, in the context of the Bill and Melinda Gates Foundation's India AIDS Initiative (Avahan) in Karnataka, South India. We examine changes in FSW arrest between two consecutive time points during the intervention and identify characteristics that may increase FSW vulnerability to arrest in Karnataka. Structural interventions with police involved advocacy work with senior police officials, sensitization workshops, and integration of HIV and human rights topics in pre-service curricula. Programmes for FSWs aimed to enhance collectivization, empowerment and awareness about human rights and to introduce crisis response mechanisms. Three rounds of integrated behavioural and biological assessment surveys were conducted among FSWs from 2004 to 2011. We conducted bivariate and multivariate analyses using data from the second (R2) and third (R3) survey rounds to examine changes in arrests among FSWs over time and to assess associations between police arrest, and the sociodemographic and sex work-related characteristics of FSWs. Among 4110 FSWs surveyed, rates of ever being arrested by the police significantly decreased over time, from 9.9% in R2 to 6.1% in R3 (adjusted odds ratio (AOR) [95% CI]=0.63 [0.48 to 0.83]). Arrests in the preceding year significantly decreased, from 5.5% in R2 to 2.8% in R3 (AOR [95% CI]=0.59 [0.41 to 0.86]). FSWs arrested as part of arbitrary police raids also decreased from 49.6 to 19.5% (AOR [95% CI]=0.21 [0.11 to 0.42]). Certain characteristics, including financial dependency on sex work, street- or brothel-based solicitation and high client volumes, were found

  9. Strategy implemented through structuring and new structures

    DEFF Research Database (Denmark)

    Nielsen, Renate

    Research objective: With the purpose of generating a new understanding of how development in organisations take place, an interpretive perspective at continuous processes in organisations will be applied: more specifically at how organisational interpretation forms an organisation's strategy...... and how the strategy is implemented through structuring, new structures and routines....

  10. Sensemaking, structuring and strategy

    DEFF Research Database (Denmark)

    Nielsen, Renate

    With the purpose of generating a new understanding of how organisations develop, an interpretive perspective at continuous processes in organisations will be applied: more specifically at sensemaking, structuring and strategising....

  11. Intervention strategies for control of foodborne pathogens

    Science.gov (United States)

    Juneja, Vijay K.

    2004-03-01

    The increasing numbers of illnesses associated with foodborne pathogens such as Listeria monocytogenes and Escherichia coli O157:H7, has renewed concerns about food safety because of consumer preferences for minimally processed foods that offer convenience in availability and preparation. Accordingly, the need for better control of foodborne pathogens has been paramount in recent years. Mechanical removal of microorganisms from food can be accomplished by centrifugation, filtration, trimming and washing. Cleaning and sanitation strategies can be used for minimizing the access of microorganisms in foods from various sources. Other strategies for control of foodborne pathogens include established physical microbiocidal treatments such as ionizing radiation and heating. Research has continued to demonstrate that food irradiation is a suitable process to control and possibly eliminate foodborne pathogens, for example Listeria monocytogenes and Escherichia coli O157:H7, from a number of raw and cooked meat and poultry products. Heat treatment is the most common method in use today for the inactivation of microorganisms. Microorganisms can also be destroyed by nonthermal treatments, such as application of high hydrostatic pressure, pulsed electric fields, oscillating magnetic fields or a combination of physical processes such as heat-irradiation, or heat-high hydrostatic pressure, etc. Each of the non-thermal technologies has specific applications in terms of the types of food that can be processed. Both conventional and newly developed physical treatments can be used in combination for controlling foodborne pathogens and enhancing the safety and shelf life of foods. Recent research has focused on combining traditional preservation factors with emerging intervention technologies. However, many key issues still need to be addressed for combination preservation factors or technologies to be useful in the food industry to meet public demands for foods with enhanced safety

  12. Neonatal Vaccination: Challenges and Intervention Strategies.

    Science.gov (United States)

    Morris, Matthew C; Surendran, Naveen

    2016-01-01

    While vaccines have been tremendously successful in reducing the incidence of serious infectious diseases, newborns remain particularly vulnerable in the first few months of their life to life-threatening infections. A number of challenges exist to neonatal vaccination. However, recent advances in the understanding of neonatal immunology offer insights to overcome many of those challenges. This review will present an overview of the features of neonatal immunity which make vaccination difficult, survey the mechanisms of action of available vaccine adjuvants with respect to the unique features of neonatal immunity, and propose a possible mechanism contributing to the inability of neonates to generate protective immune responses to vaccines. We surveyed recent published findings on the challenges to neonatal vaccination and possible intervention strategies including the use of novel vaccine adjuvants to develop efficacious neonatal vaccines. Challenges in the vaccination of neonates include interference from maternal antibody and excessive skewing towards Th2 immunity, which can be counteracted by the use of proper adjuvants. Synergistic stimulation of multiple Toll-like receptors by incorporating well-defined agonist-adjuvant combinations to vaccines is a promising strategy to ensure a protective vaccine response in neonates. © 2016 S. Karger AG, Basel.

  13. Overweight and obesity interventions and prevention strategies.

    Science.gov (United States)

    ALBashtawy, Mohammed

    2015-09-01

    To determine what secondary schoolchildren in Jordan want from overweight and obesity intervention strategies and prevention programmes. A school-based, cross-sectional study using a quantitative design was carried out during October 2014. The participants were secondary schoolchildren in grades 11 and 12. Data were analysed using SPSS program version 17. Percentages, standard deviations and means were computed. The main suggestions were for programmes at school, during school hours (n=962, 85.4%), followed by one that involved family and friends (n=951, 84.5%), and a programme at a convenient time free of charge (n=919, 81.6%). The students also suggested many strategies to tackle overweight and obesity, such as: taking more physical exercise (n=925, 82.1%), increasing consumption of more fruit and vegetables (n=712, 63.2%) eating less fast food (n=689, 61.2%). Schools, families, health providers and community organisations should encourage students to adopt healthy lifestyles, and facilitate their selection and participation in health programmes.

  14. Organizational strategy, structure, and process.

    Science.gov (United States)

    Miles, R E; Snow, C C; Meyer, A D; Coleman, H J

    1978-07-01

    Organizational adaptation is a topic that has received only limited and fragmented theoretical treatment. Any attempt to examine organizational adaptation is difficult, since the process is highly complex and changeable. The proposed theoretical framework deals with alternative ways in which organizations define their product-market domains (strategy) and construct mechanisms (structures and processes) to pursue these strategies. The framework is based on interpretation of existing literature and continuing studies in four industries (college textbook publishing, electronics, food processing, and health care).

  15. Biobehavioral Intervention for Cancer Stress: Conceptualization, Components, and Intervention Strategies

    Science.gov (United States)

    Andersen, Barbara L.; Golden-Kreutz, Deanna M.; Emery, Charles F.; Thiel, Debora L.

    2009-01-01

    Trials testing the efficacy of psychological interventions for cancer patients had their beginnings in the 1970s. Since then, hundreds of trials have found interventions to be generally efficacious. In this article, we describe an intervention grounded in a conceptual model that includes psychological, behavioral, and biological components. It is…

  16. Senescent Swallowing: Impact, Strategies and Interventions

    Science.gov (United States)

    Ney, Denise; Weiss, Jennifer; Kind, Amy; Robbins, JoAnne

    2010-01-01

    The risk for disordered oropharyngeal swallowing (dysphagia) increases with age. Loss of swallowing function can have devastating health implications including dehydration, malnutrition, and pneumonia, as well as reduced quality of life. Age-related changes place older adults at risk for dysphagia for two major reasons: One is that natural, healthy aging takes its toll on head and neck anatomy and physiologic and neural mechanisms underpinning swallowing function. This progression of change contributes to alterations in the swallowing in healthy older adults and is termed presbyphagia, naturally diminishing functional reserve. Second, disease prevalence increases with age and dysphagia is a co-morbidity of many age-related diseases and/or their treatments. Sensory changes, medication, sarcopenia and age-related diseases are discussed herein. Relatively recent findings that health complications are associated with dysphagia are presented. Nutrient requirements, fluid intake and nutritional assessment for older adults are reviewed relative to their relations to dysphagia. Dysphagia screening and the pros and cons of tube feeding as a solution are discussed. Optimal intervention strategies for elders with dysphagia ranging from compensatory interventions to more rigorous exercise approaches are presented. Compelling evidence of improved functional swallowing and eating outcomes resulting from active rehabilitation focusing on increasing strength of head and neck musculature is provided. In summary, while oropharyngeal dysphagia may be life-threatening, so are some of the traditional alternatives, particularly for frail, elderly patients. While the state of the evidence calls for more research, this review indicates the behavioral, dietary and environmental modifications emerging in this past decade are compassionate, promising and in many cases preferred alternatives to the always present option of tube feeding. PMID:19483069

  17. Logical network of genotoxic stress-induced NF-kappaB signal transduction predicts putative target structures for therapeutic intervention strategies

    Directory of Open Access Journals (Sweden)

    Rainer Poltz

    2009-12-01

    Full Text Available Rainer Poltz1, Raimo Franke1,#, Katrin Schweitzer1, Steffen Klamt2, Ernst-Dieter Gilles2, Michael Naumann11Institute of Experimental Internal Medicine, Otto von Guericke University, Magdeburg, Germany; 2Max Planck Institute for Dynamics of Complex Technical Systems, Magdeburg, Germany; #Present address: Department of Chemical Biology, Helmholtz Centre for Infection Research, Braunschweig, GermanyAbstract: Genotoxic stress is induced by a broad range of DNA-damaging agents and could lead to a variety of human diseases including cancer. DNA damage is also therapeutically induced for cancer treatment with the aim to eliminate tumor cells. However, the effectiveness of radio- and chemotherapy is strongly hampered by tumor cell resistance. A major reason for radio- and chemotherapeutic resistances is the simultaneous activation of cell survival pathways resulting in the activation of the transcription factor nuclear factor-kappa B (NF-κB. Here, we present a Boolean network model of the NF-κB signal transduction induced by genotoxic stress in epithelial cells. For the representation and analysis of the model, we used the formalism of logical interaction hypergraphs. Model reconstruction was based on a careful meta-analysis of published data. By calculating minimal intervention sets, we identified p53-induced protein with a death domain (PIDD, receptor-interacting protein 1 (RIP1, and protein inhibitor of activated STAT y (PIASy as putative therapeutic targets to abrogate NF-κB activation resulting in apoptosis. Targeting these structures therapeutically may potentiate the effectiveness of radio- and chemotherapy. Thus, the presented model allows a better understanding of the signal transduction in tumor cells and provides candidates as new therapeutic target structures.Keywords: apoptosis, Boolean network, cancer therapy, DNA-damage response, NF-κB

  18. Understanding consumer acceptance of intervention strategies for healthy food choices: a qualitative study.

    Science.gov (United States)

    Bos, Colin; Van der Lans, Ivo A; Van Rijnsoever, Frank J; Van Trijp, Hans C M

    2013-11-13

    The increasing prevalence of overweight and obesity poses a major threat to public health. Intervention strategies for healthy food choices potentially reduce obesity rates. Reviews of the effectiveness of interventions, however, show mixed results. To maximise effectiveness, interventions need to be accepted by consumers. The aim of the present study is to explore consumer acceptance of intervention strategies for low-calorie food choices. Beliefs that are associated with consumer acceptance are identified. Data was collected in the Netherlands in 8 semi-structured interviews and 4 focus group discussions (N = 39). Nine archetypical strategies representing educational, marketing and legal interventions served as reference points. Verbatim transcriptions were coded both inductively and deductively with the framework approach. We found that three beliefs are related to consumer acceptance: 1) general beliefs regarding obesity, such as who is responsible for food choice; 2) the perceived effectiveness of interventions; and 3) the perceived fairness of interventions. Furthermore, the different aspects underlying these general and intervention-specific beliefs were identified. General and intervention-specific beliefs are associated with consumer acceptance of interventions for low-calorie food choices. Policymakers in the food domain can use the findings to negotiate the development of interventions and to assess the feasibility of interventions. With respect to future research, we recommend that segments of consumers based on perceptions of intervention strategies are identified.

  19. Understanding consumer acceptance of intervention strategies for healthy food choices: a qualitative study

    Science.gov (United States)

    2013-01-01

    Background The increasing prevalence of overweight and obesity poses a major threat to public health. Intervention strategies for healthy food choices potentially reduce obesity rates. Reviews of the effectiveness of interventions, however, show mixed results. To maximise effectiveness, interventions need to be accepted by consumers. The aim of the present study is to explore consumer acceptance of intervention strategies for low-calorie food choices. Beliefs that are associated with consumer acceptance are identified. Methods Data was collected in the Netherlands in 8 semi-structured interviews and 4 focus group discussions (N = 39). Nine archetypical strategies representing educational, marketing and legal interventions served as reference points. Verbatim transcriptions were coded both inductively and deductively with the framework approach. Results We found that three beliefs are related to consumer acceptance: 1) general beliefs regarding obesity, such as who is responsible for food choice; 2) the perceived effectiveness of interventions; and 3) the perceived fairness of interventions. Furthermore, the different aspects underlying these general and intervention-specific beliefs were identified. Conclusions General and intervention-specific beliefs are associated with consumer acceptance of interventions for low-calorie food choices. Policymakers in the food domain can use the findings to negotiate the development of interventions and to assess the feasibility of interventions. With respect to future research, we recommend that segments of consumers based on perceptions of intervention strategies are identified. PMID:24225034

  20. Intervention strategies for the recovery of radioactive-contaminated environments

    International Nuclear Information System (INIS)

    Gutierrez, J.; Vazquez, C.

    2000-01-01

    Following an accident with environmental consequences, intervention may be necessary. The type of remedial actions and the strategy required will be dependent upon, inter alia, the phase and conditions within the contaminated scenario. Leaving aside the basic countermeasures (such as confinement, evacuation), which are based on internationally agreed Generic Intervention Levels (GIL's), the paper deals with intervention strategies leading to a return of the contaminated site to as close to normality as possible with the lowest social cost. The reduction of the damage from the existing contamination must be justified and optimised; the best strategy for applying recovery actions must be selected from a set of potential alternatives. A methodology for intervention strategies analysis, developed in the framework of CEC-CHECIR ECP-4 'Decontamination Strategies', is presented together with some examples of application. (author)

  1. Strategies for Suicide Intervention by Telephone.

    Science.gov (United States)

    Hinson, Jennifer

    1982-01-01

    Describes techniques helpful for telephone counselors dealing with suicide intervention, including reinstating control, reducing anxiety through problem clarification, and providing hope by active listening and tolerance of dispositions. The use of time-outs and detective work is also discussed. (JAC)

  2. Socio-Cultural Perspectives on Causes and Intervention Strategies

    African Journals Online (AJOL)

    AJRH Managing Editor

    Ngezi exclusively rely on socio-cultural intervention strategies to solve the problem of male infertility. ... infertility which integrates the socio-cultural perspectives in policy and programming, if ..... out that the concept of using traditional medicine.

  3. A search strategy for occupational health intervention studies

    NARCIS (Netherlands)

    Verbeek, J.; Salmi, J.; Pasternack, I.; Jauhiainen, M.; Laamanen, I.; Schaafsma, F.; Hulshof, C.; van Dijk, F.

    2005-01-01

    As a result of low numbers and diversity in study type, occupational health intervention studies are not easy to locate in electronic literature databases. To develop a search strategy that facilitates finding occupational health intervention studies in Medline, both for researchers and

  4. BUSINESS STRATEGY, STRUCTURE AND ORGANIZATIONAL PERFORMANCE

    OpenAIRE

    CORINA GAVREA; ROXANA STEGEREAN; LIVIU ILIES

    2012-01-01

    Organizational structure and competitive strategy play an important role in gaining competitive advantage and improving organizational performance. The objective of this paper is to examine how organizational structure and strategy affects firm performance within a sample of 92 Romanian firms. The data used in this study was collected through a questionnaire used to quantify the three variables of interest: organizational performance, strategy and structure.

  5. Improving Intervention Decisions to Prevent Genocide: Less Muddle, More Structure

    Directory of Open Access Journals (Sweden)

    Robin Gregory

    2018-03-01

    Full Text Available Decisions to intervene in a foreign country to prevent genocide and mass atrocities are among the most challenging and controversial choices facing national leaders. Drawing on techniques from decision analysis, psychology, and negotiation analysis, we propose a structured approach to these difficult choices that can provide policy makers with additional insight, consistency, efficiency, and defensibility. We propose the use of a values-based framework to clarify the key elements of these complex choices and to provide a consistent structure for comparison of the likely benefits, risks, and tradeoffs associated with alternative intervention strategies. Results from a workshop involving Ambassadors and experienced policy makers provide a first test of this new method for clarifying intervention choices. A decision-aiding framework is shown to improve the clarity and relevance of intervention deliberations, laying the groundwork for a more comprehensive and clearer understanding of the threats and opportunities associated with various intervention options.

  6. Self-Regulated Strategy Development. What Works Clearinghouse Intervention Report

    Science.gov (United States)

    What Works Clearinghouse, 2017

    2017-01-01

    "Self-Regulated Strategy Development" ("SRSD") is an intervention designed to improve students' academic skills through a six-step process that teaches students specific academic strategies and self-regulation skills. The practice is especially appropriate for students with learning disabilities, the focal population of the…

  7. A Brief Coaching Intervention for Teaching Naturalistic Strategies to Parents

    Science.gov (United States)

    Lane, Justin D.; Ledford, Jennifer R.; Shepley, Collin; Mataras, Theologia K.; Ayres, Kevin M.; Davis, Alicia B.

    2016-01-01

    Coaching parents to implement evidence-based strategies is one method for increasing the number of hours young children with autism spectrum disorder (ASD) access intervention services. The purpose of this study was to teach parents of young children with ASD to implement naturalistic strategies during play in a clinic setting. Results indicate a…

  8. Designing a Minimal Intervention Strategy to Control Taenia solium.

    Science.gov (United States)

    Lightowlers, Marshall W; Donadeu, Meritxell

    2017-06-01

    Neurocysticercosis is an important cause of epilepsy in many developing countries. The disease is a zoonosis caused by the cestode parasite Taenia solium. Many potential intervention strategies are available, however none has been able to be implemented and sustained. Here we predict the impact of some T. solium interventions that could be applied to prevent transmission through pigs, the parasite's natural animal intermediate host. These include minimal intervention strategies that are predicted to be effective and likely to be feasible. Logical models are presented which reflect changes in the risk that age cohorts of animals have for their potential to transmit T. solium. Interventions that include a combined application of vaccination, plus chemotherapy in young animals, are the most effective. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  9. Planning strategies for the avoidance of pitfalls in intervention research.

    Science.gov (United States)

    Pruitt, R H; Privette, A B

    2001-08-01

    With the exception of large clinical trials, few studies in nursing and other social sciences test interventions. The discipline of nursing needs to maintain a full range of research designs for continued knowledge development. Intervention research presents unique opportunities and challenges for the novice as well as the seasoned researcher. Some of these methodological challenges include the complex nature of human subjects and interventions, including many factors that interfere with the study variables. Preliminary studies often reveal challenges that may not always be predicted or reflected in research texts. These challenges may be as important as the study results for success in future research efforts. Difficulties encountered in intervention research and suggested strategies for maintaining the integrity of the study are addressed. These challenges include maintaining an adequate sample size, intervention demands, measuring variables, timing issues, and experiencing unexpected events. Strategies presented include the importance of extensive planning, minimizing subject expectations and rewarding efforts, attention to control group members, incorporating retention strategies, expanding knowledge of variables and the study population, preliminary studies as well as anticipating unexpected events. The need for enhanced communication among nurse researchers, educators and clinicians is addressed. In the current health care arena, nurse researchers must understand organizational dynamics and marketing strategies. Collaborative research efforts can increase the visibility of nursing research as well as funding opportunities.

  10. Effects of Preschool Intervention Strategies on School Readiness in Kindergarten

    Science.gov (United States)

    Ma, Xin; Nelson, Regena F.; Shen, Jianping; Krenn, Huilan Y.

    2015-01-01

    Using hierarchical linear modeling, the present study aimed to examine whether targeted intervention strategies implemented individually during a preschool program exhibited any short-term and long-term effects on children's school readiness in kindergarten, utilizing data gathered through the Supporting Partnerships to Assure Ready Kids (SPARK)…

  11. Effectiveness of Motor Skill Intervention Varies Based on Implementation Strategy

    Science.gov (United States)

    Brian, Ali; Taunton, Sally

    2018-01-01

    Background: Young children from disadvantaged settings often present delays in fundamental motor skills (FMS). Young children can improve their FMS delays through developmentally appropriate motor skill intervention programming. However, it is unclear which pedagogical strategy is most effective for novice and expert instructors. Purpose: The…

  12. Group Play Interventions for Children: Strategies for Teaching Prosocial Skills

    Science.gov (United States)

    Reddy, Linda A.

    2011-01-01

    Group play interventions are used to meet a broad range of developmental needs in children from various backgrounds. This book is for mental health practitioners working with children aged 5 through 12 to help them learn important social skills and self-control strategies such as making friends, asking for and offering help, controlling hands and…

  13. Behavioral economics strategies for promoting adherence to sleep interventions.

    Science.gov (United States)

    Stevens, Jack

    2015-10-01

    Cognitive-behavioral treatment for insomnia and continuous positive airway pressure therapy for obstructive sleep apnea are among the most efficacious sleep interventions. Unfortunately, adherence levels are disappointingly low for these interventions. Behavioral economics offers a promising framework for promoting adherence, often through relatively brief and straightforward strategies. The assumptions, goals, and key strategies of behavioral economics will be introduced. These strategies include providing social norms information, changing defaults, using the compromise effect, utilizing commitment devices, and establishing lottery-based systems. Then, this review will highlight specific behavioral economic approaches to promote patient adherence for three major sleep interventions: 1) behavioral treatment for pediatric insomnia, 2) cognitive-behavioral treatment for adult insomnia, and 3) continuous positive airway pressure for obstructive sleep apnea. Next, behavioral economic strategies will be discussed as ways to improve health care provider adherence to clinical practice guidelines regarding appropriate prescribing of hypnotics and ordering sleep-promoting practices for hospitalized inpatients. Finally, possible concerns that readers may have about behavioral economics strategies, including their efficacy, feasibility, and sustainability, will be addressed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Intervention strategies to improve nutrition and health behaviours before conception.

    Science.gov (United States)

    Barker, Mary; Dombrowski, Stephan U; Colbourn, Tim; Fall, Caroline H D; Kriznik, Natasha M; Lawrence, Wendy T; Norris, Shane A; Ngaiza, Gloria; Patel, Dilisha; Skordis-Worrall, Jolene; Sniehotta, Falko F; Steegers-Theunissen, Régine; Vogel, Christina; Woods-Townsend, Kathryn; Stephenson, Judith

    2018-05-05

    The nutritional status of both women and men before conception has profound implications for the growth, development, and long-term health of their offspring. Evidence of the effectiveness of preconception interventions for improving outcomes for mothers and babies is scarce. However, given the large potential health return, and relatively low costs and risk of harm, research into potential interventions is warranted. We identified three promising strategies for intervention that are likely to be scalable and have positive effects on a range of health outcomes: supplementation and fortification; cash transfers and incentives; and behaviour change interventions. On the basis of these strategies, we suggest a model specifying pathways to effect. Pathways are incorporated into a life-course framework using individual motivation and receptiveness at different preconception action phases, to guide design and targeting of preconception interventions. Interventions for individuals not planning immediate pregnancy take advantage of settings and implementation platforms outside the maternal and child health arena, since this group is unlikely to be engaged with maternal health services. Interventions to improve women's nutritional status and health behaviours at all preconception action phases should consider social and environmental determinants, to avoid exacerbating health and gender inequalities, and be underpinned by a social movement that touches the whole population. We propose a dual strategy that targets specific groups actively planning a pregnancy, while improving the health of the population more broadly. Modern marketing techniques could be used to promote a social movement based on an emotional and symbolic connection between improved preconception maternal health and nutrition, and offspring health. We suggest that speedy and scalable benefits to public health might be achieved through strategic engagement with the private sector. Political theory supports

  15. Intervention strategy to stimulate energy-saving behavior of local residents

    International Nuclear Information System (INIS)

    Han, Q.; Nieuwenhijsen, I.; Vries, B. de; Blokhuis, E.; Schaefer, W.

    2013-01-01

    This study investigates intervention strategy in stimulating energy-saving behavior to achieve energy neutral urban development. A tree structure overview of potential interventions classified into three categories is revealed. An integrated behaviour model is developed reflecting the relations between behaviour and influence factors. A latent class model is used to identify segments of local residents who differ regarding their preferences for interventions. Data are collected from a sample of residents in the Eindhoven region of the Netherlands in 2010. The results indicate that social-demographic characteristics, knowledge, motivation and context factors play important roles in energy-saving behaviour. Specifically, four segments of residents in the study area were identified that clearly differed in their preferences of interventions: cost driven residents, conscious residents, ease driven residents and environment minded residents. These findings emphasize that the intervention strategy should be focused on specific target groups to have the right mixture of interventions to achieve effective results on stimulating them to save energy. - Highlights: ► A latent class model to identify segments with preferred energy-saving interventions. ► An integrated energy-saving behavior model of casual relations. ► A tree structure overview of potential interventions

  16. An Analysis of Implementation Strategies in a School-Wide Vocabulary Intervention

    Science.gov (United States)

    Roskos, Katheen A.; Moe, Jennifer Randazzo; Rosemary, Catherine

    2017-01-01

    From an improvement research perspective, this study explores strategies used to implement a school-wide vocabulary intervention into language arts instruction at an urban elementary school. Academic language time, an innovative change in the instructional delivery system, allots time and structure for deliberate teaching of cross-disciplinary…

  17. Corner Store Inventories, Purchases, and Strategies for Intervention: A Review of the Literature.

    Science.gov (United States)

    Langellier, Brent A; Garza, Jeremiah R; Prelip, Michael L; Glik, Deborah; Brookmeyer, Ron; Ortega, Alexander N

    2013-01-01

    An increasingly popular strategy to improving the food retail environment and promoting healthy eating in low-income and minority communities is the corner store conversion. This approach involves partnering with small 'corner' food stores to expand access to high-quality fruits, vegetables, and other healthy foods. We conducted a structured review of the literature to assess inventories and sales in corner stores, as well as to identify intervention strategies employed by corner store conversions. Our review returned eight descriptive studies that discussed corner store inventories and sales, as well as ten intervention studies discussing six unique corner store conversion interventions in the United States, the Marshall Islands, and Canada. Common intervention strategies included: 1) partnering with an existing store, 2) stocking healthy foods, and 3) social marketing and nutrition education. We summarize each strategy and review the effectiveness of overall corner store conversions at changing peoples' food purchasing, preparation, and consumption behaviors. Consumption of fresh, healthy, affordable foods could be improved by supporting existing retailers to expand their selection of healthy foods and promoting healthy eating at the neighborhood level. Additional corner store conversions should be conducted to determine the effectiveness and importance of specific intervention strategies.

  18. Curriculum structure: principles and strategy

    NARCIS (Netherlands)

    Oliver, R.; Kersten, H.; Vinkka-Puhakka, H.; Alpaslan, G.; Bearn, D.; Cema, I.; Delap, E.; Dummer, P.; Goulet, J.P.; Gugushe, T.; Jeniati, E.; Jerolimov, V.; Kotsanos, N.; Krifka, S.; Levy, G.; Neway, M.; Ogawa, T.; Saag, M.; Sidlauskas, A.; Skaleric, U.; Vervoorn, M.; White, D.

    2008-01-01

    This report provides general guidelines for the structure of a curriculum, followed by specific advice on the principles of learning and teaching, the process of restructuring and change leadership and management. It provides examples of several educational philosophies, including vertical and

  19. From technically standardized interventions to analytically informed multi-perspective intervention strategies

    DEFF Research Database (Denmark)

    Søndergaard, Dorte Marie

    2014-01-01

    In this article, I argue that a multi-perspective intervention strategy can be an important part of answering how the problem of bullying in schools can be diminished and perhaps even eliminated - because bullying is a complex social phenomenon that is inadequately addressed by one-size-fits-all ......In this article, I argue that a multi-perspective intervention strategy can be an important part of answering how the problem of bullying in schools can be diminished and perhaps even eliminated - because bullying is a complex social phenomenon that is inadequately addressed by one...... and helpful than standardised techniques and fixed sets of behavioural rules. Thus, the reader will not find any behavioural rules or suggestions about standardised intervention techniques in this article. Instead, I draw some overall lines along which it is possible to reflect upon the implications...

  20. The Cycle of Reciprocity: A Social Capital Intervention Strategy for SSTR Operations

    National Research Council Canada - National Science Library

    Tolle, Glenn A

    2007-01-01

    ...? The author postulates that an intervention strategy based on fostering "bridging social capital" between two or more competing parties stands a greater probability of success than an intervention...

  1. Curriculum structure: principles and strategy.

    Science.gov (United States)

    Oliver, R; Kersten, H; Vinkka-Puhakka, H; Alpasan, G; Bearn, D; Cema, I; Delap, E; Dummer, P; Goulet, J P; Gugushe, T; Jeniati, E; Jerolimov, V; Kotsanos, N; Krifka, S; Levy, G; Neway, M; Ogawa, T; Saag, M; Sidlauskas, A; Skaleric, U; Vervoorn, M; White, D

    2008-02-01

    This report provides general guidelines for the structure of a curriculum, followed by specific advice on the principles of learning and teaching, the process of restructuring and change leadership and management. It provides examples of several educational philosophies, including vertical and horizontal integration. It discusses the use of competence, learning outcomes, level of degree and assessment and provides a number of recommendations. It does not seek to be prescriptive of time allocation to disciplines within a curriculum. Although this report has been written primarily for those who will develop an undergraduate curriculum, the information may be sufficiently generic to apply to the recent development in graduate entry ('shortened dental' or 'accelerated') courses and to postgraduate degree planning and higher education certificate or diploma courses for other dental care professionals (auxiliaries). The report may have a European bias as progress is made to converge and enhance educational standards in 29 countries with different educational approaches - a microcosm of global collaboration.

  2. Evaluations of Structural Interventions for HIV Prevention: A Review of Approaches and Methods.

    Science.gov (United States)

    Iskarpatyoti, Brittany S; Lebov, Jill; Hart, Lauren; Thomas, Jim; Mandal, Mahua

    2018-04-01

    Structural interventions alter the social, economic, legal, political, and built environments that underlie processes affecting population health. We conducted a systematic review of evaluations of structural interventions for HIV prevention in low- and middle-income countries (LMICs) to better understand methodological and other challenges and identify effective evaluation strategies. We included 27 peer-reviewed articles on interventions related to economic empowerment, education, and substance abuse in LMICs. Twenty-one evaluations included clearly articulated theories of change (TOCs); 14 of these assessed the TOC by measuring intermediary variables in the causal pathway between the intervention and HIV outcomes. Although structural interventions address complex interactions, no evaluation included methods designed to evaluate complex systems. To strengthen evaluations of structural interventions, we recommend clearly articulating a TOC and measuring intermediate variables between the predictor and outcome. We additionally recommend adapting study designs and analytic methods outside traditional epidemiology to better capture complex results, influences external to the intervention, and unintended consequences.

  3. Determining disease intervention strategies using spatially resolved simulations.

    Directory of Open Access Journals (Sweden)

    Mark Read

    Full Text Available Predicting efficacy and optimal drug delivery strategies for small molecule and biological therapeutics is challenging due to the complex interactions between diverse cell types in different tissues that determine disease outcome. Here we present a new methodology to simulate inflammatory disease manifestation and test potential intervention strategies in silico using agent-based computational models. Simulations created using this methodology have explicit spatial and temporal representations, and capture the heterogeneous and stochastic cellular behaviours that lead to emergence of pathology or disease resolution. To demonstrate this methodology we have simulated the prototypic murine T cell-mediated autoimmune disease experimental autoimmune encephalomyelitis, a mouse model of multiple sclerosis. In the simulation immune cell dynamics, neuronal damage and tissue specific pathology emerge, closely resembling behaviour found in the murine model. Using the calibrated simulation we have analysed how changes in the timing and efficacy of T cell receptor signalling inhibition leads to either disease exacerbation or resolution. The technology described is a powerful new method to understand cellular behaviours in complex inflammatory disease, permits rational design of drug interventional strategies and has provided new insights into the role of TCR signalling in autoimmune disease progression.

  4. Resensi Buku: Organization Strategy, Structure, and Process

    Directory of Open Access Journals (Sweden)

    Ayi Ahadiyat

    2009-08-01

    Full Text Available Book ReviewJudul Buku    : Organization Strategy, Structure, and ProcessPenulis    : Raymond E. Miles and Charles C. SnowPenerbit     : McGraw-Hill Kogakusha, Ltd (International Student Edition, Tokyo,  274 hlm.Tahun    : 1978

  5. Strategy elimination in games with interaction structures

    NARCIS (Netherlands)

    Witzel, A.; Apt, K.R.; Zvesper, J.A.

    2009-01-01

    We study games in the presence of an interaction structure, which allows players to communicate their preferences, assuming that each player initially only knows his own preferences. We study the outcomes of iterated elimination of strictly dominated strategies (IESDS) that can be obtained in any

  6. Classroom acoustics and intervention strategies to enhance the learning environment

    Science.gov (United States)

    Savage, Christal

    The classroom environment can be an acoustically difficult atmosphere for students to learn effectively, sometimes due in part to poor acoustical properties. Noise and reverberation have a substantial influence on room acoustics and subsequently intelligibility of speech. The American Speech-Language-Hearing Association (ASHA, 1995) developed minimal standards for noise and reverberation in a classroom for the purpose of providing an adequate listening environment. A lack of adherence to these standards may have undesirable consequences, which may lead to poor academic performance. The purpose of this capstone project is to develop a protocol to measure the acoustical properties of reverberation time and noise levels in elementary classrooms and present the educators with strategies to improve the learning environment. Noise level and reverberation will be measured and recorded in seven, unoccupied third grade classrooms in Lincoln Parish in North Louisiana. The recordings will occur at six specific distances in the classroom to simulate teacher and student positions. The recordings will be compared to the American Speech-Language-Hearing Association standards for noise and reverberation. If discrepancies are observed, the primary investigator will serve as an auditory consultant for the school and educators to recommend remediation and intervention strategies to improve these acoustical properties. The hypothesis of the study is that the classroom acoustical properties of noise and reverberation will exceed the American Speech-Language-Hearing Association standards; therefore, the auditory consultant will provide strategies to improve those acoustical properties.

  7. A Pragmatic Approach to Guide Implementation Evaluation Research: Strategy Mapping for Complex Interventions

    Directory of Open Access Journals (Sweden)

    Alexis K. Huynh

    2018-05-01

    Full Text Available IntroductionGreater specification of implementation strategies is a challenge for implementation science, but there is little guidance for delineating the use of multiple strategies involved in complex interventions. The Cardiovascular (CV Toolkit project entails implementation of a toolkit designed to reduce CV risk by increasing women’s engagement in appropriate services. The CV Toolkit project follows an enhanced version of Replicating Effective Programs (REP, an evidence-based implementation strategy, to implement the CV Toolkit across four phases: pre-conditions, pre-implementation, implementation, and maintenance and evolution. Our current objective is to describe a method for mapping implementation strategies used in real time as part of the CV Toolkit project. This method supports description of the timing and content of bundled strategies and provides a structured process for developing a plan for implementation evaluation.MethodsWe conducted a process of strategy mapping to apply Proctor and colleagues’ rubric for specification of implementation strategies, constructing a matrix in which we identified each implementation strategy, its conceptual group, and the corresponding REP phase(s in which it occurs. For each strategy, we also specified the actors involved, actions undertaken, action targets, dose of the implementation strategy, and anticipated outcome addressed. We iteratively refined the matrix with the implementation team, including use of simulation to provide initial validation.ResultsMapping revealed patterns in the timing of implementation strategies within REP phases. Most implementation strategies involving the development of stakeholder interrelationships and training and educating stakeholders were introduced during the pre-conditions or pre-implementation phases. Strategies introduced in the maintenance and evolution phase emphasized communication, re-examination, and audit and feedback. In addition to its value

  8. Kazakhstan: coronary and structural heart interventions from 2010 to 2015.

    Science.gov (United States)

    Sakhov, Orazbek S; Kuzhukeyev, Murat E; Kodasbayev, Almat T; Egemberdiev, Tolegen Zh; Berkinbayev, Salim F; Zholdin, Bekbolat K; Alimbaev, Serik A; Zhangelova, Sholpan B; Rakhimov, Rustam A; Makhanov, Daniyar I; Sabitov, Yersyn T; Teleuov, Dauren A; Baisebenov, Ruslan K; Kuzhukeyev, Arystan M

    2017-05-15

    This paper presents data on the nascence and development of the interventional cardiology service in Kazakhstan. It provides details of the structure of the Kazakhstan interventional cardiology service, staff training, the number of coronary and structural heart interventions for the period of 2010-2015, as well as the peculiarities of the capitation payment method. The number of coronary interventions is increasing year by year, though the number of intracoronary imaging techniques and intracoronary flow/pressure techniques remains inadequate. Structural heart interventions are mostly performed at tertiary hospital level, with an ever increasing number of transcatheter aortic valve implantation (TAVI) procedures.

  9. Pinning Control Strategy of Multicommunity Structure Networks

    Directory of Open Access Journals (Sweden)

    Chao Ding

    2017-01-01

    Full Text Available In order to investigate the effects of community structure on synchronization, a pinning control strategy is researched in a class of complex networks with community structure in this paper. A feedback control law is designed based on the network community structure information. The stability condition is given and proved by using Lyapunov stability theory. Our research shows that as to community structure networks, there being a threshold hT≈5, when coupling strength bellows this threshold, the stronger coupling strength corresponds to higher synchronizability; vice versa, the stronger coupling strength brings lower synchronizability. In addition the synchronizability of overlapping and nonoverlapping community structure networks was simulated and analyzed; while the nodes were controlled randomly and intensively, the results show that intensive control strategy is better than the random one. The network will reach synchronization easily when the node with largest betweenness was controlled. Furthermore, four difference networks’ synchronizability, such as Barabási-Albert network, Watts-Strogatz network, Erdös-Rényi network, and community structure network, are simulated; the research shows that the community structure network is more easily synchronized under the same control strength.

  10. Susceptibility to breast cancer Cuban families and intervention strategy proposal

    International Nuclear Information System (INIS)

    Robaina, Martha S.; Menendez, Ibis; Valdes, Zodilina; Diaz, Milania

    2009-01-01

    In breast cancer, as in most cancers, mutations usually occur in somatic cells, but sometimes occur in germ cells. The carriers of these mutations germ have up to 80% risk of having the disease course of their lives and pass it on to their offspring, they are called hereditary cancers. In this work studied 50 tested history relatives of this neoplasm from consulting advice genetic hereditary breast cancer. The tree was made pedigree of the family of each test and been classified risk using the criteria of Hampel et al. Other malignancies were identified through the analysis of pedigrees and performed syndromic classification of families. It develops an algorithm for the care of breast cancer families hereditary and plotted strategies identified by risk taking that each category implies a different intervention. It recommended to continue studying the value of marking lesions subclinical and train staff to perform this technique for its widespread use in the country. (Author)

  11. Tuberculosis in children and adolescents: Strategies for social workers' interventions.

    Science.gov (United States)

    González, Norma E; Angueira, Luciana

    2017-12-01

    In the care of children and adolescents with tuberculosis (TB), it is necessary to know the difficulties that many families have in accessing health care, obtaining a diagnosis, and receiving a timely treatment. Social workers, along with other members of the health care team, assist in providing access to health care resources and benefits that may favor treatment compliance and strengthen the health of this vulnerable population. Although the purpose of social workers involvement in this disease is to reduce the risk of becoming infected, sick or dying from TB, the current epidemiological situation of this disease in Argentina has faced social workers with the challenge of reconsidering new intervention strategies and revising current objectives. This study addresses their role and proposes actions that may contribute to decreasing TB morbidity and mortality in children and adolescents. Sociedad Argentina de Pediatría.

  12. COMPARISON OF TWO STRUCTURE AND MOTION STRATEGIES

    Directory of Open Access Journals (Sweden)

    R. Roncella

    2012-09-01

    Full Text Available Automatic orientation of image sequences in close range photogrammetry is becoming more and more important, not least to maintain a degree of competitiveness with other survey techniques, such as laser scanning. The objective of this paper is to compare two Structure from Motion (SFM strategies. The previous strategy has been used at our Department for some years already in a wide range of projects and is based on the Harris operator and the fundamental matrix plus the trifocal tensor estimation to filter out the outliers. While it has in most cases performed satisfactorily, the percentage of accepted matches is generally smaller than expected; sometimes this leads to failure of the successful estimation of the trifocal tensor. The second one has only recently been implemented and is still under testing; it is based on the SURF operator and the 5-point relative orientation algorithm. The paper will show a comparison between the two strategies on a series of test cases.

  13. Intervention strategies for the management of human error

    Science.gov (United States)

    Wiener, Earl L.

    1993-01-01

    This report examines the management of human error in the cockpit. The principles probably apply as well to other applications in the aviation realm (e.g. air traffic control, dispatch, weather, etc.) as well as other high-risk systems outside of aviation (e.g. shipping, high-technology medical procedures, military operations, nuclear power production). Management of human error is distinguished from error prevention. It is a more encompassing term, which includes not only the prevention of error, but also a means of disallowing an error, once made, from adversely affecting system output. Such techniques include: traditional human factors engineering, improvement of feedback and feedforward of information from system to crew, 'error-evident' displays which make erroneous input more obvious to the crew, trapping of errors within a system, goal-sharing between humans and machines (also called 'intent-driven' systems), paperwork management, and behaviorally based approaches, including procedures, standardization, checklist design, training, cockpit resource management, etc. Fifteen guidelines for the design and implementation of intervention strategies are included.

  14. Recruitment strategies and challenges in a large intervention trial: Systolic Blood Pressure Intervention Trial.

    Science.gov (United States)

    Ramsey, Thomas M; Snyder, Joni K; Lovato, Laura C; Roumie, Christianne L; Glasser, Steven P; Cosgrove, Nora M; Olney, Christine M; Tang, Rocky H; Johnson, Karen C; Still, Carolyn H; Gren, Lisa H; Childs, Jeffery C; Crago, Osa L; Summerson, John H; Walsh, Sandy M; Perdue, Letitia H; Bankowski, Denise M; Goff, David C

    2016-06-01

    The Systolic Blood Pressure Intervention Trial is a multicenter, randomized clinical trial of 9361 participants with hypertension who are ≥50 years old. The trial is designed to evaluate the effect of intensive systolic blood pressure control (systolic blood pressure goal recruitment strategies and lessons learned during recruitment of the Systolic Blood Pressure Intervention Trial cohort and five targeted participant subgroups: pre-existing cardiovascular disease, pre-existing chronic kidney disease, age ≥75 years, women, and minorities. In collaboration with the National Institutes of Health Project Office and Systolic Blood Pressure Intervention Trial Coordinating Center, five Clinical Center Networks oversaw clinical site selection, recruitment, and trial activities. Recruitment began on 8 November 2010 and ended on 15 March 2013 (about 28 months). Various recruitment strategies were used, including mass mailing, brochures, referrals from healthcare providers or friends, posters, newspaper ads, radio ads, and electronic medical record searches. Recruitment was scheduled to last 24 months to enroll a target of 9250 participants; in just over 28 months, the trial enrolled 9361 participants. The trial screened 14,692 volunteers, with 33% of initial screens originating from the use of mass mailing lists. Screening results show that participants also responded to recruitment efforts through referral by Systolic Blood Pressure Intervention Trial staff, healthcare providers, or friends (45%); brochures or posters placed in clinic waiting areas (15%); and television, radio, newspaper, Internet ads, or toll-free numbers (8%). The overall recruitment yield (number randomized/number screened) was 64% (9361 randomized/14,692 screened), 77% for those with cardiovascular disease, 79% for those with chronic kidney disease, 70% for those aged ≥75 years, 55% for women, and 61% for minorities. As recruitment was observed to lag behind expectations, additional

  15. Consumer acceptance of intervention strategies for healthy food choices

    NARCIS (Netherlands)

    Bos, Colin

    2016-01-01

    The need for more effective interventions to combat the obesity problem has been expressed by many public health experts. While consumer support is important for intervention effectiveness, little is known about why consumers accept or do not accept food choice interventions. The present thesis

  16. THE ESSENCE OF STRATEGY DEVELOPMENT COMPANY IN THE INTEGRATED STRUCTURE

    Directory of Open Access Journals (Sweden)

    A. I. Khorev

    2014-01-01

    Full Text Available Summary. In the beginning of the article is defined a rational sequence of the consideration of the nature of the strategy of a company development, included into an integrated structure. Further the article describes the following items separately: "a strategy", "a development of a company", and "an integrational structure", applying them to companies included to the integrated structure; separating them from a strategy of development of an autonomous company. The article defines functions which such strategy must define, taking into consideration the nature of the strategy of the company development, included into an integrated structure. Next, the article defines six steps which describe a sequence of development of the strategy of the company development, included into an integrated structure. The analysis which is defined in the article allows determining a complete definition of essence of the strategy of the company development, included into an integrated structure. The article also defines a place of the strategy of development into the hierarchical structure of the strategies. The strategy of the company development, included into an integrated structure (as well as the strategy of development of an autonomous company -- is a competition strategy, and it separates "strategy of leadership for costs", “differentiation strategy”, and “strategy of focusing for costs”. Also authors are analyzed the strategy of the cost optimization. According to the complex definition of the strategy, and the strategy's place inside the hierarchical structure, the article defines functions which corporate, competitive, and functional strategies execute during the management of companies inside an integrational structure. The article presents characteristics of applied strategic decisions at different levels of all three types of strategies. The article's researches allow companies included to the integrated structure define their place inside the

  17. A Fractual Mechanical Testing and Design Strategy for FRC Structures

    DEFF Research Database (Denmark)

    Stang, Henrik; Olesen, John Forbes

    1999-01-01

    A unified testing and design strategy for fibre reinforced concrete structures is summarised. The strategy is based on fracture mechanical concepts. Emphasis is placed on material characterisation and testing specifications.......A unified testing and design strategy for fibre reinforced concrete structures is summarised. The strategy is based on fracture mechanical concepts. Emphasis is placed on material characterisation and testing specifications....

  18. A reexamination and extension of international strategy-structure theory

    OpenAIRE

    Wolf, Joachim; Egelhoff, William G.

    2001-01-01

    Using a sample of 95 German firms, the study finds general support for the traditional fits of international strategy-structure theory. Employing an information-processing perspective, the study conceptually and empirically extends existing theory (1) to address strategy-structure fit for various types of matrix structure, and (2) by adding two new elements of international strategy to the existing international strategy-structure model: the level of international transfers and level of forei...

  19. Improving Inappropriate Social Behavior of Autistic Students Using the LISTEN Intervention Strategy

    Science.gov (United States)

    Al-Shammari, Zaid; Daniel, Cathy; Faulkner, Paula; Yawkey, Thomas D.

    2010-01-01

    A case study was conducted on the development of the LISTEN intervention strategy for use with autistic students to improve inappropriate social behaviors. The study was conducted in a special education classroom in an autism school in Kuwait. Examination of LISTEN Intervention Strategy applications included: duration of targeted behavior; methods…

  20. Therapists' causal attributions of clients' problems and selection of intervention strategies.

    Science.gov (United States)

    Royce, W S; Muehlke, C V

    1991-04-01

    Therapists' choices of intervention strategies are influenced by many factors, including judgments about the bases of clients' problems. To assess the relationships between such causal attributions and the selection of intervention strategies, 196 counselors, psychologists, and social workers responded to the written transcript of a client's interview by answering two questionnaires, a 1982 scale (Causal Dimension Scale by Russell) which measured causal attribution of the client's problem, and another which measured preference for emotional, rational, and active intervention strategies in dealing with the client, based on the 1979 E-R-A taxonomy of Frey and Raming. A significant relationship was found between the two sets of variables, with internal attributions linked to rational intervention strategies and stable attributions linked to active strategies. The results support Halleck's 1978 hypothesis that theories of psychotherapy tie interventions to etiological considerations.

  1. Exploring Animal-Assisted Therapy as a Reading Intervention Strategy

    Science.gov (United States)

    Kaymen, Maria S.

    2005-01-01

    This study is an examination of animal-assisted therapy in an attempt to explore the ways it may serve as reading intervention program for struggling readers. Due to the low rate of literacy in the U.S., children are often put into reading intervention programs where they are required to read to an adult; potentially creating anxiety that may act…

  2. Recruitment strategies and challenges in a large intervention trial: Systolic Blood Pressure Intervention Trial (SPRINT)

    Science.gov (United States)

    Ramsey, Thomas M; Snyder, Joni K; Lovato, Laura C; Roumie, Christianne L; Glasser, Steven P; Cosgrove, Nora M; Olney, Christine M; Tang, Rocky H; Johnson, Karen C; Still, Carolyn H; Gren, Lisa H; Childs, Jeffery C; Crago, Osa L; Summerson, John H; Walsh, Sandy M; Perdue, Letitia H; Bankowski, Denise M; Goff, David C

    2016-01-01

    Background The Systolic Blood Pressure Intervention Trial (SPRINT) is a multicenter, randomized clinical trial of 9,361 participants with hypertension who are ≥ 50 years old. The trial is designed to evaluate the effect of intensive systolic blood pressure control (systolic blood pressure goal recruitment strategies and lessons learned during recruitment of the SPRINT cohort and five targeted participant subgroups: pre-existing cardiovascular disease, pre-existing chronic kidney disease, age ≥ 75 years, women, and minorities. Methods In collaboration with the National Institutes of Health Project Office and SPRINT Coordinating Center, five Clinical Center Networks oversaw clinical site selection, recruitment, and trial activities. Recruitment began November 8, 2010 and ended March 15, 2013 (about 28 months). Various recruitment strategies were used, including mass mailing, brochures, referrals from healthcare providers or friends, posters, newspaper ads, radio ads, and electronic medical record searches. Results Recruitment was scheduled to last 24 months to enroll a target of 9,250 participants; in just over 28 months, the trial enrolled 9,361 participants. The trial screened 14,692 volunteers, with 33% of initial screens originating from the use of mass mailing lists. Screening results show that participants also responded to recruitment efforts through referral by SPRINT staff, healthcare providers, or friends (45%); brochures or posters placed in clinic waiting areas (15%); and television, radio, newspaper, internet ads, or toll-free numbers (8%). The overall recruitment yield (number randomized /number screened) was 64% (9,361 randomized /14,692 screened), 77% for those with cardiovascular disease, 79% for those with chronic kidney disease, 70% for those age ≥ 75 years, 55% for women, and 61% for minorities. As recruitment was observed to lag behind expectations, additional clinics were included and inclusion criteria were broadened, keeping event rates

  3. Hungry for an intervention? : Adolescents' ratings of acceptability of eating-related intervention strategies

    NARCIS (Netherlands)

    Stok, F Marijn; de Ridder, Denise T D; de Vet, Emely; Nureeva, Liliya; Luszczynska, Aleksandra; Wardle, Jane; Gaspar, Tania; de Wit, John B F

    2016-01-01

    BACKGROUND: Effective interventions promoting healthier eating behavior among adolescents are urgently needed. One factor that has been shown to impact effectiveness is whether the target population accepts the intervention. While previous research has assessed adults' acceptance of eating-related

  4. Hungry for an intervention? Adolescents' ratings of acceptability of eating-related intervention strategies

    NARCIS (Netherlands)

    Stok, F.M.; Ridder, de D.T.D.; Vet, de Emely; Nureeva, Liliya; Luszczynska, Aleksandra; Wardle, Jane; Gaspar, Tania; Wit, de J.B.F.

    2016-01-01

    Background: Effective interventions promoting healthier eating behavior among adolescents are urgently needed. One factor that has been shown to impact effectiveness is whether the target population accepts the intervention. While previous research has assessed adults' acceptance of

  5. Evolving strategies, opportunistic implementation: HIV risk reduction in Tanzania in the context of an incentive-based HIV prevention intervention.

    Directory of Open Access Journals (Sweden)

    Laura Packel

    Full Text Available Behavior change communication (BCC interventions, while still a necessary component of HIV prevention, have not on their own been shown to be sufficient to stem the tide of the epidemic. The shortcomings of BCC interventions are partly due to barriers arising from structural or economic constraints. Arguments are being made for combination prevention packages that include behavior change, biomedical, and structural interventions to address the complex set of risk factors that may lead to HIV infection.In 2009/2010 we conducted 216 in-depth interviews with a subset of study participants enrolled in the RESPECT study - an HIV prevention trial in Tanzania that used cash awards to incentivize safer sexual behaviors. We analyzed community diaries to understand how the study was perceived in the community. We drew on these data to enhance our understanding of how the intervention influenced strategies for risk reduction.We found that certain situations provide increased leverage for sexual negotiation, and these situations facilitated opportunistic implementation of risk reduction strategies. Opportunities enabled by the RESPECT intervention included leveraging conditional cash awards, but participants also emphasized the importance of exploiting new health status knowledge from regular STI testing. Risk reduction strategies included condom use within partnerships and/or with other partners, and an unexpected emphasis on temporary abstinence.Our results highlight the importance of increasing opportunities for implementing risk reduction strategies. We found that an incentive-based intervention could be effective in part by creating such opportunities, particularly among groups such as women with limited sexual agency. The results provide new evidence that expanding regular testing of STIs is another important mechanism for providing opportunities for negotiating behavior change, beyond the direct benefits of testing. Exploiting the latent demand for

  6. High School Teachers' Perceptions of Cyberbullying Prevention and Intervention Strategies

    Science.gov (United States)

    Stauffer, Sterling; Heath, Melissa Allen; Coyne, Sarah Marie; Ferrin, Scott

    2012-01-01

    Recent meta-analyses indicate that bully prevention programs produce minimal change in student behavior. This study examined 66 high school teachers' perceptions regarding the effect of cyberbullying on students, which intervening strategies teachers would use when dealing with cyberbullying, and which prevention strategies would assist in…

  7. "Teacher, I Can Read!" The Marvels of Early Intervention Strategies

    Science.gov (United States)

    Murphy, Jean C.; Hernandez, Leonor

    2011-01-01

    "Teacher, I can read!" exclaimed Saree, a fourth-quarter second grader who was placed in the lowest of reading groups at a southwest side elementary school in Chicago. This was her proud announcement after three weeks of intensive intervention with Ms. Gomez, a student teacher in her final semester at Chicago State University. "Ms.…

  8. Failure To Thrive: Strategies for Evaluation and Intervention.

    Science.gov (United States)

    Black, Maureen M.

    1995-01-01

    Reviews the definition of failure to thrive (FTT) and its relationship to theories of child development as FTT is an early physical marker of risk with long-term consequences. These children are often eligible for services through PL99-457, and psychologists can play an integral role in multidisciplinary evaluation and on intervention team.…

  9. Selective Mutism: Practice and Intervention Strategies for Children

    Science.gov (United States)

    Hung, Shu-Lan; Spencer, Michael S.; Dronamraju, Rani

    2012-01-01

    The onset of selective mutism (SM) is usually between the ages of three and five years, when the children first go to preschool. However, these children are most commonly referred for treatment between the ages of six and 11, when they are entering the elementary school system. Early detection and early intervention is suggested for effective SM…

  10. ADHD in the Schools: Assessment and Intervention Strategies. Second Edition

    Science.gov (United States)

    DuPaul, George J.; Stoner, Gary

    2004-01-01

    This popular reference and text provides essential guidance for school-based professionals meeting the challenges of ADHD at any grade level. Comprehensive and practical, the book includes several reproducible assessment tools and handouts. A team-based approach to intervention is emphasized in chapters offering research-based guidelines for: (1)…

  11. Prevention and Firesetting: Juvenile Justice and Intervention Strategies.

    Science.gov (United States)

    Slavkin, Michael L.

    2003-01-01

    Examines the literature on preventing firesetting behavior in preadolescents and adolescents, suggesting the need for policies and programs designed to help juveniles by providing community support and stability. Alternatives to juvenile justice interventions include making changes in the home environment, acquiring a greater sense of self, and…

  12. A systematic review investigating the behaviour change strategies in interventions to prevent misuse of anabolic steroids.

    Science.gov (United States)

    Bates, Geoff; Begley, Emma; Tod, David; Jones, Lisa; Leavey, Conan; McVeigh, Jim

    2017-10-01

    We examined intervention effectiveness of strategies to prevent image- and performance-enhancing drug use. Comprehensive searches identified 14 interventions that met review inclusion criteria. Interventions were predominantly educational and delivered within school sport settings, but targeted a wide range of mediating factors. Identification of effective components was limited across studies by brief or imprecise descriptions of intervention content, lack of behavioural outcome measures and short-term follow-up times. However, studies with components in addition to information provision may be more promising. Interventions outside of sport settings are required to reflect the transition of this form of substance use to the general population.

  13. Organization Strategy and Structural Differences for Radical Versus Incremental Innovation

    OpenAIRE

    John E. Ettlie; William P. Bridges; Robert D. O'Keefe

    1984-01-01

    The purpose of this study was to test a model of the organizational innovation process that suggests that the strategy-structure causal sequence is differentiated by radical versus incremental innovation. That is, unique strategy and structure will be required for radical innovation, especially process adoption, while more traditional strategy and structure arrangements tend to support new product introduction and incremental process adoption. This differentiated theory is strongly supported ...

  14. Strategies to Engage Adolescents in Digital Health Interventions for Obesity Prevention and Management

    Directory of Open Access Journals (Sweden)

    Stephanie R. Partridge

    2018-06-01

    Full Text Available Obesity is one of the greatest health challenges facing today’s adolescents. Dietary interventions are the foundation of obesity prevention and management. As adolescents are digital frontrunners and early adopters of technology, digital health interventions appear the most practical modality for dietary behavior change interventions. Despite the rapid growth in digital health interventions, effective engagement with adolescents remains a pertinent issue. Key strategies for effective engagement include co-designing interventions with adolescents, personalization of interventions, and just-in-time adaptation using data from wearable devices. The aim of this paper is to appraise these strategies, which may be used to improve effective engagement and thereby improve the dietary behaviors of adolescents now and in the future.

  15. Fetal alcohol spectrum disorders: experimental treatments and strategies for intervention.

    Science.gov (United States)

    Idrus, Nirelia M; Thomas, Jennifer D

    2011-01-01

    Despite the known damaging effects of prenatal alcohol exposure, women continue to drink during pregnancy, creating a need for effective interventions and treatments for fetal alcohol spectrum disorders (FASD). Experimental models can be useful in identifying potential treatments, and this article describes the spectrum of experimental therapeutics that currently are being investigated, including pharmacological, nutritional, and environmental/behavioral interventions. Some treatments target the underlying mechanisms that contribute to alcohol-induced damage, protecting against alcohol's teratogenic effects, whereas other treatments may enhance central nervous system plasticity either during alcohol exposure or long after alcohol exposure has ceased. The insights gained to date from experimental models offer several candidates for attenuating the deficits associated with FASD.

  16. Patient decision making: strategies for diabetes diet adherence intervention.

    Science.gov (United States)

    Kavookjian, Jan; Berger, Bruce A; Grimley, Diane M; Villaume, William A; Anderson, Heidi M; Barker, Kenneth N

    2005-09-01

    Patient self-care is critical in controlling diabetes and its complications. Lack of diet adherence is a particular challenge to effective diabetes intervention. The Transtheoretical Model (TTM) of Change, decision-making theory, and self-efficacy have contributed to successful tailoring of interventions in many target behaviors. The purpose of this study was to develop a diagnostic tool, including TTM measures for the stages of change, decisional balance, and self-efficacy, that pharmacists involved in diabetes intervention can use for patients resistant to a diet regimen. A questionnaire was developed through a literature review, interviews with diabetic patients, an expert panel input, and pretesting. Cross-sectional implementation of the questionnaire among a convenience sample of 193 type 1 and type 2 diabetic patients took place at 4 patient care sites throughout the southeastern United States. Validated measures were used to collect respondent self-report for the TTM variables and for demographic and diabetes history variables. Social desirability was also assessed. Relationships among TTM measures for diet adherence generally replicated those established for other target behaviors. Salient items were identified as potential facilitators (decisional balance pros) or barriers (decisional balance cons and self-efficacy tempting situations) to change. Social desirability exhibited a statistically significant relationship with patient report of diet adherence, with statistically significant differences in mean social desirability across race categories. The TTM measures for the stages of change, decisional balance, and self-efficacy are useful for making decisions on individually tailored interventions for diet adherence, with caution asserted about the potential of diabetes patients to self-report the target behavior in a socially desirable manner. Future research directions, implications, and limitations of the findings are also presented.

  17. What Would You Do? Strategies for Bystander Intervention to Prevent Sexual Violence by College Students

    Science.gov (United States)

    McMahon, Sarah; Hoffman, Melanie Lowe; McMahon, Sheila M.; Zucker, Sharon; Koenick, Ruth Anne

    2013-01-01

    Bystander education is an increasingly utilized strategy for addressing sexual assault prevention and intervention on U.S. college campuses. Given the paramount importance of peers among college students, what types of pro-social bystander interventions do students themselves deem feasible in the campus context? Drawing on self-reports from…

  18. Evaluation of intervention strategies for a road link in the Netherlands

    NARCIS (Netherlands)

    Adey, B.T.; Lethanh, N.; Hartmann, Andreas; Viti, F.

    2014-01-01

    Purpose – The purpose of this paper is to investigate the use of the impact hierarchy and the optimization model to determine the optimal intervention strategy for a road link composed of multiple objects. The paper focusses on the results of a case study of intervention project on A20 road link in

  19. Implementing multiple intervention strategies in Dutch public health-related policy networks

    NARCIS (Netherlands)

    Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

    2017-01-01

    Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to

  20. On-scene crisis intervention: psychological guidelines and communication strategies for first responders.

    Science.gov (United States)

    Miller, Laurence

    2010-01-01

    Effective emergency mental health intervention for victims of crime, natural disaster or terrorism begins the moment the first responders arrive. This article describes a range of on-scene crisis intervention options, including verbal communication, body language, behavioral strategies, and interpersonal style. The correct intervention in the first few moments and hours of a crisis can profoundly influence the recovery course of victims and survivors of catastrophic events.

  1. Integrating Educational, Environmental, and Behavioral Economic Strategies May Improve the Effectiveness of Obesity Interventions

    OpenAIRE

    Joel Gittelsohn; Katherine Lee

    2013-01-01

    Interventions that change the food environment, provide nutrition education, and employ behavioral economics strategies can potentially contribute to healthier diets and reduce the risk of chronic disease, but no attempt has been made to integrate these into the same conceptual framework. We present case studies of three multilevel, integrated interventions implemented by Johns Hopkins University between 2004–2011. We develop a conceptual model based on these case studies. Interventions and p...

  2. Crisis Intervention Strategies for School-Based Helpers. Second Edition.

    Science.gov (United States)

    Fairchild, Thomas N., Ed.

    School-based helpers are helping professionals who work within educational settings and whose training and primary responsibility is to promote the mental health of students. Few resource materials provide these helpers with needed information and practical strategies--this text tries to meet that need. The 12 chapters here cover a wide range of…

  3. Assessment and Intervention for Academic Task Attack Strategy Competencies

    Science.gov (United States)

    Busse, R. T.; Lee, Charlene

    2015-01-01

    Many students who underachieve in schools may not be learning as effectively as they could. Direct assessments such as the Academic Competence Evaluation Scales (ACES), School Motivation and Learning Strategies Inventory (SMALSI), and the Academic Task Attack Checklist System (ATACS) can be used to evaluate students' knowledge and use of…

  4. Sleep and academic success: mechanisms, empirical evidence, and interventional strategies.

    Science.gov (United States)

    Gruber, Reut; Wiebe, Sabrina T; Wells, Samantha Ashley; Cassoff, Jamie; Monson, Eva

    2010-12-01

    Mounting evidence indicates that sleep is beneficial for learning, memory, attention, and academic success. However, the importance of sleep in these contexts has rarely been addressed in programs aimed at optimizing academic performance. This review aims to describe the role that sleep plays in processes pertaining to academic achievement. We first describe the basic sleep processes and their role with respect to cognitive and behavioral/emotional systems important for academic performance. We next review studies conducted to assess the association between sleep and academic performance, concluding by describing interventional programs being used to optimize sleep in the context of academic success.

  5. Optimal intervention strategies for cholera outbreak by education and chlorination

    Science.gov (United States)

    Bakhtiar, Toni

    2016-01-01

    This paper discusses the control of infectious diseases in the framework of optimal control approach. A case study on cholera control was studied by considering two control strategies, namely education and chlorination. We distinct the former control into one regarding person-to-person behaviour and another one concerning person-to-environment conduct. Model are divided into two interacted populations: human population which follows an SIR model and pathogen population. Pontryagin maximum principle was applied in deriving a set of differential equations which consists of dynamical and adjoin systems as optimality conditions. Then, the fourth order Runge-Kutta method was exploited to numerically solve the equation system. An illustrative example was provided to assess the effectiveness of the control strategies toward a set of control scenarios.

  6. Biotechnological interventions in sugarcane improvement: strategies, methods and progress

    International Nuclear Information System (INIS)

    Suprasanna, P.

    2010-01-01

    Work has been conducted towards employing in vitro culture system combined with radiation induced mutagenesis in the improvement of sugarcane. Several radiation induced mutants with agronomically desirable traits were isolated and evaluated under field conditions, besides studying abiotic stress responses using biochemical, physiological and molecular tools. This article describes the developments in the in vitro culture systems and related biotechnologies that are evolving as novel strategies in the recent years for use in sugarcane improvement

  7. Effects of different intervention strategies on the incidence of papillomatous digital dermatitis in dairy cows

    NARCIS (Netherlands)

    Holzhauer, M.; Doepfer, D.; Boer, de J.; Schaik, van G.

    2008-01-01

    The effects of four different intervention strategies on the incidence of severe lesions of digital dermatitis in an experimental dairy herd were compared with the effects of a control strategy consisting of walking the cows twice through a footbath containing 4 per cent formaldehyde on one day a

  8. Comparing Student Perceptions of Coping Strategies and School Interventions in Managing Bullying and Cyberbullying Incidents

    Science.gov (United States)

    Paul, Simone; Smith, Peter K.; Blumberg, Herbert H.

    2012-01-01

    A total of 407 students in a central London secondary school participated in a survey of different approaches to managing traditional bullying and cyberbullying. Student perceptions of individual coping strategies and school interventions for traditional bullying and cyberbullying were measured. Rankings of the strategies for traditional bullying…

  9. Dietary intervention strategies to modulate prostate cancer risk and prognosis.

    Science.gov (United States)

    Freedland, Stephen J; Aronson, William J

    2009-05-01

    There is increasing interest in complementary and holistic approaches for cancer prevention and management. We sought to review the latest literature regarding dietary interventions for prostate cancer with a special emphasis on dietary fat and carbohydrate intake for modulating prognosis among men with prostate cancer. Several recent prospective trials have investigated various dietary and lifestyle investigations on malignant prostate tissue biology. These interventions included a very low-fat (12% fat kcals) vegan diet with various supplements and lifestyle changes, a more traditional low-fat diet (25% fat kcals) with flaxseed supplementation, and a low-glycemic index diet. Low-glycemic index and very low-fat vegan diets (with supplements and lifestyle changes) alter tumor biology as assessed by tumor gene expression changes, with a common mechanism perhaps being weight loss whereas no effects were seen with a traditional low-fat diet. In mice, either very low-fat or low-carbohydrate diets significantly slow tumor growth independent of weight loss. Epidemiologic and preclinical data also suggest cholesterol intake and serum cholesterol levels may be linked with the development and progression of prostate cancer. Small clinical trials suggest that tumor biology can be altered by either a vegan low-fat diet or eliminating simple carbohydrates accompanied by weight loss. Larger and longer term studies are needed to determine the clinical relevance of these findings.

  10. Digital Media Use in Families: Theories and Strategies for Intervention.

    Science.gov (United States)

    Dalope, Kristin A; Woods, Leonard J

    2018-04-01

    Family dynamics are increasingly being influenced by digital media. Three frameworks are described to help clinicians to understand and respond to this influence. First, a social-ecological framework shows how media has both a direct and indirect impact on individuals, relationships, communities, and society. Next, family systems theory is introduced to demonstrate digital media-related interactions within families. Finally, a developmental framework explores the role of digital media in shaping parenting. These theories are then integrated into practical strategies that clinicians can use, including recommendations and resources from the American Academy of Pediatrics. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Learning disabilities: definitions, epidemiology, diagnosis, and intervention strategies.

    Science.gov (United States)

    Lagae, Lieven

    2008-12-01

    Learning problems occur in about 5% of school-aged children. Learning disabilities are specific and life-long but present with different school problems at different ages, depending on such factors as age, medical history, family history, and intelligence quotient. Proper individualized diagnosis and treatment plans are necessary to remediate these problems and to offer adequate coping strategies. Many children who have learning problems can be classified into one of two major categories: the dyslexia group or the nonverbal learning disability group. The role of the medical professional is important to guide parents in the diagnostic and therapeutic process.

  12. Market Structure in the Context of Developing Competitive Strategy

    OpenAIRE

    Algirdas Krivka; Romualdas Ginevičius

    2011-01-01

    The abstract deals with the application of positioning strategies under the conditions of classical market structures. It is discovered that the assumptions of pure competition leave no space for M. Porter’s generic cost leadership and differentiation strategies to be applied. The enterprise’s actions, influencing five competitive forces and implementing generic strategies, are reasonable under the conditions of imperfect competition market structures. The game theory models, applied to oligo...

  13. Nutrition intervention strategies to combat zinc deficiency in developing countries.

    Science.gov (United States)

    Gibson, R S; Ferguson, E L

    1998-06-01

    Widespread zinc deficiency is likely to exist in developing countries where staple diets are predominantly plant based and intakes of animal tissues are low. The severe negative consequences of zinc deficiency on human health in developing countries, however, have only recently been recognized. An integrated approach employing targeted supplementation, fortification and dietary strategies must be used to maximize the likelihood of eliminating zinc deficiency at a national level in developing countries. Supplementation is appropriate only for populations whose zinc status must be improved over a relatively short time period, and when requirements cannot be met from habitual dietary sources. As well, the health system must be capable of providing consistent supply, distribution, delivery and consumption of the zinc supplement to the targeted groups. Uncertainties still exist about the type, frequency, and level of supplemental zinc required for prevention and treatment of zinc deficiency. Salts that are readily absorbed and at levels that will not induce antagonistic nutrient interactions must be used. At a national level, fortification with multiple micronutrients could be a cost effective method for improving micronutrient status, including zinc, provided that a suitable food vehicle which is centrally processed is available. Alternatively, fortification could be targeted for certain high risk groups (e.g. complementary foods for infants). Efforts should be made to develop protected fortificants for zinc, so that potent inhibitors of zinc absorption (e.g. phytate) present either in the food vehicle and/or indigenous meals do not compromise zinc absorption. Fortification does not require any changes in the existing food beliefs and practices for the consumer and, unlike supplementation, does not impose a burden on the health sector. A quality assurance programme is required, however, to ensure the quality of the fortified food product from production to consumption

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

    Science.gov (United States)

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

    2016-08-01

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

  15. Acceptability and feasibility of potential intervention strategies for influencing sedentary time at work: focus group interviews in executives and employees.

    Science.gov (United States)

    De Cocker, Katrien; Veldeman, Charlene; De Bacquer, Dirk; Braeckman, Lutgart; Owen, Neville; Cardon, Greet; De Bourdeaudhuij, Ilse

    2015-02-18

    Occupational sitting can be the largest contributor to overall daily sitting time in white-collar workers. With adverse health effects in adults, intervention strategies to influence sedentary time on a working day are needed. Therefore, the present aim was to examine employees' and executives' reflections on occupational sitting and to examine the potential acceptability and feasibility of intervention strategies to reduce and interrupt sedentary time on a working day. Seven focus groups (four among employees, n = 34; three among executives, n = 21) were conducted in a convenience sample of three different companies in Flanders (Belgium), using a semi-structured questioning route in five themes [personal sitting patterns; intervention strategies during working hours, (lunch) breaks, commuting; and intervention approach]. The audiotaped interviews were verbatim transcribed, followed by a qualitative inductive content analysis in NVivo 10. The majority of participants recognized they spend their working day mostly sitting and associated this mainly with musculoskeletal health problems. Participants suggested a variety of possible strategies, primarily for working hours (standing during phone calls/meetings, PC reminders, increasing bathroom use by drinking more water, active sitting furniture, standing desks, rearranging the office) and (lunch) breaks (physical activity, movement breaks, standing tables). However, several barriers were reported, including productivity concerns, impracticality, awkwardness of standing, and the habitual nature of sitting. Facilitating factors were raising awareness, providing alternatives for simply standing, making some strategies obligatory and workers taking some personal responsibility. There are some strategies targeting sedentary time on a working day that are perceived to be realistic and useful. However several barriers emerged, which future trials and practical initiatives should take into account.

  16. Optimal inspection strategies for offshore structural systems

    DEFF Research Database (Denmark)

    Faber, M. H.; Sorensen, J. D.; Kroon, I. B.

    1992-01-01

    a mathematical framework for the estimation of the failure and repair costs a.ssociated with systems failure. Further a strategy for selecting the components to inspect based on decision tree analysis is suggested. Methods and analysis schemes are illustrated by a simple example....

  17. Dynamic simulation of crime perpetration and reporting to examine community intervention strategies.

    Science.gov (United States)

    Yonas, Michael A; Burke, Jessica G; Brown, Shawn T; Borrebach, Jeffrey D; Garland, Richard; Burke, Donald S; Grefenstette, John J

    2013-10-01

    To develop a conceptual computational agent-based model (ABM) to explore community-wide versus spatially focused crime reporting interventions to reduce community crime perpetrated by youth. Agents within the model represent individual residents and interact on a two-dimensional grid representing an abstract nonempirically grounded community setting. Juvenile agents are assigned initial random probabilities of perpetrating a crime and adults are assigned random probabilities of witnessing and reporting crimes. The agents' behavioral probabilities modify depending on the individual's experience with criminal behavior and punishment, and exposure to community crime interventions. Cost-effectiveness analyses assessed the impact of activating different percentages of adults to increase reporting and reduce community crime activity. Community-wide interventions were compared with spatially focused interventions, in which activated adults were focused in areas of highest crime prevalence. The ABM suggests that both community-wide and spatially focused interventions can be effective in reducing overall offenses, but their relative effectiveness may depend on the intensity and cost of the interventions. Although spatially focused intervention yielded localized reductions in crimes, such interventions were shown to move crime to nearby communities. Community-wide interventions can achieve larger reductions in overall community crime offenses than spatially focused interventions, as long as sufficient resources are available. The ABM demonstrates that community-wide and spatially focused crime strategies produce unique intervention dynamics influencing juvenile crime behaviors through the decisions and actions of community adults. It shows how such models might be used to investigate community-supported crime intervention programs by integrating community input and expertise and provides a simulated setting for assessing dimensions of cost comparison and intervention effect

  18. On Control Strategies for Responsive Architectural Structures

    DEFF Research Database (Denmark)

    Kirkegaard, Poul Henning; Parigi, Dario

    2012-01-01

    The present paper considers control of responsive architectural structures for improvement of structural performance by recognizing changes in their environments and loads, adapting to meet goals, and using past events to improve future performance or maintain serviceability. The general scope of...

  19. Strategies for Worksite Health Interventions to Employees with Elevated Risk of Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Lu Meng

    2017-06-01

    Full Text Available Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n = 13, cardiovascular diseases (n = 8, and diabetes (n = 6. Intervention strategies included instructional education/counseling (n = 20, workplace environmental change (n = 6, physical activity (n = 10, use of technology (n = 10, and incentives (n = 13. Self-reported data (n = 21, anthropometric measurements (n = 17, and laboratory tests (n = 14 were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.

  20. Strategies for Worksite Health Interventions to Employees with Elevated Risk of Chronic Diseases.

    Science.gov (United States)

    Meng, Lu; Wolff, Marilyn B; Mattick, Kelly A; DeJoy, David M; Wilson, Mark G; Smith, Matthew Lee

    2017-06-01

    Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity ( n   =  13), cardiovascular diseases ( n   =  8), and diabetes ( n   =  6). Intervention strategies included instructional education/counseling ( n   =  20), workplace environmental change ( n   =  6), physical activity ( n   =  10), use of technology ( n   =  10), and incentives ( n   =  13). Self-reported data ( n   =  21), anthropometric measurements ( n   =  17), and laboratory tests ( n   =  14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.

  1. The process evaluation of two alternative participatory ergonomics intervention strategies for construction companies.

    Science.gov (United States)

    Visser, Steven; van der Molen, Henk F; Sluiter, Judith K; Frings-Dresen, Monique H W

    2018-03-26

    To gain insight into the process of applying two guidance strategies - face-to-face (F2F) or e-guidance strategy (EC) - of a Participatory Ergonomics (PE) intervention and whether differences between these guidance strategies occur, 12 construction companies were randomly assigned to a strategy. The process evaluation contained reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change of individual workers. Data were assessed by logbooks, and questionnaires and interviews at baseline and/or after six months. Reach was low (1%). Dose delivered (F2F: 63%; EC: 44%), received (F2F: 42%; EC: 16%) were not sufficient. The precision and competence were sufficient for both strategies and satisfaction was strongly affected by dose received. For behavioural change, knowledge (F2F) and culture (EC) changed positively within companies. Neither strategy was delivered as intended. Compliance to the intervention was low, especially for EC. Starting with a face-to-face meeting might lead to higher compliance, especially in the EC group. Practitioner Summary: This study showed that compliance to a face-to-face and an e-guidance strategy is low. To improve the compliance, it is advised to start with a face-to-face meeting to see which parts of the intervention are needed and which guidance strategy can be used for these parts. ISRCTN73075751.

  2. Cec-CHECIR ECP-4 optimization of intervention strategies for the recovery of radioactive contaminated environments

    International Nuclear Information System (INIS)

    Vazquez, C.; Gutierrez, J.; Trueba, C.; Savkin, M.

    1996-01-01

    The goal of this work is to evaluate different options of intervention for the recovery of contaminated environments. It will consider not only the efficiency of the countermeasures in terms of dose reduction, but also in terms of costs, wastes and other possible secondary consequences, in order to obtain the best possible strategy for each particular circumstance. This paper summarizes the methodology of optimization of intervention, which has been carried out in the framework of CEC-CHECIR ECP-4 Project

  3. Market structure, market strategy and customer satisfaction

    DEFF Research Database (Denmark)

    Eskildsen, Jacob Kjær; Kristensen, Kai; Steensen, Elmer Fly

    2007-01-01

    The popularity of customer satisfaction measurements has grown considerably over the last few years but we know very little about how the structure of the individual markets with respect to the transparency of products and services as well as how consumer preferences affect customer satisfaction....... Here a total of 14540 customers have evaluated their preferred supplier with respect to banking, property insurance, supermarkets and mobile telecom. The analysis shows that market structure has a profound effect on customer satisfaction measurements and that this effect differs from industry...... to industry. The paper concludes with an evaluation of the implications of the findings in relation to the use of results from customer satisfaction studies....

  4. Implementing the Integrated Strategy for the Cultural Adaptation of Evidence-Based Interventions: An Illustration.

    Science.gov (United States)

    Sidani, Souraya; Ibrahim, Sarah; Lok, Jana; Fan, Lifeng; Fox, Mary

    2018-01-01

    Background Persons' cultural beliefs about a health problem can affect their perceived acceptability of evidence-based interventions, undermining evidence-based interventions' adherence, and uptake to manage the problem. Cultural adaptation has the potential to enhance the acceptability, uptake, and adherence to evidence-based interventions. Purpose To illustrate the implementation of the first two phases of the integrated strategy for cultural adaptation by examining Chinese Canadians' perceptions of chronic insomnia and evidence-based behavioral therapies for insomnia. Methods Chinese Canadians ( n = 14) with chronic insomnia attended a group session during which they completed established instruments measuring beliefs about sleep and insomnia, and their perceptions of factors that contribute to chronic insomnia. Participants rated the acceptability of evidence-based behavioral therapies and discussed their cultural perspectives regarding chronic insomnia and its treatment. Results Participants actively engaged in the activities planned for the first two phases of the integrated strategy and identified the most significant factor contributing to chronic insomnia and the evidence-based intervention most acceptable for their cultural group. Conclusions The protocol for implementing the two phases of the integrated strategy for cultural adaptation of evidence-based interventions was feasible, acceptable, and useful in identifying culturally relevant evidence-based interventions.

  5. Organisational sensemaking, strategy, structuring and routines

    DEFF Research Database (Denmark)

    Nielsen, Renate

    2001-01-01

    Research objective: The purpose of my research is to generate new understanding of what organisational interpretation, sensemaking and structuring processes in organisations mean in a way that can be used not only retrospectively but actively in strategic planning. In the study of these processes...

  6. Strategies for Optimal Design of Structural Systems

    DEFF Research Database (Denmark)

    Enevoldsen, I.; Sørensen, John Dalsgaard

    1992-01-01

    Reliability-based design of structural systems is considered. Especially systems where the reliability model is a series system of parallel systems are analysed. A sensitivity analysis for this class of problems is presented. Direct and sequential optimization procedures to solve the optimization...

  7. INTERVENTION STRATEGIES USED TO ADDRESS ALCOHOL ABUSE IN THE NORTH WEST PROVINCE, SOUTH AFRICA

    Directory of Open Access Journals (Sweden)

    Setlalentoa, Marilyn

    2015-09-01

    Full Text Available One of the purposes of the Alcohol Sub-Study of the Prospective Urban and Rural Epidemiological (PURE study was to identify the socio-economic effects of binge drinking from the perspective of community support networks and assess their intervention efforts to address the alcohol abuse problem in the selected areas of study. Emphasis was placed on implementation of plans and legislation; however, eradication of the problem seems to be insignificant for various reasons. This article reports on these identified challenges and proposes appropriate intervention strategies that take cognisance of the nature of the communities for which intervention efforts are intended

  8. Base isolation strategies for structures and components

    International Nuclear Information System (INIS)

    Varma, Veto; Reddy, G.R.; Vaze, K.K.; Kushwaha, H.S.

    2003-08-01

    In the present report the effect of laminated rubber bearing (LRB) system on the dynamic response of the structure was studied. A LRB system was designed and tested in the laboratory for its dynamic characteristics. Finite element analysis was also performed and based on this analysis, isolator for PHWR nuclear power plant was designed. Analysis of the building was performed with and without isolator. Comparison of responses was made in terms of frequencies, accelerations and displacements and floor response spectra. (author)

  9. Mapping strategy, structure, ownership and performance in European corporations : Introduction

    NARCIS (Netherlands)

    Colli, A.; Iversen, M.J.; de Jong, A.

    2011-01-01

    This paper is the introduction to the Business History special issue on European Business Models. The volume presents results of the international project about mapping European corporations, within the strategy, structure, ownership and performance (SSOP) framework. The paper describes the

  10. Optimal Inspection and Maintenance Strategies for Structural Systems

    DEFF Research Database (Denmark)

    Sommer, A. M.

    The aim of this thesis is to give an overview of conventional and optimal reliability-based inspection and maintenance strategies and to examine for specific structures how the cost can be reduced and/or the safety can be improved by using optimal reliability-based inspection strategies....... For structures with several almost similar components it is suggested that individual inspection strategies should be determined for each component or a group of components based on the reliability of the actual component. The benefit of this procedure is assessed in connection with the structures considered....... Furthermore, in relation to the calculations performed the intention is to modify an existing program for determination of optimal inspection strategies. The main purpose of inspection and maintenance of structural systems is to prevent or delay damage or deterioration to protect people, environment...

  11. Intervention Strategies Based on Information-Motivation-Behavioral Skills Model for Health Behavior Change: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Sun Ju Chang, RN, PhD

    2014-09-01

    Conclusion: This review indicates the potential strength of the IMB model as a theoretical framework to develop behavioral interventions. The specific integration strategies delineated for each construct of the model can be utilized to design model-based interventions.

  12. NEMESIS: NEtwork Modeling Environment for Structural Intervention Strategies

    National Research Council Canada - National Science Library

    Stacy, Webb; Salter, William; Serfaty, Daniel; MacMillan, Jean; Chopra, Kari; Levchuk, Georgiy; Burt, Tim; Lecours, Dan; Mizrahi, Gilbert; Colonna-Romano, John; Rantz, Matt; Pattipati, Krishna; Willett, Peter; Tu, Haiying; Singh, Satnam; Allanach, Jeff; Carley, Kathleen; Reminga, Jeff

    2005-01-01

    ... (in the form of local task lists), for maximum convenience and minimum obtrusiveness. The NEMESIS integration architecture is bus-oriented and is centered around an XML Schema based language named Organizational Description Language (ODL...

  13. Identifying quality improvement intervention publications - A comparison of electronic search strategies

    Directory of Open Access Journals (Sweden)

    Rubenstein Lisa V

    2011-08-01

    Full Text Available Abstract Background The evidence base for quality improvement (QI interventions is expanding rapidly. The diversity of the initiatives and the inconsistency in labeling these as QI interventions makes it challenging for researchers, policymakers, and QI practitioners to access the literature systematically and to identify relevant publications. Methods We evaluated search strategies developed for MEDLINE (Ovid and PubMed based on free text words, Medical subject headings (MeSH, QI intervention components, continuous quality improvement (CQI methods, and combinations of the strategies. Three sets of pertinent QI intervention publications were used for validation. Two independent expert reviewers screened publications for relevance. We compared the yield, recall rate, and precision of the search strategies for the identification of QI publications and for a subset of empirical studies on effects of QI interventions. Results The search yields ranged from 2,221 to 216,167 publications. Mean recall rates for reference publications ranged from 5% to 53% for strategies with yields of 50,000 publications or fewer. The 'best case' strategy, a simple text word search with high face validity ('quality' AND 'improv*' AND 'intervention*' identified 44%, 24%, and 62% of influential intervention articles selected by Agency for Healthcare Research and Quality (AHRQ experts, a set of exemplar articles provided by members of the Standards for Quality Improvement Reporting Excellence (SQUIRE group, and a sample from the Cochrane Effective Practice and Organization of Care Group (EPOC register of studies, respectively. We applied the search strategy to a PubMed search for articles published in 10 pertinent journals in a three-year period which retrieved 183 publications. Among these, 67% were deemed relevant to QI by at least one of two independent raters. Forty percent were classified as empirical studies reporting on a QI intervention. Conclusions The presented

  14. Enumeration of smallest intervention strategies in genome-scale metabolic networks.

    Directory of Open Access Journals (Sweden)

    Axel von Kamp

    2014-01-01

    Full Text Available One ultimate goal of metabolic network modeling is the rational redesign of biochemical networks to optimize the production of certain compounds by cellular systems. Although several constraint-based optimization techniques have been developed for this purpose, methods for systematic enumeration of intervention strategies in genome-scale metabolic networks are still lacking. In principle, Minimal Cut Sets (MCSs; inclusion-minimal combinations of reaction or gene deletions that lead to the fulfilment of a given intervention goal provide an exhaustive enumeration approach. However, their disadvantage is the combinatorial explosion in larger networks and the requirement to compute first the elementary modes (EMs which itself is impractical in genome-scale networks. We present MCSEnumerator, a new method for effective enumeration of the smallest MCSs (with fewest interventions in genome-scale metabolic network models. For this we combine two approaches, namely (i the mapping of MCSs to EMs in a dual network, and (ii a modified algorithm by which shortest EMs can be effectively determined in large networks. In this way, we can identify the smallest MCSs by calculating the shortest EMs in the dual network. Realistic application examples demonstrate that our algorithm is able to list thousands of the most efficient intervention strategies in genome-scale networks for various intervention problems. For instance, for the first time we could enumerate all synthetic lethals in E.coli with combinations of up to 5 reactions. We also applied the new algorithm exemplarily to compute strain designs for growth-coupled synthesis of different products (ethanol, fumarate, serine by E.coli. We found numerous new engineering strategies partially requiring less knockouts and guaranteeing higher product yields (even without the assumption of optimal growth than reported previously. The strength of the presented approach is that smallest intervention strategies can be

  15. Implementing multiple intervention strategies in Dutch public health-related policy networks.

    Science.gov (United States)

    Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

    2017-10-13

    Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to implement an intervention mix. Data were collected (2009-14) from 29 Dutch public health policy networks. Surveys were used to identify the number of policy sectors, participation of actors, level of trust, networking by the project leader, and intervention strategies implemented. Conditions sufficient for an intervention mix (≥3 of 4 non-educational strategies present) were determined in a fuzzy-set qualitative comparative analysis. A multisectoral policy network (≥7 of 14 sectors present) was neither a necessary nor a sufficient condition. In multisectoral networks, additionally required was either the active participation of network actors (≥50% actively involved) or active networking by the project leader (≥monthly contacts with network actors). In policy networks that included few sectors, a high level of trust (positive perceptions of each other's intentions) was needed-in the absence though of any of the other conditions. If the network actors were also actively involved, an extra requirement was active networking by the project leader. We conclude that the multisectoral composition of policy networks can contribute to the implementation of a variety of intervention strategies, but not without additional efforts. However, policy networks that include only few sectors are also able to implement an intervention mix. Here, trust seems to be the most important condition. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Toward interventions to address moral distress: navigating structure and agency.

    Science.gov (United States)

    Musto, Lynn C; Rodney, Patricia A; Vanderheide, Rebecca

    2015-02-01

    The concept of moral distress has been the subject of nursing research for the past 30 years. Recently, there has been a call to move from developing an understanding of the concept to developing interventions to help ameliorate the experience. At the same time, the use of the term moral distress has been critiqued for a lack of clarity about the concepts that underpin the experience. Some researchers suggest that a closer examination of how socio-political structures influence healthcare delivery will move moral distress from being seen as located in the individual to an experience that is also located in broader healthcare structures. Informed by new thinking in relational ethics, we draw on research findings from neuroscience and attachment literature to examine the reciprocal relationship between structures and agents and frame the experience of moral distress. We posit moral distress as a form of relational trauma and subsequently point to the need to better understand how nurses as moral agents are influenced by-and influence-the complex socio-political structures they inhabit. In so doing, we identify this reciprocity as a framework for interventions. © The Author(s) 2014.

  17. A 7-Step Strategy for the Implementation of Worksite Lifestyle Interventions: Helpful or Not?

    Science.gov (United States)

    Wierenga, Debbie; Engbers, Luuk H; Van Empelen, Pepjin; van Mechelen, Willem

    2016-05-01

    The aim of this study was to evaluate the use of and adherence to a 7-step strategy for the development, implementation, and continuation of a comprehensive, multicomponent lifestyle program. Strategy use and adherence was assessed with 12 performance indicators. Data were collected by combining onsite monitoring with semi-structured interviews at baseline and follow-up (6, 12, and 18 months). Not all performance indicators were met so partial strategy adherence was obtained. The strategy could be improved on the following aspects: support among management, project structure, adaptation to needs of employees, planning, and maintenance. The results of this evaluation indicate that strategy adherence facilitated structured development and implementation. On the basis of the qualitative data, this study suggests that when improvements will be made on both the content and performance, the 7-step strategy could be an effective tool to successfully implement a multicomponent WHPP.

  18. Alpha test results for a Housing First eLearning strategy: the value of multiple qualitative methods for intervention design.

    Science.gov (United States)

    Ahonen, Emily Q; Watson, Dennis P; Adams, Erin L; McGuire, Alan

    2017-01-01

    Detailed descriptions of implementation strategies are lacking, and there is a corresponding dearth of information regarding methods employed in implementation strategy development. This paper describes methods and findings related to the alpha testing of eLearning modules developed as part of the Housing First Technical Assistance and Training (HFTAT) program's development. Alpha testing is an approach for improving the quality of a product prior to beta (i.e., real world) testing with potential applications for intervention development. Ten participants in two cities tested the modules. We collected data through (1) a structured log where participants were asked to record their experiences as they worked through the modules; (2) a brief online questionnaire delivered at the end of each module; and (3) focus groups. The alpha test provided useful data related to the acceptability and feasibility of eLearning as an implementation strategy, as well as identifying a number of technical issues and bugs. Each of the qualitative methods used provided unique and valuable information. In particular, logs were the most useful for identifying technical issues, and focus groups provided high quality data regarding how the intervention could best be used as an implementation strategy. Alpha testing was a valuable step in intervention development, providing us an understanding of issues that would have been more difficult to address at a later stage of the study. As a result, we were able to improve the modules prior to pilot testing of the entire HFTAT. Researchers wishing to alpha test interventions prior to piloting should balance the unique benefits of different data collection approaches with the need to minimize burdens for themselves and participants.

  19. Economies of scale and scope in banking : Effects of government intervention, corporate strategy and market power

    NARCIS (Netherlands)

    Dijkstra, M.A.

    2017-01-01

    The financial crisis and ensuing policy responses have made the question of economies of scale and scope in the banking sector as topical as ever. This dissertation estimates economies of scale and scope in the banking sector and discusses the role of government intervention, corporate strategy and

  20. Peer-Mediated Intervention: An Effective, Inclusive Strategy for All Young Children

    Science.gov (United States)

    Harris, Kathleen; Pretti-Frontczak, Kristie; Brown, Teresa

    2009-01-01

    The authors describe a teaching strategy that can support the development and learning of all children in inclusive learning environments. They give an overview of peer-mediated intervention and share useful information on how classroom teachers can use this tool to promote learning, particularly in the areas of social and communication…

  1. A Social-Behavioral Learning Strategy Intervention for a Child with Asperger Syndrome: Brief Report

    Science.gov (United States)

    Bock, Marjorie A.

    2007-01-01

    This study examined the effect of a social-behavioral learning strategy intervention (Stop-Observe-Deliberate-Act; SODA) on the social interaction skills of one middle school student with Asperger syndrome (AS). More specifically, the study investigated the effect of SODA training on the ability of one student with AS to participate in cooperative…

  2. Video Self-Modeling as an Intervention Strategy for Individuals with Autism Spectrum Disorders

    Science.gov (United States)

    Gelbar, Nicholas W.; Anderson, Candace; McCarthy, Scott; Buggey, Tom

    2012-01-01

    Video self-modeling demonstrates promise as an intervention strategy to improve outcomes in individuals with autism spectrum disorders. This article summarizes the empirical evidence supporting the use of video self-modeling with individuals with autism spectrum disorders to increase language and communication, increase social skills, modify…

  3. Remediation of social communication impairments following traumatic brain injury using metacognitive strategy intervention: a pilot study.

    Science.gov (United States)

    Finch, Emma; Cornwell, Petrea; Copley, Anna; Doig, Emmah; Fleming, Jennifer

    2017-01-01

    To perform a pilot study to evaluate whether a novel metacognitive, goal-based intervention improved and maintained the social communication skills of adults with traumatic brain injury (TBI). Eight community-dwelling participants with TBI completed three study phases: (1) baseline, (2) eight-week intervention targeting social communication impairments and (3) follow-up. Participants completed the Profile of Pragmatic Impairment in Communication (PPIC), LaTrobe Communication Questionnaire (LCQ) and Goal Attainment Scaling (GAS) at the commencement of baseline phase, pre- and post-intervention and completion of the follow-up phase. During the intervention programme phase, participants attended two 1-hour therapy sessions (one individual; one group) per week focusing on remediating impaired social communication skills using metacognitive strategy intervention and goal-based therapy. Variable changes in PPIC feature-summary scores were observed post-intervention. A non-significant improvement in LCQ scores was also observed. There was a significant increase in GAS goal T-scores following the intervention, with six of the eight participants achieving or exceeding their expected level of performance on all goals. A goal-driven, metacognitive approach to intervention may assist individuals with TBI to achieve their personal social communication goals, with benefits reported by participants and observable during conversations. Further research is required.

  4. Physician-based smoking intervention: a rededication to a five-step strategy to smoking research.

    Science.gov (United States)

    Ockene, J K; Zapka, J G

    1997-01-01

    It is well established that physicians can have a significant effect on the smoking behavior of their patients. To do this, attention must be paid to putting in place multiple strategies or mechanisms in the organization where the physician practices, as well as in the macroenvironment (i.e., social and public policy). It has been questioned whether or not there is stagnation in the field of clinical smoking intervention requiring a rededication to basic research regarding smoking. With respect to physician-based smoking intervention, we alternatively suggest that recommitment to all phases of research is essential for moving forward physician-based smoking interventions in the rapidly changing health services and social environment. In this article, we first review the essential framework of the National Cancer Institute's research science approach to cancer prevention and control. Evidence concerning physician-based interventions is then reviewed, followed by a schematic of a comprehensive framework for thinking about the process and intervention components needed for physician-based smoking intervention to take place in the health-care setting, the impact they have, and the eventual outcome of such interventions. There is a discussion of the challenges for the delivery of smoking-cessation services presented by the rapidly changing healthy delivery system of the 1990s. Finally, we present recommendations concerning research priorities for physician-based smoking intervention and the research funding process.

  5. Market Structure in the Context of Developing Competitive Strategy

    Directory of Open Access Journals (Sweden)

    Algirdas Krivka

    2011-04-01

    Full Text Available The abstract deals with the application of positioning strategies under the conditions of classical market structures. It is discovered that the assumptions of pure competition leave no space for M. Porter’s generic cost leadership and differentiation strategies to be applied. The enterprise’s actions, influencing five competitive forces and implementing generic strategies, are reasonable under the conditions of imperfect competition market structures. The game theory models, applied to oligopoly, indicate the close interaction of enterprises and interdependence of their strategic decisions: cost reduction and differentiation strategies not only increase the profit of the enterprise, implementing the strategy, but by affecting market price and residual demand decrease the competitor’s profit.Article in Lithuanian

  6. From intervention to innovation: applying a formal implementation strategy in community primary care.

    Science.gov (United States)

    Wallace, Andrea S; Sussman, Andrew L; Anthoney, Mark; Parker, Edith A

    2013-01-01

    Objective. To describe a comprehensive strategy for implementing an effective diabetes self-management support intervention incorporating goal-setting and followup support in community health clinics (CHCs) serving vulnerable patients. Methods. The Replicating Effective Programs (REP) framework was applied to develop an intervention strategy. In order to create a strategy consistent with the REP framework, four CHCs engaged in an iterative process involving key-informant interviews with clinic staff, ongoing involvement of clinic staff facilitating translational efforts, feedback from national experts, and an instructional designer. Results. Moving through the REP process resulted in an implementation strategy that aims to facilitate commitment, communication, and change at the clinic level, as well as means of providing interactive, time-limited education about patient behavior change and support to health care providers. Conclusion. The REP offered a useful framework for providing guidance toward the development of a strategy to implement a diabetes self-management intervention in CHCs serving medically underserved and underrepresented patient populations.

  7. From Intervention to Innovation: Applying a Formal Implementation Strategy in Community Primary Care

    Directory of Open Access Journals (Sweden)

    Andrea S. Wallace

    2013-01-01

    Full Text Available Objective. To describe a comprehensive strategy for implementing an effective diabetes self-management support intervention incorporating goal-setting and followup support in community health clinics (CHCs serving vulnerable patients. Methods. The Replicating Effective Programs (REP framework was applied to develop an intervention strategy. In order to create a strategy consistent with the REP framework, four CHCs engaged in an iterative process involving key-informant interviews with clinic staff, ongoing involvement of clinic staff facilitating translational efforts, feedback from national experts, and an instructional designer. Results. Moving through the REP process resulted in an implementation strategy that aims to facilitate commitment, communication, and change at the clinic level, as well as means of providing interactive, time-limited education about patient behavior change and support to health care providers. Conclusion. The REP offered a useful framework for providing guidance toward the development of a strategy to implement a diabetes self-management intervention in CHCs serving medically underserved and underrepresented patient populations.

  8. Developing complex interventions: lessons learned from a pilot study examining strategy training in acute stroke rehabilitation.

    Science.gov (United States)

    Skidmore, Elizabeth R; Dawson, Deirdre R; Whyte, Ellen M; Butters, Meryl A; Dew, Mary Amanda; Grattan, Emily S; Becker, James T; Holm, Margo B

    2014-04-01

    To examine the feasibility of a strategy training clinical trial in a small group of adults with stroke-related cognitive impairments in inpatient rehabilitation, and to explore the impact of strategy training on disability. Non-randomized two-group intervention pilot study. Two inpatient rehabilitation units within an academic health centre. Individuals with a primary diagnosis of acute stroke, who were admitted to inpatient rehabilitation and demonstrated cognitive impairments were included. Individuals with severe aphasia; dementia; major depressive disorder, bipolar, or psychotic disorder; recent drug or alcohol abuse; and anticipated length of stay less than five days were excluded. Participants received strategy training or an attention control session in addition to usual rehabilitation care. Sessions in both groups were 30-40 minutes daily, five days per week, for the duration of inpatient rehabilitation. We assessed feasibility through participants' recruitment and retention; research intervention session number and duration; participants' comprehension and engagement; intervention fidelity; and participants' satisfaction. We assessed disability at study admission, inpatient rehabilitation discharge, 3 and 6 months using the Functional Independence Measure. Participants in both groups (5 per group) received the assigned intervention (>92% planned sessions; >94% fidelity) and completed follow-up testing. Strategy training participants in this small sample demonstrated significantly less disability at six months (M (SE) = 117 (3)) than attention control participants (M(SE) = 96 (14); t 8 = 7.87, P = 0.02). It is feasible and acceptable to administer both intervention protocols as an adjunct to acute inpatient rehabilitation, and strategy training shows promise for reducing disability.

  9. Pragmatism rules: the intervention and prevention strategies used by psychiatric nurses working with non-suicidal self-harming individuals.

    Science.gov (United States)

    O'Donovan, A

    2007-02-01

    Self harm in the absence of expressed suicidal intent is an under explored area in psychiatric nursing research. This paper reports on findings of a study undertaken in two acute psychiatric inpatient units in Ireland. The purpose of the study was to gain an understanding of the practices of psychiatric nurses in relation to people who self harm, but who are not considered suicidal. Semi structured interviews were held with eight psychiatric nurses. Content analysis revealed several themes. For the purpose of this paper the prevention and intervention strategies psychiatric nurses engage in when working with non-suicidal self harming individuals are presented. Recommendations for further research are offered.

  10. Workplace experience of radiographers: impact of structural and interpersonal interventions

    Energy Technology Data Exchange (ETDEWEB)

    Kubik-Huch, R.A.; Roempler, M.; Weber, A. [Kantonsspital Baden, Institute of Radiology, Baden (Switzerland); Klaghofer, R.; Buddeberg-Fischer, B. [Zurich University Hospital, Department of Psychosocial Medicine, Zurich (Switzerland)

    2010-02-15

    Within the framework of organisational development, an assessment of the workplace experience of radiographers (RGs) was conducted. The aims of this study were to develop structural and interpersonal interventions and to prove their effectiveness and feasibility. A questionnaire consisting of work-related factors, e.g. time management and communication, and two validated instruments (Workplace Analysis Questionnaire, Effort-Reward Imbalance Scale) was distributed to all RGs (n = 33) at baseline (T1). Interventions were implemented and a follow-up survey (T2) was performed 18 months after the initial assessment. At T1, areas with highest dissatisfaction were communication and time management for ambulant patients (bad/very bad, 57% each). The interventions addressed adaptation of work plans, coaching in developing interpersonal and team leadership skills, and regular team meetings. The follow-up survey (T2) showed significantly improved communication and cooperation within the team and improved qualification opportunities, whereas no significant changes could be identified in time management and in the workplace-related scales 'effort' expended at work and 'reward' received in return for the effort. Motivating workplace experience is important for high-level service quality and for attracting well-qualified radiographers to work at a place and to stay in the team for a longer period. (orig.)

  11. Workplace experience of radiographers: impact of structural and interpersonal interventions

    International Nuclear Information System (INIS)

    Kubik-Huch, R.A.; Roempler, M.; Weber, A.; Klaghofer, R.; Buddeberg-Fischer, B.

    2010-01-01

    Within the framework of organisational development, an assessment of the workplace experience of radiographers (RGs) was conducted. The aims of this study were to develop structural and interpersonal interventions and to prove their effectiveness and feasibility. A questionnaire consisting of work-related factors, e.g. time management and communication, and two validated instruments (Workplace Analysis Questionnaire, Effort-Reward Imbalance Scale) was distributed to all RGs (n = 33) at baseline (T1). Interventions were implemented and a follow-up survey (T2) was performed 18 months after the initial assessment. At T1, areas with highest dissatisfaction were communication and time management for ambulant patients (bad/very bad, 57% each). The interventions addressed adaptation of work plans, coaching in developing interpersonal and team leadership skills, and regular team meetings. The follow-up survey (T2) showed significantly improved communication and cooperation within the team and improved qualification opportunities, whereas no significant changes could be identified in time management and in the workplace-related scales 'effort' expended at work and 'reward' received in return for the effort. Motivating workplace experience is important for high-level service quality and for attracting well-qualified radiographers to work at a place and to stay in the team for a longer period. (orig.)

  12. Structure coefficients and strategy selection in multiplayer games.

    Science.gov (United States)

    McAvoy, Alex; Hauert, Christoph

    2016-01-01

    Evolutionary processes based on two-player games such as the Prisoner's Dilemma or Snowdrift Game are abundant in evolutionary game theory. These processes, including those based on games with more than two strategies, have been studied extensively under the assumption that selection is weak. However, games involving more than two players have not received the same level of attention. To address this issue, and to relate two-player games to multiplayer games, we introduce a notion of reducibility for multiplayer games that captures what it means to break down a multiplayer game into a sequence of interactions with fewer players. We discuss the role of reducibility in structured populations, and we give examples of games that are irreducible in any population structure. Since the known conditions for strategy selection, otherwise known as [Formula: see text]-rules, have been established only for two-player games with multiple strategies and for multiplayer games with two strategies, we extend these rules to multiplayer games with many strategies to account for irreducible games that cannot be reduced to those simpler types of games. In particular, we show that the number of structure coefficients required for a symmetric game with [Formula: see text]-player interactions and [Formula: see text] strategies grows in [Formula: see text] like [Formula: see text]. Our results also cover a type of ecologically asymmetric game based on payoff values that are derived not only from the strategies of the players, but also from their spatial positions within the population.

  13. Implementing a WIC-Based Intervention to Promote Exclusive Breastfeeding: Challenges, Facilitators, and Adaptive Strategies.

    Science.gov (United States)

    Eldridge, Johanna D; Hartnett, Josette O; Lee, Furrina F; Sekhobo, Jackson P; Edmunds, Lynn S

    Understand factors that contributed to the implementation of a successful multicomponent intervention to promote exclusive breastfeeding (EBF) within Special Supplemental Nutrition Program for Woman, Infants, and Children (WIC) clinics. Qualitative study of staff implementers' experiences using implementation status reports, facilitated group discussion immediately after implementation, and WIC administrative data. WIC staff from 12 clinics participated in an EBF Learning Community composed of 8 intervention trainings and ongoing support from trainers and peers. A total of 47 WIC staff including 11 directors, 20 other administrators, 8 nutritionists, and 6 peer counselors. A WIC-integrated EBF promotion initiative, supported through a Learning Community, composed of prenatal screening, tailored trimester-specific counseling, and timely postpartum follow-up. Challenges and facilitators to implementation within clinics. Iterative qualitative analysis using directed, emergent, and thematic coding. Implementation experiences were characterized by (1) perceived benefits of implementation, including improved EBF knowledge and counseling confidence among staff; and (2) managing implementation, including responding to challenges posed by clinic settings (resources, routine practices, values, and perceptions of mothers) through strategies such as adapting clinic practices and intervention components. Implementation was shaped by clinic setting and adaptive strategies. Future WIC interventions may benefit from formal consideration of intervention fit with local clinic setting and allowable adaptations. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  14. Feasibility of a cognitive strategy training intervention for people with Parkinson's disease.

    Science.gov (United States)

    Foster, Erin R; Spence, Daniel; Toglia, Joan

    2018-05-01

    To investigate the feasibility of a novel client-centered cognitive strategy training intervention for people with Parkinson's disease (PD). This was a case series of seven people with PD without dementia but with subjective cognitive decline. The intervention involved ≥5 treatment sessions at the participant's home. Participant acceptance and engagement were assessed by the Credibility/Expectancy Questionnaire (CEQ), Client Satisfaction Questionnaire (CSQ), enjoyment and effort ratings, and homework completion. Logistical information was tracked, and the Canadian Occupational Performance Measure (COPM) was an exploratory outcome measure. Data analysis was descriptive. CEQ scores were positive and increased over time. CSQ scores were high (M = 30.8, SD = 0.75), with all participants rating all items positively. Almost all (95%) effort and enjoyment ratings were ≥3 (Much), and homework completion rates averaged 84% (SD = 18). Intervention duration was 6-15 weeks (M = 9.2, SD = 2.8), with treatment sessions averaging 1.7 h (SD = 0.5). Group and most individual COPM ratings improved ≥2 points. These findings support the feasibility of the intervention for people with PD. It was acceptable, engaging, and promising in terms of its effect on self-identified functional cognitive problems. Implications for Rehabilitation People with Parkinson's disease (PD) without dementia can experience cognitive decline that negatively impacts function and quality of life. Strategy-based interventions that explicitly train for transfer may mitigate the negative functional consequences of cognitive decline in this population. We developed a client-centered cognitive strategy training intervention for people with PD. This small case series supports its feasibility, indicating that it is acceptable and engaging for people with PD and promising in terms of its effect on self-identified functional cognitive problems.

  15. Falls Assessment Clinical Trial (FACT: design, interventions, recruitment strategies and participant characteristics

    Directory of Open Access Journals (Sweden)

    Lawton Beverley

    2007-07-01

    Full Text Available Abstract Background Guidelines recommend multifactorial intervention programmes to prevent falls in older adults but there are few randomised controlled trials in a real life health care setting. We describe the rationale, intervention, study design, recruitment strategies and baseline characteristics of participants in a randomised controlled trial of a multifactorial falls prevention programme in primary health care. Methods Participants are patients from 19 primary care practices in Hutt Valley, New Zealand aged 75 years and over who have fallen in the past year and live independently. Two recruitment strategies were used – waiting room screening and practice mail-out. Intervention participants receive a community based nurse assessment of falls and fracture risk factors, home hazards, referral to appropriate community interventions, and strength and balance exercise programme. Control participants receive usual care and social visits. Outcome measures include number of falls and injuries over 12 months, balance, strength, falls efficacy, activities of daily living, quality of life, and physical activity levels. Results 312 participants were recruited (69% women. Of those who had fallen, 58% of people screened in the practice waiting rooms and 40% when screened by practice letter were willing to participate. Characteristics of participants recruited using the two methods are similar (p > 0.05. Mean age of all participants was 81 years (SD 5. On average participants have 7 medical conditions, take 5.5 medications (29% on psychotropics with a median of 2 falls (interquartile range 1, 3 in the previous year. Conclusion The two recruitment strategies and the community based intervention delivery were feasible and successful, identifying a high risk group with multiple falls. Recruitment in the waiting room gave higher response rates but was less efficient than practice mail-out. Testing the effectiveness of an evidence based intervention in a

  16. Informing Intervention Strategies to Reduce Energy Drink Consumption in Young People: Findings From Qualitative Research.

    Science.gov (United States)

    Francis, Jacinta; Martin, Karen; Costa, Beth; Christian, Hayley; Kaur, Simmi; Harray, Amelia; Barblett, Ann; Oddy, Wendy Hazel; Ambrosini, Gina; Allen, Karina; Trapp, Gina

    2017-10-01

    To determine young people's knowledge of energy drinks (EDs), factors influencing ED consumption, and intervention strategies to decrease ED consumption in young people. Eight group interviews with young people (aged 12-25 years). Community groups and secondary schools in Perth, Western Australia. Forty-one young people, 41% of whom were male and 73% of whom consumed EDs. Factors influencing ED consumption and intervention strategies informed by young people to reduce ED consumption. Two researchers conducted a qualitative content analysis on the data using NVivo software. Facilitators of ED consumption included enhanced energy, pleasant taste, low cost, peer pressure, easy availability, and ED promotions. Barriers included negative health effects, unpleasant taste, high cost, and parents' disapproval. Strategies to reduce ED consumption included ED restrictions, changing ED packaging, increasing ED prices, reducing visibility in retail outlets, and research and education. Because many countries allow the sale of EDs to people aged consumption. In addition to more research and education, these strategies included policy changes targeting ED sales, packaging, price, and visibility. Future research might examine the feasibility of implementing such interventions. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  17. Targeted intervention strategies to optimise diversion of BMW in the Dublin, Ireland region

    International Nuclear Information System (INIS)

    Purcell, M.; Magette, W.L.

    2011-01-01

    Highlights: → Previous research indicates that targeted strategies designed for specific areas should lead to improved diversion. → Survey responses and GIS model predictions from previous research were the basis for goal setting. → Then logic modelling and behavioural research were employed to develop site-specific management intervention strategies. → Waste management initiatives can be tailored to specific needs of areas rather than one size fits all means currently used. - Abstract: Urgent transformation is required in Ireland to divert biodegradable municipal waste (BMW) from landfill and prevent increases in overall waste generation. When BMW is optimally managed, it becomes a resource with value instead of an unwanted by-product requiring disposal. An analysis of survey responses from commercial and residential sectors for the Dublin region in previous research by the authors proved that attitudes towards and behaviour regarding municipal solid waste is spatially variable. This finding indicates that targeted intervention strategies designed for specific geographic areas should lead to improved diversion rates of BMW from landfill, a requirement of the Landfill Directive 1999/31/EC. In the research described in this paper, survey responses and GIS model predictions from previous research were the basis for goal setting, after which logic modelling and behavioural research were employed to develop site-specific waste management intervention strategies. The main strategies devised include (a) roll out of the Brown Bin (Organics) Collection and Community Workshops in Dun Laoghaire Rathdown, (b) initiation of a Community Composting Project in Dublin City (c) implementation of a Waste Promotion and Motivation Scheme in South Dublin (d) development and distribution of a Waste Booklet to promote waste reduction activities in Fingal (e) region wide distribution of a Waste Booklet to the commercial sector and (f) Greening Irish Pubs Initiative. Each of these

  18. Hybrid competitive strategies, organizational structure, and firm performance

    OpenAIRE

    Pertusa Ortega, Eva María

    2008-01-01

    Comunicación presentada en SMS 28th Annual International Conference, Cologne, Germany, October 12-15, 2008. This paper analyzes the internal characteristics of organizational structure which have an influence on the development of hybrid competitive strategies and their link to firm performance. The study examines a sample of large Spanish firms belonging to different sectors by means of the Partial Least Squares (PLS) technique, using formative dimensions for competitive strategy and orga...

  19. The use of concept mapping to identify community-driven intervention strategies for physical and mental health.

    Science.gov (United States)

    Vaughn, Lisa M; Jacquez, Farrah; McLinden, Daniel

    2013-09-01

    Research that partners with youth and community stakeholders increases contextual relevance and community buy-in and therefore maximizes the chance for intervention success. Concept mapping is a mixed-method participatory research process that accesses the input of the community in a collaborative manner. After a school-wide health needs assessment at a low-income, minority/immigrant K-8 school identified bullying and obesity as the most important health issues, concept mapping was used to identify and prioritize specific strategies to address these two areas. Stakeholders including 160 K-8 students, 33 college students working in the school, 35 parents, 20 academic partners, and 22 teachers/staff brainstormed strategies to reduce and prevent obesity and bullying. A smaller group of stakeholders worked individually to complete an unstructured sorting of these strategies into groups of similar ideas, once for obesity and again for bullying. Multidimensional scaling and cluster analysis was applied to the sorting data to produce a series of maps that illustrated the stakeholders' conceptual thinking about obesity and bullying prevention strategies. The maps for both obesity and bullying organized specific strategies into themes that included education, parental role, teacher/school supervision, youth role, expert/professional role, and school structure/support.

  20. A randomized controlled trial of two primary school intervention strategies to prevent early onset tobacco smoking.

    Science.gov (United States)

    Storr, Carla L; Ialongo, Nicholas S; Kellam, Sheppard G; Anthony, James C

    2002-03-01

    In this article, we examine the impact of two universal, grade 1 preventive interventions on the onset of tobacco smoking as assessed in early adolescence. The classroom-centered (CC) intervention was designed to reduce the risk for tobacco smoking by enhancing teachers' behavior management skills in first grade and, thereby, reducing child attention problems and aggressive and shy behavior-known risk behaviors for later substance use. The family-school partnership (FSP) intervention targeted these early risk behaviors via improvements in parent-teacher communication and parents' child behavior management strategies. A cohort of 678 urban, predominately African-American, public school students were randomly assigned to one of three Grade 1 classrooms at entrance to primary school (age 6). One classroom featured the CC intervention, a second the FSP intervention, and the third served as a control classroom. Six years later, 81% of the students completed audio computer-assisted self-interviews. Relative to controls, a modest attenuation in the risk of smoking initiation was found for students who had been assigned to either the CC or FSP intervention classrooms (26% versus 33%) (adjusted relative risk for CC/control contrast=0.57, 95% confidence interval (CI), 0.34-0.96; adjusted relative risk for FSP/control contrast=0.69, 95% CI, 0.50-0.97). Results lend support to targeting the early antecedent risk behaviors for tobacco smoking.

  1. Developing team leadership to facilitate guideline utilization: planning and evaluating a 3-month intervention strategy.

    Science.gov (United States)

    Gifford, Wendy; Davies, Barbara; Tourangeau, Ann; Lefebre, Nancy

    2011-01-01

    Research describes leadership as important to guideline use. Yet interventions to develop current and future leaders for this purpose are not well understood. To describe the planning and evaluation of a leadership intervention to facilitate nurses' use of guideline recommendations for diabetic foot ulcers in home health care. Planning the intervention involved a synthesis of theory and research (qualitative interviews and chart audits). One workshop and three follow-up teleconferences were delivered at two sites to nurse managers and clinical leaders (n=15) responsible for 180 staff nurses. Evaluation involved workshop surveys and interviews. Highest rated intervention components (four-point scale) were: identification of target indicators (mean 3.7), and development of a team leadership action plan (mean 3.5). Pre-workshop barriers assessment rated lowest (mean 2.9). Three months later participants indicated their leadership performance had changed as a result of the intervention, being more engaged with staff and clear about implementation goals. Creating a team leadership action plan to operationalize leadership behaviours can help in delivery of evidence-informed care. Access to clinical data and understanding team leadership knowledge and skills prior to formal training will assist nursing management in tailoring intervention strategies to identify needs and gaps. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  2. Structures and scan strategies of software net models

    International Nuclear Information System (INIS)

    Puhr-Westerheide, P.; Sandbaek, H.

    1984-01-01

    The present paper deals with some aspects of plant control and monitoring systems as used in nuclear power plants. These aspects concern executable net models to run on computers. A short survey on the nets' environment and on some net scan strategies is given. Among the strategies are the 'topologically ordered scan' and the 'signal propagation scan'. A combined method 'topologically ordered signal propagation (TOSIP) scan' will be outlined as well as a net model data structure that allows the definition of subsystems for the use of clear structuration and dischargement to distributed systems. (author)

  3. Innovation in Active Vibration Control Strategy of Intelligent Structures

    Directory of Open Access Journals (Sweden)

    A. Moutsopoulou

    2014-01-01

    Full Text Available Large amplitudes and attenuating vibration periods result in fatigue, instability, and poor structural performance. In light of past approaches in this field, this paper intends to discuss some innovative approaches in vibration control of intelligent structures, particularly in the case of structures with embedded piezoelectric materials. Control strategies are presented, such as the linear quadratic control theory, as well as more advanced theories, such as robust control theory. The paper presents sufficiently a recognizable advance in knowledge of active vibration control in intelligent structures.

  4. Development and pilot study of a marketing strategy for primary care/internet-based depression prevention intervention for adolescents (the CATCH-IT intervention).

    Science.gov (United States)

    Van Voorhees, Benjamin W; Watson, Natalie; Bridges, John F P; Fogel, Joshua; Galas, Jill; Kramer, Clarke; Connery, Marc; McGill, Ann; Marko, Monika; Cardenas, Alonso; Landsback, Josephine; Dmochowska, Karoline; Kuwabara, Sachiko A; Ellis, Justin; Prochaska, Micah; Bell, Carl

    2010-01-01

    Adolescent depression is both common and burdensome, and while evidence-based strategies have been developed to prevent adolescent depression, participation in such interventions remains extremely low, with less than 3% of at-risk individuals participating. To promote participation in evidence-based preventive strategies, a rigorous marketing strategy is needed to translate research into practice. To develop and pilot a rigorous marketing strategy for engaging at-risk individuals with an Internet-based depression prevention intervention in primary care targeting key attitudes and beliefs. A marketing design group was constituted to develop a marketing strategy based on the principles of targeting, positioning/competitor analysis, decision analysis, and promotion/distribution and incorporating contemporary models of behavior change. We evaluated the formative quality of the intervention and observed the fielding experience for prevention using a pilot study (observational) design. The marketing plan focused on "resiliency building" rather than "depression intervention" and was relayed by office staff and the Internet site. Twelve practices successfully implemented the intervention and recruited a diverse sample of adolescents with > 30% of all those with positive screens and > 80% of those eligible after phone assessment enrolling in the study with a cost of $58 per enrollee. Adolescent motivation for depression prevention (1-10 scale) increased from a baseline mean value of 7.45 (SD = 2.05) to 8.07 poststudy (SD = 1.33) (P = .048). Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care.

  5. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.

    Science.gov (United States)

    Pérez Velasco, Román; Praditsitthikorn, Naiyana; Wichmann, Kamonthip; Mohara, Adun; Kotirum, Surachai; Tantivess, Sripen; Vallenas, Constanza; Harmanci, Hande; Teerawattananon, Yot

    2012-01-01

    Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita), the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost effectiveness should be readily implemented in forthcoming events that

  6. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.

    Directory of Open Access Journals (Sweden)

    Román Pérez Velasco

    Full Text Available BACKGROUND: Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. METHODS: The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. RESULTS: 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita, the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. CONCLUSION: The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost

  7. Cessation Strategies Young Adult Smokers Use After Participating in a Facebook Intervention.

    Science.gov (United States)

    Thrul, Johannes; Ramo, Danielle E

    2017-01-28

    Young adults underutilize current evidence-based smoking cessation strategies; yet social media are widely used and accepted among this population. A better understanding of whether and how young adults try to quit smoking in the context of a social media smoking cessation intervention could inform future intervention improvements. We examined frequency, strategies used, and predictors of self-initiated 24-hour quit attempts among young adults participating in a Facebook intervention. A total of 79 young adult smokers (mean age = 20.8; 20.3% female) were recruited on Facebook for a feasibility trial. Participants joined motivationally tailored private Facebook groups and received daily posts over 12 weeks. Assessments were completed at baseline, 3-, 6-, and 12-month follow-up. In 12 months, 52 participants (65.5%) completed 215 quit attempts (mean = 4.1; median = 4; range 1-14); 75.4% of attempts were undertaken with the Facebook intervention alone, 17.7% used an electronic cigarette (e-cigarette), 7.4% used nicotine replacement therapy (NRT), and 3.7% used additional professional advice. Non-daily smokers, those who smoked fewer cigarettes, and those in an advanced stage of change at baseline were more likely to make a quit attempt. E-cigarette use to aide a quit attempt during the study period was associated with reporting a past year quit attempt at baseline. No baseline characteristics predicted NRT use. After participating in a Facebook smoking cessation intervention, young adults predominantly tried to quit without additional assistance. E-cigarettes are used more frequently as cessation aid than NRT. The use of evidence-based smoking cessation strategies should be improved in this population.

  8. Recruitment and group composition strategies for family-based substance misuse prevention interventions: an exploratory evaluation

    OpenAIRE

    Segrott, Jeremy

    2013-01-01

    Purpose – This paper aims to report findings from an evaluation of the Strengthening Families Programme 10-14 (UK) (SFP 10-14 UK), focusing on the strategies used to recruit families into a universal prevention intervention, the approach taken to group composition, and the experiences of participating families.\\ud \\ud Design/methodology/approach – Methods comprised interviews with programme coordinating team members, a focus group with programme facilitators, focus groups with parents and you...

  9. Optimization of behavioral, biobehavioral, and biomedical interventions the multiphase optimization strategy (MOST)

    CERN Document Server

    Collins, Linda M

    2018-01-01

    This book presents a framework for development, optimization, and evaluation of behavioral,  biobehavioral, and biomedical interventions.  Behavioral, biobehavioral, and biomedical interventions are programs with the objective of improving and maintaining human health and well-being, broadly defined, in individuals, families, schools, organizations, or communities.  These interventions may be aimed at, for example, preventing or treating disease, promoting physical and mental health, preventing violence, or improving academic achievement.   This volume introduces the Multiphase Optimization Strategy (MOST), pioneered at The Methodology Center at the Pennsylvania State University, as an alternative to the classical approach of relying solely on the randomized controlled trial (RCT).  MOST borrows heavily from perspectives taken and approaches used in engineering, and also integrates concepts from statistics and behavioral science, including the RCT.  As described in detail in this book, MOST consists of ...

  10. Fatherhood and Intimate Partner Violence: Bringing the Parenting Role into Intervention Strategies.

    Science.gov (United States)

    Stover, Carla Smith; Morgos, Dorothy

    2013-08-01

    A large percentage of men who perpetrate intimate partner violence (IPV) are fathers who continue to live with or have visitation with their children. Yet, providers rarely consider that fathers who perpetrate IPV may benefit from a parent-child focused intervention. Therapeutic work with men, who perpetrate IPV, especially with their children, is complex with issues of child safety taking precedence. This article is meant to provide: 1) a rationale for considering father-child intervention in the context of IPV; 2) specific strategies for assessment; 3) guidelines for determining if a father is appropriate for such intervention; and 4) a review of treatment approaches that have been developed that may assist clinicians in work with this population.

  11. Interventional and surgical therapeutic strategies for pulmonary arterial hypertension: Beyond palliative treatments.

    Science.gov (United States)

    Sandoval, Julio; Gomez-Arroyo, Jose; Gaspar, Jorge; Pulido-Zamudio, Tomas

    2015-10-01

    Despite significant advances in pharmacological treatments, pulmonary arterial hypertension remains an incurable disease with an unreasonably high morbidity and mortality. Although specific pharmacotherapies have shifted the survival curves of patients and improved exercise endurance as well as quality of life, it is also true that these pharmacological interventions are not always accessible (particularly in developing countries) and, perhaps most importantly, not all patients respond similarly to these drugs. Furthermore, many patients will continue to deteriorate and will eventually require an additional, non-pharmacological, intervention. In this review we analyze the role of atrial septostomy and Potts anastomosis in the management of patients with pulmonary arterial hypertension, we summarize the current worldwide clinical experience (case reports and case series), and discuss why these interventional/surgical strategies might have a therapeutic role beyond that of a "bridge" to transplantation. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  12. Optimal Inspection and Repair Strategies for Structural Systems

    DEFF Research Database (Denmark)

    Sommer, A. M.; Nowak, A. S.; Thoft-Christensen, Palle

    1992-01-01

    and a design variable as optimization variables. A model for estimating the total expected costs for structural systems is given including the costs associated with the loss of individual structural members as well as the costs associated with the loss of at least one element of a particular group......A model for reliability-based repair and maintenance strategies of structural systems is described. The total expected costs in the lifetime of the structure are minimized with the number of inspections, the number and positions of the inspected points, the inspection efforts, the repair criteria...... of structural members and the costs associated with the simultaneous loss of all members of a specific group of structural members. The approach is based on the pre-posteriori analysis from the classical decision theory. Special emphasis is given to the problem of selecting the number of points in the structure...

  13. Intervention strategies for the reduction of microbiological contamination on the hands of food handlers

    Directory of Open Access Journals (Sweden)

    Naína Lopes de JESUS

    Full Text Available Abstract The purpose of this study was to evaluate intervention strategies for the reduction of microbiological contamination on the hands of food handlers. The study was conducted from January 2009 to December 2014 at a food and nutrition company in Curitiba, Brazil. Samples from the hands of 877 handlers were collected for microbiological analysis. The intervention strategies applied during each year were: 2009, substitute the use of odorless liquid soap and an antiseptic product by one product; 2010, was increasing the staff of technical supervisors and conducting biannual training; 2011 was to move the lavatories for handwashing, and the use of 70% alcohol gel; 2012, was to increase the frequency of the training of food handlers; 2013, was new weekly monitoring, to evaluation of the use of bactericide soap; 2013 and 2014 was implemented an internal program to verify food production. The intervention introduced in 2011 the 2012 and 2013 the 2014 reduced the contamination of the hands of food handlers. The use of 70% alcohol gel, the moving of the location of the lavatories, weekly monitoring of the use of bactericide soap and implementation of the internal program, were the strategies that contributed the most to the reduction of the microbial.

  14. Effective strategies of socio-educational intervention with adolescents in social risk situation

    Directory of Open Access Journals (Sweden)

    Miguel Melendro

    2013-04-01

    Full Text Available Although the characterization of teenagers and young population at risk of social exclusion has been thoroughly investigated, that’s not the case of the intervention strategies used. This article refers to a research performed between 2011 and 2012 which advances on the description, categorization and study of effective intervention strategies, so they can be used as an information source for good professional performance, reproducible and useful to improve the situation of teenagers at risk.From a research-action approach, the contributions from the professionals working with this population, collected from about a hundred tests and seven discussion groups, are a direct and well-documented source of knowledge. This information is useful in order to underline the most relevant elements of this intervention, as well as the obstacles, limitations and practices that can be improved in this field of work.Part of the results and the discussion about them are, among others, the proposals of effective intervention in conflictive familiar dynamics, the worrying and increasing violence, teenagers migratory grief and its effects of risk and marginalization, the limited and weak participation of teenagers in their own life decision making and the important educational needs of the group of people working with this population.Furthermore, relevant strategic elements are shaped as the base of the intervention with teenagers at risk situation. Among those elements we find the flexibility to deal with uncertain situations, the link, empathy and affective proximity as necessary tools in socio-educational action, the contextualization of intervention in conflict situations and the debate about resilience and its contributions to the field of Social Pedagogy.

  15. Capital Structure, Environmental Dynamism, Innovation Strategy, and Strategic Risk Management

    DEFF Research Database (Denmark)

    Juul Andersen, Torben

    2005-01-01

    Previous research found that capital structure affects performance when it is adapted to the level of environmental dynamism and pursuit of an innovation strategy. The current study reproduces some of these relationships in a more recent dataset but also identifies significant nuances across...... industrial environments. Analyses of a large cross sectional sample and various industry sub-samples suggest that other factors have influenced capital structure effects in recent years including flexibilities in multinational organization and effective strategic risk management capabilities....

  16. [DGRW-update: neurology--from empirical strategies towards evidence based interventions].

    Science.gov (United States)

    Schupp, W

    2011-12-01

    Stroke, Multiple Sclerosis (MS), traumatic brain injuries (TBI) and neuropathies are the most important diseases in neurological rehabilitation financed by the German Pension Insurance. The primary goal is vocational (re)integration. Driven by multiple findings of neuroscience research the traditional holistic approach with mainly empirically derived strategies was developed further and improved by new evidence-based interventions. This process had been, and continues to be, necessary to meet the health-economic pressures for ever shorter and more efficient rehab measures. Evidence-based interventions refer to symptom-oriented measures, to team-management concepts, as well as to education and psychosocial interventions. Drug therapy and/or neurophysiological measures can be added to increase neuroregeneration and neuroplasticity. Evidence-based aftercare concepts support sustainability and steadiness of rehab results.Mirror therapy, robot-assisted training, mental training, task-specific training, and above all constraint-induced movement therapy (CIMT) can restore motor arm and hand functions. Treadmill training and robot-assisted training improve stance and gait. Botulinum toxine injections in combination with physical and redressing methods are superior in managing spasticity. Guideline-oriented management of associated pain syndromes (myofascial, neuropathic, complex-regional=dystrophic) improve primary outcome and quality of life. Drug therapy with so-called co-analgetics and physical therapy play an important role in pain management. Swallowing disorders lead to higher mortality and morbidity in the acute phase; stepwise diagnostics (screening, endoscopy, radiology) and specific swallowing therapy can reduce these risks and frequently can restore normal eating und drinking.In our modern industrial societies communicative and cognitive disturbances are more impairing than the above mentioned disorders. Speech and language therapy (SLT) is dominant in

  17. Assessment of Peer-Based and Structural Strategies for Increasing ...

    African Journals Online (AJOL)

    Assessment of Peer-Based and Structural Strategies for Increasing Male Participation in an Antenatal Setting in Lilongwe, Malawi. SM Mphonda, NE Rosenberg, E Kamanga, I Mofolo, G Mwale, E Boa, M Mwale, F Martinson, I Hoffman, MC Hosseinipour ...

  18. Sibling relationship quality moderates the associations between parental interventions and siblings' independent conflict strategies and outcomes.

    Science.gov (United States)

    Recchia, Holly E; Howe, Nina

    2009-08-01

    This study extends research on sibling conflict strategies and outcomes by examining unique and interactive associations with age, relative birth order, sibling relationship quality, and caregivers' interventions into conflict. Each of 62 sibling dyads (older sibling mean age = 8.39 years; younger sibling mean age = 6.06 years) discussed 1 recurring conflict alone (dyadic negotiation) and a 2nd conflict with their primary parental caregiver (triadic negotiation). Negotiations were coded for children's conflict strategies, outcomes, and caregiver interventions; each family member provided ratings of sibling relationship quality. Results revealed that age was associated with siblings' constructive strategies, particularly in the dyadic negotiation. With age controlled, younger siblings referred more frequently to their own perspective. Caregivers' future orientation in the triadic negotiation was associated with children's future orientation in the dyadic negotiation; however, this association was most evident when sibling relationship quality was high. Similarly, caregivers' past orientation was positively associated with dyadic compromise, especially when relationship quality was high. Results reveal the value of simultaneously considering associations among parental, affective, and developmental correlates of sibling conflict strategies. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

  19. A Systematised Review of Primary School Whole Class Child Obesity Interventions: Effectiveness, Characteristics, and Strategies

    Directory of Open Access Journals (Sweden)

    Elise C. Brown

    2016-01-01

    Full Text Available Background. A systematised review was conducted to examine the effectiveness of school-based interventions that focus on changing dietary intake and physical activity levels to reduce childhood obesity. Methods. Multiple databases were searched for randomised and nonrandomised interventions from 2007 to 2016 in full-time elementary schools, which were delivered to the whole class, included dietary and physical activity components, involved both sexes, were written in English, and used body mass index (BMI as an outcome. Results. The database search produced 8,866 titles from which 78 were deemed relevant and assessed for inclusion resulting in 15 studies meeting all inclusion criteria. From these 15 studies, 9 yielded a reduction or stabilisation in BMI or BMI z-score in the entire intervention group and/or subgroups. Programmes lasting between 6 and 12 months that involve multiple environmental, educational, and physical strategies appear to be most likely to result in BMI or BMI z-score improvement. Moderators most likely influencing an improvement in BMI included increased physical activity, decreased sugar sweetened beverages intake, and increased fruit intake. Conclusions. School-based interventions may be an effective means for child obesity prevention. The identification of consistent elements used in school-based interventions that have demonstrated effectiveness may aid in preventing child obesity.

  20. Evidence-based tick acaricide resistance intervention strategy in Uganda: Concept and feedback of farmers and stakeholders.

    Science.gov (United States)

    Vudriko, Patrick; Okwee-Acai, James; Byaruhanga, Joseph; Tayebwa, Dickson Stuart; Omara, Robert; Muhindo, Jeanne Bukeka; Lagu, Charles; Umemiya-Shirafuji, Rika; Xuan, Xuenan; Suzuki, Hiroshi

    2018-02-01

    The emergence of multi-acaricide resistant ticks has led to unprecedented level of acaricide failure in central and western Uganda. In the absence of a national acaricide resistance management strategy, the country's dairy sector is threatened by upsurge of ticks and tick-borne diseases. In this study, we developed a short-to-medium-term intervention approach called Evidence-Based Acaricide Tick Control (EBATIC): Identify, Test, Intervene and Eradicate (IT-IE). Furthermore, the perception of 199 farmers and extension workers, 12 key informants in four districts and 47 stakeholders in the animal industry in Uganda were assessed using semi-structured questionnaires. We report that the establishment of a specialized laboratory is pivotal in identifying and testing (IT) acaricide resistant ticks for prompt intervention and eradication (IE). The laboratory test results and the farm tick control gaps identified are very important in guiding acaricide resistance management strategies such as evidence-based acaricide rotation, development and dissemination of extension materials, training of farmers and extension workers, and stakeholders' engagement towards finding sustainable solutions. All the 47 stakeholders and 91.0% (181/199) of the farmers and extension workers reported that the EBATIC approach will help in solving the tick acaricide resistance crisis in Uganda. Similarly, all the 12 key informants and 92.5% (184/199) of the farmers and extension workers suggested that the EBATIC approach should be sustained and rolled out to other districts. The EBATIC stakeholders' dialogue generated both short-to-medium and long-term strategies for sustainable management of tick acaricide resistance in the country. Overall, the positive feedback from farmers, district veterinarians and stakeholders in the animal industry suggest that the EBATIC approach is a useful proof-of-concept on scalable intervention pathway against tick acaricide resistance in Uganda with possibility of

  1. Strategies for Structural Youth Unemployment: a Capability Approach for Guidance

    OpenAIRE

    Massimiliano Costa; Daniele Morselli; John Polesel; Suzanne Rice

    2015-01-01

    The aim of this article is to present an innovative approach for guidance. The article starts by introducing the structural reason of unemployment in Italy. It presents the Australian model of guidance and the new reforms on guidance which are being introduced in Italy. It then describes a Change Laboratory intervention carried in a vocational setting in Australia in 2012, which is proposed as model of guidance based on the capability approach.The different stakeholders actively participate i...

  2. Whose statistical reasoning is facilitated by a causal structure intervention?

    Science.gov (United States)

    McNair, Simon; Feeney, Aidan

    2015-02-01

    People often struggle when making Bayesian probabilistic estimates on the basis of competing sources of statistical evidence. Recently, Krynski and Tenenbaum (Journal of Experimental Psychology: General, 136, 430-450, 2007) proposed that a causal Bayesian framework accounts for peoples' errors in Bayesian reasoning and showed that, by clarifying the causal relations among the pieces of evidence, judgments on a classic statistical reasoning problem could be significantly improved. We aimed to understand whose statistical reasoning is facilitated by the causal structure intervention. In Experiment 1, although we observed causal facilitation effects overall, the effect was confined to participants high in numeracy. We did not find an overall facilitation effect in Experiment 2 but did replicate the earlier interaction between numerical ability and the presence or absence of causal content. This effect held when we controlled for general cognitive ability and thinking disposition. Our results suggest that clarifying causal structure facilitates Bayesian judgments, but only for participants with sufficient understanding of basic concepts in probability and statistics.

  3. Operational scale entomological intervention for malaria control: strategies, achievements and challenges in Zambia

    Directory of Open Access Journals (Sweden)

    Chanda Emmanuel

    2013-01-01

    Full Text Available Abstract Background While consensus on malaria vector control policy and strategy has stimulated unprecedented political-will, backed by international funding organizations and donors, vector control interventions are expansively being implemented based on assumptions with unequaled successes. This manuscript reports on the strategies, achievements and challenges of the past and contemporary malaria vector control efforts in Zambia. Case description All available information and accessible archived documentary records on malaria vector control in Zambia were reviewed. Retrospective analysis of routine surveillance data from the Health Management Information System (HMIS, data from population-based household surveys and various operations research reports was conducted to assess the status in implementing policies and strategies. Discussion and evaluation Empirical evidence is critical for informing policy decisions and tailoring interventions to local settings. Thus, the World Health Organization (WHO encourages the adoption of the integrated vector management (IVM strategy which is a rational decision making process for optimal use of available resources. One of the key features of IVM is capacity building at the operational level to plan, implement, monitor and evaluate vector control and its epidemiological and entomological impact. In Zambia, great progress has been made in implementing WHO-recommended vector control policies and strategies within the context of the IVM Global Strategic framework with strong adherence to its five key attributes. Conclusions The country has solid, consistent and coordinated policies, strategies and guidelines for malaria vector control. The Zambian experience demonstrates the significance of a coordinated multi-pronged IVM approach effectively operationalized within the context of a national health system.

  4. Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries

    DEFF Research Database (Denmark)

    Thapa, Subash; Hannes, Karin; Cargo, Margaret

    2015-01-01

    BACKGROUND: Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors......, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention...... strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle...

  5. Three-dimensional protein structure prediction: Methods and computational strategies.

    Science.gov (United States)

    Dorn, Márcio; E Silva, Mariel Barbachan; Buriol, Luciana S; Lamb, Luis C

    2014-10-12

    A long standing problem in structural bioinformatics is to determine the three-dimensional (3-D) structure of a protein when only a sequence of amino acid residues is given. Many computational methodologies and algorithms have been proposed as a solution to the 3-D Protein Structure Prediction (3-D-PSP) problem. These methods can be divided in four main classes: (a) first principle methods without database information; (b) first principle methods with database information; (c) fold recognition and threading methods; and (d) comparative modeling methods and sequence alignment strategies. Deterministic computational techniques, optimization techniques, data mining and machine learning approaches are typically used in the construction of computational solutions for the PSP problem. Our main goal with this work is to review the methods and computational strategies that are currently used in 3-D protein prediction. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Assessing the impact of intervention strategies against Taenia solium cysticercosis using the EPICYST transmission model.

    Science.gov (United States)

    Winskill, Peter; Harrison, Wendy E; French, Michael D; Dixon, Matthew A; Abela-Ridder, Bernadette; Basáñez, María-Gloria

    2017-02-09

    The pork tapeworm, Taenia solium, and associated human infections, taeniasis, cysticercosis and neurocysticercosis, are serious public health problems, especially in developing countries. The World Health Organization (WHO) has set goals for having a validated strategy for control and elimination of T. solium taeniasis/cysticercosis by 2015 and interventions scaled-up in selected countries by 2020. Timely achievement of these internationally-endorsed targets requires that the relative benefits and effectiveness of potential interventions be explored rigorously within a quantitative framework. A deterministic, compartmental transmission model (EPICYST) was developed to capture the dynamics of the taeniasis/cysticercosis disease system in the human and pig hosts. Cysticercosis prevalence in humans, an outcome of high epidemiological and clinical importance, was explicitly modelled. A next generation matrix approach was used to derive an expression for the basic reproduction number, R 0 . A full sensitivity analysis was performed using a methodology based on Latin-hypercube sampling partial rank correlation coefficient index. EPICYST outputs indicate that chemotherapeutic intervention targeted at humans or pigs would be highly effective at reducing taeniasis and cysticercosis prevalence when applied singly, with annual chemotherapy of humans and pigs resulting, respectively, in 94 and 74% of human cysticercosis cases averted. Improved sanitation, meat inspection and animal husbandry are less effective but are still able to reduce prevalence singly or in combination. The value of R 0 for taeniasis was estimated at 1.4 (95% Credible Interval: 0.5-3.6). Human- and pig-targeted drug-focussed interventions appear to be the most efficacious approach from the options currently available. The model presented is a forward step towards developing an informed control and elimination strategy for cysticercosis. Together with its validation against field data, EPICYST will be a

  7. Structured dyadic behavior therapy processes for ADHD intervention.

    Science.gov (United States)

    Curtis, David F

    2014-03-01

    Children with Attention-Deficit/Hyperactivity Disorder (ADHD) present significant problems with behavioral disinhibition that often negatively affect their peer relationships. Although behavior therapies for ADHD have traditionally aimed to help parents and teachers better manage children's ADHD-related behaviors, therapy processes seldom use peer relationships to implement evidence-based behavioral principles. This article introduces Structured Dyadic Behavior Therapy as a milieu for introducing effective behavioral techniques within a socially meaningful context. Establishing collaborative behavioral goals, benchmarking, and redirection strategies are discussed to highlight how in-session dyadic processes can be used to promote more meaningful reinforcement and change for children with ADHD. Implications for improving patient care, access to care, and therapist training are also discussed.

  8. Systematic review of structural interventions for intimate partner violence in low- and middle-income countries: organizing evidence for prevention.

    Science.gov (United States)

    Bourey, Christine; Williams, Whitney; Bernstein, Erin Elizabeth; Stephenson, Rob

    2015-11-23

    Despite growing attention to intimate partner violence (IPV) globally, systematic evaluation of evidence for IPV prevention remains limited. This particularly is true in relation to low- and middle-income countries (LMIC), where researchers often organize evidence by current interventions strategies rather than comprehensive models of IPV. Applying the concept of structural interventions to IPV, we systematically reviewed the quantitative impact of such interventions for prevention of male-to-female IPV in LMIC in order to (a) highlight current opportunities for IPV research and programming and (b) demonstrate how structural interventions may provide an organizing framework through which to build an evidence base for IPV prevention. We identified articles by systematically searching PubMed and Web of Science, reviewing references of selected studies, and contacting 23 experts. Inclusion criteria included original research, written in English, published between January 2000 and May 2015 in the peer-reviewed literature. Studies evaluated the quantitative impact of structural interventions for the prevention of male-to-female IPV in LMIC through (a) IPV incidence or prevalence or (b) secondary outcomes theoretically linked to IPV by study authors. After initial screening, we evaluated full text articles for inclusion and extracted data on study characteristics, outcomes, and risk of bias, using forms developed for the review. Twenty articles (16 studies) from nine countries met inclusion criteria, representing 13 randomized control trials and seven additional studies, all of which reported results from economic, social, or combined economic and social interventions. Standardized at p prevention. Structural interventions, as an organizing framework, may advance IPV prevention by consolidating available evidence; highlighting opportunities to assess a broader range of interventions, including politico-legal and physical approaches; and emphasizing opportunities to

  9. Prevention of type 2 diabetes; a systematic review and meta-analysis of different intervention strategies.

    Science.gov (United States)

    Merlotti, C; Morabito, A; Pontiroli, A E

    2014-08-01

    Different intervention strategies can prevent type 2 diabetes (T2DM). Aim of the present systematic review and meta-analysis was to evaluate the effectiveness of different strategies. Studies were grouped into 15 different strategies: 1: diet plus physical activity; 2: physical activity; 3-6: anti-diabetic drugs [glitazones, metformin, beta-cell stimulating drugs (sulphanylureas, glinides), alfa-glucosidase inhibitors]; 7-8: cardiovascular drugs (ACE inhibitors, ARB, calcium antagonists); 9-14 [diets, lipid-affecting drugs (orlistat, bezafibrate), vitamins, micronutrients, estrogens, alcohol, coffee]; 15: bariatric surgery. Only controlled studies were included in the analysis, whether randomized, non-randomized, observational studies, whether primarily designed to assess incident cases of diabetes, or performed with other purposes, such as control of hypertension, of ischemic heart disease or prevention of cardiovascular events. Appropriate methodology [preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement] was used. Seventy-one studies (490 813 subjects), published as full papers, were analysed to identify predictors of new cases of T2DM, and were included in a meta-analysis (random-effects model) to study the effect of different strategies. Intervention effect (new cases of diabetes) was expressed as odds ratio (OR), with 95% confidence intervals (C.I.s). Publication bias was formally assessed. Body mass index was in the overweight range for 13 groups, obese or morbidly obese in lipid-affecting drugs and in bariatric surgery. Non-surgical strategies, except for beta-cell stimulating drugs, estrogens and vitamins, were able to prevent T2DM, with different effectiveness, from 0.37 (C.I. 0.26-0.52) to 0.85 (C.I. 0.77-0.93); the most effective strategy was bariatric surgery in morbidly obese subjects [0.16 (C.I. 0.11,0.24)]. At meta-regression analysis, age of subjects and amount of weight lost were associated with effectiveness of

  10. Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

    Science.gov (United States)

    Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

    2013-01-01

    Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a

  11. Agent Based Simulation of Group Emotions Evolution and Strategy Intervention in Extreme Events

    Directory of Open Access Journals (Sweden)

    Bo Li

    2014-01-01

    Full Text Available Agent based simulation method has become a prominent approach in computational modeling and analysis of public emergency management in social science research. The group emotions evolution, information diffusion, and collective behavior selection make extreme incidents studies a complex system problem, which requires new methods for incidents management and strategy evaluation. This paper studies the group emotion evolution and intervention strategy effectiveness using agent based simulation method. By employing a computational experimentation methodology, we construct the group emotion evolution as a complex system and test the effects of three strategies. In addition, the events-chain model is proposed to model the accumulation influence of the temporal successive events. Each strategy is examined through three simulation experiments, including two make-up scenarios and a real case study. We show how various strategies could impact the group emotion evolution in terms of the complex emergence and emotion accumulation influence in extreme events. This paper also provides an effective method of how to use agent-based simulation for the study of complex collective behavior evolution problem in extreme incidents, emergency, and security study domains.

  12. The price of the precautionary principle: cost-effectiveness of BSE intervention strategies in The Netherlands.

    Science.gov (United States)

    Benedictus, A; Hogeveen, H; Berends, B R

    2009-06-01

    Since 1996, bovine spongiform encephalopathy (BSE) in cattle has been linked to a new variant of Creutzfeldt-Jakob disease (vCJD), a fatal brain disease in man. This paper assessed the cost-effectiveness of BSE control strategies instituted by the European Commission. In a Monte Carlo simulation model, a non-intervention baseline scenario was compared to three intervention strategies: removal of specified risk materials from slaughter animals, post-mortem testing for BSE and the culling of feed and age cohorts of BSE cases. The food risk in the baseline scenario ranged from 16.98 lost life years in 2002 to 2.69 lost life years in 2005. Removing specified risk materials removal practices, post-mortem testing and post-mortem testing plus cohort culling reduced this risk with 93%, 82.7% and 83.1%. The estimated cost-effectiveness of all BSE measures in The Netherlands ranged from 4.3 million euros per life year saved in 2002 to 17.7 million euros in 2005. It was discussed that the cost-effectiveness of BSE control strategies will further deviate from regular health economics thresholds as BSE prevalence and incidence declines.

  13. Recruitment strategy effectiveness for a cryotherapy intervention for a venous leg ulcer prevention study.

    Science.gov (United States)

    Kelechi, Teresa J; Watts, Ashlee; Wiseman, Jan

    2010-01-01

    To describe the strategies and costs associated with recruiting African American and white adults into a randomized controlled pilot trial. "Cryotherapy for Venous Disorders: A Pilot Study" is a randomized controlled trial designed to determine the effects of a cool gel wrap and leg elevation intervention versus a leg elevation alone intervention on skin temperature, skin microcirculation, quality of life, and pain in adults with stages 4 and 5 chronic venous disorders. We sought to recruit 60 participants (21 African Americans, 37 whites, and 2 Hispanic or Latino) to complete the study. These enrollment targets reflect the demographic distribution of the community in which the study was conducted (33% African American, 66% white, and 2% Latino). Proactive and reactive recruitment strategies were implemented to recruit subjects. Seventy-three individuals (9 African American men, 29 African American women, 11 white men, 22 white women, 1 Asian woman, and 1 Hispanic woman) were screened, and of those, 67 were randomized (9 African American men, 25 African American women, 9 white men, 22 white women, 1 Asian woman, and 1 Hispanic women). Fifty-eight completed the study, yielding an overall 11% attrition rate. An additional 8 subjects canceled or did not show up for a first appointment. Reactive recruitment strategies were most successful for recruiting men, women, African American, and white participants. The 3 most successful reactive strategies were referrals from providers/clinics (34%), flyers posted in the hospital elevators (22%), and targeted mailings from a business (16%). Of the healthcare provider referrals (19), wound care nurses referred 12 completed participants. The amount budgeted for advertisement was $5,000 (2% of the total grant award). The amount spent on recruitment including labor was $5,978, which averaged $103 per participant who completed the study (N = 58). Reactive strategies per participant completer proved more cost-efficient than proactive

  14. Understanding Teen Dating Violence: Practical screening and intervention strategies for pediatric and adolescent healthcare providers

    Science.gov (United States)

    Cutter-Wilson, Elizabeth; Richmond, Tracy

    2012-01-01

    Purpose of Review Teen Dating Violence (TDV) is a serious and potentially lethal form of relationship violence in adolescence. TDV is highly correlated with several outcomes related to poor physical and mental health. Although incidence and prevalence data indicates high rates of exposure to TDV among adolescents throughout the United States, significant confusion remains in healthcare communities concerning the definition and implications of TDV. Additionally, healthcare providers are uncertain about effective screening and intervention methods. The article will review the definition and epidemiology of TDV and discuss possible screening and intervention strategies. Recent Findings TDV research is a relatively new addition to the field of relationship violence. Although some confusion remains, the definition and epidemiology of TDV is better understood which has greatly lead to effective ways in which to screen and intervene when such violence is detected. Universal screening with a focus on high risk subgroups combined with referrals to local and national support services are key steps in reducing both primary and secondary exposure. Summary TDV is a widespread public health crisis with serious short and long-term implications. It is necessary for pediatric and adolescent healthcare providers to be aware of TDV, its potential repercussions, as well as possible methods for screening and intervention. More research is needed to better understand TDV as well as to further define effective screening and intervention protocol for the clinical environment. PMID:21670679

  15. Strategies for measuring evolutionary conservation of RNA secondary structures

    Directory of Open Access Journals (Sweden)

    Hofacker Ivo L

    2008-02-01

    Full Text Available Abstract Background Evolutionary conservation of RNA secondary structure is a typical feature of many functional non-coding RNAs. Since almost all of the available methods used for prediction and annotation of non-coding RNA genes rely on this evolutionary signature, accurate measures for structural conservation are essential. Results We systematically assessed the ability of various measures to detect conserved RNA structures in multiple sequence alignments. We tested three existing and eight novel strategies that are based on metrics of folding energies, metrics of single optimal structure predictions, and metrics of structure ensembles. We find that the folding energy based SCI score used in the RNAz program and a simple base-pair distance metric are by far the most accurate. The use of more complex metrics like for example tree editing does not improve performance. A variant of the SCI performed particularly well on highly conserved alignments and is thus a viable alternative when only little evolutionary information is available. Surprisingly, ensemble based methods that, in principle, could benefit from the additional information contained in sub-optimal structures, perform particularly poorly. As a general trend, we observed that methods that include a consensus structure prediction outperformed equivalent methods that only consider pairwise comparisons. Conclusion Structural conservation can be measured accurately with relatively simple and intuitive metrics. They have the potential to form the basis of future RNA gene finders, that face new challenges like finding lineage specific structures or detecting mis-aligned sequences.

  16. Prevention-intervention strategies to reduce exposure to e-waste.

    Science.gov (United States)

    Heacock, Michelle; Trottier, Brittany; Adhikary, Sharad; Asante, Kwadwo Ansong; Basu, Nil; Brune, Marie-Noel; Caravanos, Jack; Carpenter, David; Cazabon, Danielle; Chakraborty, Paromita; Chen, Aimin; Barriga, Fernando Diaz; Ericson, Bret; Fobil, Julius; Haryanto, Budi; Huo, Xia; Joshi, T K; Landrigan, Philip; Lopez, Adeline; Magalini, Frederico; Navasumrit, Panida; Pascale, Antonio; Sambandam, Sankar; Aslia Kamil, Upik Sitti; Sly, Leith; Sly, Peter; Suk, Ann; Suraweera, Inoka; Tamin, Ridwan; Vicario, Elena; Suk, William

    2018-05-11

    As one of the largest waste streams, electronic waste (e-waste) production continues to grow in response to global demand for consumer electronics. This waste is often shipped to developing countries where it is disassembled and recycled. In many cases, e-waste recycling activities are conducted in informal settings with very few controls or protections in place for workers. These activities involve exposure to hazardous substances such as cadmium, lead, and brominated flame retardants and are frequently performed by women and children. Although recycling practices and exposures vary by scale and geographic region, we present case studies of e-waste recycling scenarios and intervention approaches to reduce or prevent exposures to the hazardous substances in e-waste that may be broadly applicable to diverse situations. Drawing on parallels identified in these cases, we discuss the future prevention and intervention strategies that recognize the difficult economic realities of informal e-waste recycling.

  17. Structuring strategy and relationships in North American gas markets

    International Nuclear Information System (INIS)

    Fisher, J.

    1998-01-01

    Duke Energy's experience in strategy development and structuring relationships with other companies were described. Included was a description of their partnership with PanEnergy and Mobil and a merger between PanEnergy and Duke. In developing their growth strategy, Duke Energy was guided by the following considerations: (1) an assessment of the market, (2) the identification of opportunities, (3) a self-assessment, (4) the establishment of goals, and (5) determining strategic alternatives. The advantages and disadvantages of different structuring relationships were reviewed. Duke Energy's approach to Ontario's residential market and their agreement with Alliance Gas Management were also discussed. The goal of the Alliance Gas management agreement was to simplify Alliance's wholesale gas supply management needs and to allow Alliance access to diverse gas supplies. figs

  18. Market Structure and Competitive Strategy in Market Square

    Institute of Scientific and Technical Information of China (English)

    PENG Juanjuan

    2007-01-01

    Market Square shopping center contains several restaurants and cafés providing a diverse range of Asian foods and delicacies and this area is known by locals and Griffith University students as a great location for 'eating out'. Then, what is the market structure in this shopping mall and what kind of competitive strategies should be used to maximize profits according to the characteristics in this shopping center?

  19. Strategies to teach family assessment and intervention through an online international curriculum.

    Science.gov (United States)

    Anderson, Kathryn Hoehn; Friedemann, Marie-Luise

    2010-05-01

    A Web-based certificate program for international health professionals to acquire understanding of family health and strategies to implement culturally sensitive health care of families is outlined. In four Web courses and a project, students progress interactively to apply culture, family, and interdisciplinary health system theories to assessments and clinical interventions with families in the interdisciplinary setting. Four online educational strategies to facilitate student success from the virtual classroom to actual clinical care are described: adjusting to the technology, communicating the learning progress openly, giving mutual feedback, and implementing evidence-based family care. Outcomes addressing student learning and skill enhancement, family interaction, and student and faculty experiences in the virtual learning environment are explored. Overall, students learned to work successfully with families in health care, experienced increasing comfort and competency in challenging situations, introduced family care in their work setting, and emerged as leaders while working in interdisciplinary teams.

  20. A stochastic SIRS epidemic model with infectious force under intervention strategies

    Science.gov (United States)

    Cai, Yongli; Kang, Yun; Banerjee, Malay; Wang, Weiming

    2015-12-01

    In this paper, we extend a classical SIRS epidemic model with the infectious forces under intervention strategies from a deterministic framework to a stochastic differential equation (SDE) one through introducing random fluctuations. The value of our study lies in two aspects. Mathematically, by using the Markov semigroups theory, we prove that the reproduction number R0S can be used to govern the stochastic dynamics of SDE model. If R0S 1, under mild extra conditions, it has an endemic stationary distribution which leads to the stochastical persistence of the disease. Epidemiologically, we find that random fluctuations can suppress disease outbreak, which can provide us some useful control strategies to regulate disease dynamics.

  1. Interventional Vitamin C-A Strategy for Attenuation of Coagulopathy and Inflammation in Hemorrhagic Trauma and Shock

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-15-2-0064 TITLE: Interventional Vitamin C -A Strategy for Attenuation of Coagulopathy and Inflammation in Hemorrhagic...COVERED 30 Sep 2016 - 29 Sep 2017 4. TITLE AND SUBTITLE Interventional Vitamin C -A Strategy for Attenuation of Coagulopathy and Inflammation in...high dose parenteral vitamin C (VitC) in a swine model of combined hemorrhagic shock and tissue trauma that simulates the course of a combat casualty

  2. The Work Compatibility Improvement Framework: theory and application of improvement action and intervention strategies.

    Science.gov (United States)

    Genaidy, Ash M; Rinder, Magda M; Sequeira, Reynold; A-Rehim, Amal D

    2009-05-01

    Challenges facing management of manufacturing firms can be transformed into asset gains by giving careful consideration to the worker-work environment interface. The benefits of a 'healthy' interface may lead to sizable reductions in rising health care costs and retention of highly qualified workers. This paper presents a novel approach for the 'improve' phase of the Work Compatibility Improvement Framework. The work tasks of this research consisted of: (a) fundamentals of cognitive-based improvement action and intervention; (b) design concepts and process of improvement action/intervention generation; (c) assessment model of estimated gains in company's assets; (d) application demonstration in the manufacturing sector. The process of improvement action/intervention generation is described, preceded by a description of the fundamentals of cognitive-based improvement action and intervention and system architecture. This is followed by a documentation of estimated asset gains as a result of the improvement plan. The results showed that expert workers were, on average, 78% in agreement with the algorithm-identified improvement actions. Their knowledge was used to update the recommended actions as well as to detail the multiple strategies required to address the improvement actions. As a result, an integrated improvement plan was developed resulting in estimated asset gains of $1.6 million, which was validated by the general manager. The research reported herein documented the theory and application of the 'improve' phase of the Work Compatibility Improvement Framework. The economic assessment of the suggested improvement is also reported and this has proved to be an important driver to secure the firm collaboration of manufacturing enterprise management. An integrated improvement solution plan backed by a detailed economic assessment of suggested improvements is essential to demonstrate the full potential of workplace micro- and macro-ergonomic interventions.

  3. Acquisition of Requests and Apologies in Spanish and French: Impact of Study Abroad and Strategy-Building Intervention

    Science.gov (United States)

    Cohen, Andrew D.; Shively, Rachel L.

    2007-01-01

    The primary aim of this study was to assess the impact of a curricular intervention on study-abroad students' use of language- and culture-learning strategies and on their acquisition of requests and apologies. The intervention consisted of a brief face-to-face orientation to learning speech acts, a self-study guidebook on language and culture…

  4. Community therapy application in intervention with adolescents: new strategies for prevention and promotion

    Directory of Open Access Journals (Sweden)

    Flávia Cristina Zago

    2013-08-01

    Full Text Available Given adolescents vulnerability facing transformations and resistances, the group work used by Occupational Therapy through techniques and dynamics favors expression, anxiety control and biopsychosocial maturity in intervention. Currently, one strategy used with teenagers is Community Therapy (CT, because it provides a welcoming environment where all are equal and can share their sufferings, anxieties and affinities. Thus, this study examined the effectiveness of group activities used in occupational therapy as warm up strategies in Community Therapy circles. Eleven teenagers aged 12 to 14 years old participated in the research. The study was carried out in a social institution that aims to support children and youth in the municipality of Uberaba, Minas Gerais state. Video and photo images and handwritten records were used as data collection instruments during the application of the 12 strategies, divided into three categories: competition, cooperation, and self-knowledge/self-esteem, applied for warming up the CT circles. Data were analyzed and presented through the use of a chart for better visualization and understanding of the adolescents’ behavior during the warm up CT circles. The results obtained showed dispute, unrest, lack of attention and sociability; behaviors that are inherent to adolescence due to the several changes, emotional alterations and search for identity that these subjects experience. Based on the survey results, it was possible observe that the behaviors have triggered direct-indirect relationship with the strategies used as facilitators in the discussion development regarding the issues addressed in the CT circles.

  5. STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness

    Science.gov (United States)

    Best, Christoph; Tschan, Regine; Stieber, Nikola; Beutel, Manfred E.; Eckhardt-Henn, Annegret; Dieterich, Marianne

    2015-01-01

    Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles. PMID:26843786

  6. Students’ Reading Comprehension Performance with Emotional Literacy-Based Strategy Intervention

    Directory of Open Access Journals (Sweden)

    Yusfarina Mohd Yussof

    2013-07-01

    Full Text Available An effective reading comprehension process demands a strategy to enhance the cognitive ability to digest text information in the effort to elicit meaning contextually. In addition, the role of emotions also influences the efficacy of this process, especially in narrative text comprehension. This quasi-experimental study aims to observe students’ performance in the Reading Comprehension Test resulting from Emotional Literacy-Based Reading Comprehension Strategy (ELBRCS, which is a combination of cognitive and affective strategies. This study involved 90 students, whereby 45 students were clustered in the Experimental Group and received the ELBRCS intervension. The remaining 45 students were placed in the Control Group and underwent the conventional strategy (prevalent classroom method.The students’ reading comprehension performance was measured using the Reading Comprehension Test (RCT. The findings show that the experimental group received a higher score than the control group for RCT. The intervention has successfully increased student’s Reading Comprehension from literal comprehension to higher levels of comprehension i.e. inferential, evaluative and appreciative levels, as indicated by Barret’s Taxonomy.

  7. STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness

    Directory of Open Access Journals (Sweden)

    Christoph Best

    2015-01-01

    Full Text Available Patients with somatoform vertigo and dizziness (SVD disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (QH/V, reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n=28; baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ. Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: QH/V=0.31 versus controls: QH/V=0.38; p=0.022. After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles.

  8. Development of a health education intervention strategy using an implementation research method to control taeniasis and cysticercosis in Burkina Faso.

    Science.gov (United States)

    Ngowi, Helena; Ozbolt, Ivan; Millogo, Athanase; Dermauw, Veronique; Somé, Télesphore; Spicer, Paul; Jervis, Lori L; Ganaba, Rasmané; Gabriel, Sarah; Dorny, Pierre; Carabin, Hélène

    2017-06-01

    Taeniasis and cysticercosis are two diseases caused by Taenia solium, a parasite transmitted between humans and pigs, leading to considerable economic loss and disabilities. Transmission of the parasite is linked to environmental and behavioural factors such as inadequate sanitation and hygiene, poor pig management, and consumption of infected pork. This study used implementation research method to design a health education intervention strategy for reducing T. solium infections in Burkina Faso, a country endemic for the parasite. Eighteen group discussions were conducted with 8-18 participants each in three villages. In addition, structured interviews were conducted among 4 777 participants and 2 244 pig owners, who were selected through cluster random sampling in 60 villages of three provinces of Burkina Faso. Both approaches assessed knowledge and practices related to T. solium. The information obtained was used to develop a community-adapted health education intervention strategy to control taeniasis and cysticercosis in Burkina Faso. The group discussions revealed that participants had a poor quality of life due to the diseases as well as inadequate access to latrines, safe water, and healthcare services. In addition, it was found that pig production was an important economic activity, especially for women. Furthermore, financial and knowledge constraints were important limitations to improved pig management and latrine construction. The survey data also showed that open defecation and drinking unboiled water were common behaviours, enhanced by a lack of knowledge regarding the transmission of the parasite, perceived financial barriers to the implementation of control measures, lack of public sensitization, as well as a lack of self-efficacy towards control of the parasite. Nevertheless, the perceived financial benefits of controlling porcine cysticercosis could be emphasized by an education program that discourages open defecation and encourages drinking safe

  9. Cognitive and emotional consequences of TBI: intervention strategies for vocational rehabilitation.

    Science.gov (United States)

    Mateer, Catherine A; Sira, Claire S

    2006-01-01

    The effects of a traumatic brain injury on vocational outcome can be predicted on the basis of several factors. Environmental factors such as a supportive work environment, and person specific factors, including the client's age, premorbid occupation, injury variables, level of awareness, psychosocial adjustment, coping skills, and cognitive deficits have all been found to predict return to work following a traumatic brain injury. Some of these factors are amenable to treatment, and clinicians can impact clients' likelihood of returning to work by intervening in various ways. Through case studies and a literature review on the effectiveness of cognitive rehabilitation interventions, we have outlined specific strategies and recommendations for interventions. Cognitive rehabilitation strategies that address attention, memory and executive deficits can improve clients' abilities to manage workplace tasks and demands. Many clients continue to experience problems with social and emotional adjustment following a brain injury that impact return to work. Cognitive behavioural therapy is well suited for improving coping skills, helping clients to manage cognitive difficulties, and addressing more generalized anxiety and depression in the context of a brain injury.

  10. Culinary workshop as a strategy for Occupational Therapy intervention with adolescents in situation of social vulnerability

    Directory of Open Access Journals (Sweden)

    Diane Coelho Pereira

    2014-12-01

    Full Text Available Objective: To describe the role of occupational therapy with adolescents in vulnerable situations, using a cooking workshop as intervention strategy. Methods: A culinary workshop was carried out in a philanthropic institution that attends adolescents in situations of social vulnerability, located in the municipality of Uberaba, Minas Gerais state, Brazil. The workshop participants were of both sexes, 12 and 16 years old, divided into two groups. There were six meetings of approximately 90 minutes aiming to promote friendly relationships between adolescents; strengthen youth leadership and self-esteem; promote empowerment, citizenship, social participation and the development social skills; express emotions and feelings; motivate proactivity, autonomy and the process of collective creation, discussion and reflection on the everyday activities and universe of adolescents. Results: We realized the importance of establishing a link to identify the needs of the target population, so that they can be involved in the intervention and achieve the objectives proposed. At the end of the meetings, the communication between teenagers became more subtle, contributing to cooperativeness within the group, recognition of skills and capabilities, and consequent strengthening of self-esteem, autonomy and elaboration of life projects. Conclusions: We highlight the importance of strategies such as these, which promote the rights, participation, and citizenship of specific social groups, such as adolescents in situations of social vulnerability

  11. A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions.

    Science.gov (United States)

    Dunne, Tom; Bishop, Lisa; Avery, Susan; Darcy, Stephen

    2017-05-01

    The majority of adult mental health and substance use (MH&SU) conditions emerge in adolescence. Prevention, diagnosis, and treatment programs targeting this age group have a unique opportunity to significantly impact the well-being of the future generation of adults. At the same time, youth are reluctant to seek treatment and have high rates of dropout from interventions. An emphasis on youth engagement in prevention and treatment interventions for MH&SU results in better health outcomes for those youth. This literature review was undertaken to evaluate opportunities to improve youth engagement in MH&SU programs. The intent was to determine best practices in the field that combined community-level improvement in clinical outcomes with proven strategies in engagement enhancement to inform program development at a local level. The results discuss 40 studies, reviews, and program reports demonstrating effective youth engagement. These have been grouped into six themes based on the underlying engagement mechanism: youth participation in program development, parental relationships, technology, the health clinic, school, and social marketing. A broad range of tools are discussed that intervention developers can leverage to improve youth engagement in prevention or treatment programs. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. The effect of nonpharmacological training on delirium identification and intervention strategies of intensive care nurses.

    Science.gov (United States)

    Öztürk Birge, Ayşegül; Tel Aydin, Hatice

    2017-08-01

    This study aims to investigate the effect of nonpharmacological intervention training on delirium recognition and the intervention strategies of intensive care (ICU) nurses. This is a quasi-experimental study conducted using a pretest-posttest design. The study sample included a total of 95 patients staying in the medical ICU of a university hospital and 19 nurses working in these units. The data were collected using the Patient and Nurse Introduction, Confusion Assessment Method for the ICU, and Delirium Risk Factors, and Non-pharmacological Interventions in Delirium Prevention Forms. Delirium was identified in 26.5% and 20.9% of the patients in the pre- and posttraining phase, respectively. Patients with delirium had a longer duration of stay in the ICU, lower mean Glasgow Coma Scale score and a higher number of medications in daily treatment (pdelirium increased 8.5-fold by physical restriction and 3.4-fold by the presence of hypo/hypernatremia. The delirium recognition rate of nurses increased from 7.7% to 33.3% in the post-training phase. Our study results show that training can increase the efficiency of ICU nurses in the management of delirium. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. [A unit for emergency psychiatry and crisis intervention--concepts, structure and initial experiences].

    Science.gov (United States)

    Feuerlein, W; Bronisch, T; Fürmaier, A

    1983-03-01

    The article reports on a ward with 12 beds which has been set up for emergency cases in psychiatry or for immediate intervention in case of a crisis experienced by a patient. In the theoretical part of this article, it is explained that crisis situations are present in most of the psychiatric emergency patients. The article then goes briefly into the fundamentals of therapeutic strategy in such patients: A therapy which helps to uncover hidden conflicts, the pros and cons of therapy focussed on conflict and on supportive measures; as well as a therapy which supports and promotes the ego. This is followed by a comparison of the ward with corresponding facilities in Germany and abroad and a description of their structure, their patients and their function within a psychiatric care system. The concluding part of the article is devoted to a description of the authors' initial experiences and impressions gained during their work with the ward patients, quoting several examples.

  14. Analysis of Prostate Patient Setup and Tracking Data: Potential Intervention Strategies

    International Nuclear Information System (INIS)

    Su Zhong; Zhang Lisha; Murphy, Martin; Williamson, Jeffrey

    2011-01-01

    Purpose: To evaluate the setup, interfraction, and intrafraction organ motion error distributions and simulate intrafraction intervention strategies for prostate radiotherapy. Methods and Materials: A total of 17 patients underwent treatment setup and were monitored using the Calypso system during radiotherapy. On average, the prostate tracking measurements were performed for 8 min/fraction for 28 fractions for each patient. For both patient couch shift data and intrafraction organ motion data, the systematic and random errors were obtained from the patient population. The planning target volume margins were calculated using the van Herk formula. Two intervention strategies were simulated using the tracking data: the deviation threshold and period. The related planning target volume margins, time costs, and prostate position 'fluctuation' were presented. Results: The required treatment margin for the left-right, superoinferior, and anteroposterior axes was 8.4, 10.8, and 14.7 mm for skin mark-only setup and 1.3, 2.3, and 2.8 mm using the on-line setup correction, respectively. Prostate motion significantly correlated among the superoinferior and anteroposterior directions. Of the 17 patients, 14 had prostate motion within 5 mm of the initial setup position for ≥91.6% of the total tracking time. The treatment margin decreased to 1.1, 1.8, and 2.3 mm with a 3-mm threshold correction and to 0.5, 1.0, and 1.5 mm with an every-2-min correction in the left-right, superoinferior, and anteroposterior directions, respectively. The periodic corrections significantly increase the treatment time and increased the number of instances when the setup correction was made during transient excursions. Conclusions: The residual systematic and random error due to intrafraction prostate motion is small after on-line setup correction. Threshold-based and time-based intervention strategies both reduced the planning target volume margins. The time-based strategies increased the

  15. Understanding the relationship of maternal health behavior change and intervention strategies in a Nicaraguan NGO network.

    Science.gov (United States)

    Valadez, Joseph J; Hage, Jerald; Vargas, William

    2005-09-01

    Few studies of community interventions examine independent effects of investments in: (1) capital (i.e., physical, human and social capital), and (2) management systems (e.g., monitoring and evaluation systems (M&E)) on maternal and child health behavior change. This paper does this in the context of an inter-organizational network. In Nicaragua, international non-governmental organizations (NGOs) and local NGOs formed the NicaSalud Federation. Using Lot Quality Assurance Sampling (LQAS), 14 member organizations took baselines measures of maternal safe motherhood and child health behavior indicators during November 1999 and August 2000, respectively, and final evaluation measures in December 2001. In April 2002, retrospective interviews were conducted with supervisors and managers in the 14 organizations to explore changes made to community health strategies, factors associated with the changes, and impacts they attributed to participating in NicaSalud. Physical capital (density of health huts), human capital (density and variety of paramedical personnel) and social capital (density of health committees) were associated with pregnant women attending antenatal care (ANC) 3+ times, and/or retaining ANC cards. The variety of paramedic personnel was also associated with women making post-partum visits to clinics. Physical capital (density of health huts) and social capital (density of health committees and mothers' clubs) were associated with child diarrhea case management indicators. One safe motherhood indicator (delivery of babies by a clinician) was not associated with intervention strategies. At the management level, NicaSalud's training of members to use LQAS for M&E was associated with the number of strategic and tactical changes they subsequently made to interventions (organizational learning). Organizational learning was related to changes in maternal and child health behaviors of the women (including changes in the proportion using post-partum care). As the

  16. Aligning USGS senior leadership structure with the USGS science strategy

    Science.gov (United States)

    ,

    2010-01-01

    The U.S. Geological Survey (USGS) is realigning its management and budget structure to further enhance the work of its science programs and their interdisciplinary focus areas related to the USGS Science Strategy as outlined in 'Facing Tomorrow's Challenges-U.S. Geological Survey Science in the Decade 2007-2017' (U.S. Geological Survey, 2007). In 2007, the USGS developed this science strategy outlining major natural-science issues facing the Nation and focusing on areas where natural science can make a substantial contribution to the well being of the Nation and the world. These areas include global climate change, water resources, natural hazards, energy and minerals, ecosystems, and data integration.

  17. A microgrid cluster structure and its autonomous coordination control strategy

    DEFF Research Database (Denmark)

    Zhou, Xiaoping; Zhou, Leming; Chen, Yandong

    2018-01-01

    This paper proposes a microgrid cluster structure and its autonomous coordination control strategy. Unlike existing microgrids that are purely AC or DC, the microgrid cluster studied here is an interconnected system with multiple AC and DC microgrids, which enables mutual power support among...... control method combining the normalized droop-based control and adaptive control is proposed for PEU, which can effectively realize mutual power support among microgrids and reduce the bus voltage or frequency deviation in microgrids. In addition, the adaptive control strategy of PEU can ensure...... that the bigger the normalized index of microgrid is, the larger the active power exchange coefficient is, which can make all of microgrids operate around the rated state as much as possible. Besides, EP is mainly used to balance the system power, and the hierarchical coordinated control method of EP is proposed...

  18. Technology strategy for cost-effective drilling and intervention; Technology Target Areas; TTA4 - Cost effective drilling and intervention

    Energy Technology Data Exchange (ETDEWEB)

    2007-07-01

    The main goals of the OG21 initiative are to (1) develop new technology and knowledge to increase the value creation of Norwegian oil and gas resources and (2) enhance the export of Norwegian oil and gas technology. The OG21 Cost-effective Drilling and Intervention (CEDI) Technology Target Area (TTA) has identified some key strategic drilling and well intervention needs to help meet the goals of OG21. These key strategic drilling and well intervention needs are based on a review of present and anticipated future offshore-Norway drilling and well intervention conditions and the Norwegian drilling and well intervention industry. A gap analysis has been performed to assess the extent to which current drilling and well intervention research and development and other activities will meet the key strategic needs. Based on the identified strategic drilling and well intervention needs and the current industry res each and development and other activities, the most important technology areas for meeting the OG21 goals are: environment-friendly and low-cost exploration wells; low-cost methods for well intervention/sidetracks; faster and extended-reach drilling; deep water drilling, completion and intervention; offshore automated drilling; subsea and sub-ice drilling; drilling through basalt and tight carbonates; drilling and completion in salt formation. More specific goals for each area: reduce cost of exploration wells by 50%; reduce cost for well intervention/sidetracks by 50%; increase drilling efficiency by 40%; reduce drilling cost in deep water by 40 %; enable offshore automated drilling before 2012; enable automated drilling from seabed in 2020. Particular focus should be placed on developing new technology for low-cost exploration wells to stem the downward trends in the number of exploration wells drilled and the volume of discovered resources. The CEDI TTA has the following additional recommendations: The perceived gaps in addressing the key strategic drilling and

  19. Electric utility strategies and the emerging industry structure - Part 1

    International Nuclear Information System (INIS)

    Motupalli, S.

    1991-01-01

    The electric utility industry is our most capital intensive industry by far. Over the past few decades, socioeconomic and technological forces have been quietly revolutionizing the way the industry conducts itself. During the 1980s, these changes have been particularly intense, often catching both regulators and regulated ill-prepared to develop effective and profitable strategies to deal with such change. Much has already been written about these changes: independent power producers, competitive procurement of resources, incentive-based regulation, the benefits of affiliated company structures, mergers and consolidation, customer energy conservation, and marketing strategy development are all currently highly popular article and seminar topics. The author's object in this two-part series is to facilitate development of a decision framework to put these various changes in perspective, to help develop effective strategies through better focused and equipped planning methodologies. Gaining an understanding of the role, strengths and weaknesses of the various players in an industry and the structural constraints in which they operate is a necessary precursor to developing effective operating strategies to deal with change or to manipulate industry forces in your favor. Michael Port's popular five forces model provides a convenient way to develop such an understanding. It provides a way to map the industry forces driving profitability, through a review of the strengths, weaknesses and leverage of: current industry players, suppliers to the industry, customers for the industry's product, new entrants into the market, and substitute products providing equal or better value. Part 1 of this series reviews each of these five forces along some key dimensions to determine their direction of change or influence, and whether this change impacts a utility's competitive position favorably or unfavorably

  20. The impact of intervention strategies that target arterial stiffness in end-stage renal disease: a systematic review protocol.

    Science.gov (United States)

    Rodriguez, Rosendo A; Shea, Beverley; Hae, Richard; Burns, Kevin D

    2016-07-19

    Vascular damage contributes to the high cardiovascular morbidity and mortality in end-stage renal disease (ESRD). Increased aortic stiffness measured by carotid-femoral pulse wave velocity (cf-PWV) is a strong and independent predictor of the cardiovascular risk in ESRD patients. Recently, there has been considerable interest in developing strategies to lessen the progression of arterial stiffness in ESRD patients using cf-PWV as a tool to monitor therapeutic responses, but their benefit on the long-term cardiovascular risk is not known. Appraisal of the effects of existing stiffness-based interventions on the cf-PWV would facilitate selecting optimal therapies to be tested in randomized clinical trials. The aim of this systematic review will be to evaluate the impact of arterial stiffness-based interventions on the cf-PWV in ESRD patients. Secondarily, for each intervention, we will determine the minimal duration needed to achieve a significant reduction of cf-PWV, the minimal cf-PWV reduction threshold or effect size, and adverse events. This review will be conducted using MEDLINE, EMBASE, and EBM Reviews. We will select clinical trials and observational studies (cohort, case-control, and before/after studies and case series) that evaluated pharmacologic or non-pharmacologic interventions in which the primary effect is to improve structural and/or dynamic components of arterial stiffness in adults with stage 5 chronic kidney disease. The primary outcome of interest will be cf-PWV. Study selection and data collection will be performed by two reviewers. Validated tools will be used to assess the methodological quality and risk of bias among different study designs. We will describe all included citations according to study characteristics, methodological quality, and outcomes. Suitability for meta-analysis will be determined by the degree of clinical and statistical heterogeneity between studies. If appropriate, we will calculate effect estimates by obtaining the

  1. Development and Pilot Study of a Marketing Strategy for Primary Care/Internet–Based Depression Prevention Intervention for Adolescents (The CATCH-IT Intervention)

    Science.gov (United States)

    Watson, Natalie; Bridges, John F. P.; Fogel, Joshua; Galas, Jill; Kramer, Clarke; Connery, Marc; McGill, Ann; Marko, Monika; Cardenas, Alonso; Landsback, Josephine; Dmochowska, Karoline; Kuwabara, Sachiko A.; Ellis, Justin; Prochaska, Micah; Bell, Carl

    2010-01-01

    Background: Adolescent depression is both common and burdensome, and while evidence-based strategies have been developed to prevent adolescent depression, participation in such interventions remains extremely low, with less than 3% of at-risk individuals participating. To promote participation in evidence-based preventive strategies, a rigorous marketing strategy is needed to translate research into practice. Objective: To develop and pilot a rigorous marketing strategy for engaging at-risk individuals with an Internet-based depression prevention intervention in primary care targeting key attitudes and beliefs. Method: A marketing design group was constituted to develop a marketing strategy based on the principles of targeting, positioning/competitor analysis, decision analysis, and promotion/distribution and incorporating contemporary models of behavior change. We evaluated the formative quality of the intervention and observed the fielding experience for prevention using a pilot study (observational) design. Results: The marketing plan focused on “resiliency building” rather than “depression intervention” and was relayed by office staff and the Internet site. Twelve practices successfully implemented the intervention and recruited a diverse sample of adolescents with > 30% of all those with positive screens and > 80% of those eligible after phone assessment enrolling in the study with a cost of $58 per enrollee. Adolescent motivation for depression prevention (1–10 scale) increased from a baseline mean value of 7.45 (SD = 2.05) to 8.07 poststudy (SD = 1.33) (P = .048). Conclusions: Marketing strategies for preventive interventions for mental disorders can be developed and successfully introduced and marketed in primary care. PMID:20944776

  2. Intervention implementation research: an exploratory study of reduction strategies for occupational contact dermatitis in the printing industry.

    Science.gov (United States)

    Brown, Terry P; Rushton, Lesley; Williams, Hywel C; English, John S C

    2007-01-01

    Occupational dermatitis is a problem in the printing industry but can be avoided through adequate protective measures. Research into intervention implementation is fundamental to the success of a formal intervention effectiveness trial. The preliminary testing of four risk reduction strategies for occupationally caused dermatitis, which represent a range of approaches and cost implications. The strategies, the provision of (i) skin checks plus treatment advice; provision of (ii) gloves of the correct type/size plus use of an after-work cream; provision of (iii) information highlighting the problem of occupational dermatitis and (iv) development of a best practice skin care policy, were evaluated over 3 months in two non-randomly selected companies. A post-intervention evaluation into the effectiveness and efficacy of the intervention was also carried out. All interventions were found to be acceptable to some extent. No single intervention appeared to be completely effective. The most practical intervention appeared to be the regular use of gloves of the correct type and size. This preliminary intervention study has demonstrated an improvement in the skin condition of workers examined and points towards the need for further testing of risk reduction strategies for the prevention of dermatitis in the printing industry on a much larger scale.

  3. Using the multiphase optimization strategy (MOST to optimize an HIV care continuum intervention for vulnerable populations: a study protocol

    Directory of Open Access Journals (Sweden)

    Marya Viorst Gwadz

    2017-05-01

    Full Text Available Abstract Background More than half of persons living with HIV (PLWH in the United States are insufficiently engaged in HIV primary care and not taking antiretroviral therapy (ART, mainly African Americans/Blacks and Hispanics. In the proposed project, a potent and innovative research methodology, the multiphase optimization strategy (MOST, will be employed to develop a highly efficacious, efficient, scalable, and cost-effective intervention to increase engagement along the HIV care continuum. Whereas randomized controlled trials are valuable for evaluating the efficacy of multi-component interventions as a package, they are not designed to evaluate which specific components contribute to efficacy. MOST, a pioneering, engineering-inspired framework, addresses this problem through highly efficient randomized experimentation to assess the performance of individual intervention components and their interactions. We propose to use MOST to engineer an intervention to increase engagement along the HIV care continuum for African American/Black and Hispanic PLWH not well engaged in care and not taking ART. Further, the intervention will be optimized for cost-effectiveness. A similar set of multi-level factors impede both HIV care and ART initiation for African American/Black and Hispanic PLWH, primary among them individual- (e.g., substance use, distrust, fear, social- (e.g., stigma, and structural-level barriers (e.g., difficulties accessing ancillary services. Guided by a multi-level social cognitive theory, and using the motivational interviewing approach, the study will evaluate five distinct culturally based intervention components (i.e., counseling sessions, pre-adherence preparation, support groups, peer mentorship, and patient navigation, each designed to address a specific barrier to HIV care and ART initiation. These components are well-grounded in the empirical literature and were found acceptable, feasible, and promising with respect to

  4. A strategy to tialor performance interventions based on the nature of organisational maturity of south manufacturing firms

    Directory of Open Access Journals (Sweden)

    Ebrahim, Zahier

    2016-08-01

    Full Text Available The South African automotive component manufacturing sector is facing global pressure to remain competitive. Performance improvement interventions are often deployed in manufacturing companies that are aimed at improving competitiveness. The high failure rate of these performance improvement interventions should be considered when developing a programme strategy for implementation. Consideration should be given to the organisation’s maturity and current performance when deciding which performance improvement intervention to select. The research objective was to establish the role of the organisational maturity variables in tailoring an integrated performance improvement intervention that develops organisational maturity and performance.

  5. Rethinking policy perspectives on childhood stunting: time to formulate a structural and multifactorial strategy.

    Science.gov (United States)

    Subramanian, S V; Mejía-Guevara, Iván; Krishna, Aditi

    2016-05-01

    Stunting and chronic undernutrition among children in South Asia remain a major unresolved global health issue. There are compelling intrinsic and moral reasons to ensure that children attain their optimal growth potential facilitated via promotion of healthy living conditions. Investments in efforts to ensure that children's growth is not faltered also have substantial instrumental benefits in terms of cognitive and economic development. Using the case of India, we critique three prevailing approaches to reducing undernutrition among children: an over-reliance on macroeconomic growth as a potent policy instrument, a disproportionate focus on interpreting undernutrition as a demand-side problem and an over-reliance on unintegrated single-factorial (one at a time) approaches to policy and research. Using existing evidence, we develop a case for support-led policy approach with a focus on integrated and structural factors to addressing the problem of undernutrition among children in India. Key messages Eliminating child undernutrition is important from an intrinsic perspective and offers considerable instrumental benefits to individual and society. Evidence suggests that an exclusive reliance on a growth-mediated strategy to eliminate stunting needs to be reconsidered, suggesting the need for a substantial support-led strategy. Interpreting and addressing undernutrition as a demand-side problem with proximal single-factorial interventions is futile. There is an urgent need to develop interventions that address the broader structural and upstream causes of child undernutrition. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

  6. Health level seven interoperability strategy: big data, incrementally structured.

    Science.gov (United States)

    Dolin, R H; Rogers, B; Jaffe, C

    2015-01-01

    Describe how the HL7 Clinical Document Architecture (CDA), a foundational standard in US Meaningful Use, contributes to a "big data, incrementally structured" interoperability strategy, whereby data structured incrementally gets large amounts of data flowing faster. We present cases showing how this approach is leveraged for big data analysis. To support the assertion that semi-structured narrative in CDA format can be a useful adjunct in an overall big data analytic approach, we present two case studies. The first assesses an organization's ability to generate clinical quality reports using coded data alone vs. coded data supplemented by CDA narrative. The second leverages CDA to construct a network model for referral management, from which additional observations can be gleaned. The first case shows that coded data supplemented by CDA narrative resulted in significant variances in calculated performance scores. In the second case, we found that the constructed network model enables the identification of differences in patient characteristics among different referral work flows. The CDA approach goes after data indirectly, by focusing first on the flow of narrative, which is then incrementally structured. A quantitative assessment of whether this approach will lead to a greater flow of data and ultimately a greater flow of structured data vs. other approaches is planned as a future exercise. Along with growing adoption of CDA, we are now seeing the big data community explore the standard, particularly given its potential to supply analytic en- gines with volumes of data previously not possible.

  7. Substituting sugar confectionery with fruit and healthy snacks at checkout - a win-win strategy for consumers and food stores? a study on consumer attitudes and sales effects of a healthy supermarket intervention.

    Science.gov (United States)

    Winkler, Lise L; Christensen, Ulla; Glümer, Charlotte; Bloch, Paul; Mikkelsen, Bent E; Wansink, Brian; Toft, Ulla

    2016-11-22

    The widespread use of in-store marketing strategies to induce unhealthy impulsive purchases has implications for shopping experience, food choice and possibly adverse health outcomes. The aim of this study was to examine consumer attitudes and evaluate sales effects of a healthy checkout supermarket intervention. The study was part of Project Sundhed & Lokalsamfund (Project SoL); a Danish participatory community-based health promotion intervention. Consumer attitudes towards unhealthy snack exposure in supermarkets were examined in a qualitative pre-intervention study (29 short in-store interviews, 11 semi-structured interviews and three focus group interviews). Findings were presented to food retailers and informed the decision to test a healthy checkout intervention. Sugar confectionery at one checkout counter was substituted with fruit and healthy snacking items in four stores for 4 weeks. The intervention was evaluated by 48 short exit interviews on consumer perceptions of the intervention and by linear mixed model analyses of supermarket sales data from the intervention area and a matched control area. The qualitative pre-intervention study identified consumer concern and annoyance with placement and promotion of unhealthy snacks in local stores. Store managers were willing to respond to local consumer concern and a healthy checkout intervention was therefore implemented. Exit interviews found positive attitudes towards the intervention, while intervention awareness was modest. Most participants believed that the intervention could help other consumers make healthier choices, while fewer expected to be influenced by the intervention themselves. Statistical analyses suggested an intervention effect on sales of carrot snack packs when compared with sales before the intervention in Bornholm control stores (P branding opportunity for supermarkets, thus representing a win-win strategy for store managers and consumers in the short term. However, the intervention

  8. Progression to multi-scale models and the application to food system intervention strategies.

    Science.gov (United States)

    Gröhn, Yrjö T

    2015-02-01

    The aim of this article is to discuss how the systems science approach can be used to optimize intervention strategies in food animal systems. It advocates the idea that the challenges of maintaining a safe food supply are best addressed by integrating modeling and mathematics with biological studies critical to formulation of public policy to address these challenges. Much information on the biology and epidemiology of food animal systems has been characterized through single-discipline methods, but until now this information has not been thoroughly utilized in a fully integrated manner. The examples are drawn from our current research. The first, explained in depth, uses clinical mastitis to introduce the concept of dynamic programming to optimize management decisions in dairy cows (also introducing the curse of dimensionality problem). In the second example, a compartmental epidemic model for Johne's disease with different intervention strategies is optimized. The goal of the optimization strategy depends on whether there is a relationship between Johne's and Crohn's disease. If so, optimization is based on eradication of infection; if not, it is based on the cow's performance only (i.e., economic optimization, similar to the mastitis example). The third example focuses on food safety to introduce risk assessment using Listeria monocytogenes and Salmonella Typhimurium. The last example, practical interventions to effectively manage antibiotic resistance in beef and dairy cattle systems, introduces meta-population modeling that accounts for bacterial growth not only in the host (cow), but also in the cow's feed, drinking water and the housing environment. Each example stresses the need to progress toward multi-scale modeling. The article ends with examples of multi-scale systems, from food supply systems to Johne's disease. Reducing the consequences of foodborne illnesses (i.e., minimizing disease occurrence and associated costs) can only occur through an

  9. Consumer Acceptance of Population-Level Intervention Strategies for Healthy Food Choices: The Role of Perceived Effectiveness and Perceived Fairness

    Directory of Open Access Journals (Sweden)

    Colin Bos

    2015-09-01

    Full Text Available The present study investigates acceptance of intervention strategies for low-calorie snack choices that vary regarding the effect they have on consumers’ freedom of choice (providing information, guiding choice through (disincentives, and restricting choice. We examine the mediating effects of perceived effectiveness and perceived fairness, and the moderating effects of barriers to choose low-calorie snacks and perceived responsibility for food choice. Data was collected through an online survey, involving three waves that were completed over a seven week timespan. Information was collected on barriers and perceived responsibility, and evaluations of a total of 128 intervention strategies with varying levels of intrusiveness that were further systematically varied in terms of source, location, approach/avoidance, type, and severity. A total of 1173 respondents completed all three waves. We found that the effect of intervention intrusiveness on acceptance was mediated by the perceived personal- and societal effectiveness, and the perceived fairness of interventions. For barriers and perceived responsibility, only main effects on intervention-specific beliefs were found. Government interventions were accepted less than interventions by food manufacturers. In conclusion, the present study shows that acceptance of interventions depends on perceptions of personal- and societal effectiveness and fairness, thereby providing novel starting points for increasing acceptance of both existing and new food choice interventions.

  10. Consumer Acceptance of Population-Level Intervention Strategies for Healthy Food Choices: The Role of Perceived Effectiveness and Perceived Fairness

    Science.gov (United States)

    Bos, Colin; Van Der Lans, Ivo; Van Rijnsoever, Frank; Van Trijp, Hans

    2015-01-01

    The present study investigates acceptance of intervention strategies for low-calorie snack choices that vary regarding the effect they have on consumers’ freedom of choice (providing information, guiding choice through (dis)incentives, and restricting choice). We examine the mediating effects of perceived effectiveness and perceived fairness, and the moderating effects of barriers to choose low-calorie snacks and perceived responsibility for food choice. Data was collected through an online survey, involving three waves that were completed over a seven week timespan. Information was collected on barriers and perceived responsibility, and evaluations of a total of 128 intervention strategies with varying levels of intrusiveness that were further systematically varied in terms of source, location, approach/avoidance, type, and severity. A total of 1173 respondents completed all three waves. We found that the effect of intervention intrusiveness on acceptance was mediated by the perceived personal- and societal effectiveness, and the perceived fairness of interventions. For barriers and perceived responsibility, only main effects on intervention-specific beliefs were found. Government interventions were accepted less than interventions by food manufacturers. In conclusion, the present study shows that acceptance of interventions depends on perceptions of personal- and societal effectiveness and fairness, thereby providing novel starting points for increasing acceptance of both existing and new food choice interventions. PMID:26389949

  11. Consumer Acceptance of Population-Level Intervention Strategies for Healthy Food Choices: The Role of Perceived Effectiveness and Perceived Fairness.

    Science.gov (United States)

    Bos, Colin; Lans, Ivo Van Der; Van Rijnsoever, Frank; Van Trijp, Hans

    2015-09-15

    The present study investigates acceptance of intervention strategies for low-calorie snack choices that vary regarding the effect they have on consumers' freedom of choice (providing information, guiding choice through (dis)incentives, and restricting choice). We examine the mediating effects of perceived effectiveness and perceived fairness, and the moderating effects of barriers to choose low-calorie snacks and perceived responsibility for food choice. Data was collected through an online survey, involving three waves that were completed over a seven week timespan. Information was collected on barriers and perceived responsibility, and evaluations of a total of 128 intervention strategies with varying levels of intrusiveness that were further systematically varied in terms of source, location, approach/avoidance, type, and severity. A total of 1173 respondents completed all three waves. We found that the effect of intervention intrusiveness on acceptance was mediated by the perceived personal- and societal effectiveness, and the perceived fairness of interventions. For barriers and perceived responsibility, only main effects on intervention-specific beliefs were found. Government interventions were accepted less than interventions by food manufacturers. In conclusion, the present study shows that acceptance of interventions depends on perceptions of personal- and societal effectiveness and fairness, thereby providing novel starting points for increasing acceptance of both existing and new food choice interventions.

  12. A strategy to compute plastic post-buckling of structures

    International Nuclear Information System (INIS)

    Combescure, A.

    1983-08-01

    The paper gives a general framework to the different strategies used to compute the post-buckling of structures. Two particular strategies are studied in more details and it is shown how they can be applied in the plastic regime. All the methods suppose that the loads F are proportional to a simple parameter lambda; more precisely: eq (1) F = lambda F 0 . The paper shows how these methods can be implemented in a very simple way. In the elastic case we show the application of the method to the calculation of post buckling response of a clamped arch. The method is also applied to a very simple case of two bars which can be calculated analytically. In the plastic range, the method is applied to the post-buckling of an imperfect ring which can be calculated analytically. Another example is the comparison of the comparison of the computed post-buckling of a thin cylinder under axial compression, and of the experimental behavior on the same cylinder. The limitation of these types of strategies are also mentionned and the physical signifiance of calculations in the post-buckling regime are discussed

  13. Effect of recovery interventions on cycling performance and pacing strategy in the heat.

    Science.gov (United States)

    De Pauw, Kevin; Roelands, Bart; Vanparijs, Jef; Meeusen, Romain

    2014-03-01

    To determine the effect of active recovery (AR), passive rest (PR), and cold-water immersion (CWI) after 90 min of intensive cycling on a subsequent 12-min time trial (TT2) and the applied pacing strategy in TT2. After a maximal test and familiarization trial, 9 trained male subjects (age 22 ± 3 y, VO2max 62.1 ± 5.3 mL · min-1 · kg-1) performed 3 experimental trials in the heat (30°C). Each trial consisted of 2 exercise tasks separated by 1 h. The first was a 60-min constant-load trial at 55% of the maximal power output followed by a 30-min time trial (TT1). The second comprised a 12-min simulated time trial (TT2). After TT1, AR, PR, or CWI was applied for 15 min. No significant TT2 performance differences were observed, but a 1-sample t test (within each condition) revealed different pacing strategies during TT2. CWI resulted in an even pacing strategy, while AR and PR resulted in a gradual decline of power output after the onset of TT2 (P ≤ .046). During recovery, AR and CWI showed a trend toward faster blood lactate ([BLa]) removal, but during TT2 significantly higher [BLa] was only observed after CWI compared with PR (P = .011). The pacing strategy during subsequent cycling performance in the heat is influenced by the application of different postexercise recovery interventions. Although power was not significantly altered between groups, CWI enabled a differently shaped power profile, likely due to decreased thermal strain.

  14. Research on Integrated Analysis Method for Equipment and Tactics Based on Intervention Strategy Discussion

    Institute of Scientific and Technical Information of China (English)

    陈超; 张迎新; 毛赤龙

    2012-01-01

    As the increase of the complexity of the information warfare,its intervention strategy needs to be designed in an integrated environment.However,the current research always breaks the internal relation between equipment and tactics,and it is difficult to meet the requirements of their integrated analysis.In this paper,the research status quo of the integrated analysis about equipment and tactics is discussed first,some shortages of the current methods are summarized then,and an evolvement mechanism of the integrated analysis for equipment and tactics is given finally.Based on these,a framework of integrated analysis is proposed.This method's effectiveness is validated by an example.

  15. Transcription Factor NF-κB: An Update on Intervention Strategies.

    Science.gov (United States)

    Panday, Arvind; Inda, Maria Eugenia; Bagam, Prathyusha; Sahoo, Malaya K; Osorio, Diana; Batra, Sanjay

    2016-12-01

    The nuclear factor (NF)-κB family of transcription factors are ubiquitous and pleiotropic molecules that regulate the expression of more than 150 genes involved in a broad range of processes including inflammation, immunity, cell proliferation, differentiation, and survival. The chronic activation or dysregulation of NF-κB signaling is the central cause of pathogenesis in many disease conditions and, therefore, NF-κB is a major focus of therapeutic intervention. Because of this, understanding the relationship between NF-κB and the induction of various downstream signaling molecules is imperative. In this review, we provide an updated synopsis of the role of NF-κB in DNA repair and in various ailments including cardiovascular diseases, HIV infection, asthma, herpes simplex virus infection, chronic obstructive pulmonary disease, and cancer. Furthermore, we also discuss the specific targets for selective inhibitors and future therapeutic strategies.

  16. Neuropsychological Care and Rehabilitation of Cancer Patients With Chemobrain: Strategies For Evaluation and Intervention Development

    Science.gov (United States)

    Jean-Pierre, Pascal; Johnson-Greene, Douglas; Burish, Thomas G.

    2014-01-01

    Malignant tumors and their various treatments such as chemotherapy, radiotherapy and hormonal therapy can deleteriously affect a large number of cancer patients and survivors on multiple dimensions of psychosocial and neurocognitive functioning. Oncology researchers and clinicians are increasingly cognizant of the negative effects of cancer and its treatments on the brain and its mental processes and cognitive outcomes. Nevertheless, effective interventions to treat cancer and treatment-related neurocognitive dysfunction (CRND), also known as chemobrain, are still lacking. The paucity of data on effective treatments for CRND is due, at least partly, to difficulties understanding its etiology, and a lack of reliable methods for assessing its presence and severity. This paper provides an overview of the incidence, etiology, and magnitude of CRND, and discusses the plausible contributions of psychological, motor function, and linguistic and behavioral complications to CRND. Strategies for reliable neuropsychological screening and assessment, and development and testing of effective ways to mitigate CRND are also discussed. PMID:24671433

  17. Early stages of bipolar disorder: characterization and strategies for early intervention

    Directory of Open Access Journals (Sweden)

    Adiel C. Rios

    2015-12-01

    Full Text Available Objective: To characterize the early stages of bipolar disorder (BD, defined as the clinical prodrome/subsyndromal stage and first-episode phase, and strategies for their respective treatment. Methods: A selective literature search of the PubMed, Embase, PsycINFO, and ISI databases from inception until March 2014 was performed. Included in this review were articles that a characterized prodromal and first-episode stages of BD or b detailed efficacy and safety/tolerability of interventions in patients considered prodromal for BD or those with only one episode of mania/hypomania. Results: As research has only recently focused on characterization of the early phase of BD, there is little evidence for the effectiveness of any treatment option in the early phase of BD. Case management; individual, group, and family therapy; supportive therapy; and group psychoeducation programs have been proposed. Most evidence-based treatment guidelines for BD do not address treatment specifically in the context of the early stages of illness. Evidence for pharmacotherapy is usually presented in relation to illness polarity (i.e., manic/mixed or depressed or treatment phase. Conclusions: Although early recognition and treatment are critical to preventing unfavorable outcomes, there is currently little evidence for interventions in these stages of BD.

  18. Consumer Intervention Mapping—A Tool for Designing Future Product Strategies within Circular Product Service Systems

    Directory of Open Access Journals (Sweden)

    Matt Sinclair

    2018-06-01

    Full Text Available Re-distributed manufacturing presents a number of opportunities and challenges for New Product Development in a future Circular Economy. It has been argued that small-scale, flexible and localised production systems will reduce resource consumption, lower transport emissions and extend product lifetimes. At the same time smart products within the Internet of Things will gather and report data on user behaviour and product status. Many sustainable design tools have previously been developed but few are able to imagine and develop visions of how future sustainable product service systems might be manifested. This paper introduces the concept of Consumer Intervention Mapping as a tool for creating future product strategies. The tool visualises the points within a product’s lifecycle where stakeholders are able to intervene in the product’s expected journey. This perspective enables the rapid construction of scenarios that explore and describe future circular product service systems. Validation of the tool in three workshops is described and the outcomes are presented. Consumer Intervention Mapping is successful in creating scenarios that describe existing product service systems and new product concepts adapted to a Circular Economy paradigm. Further work is required to refine the tool’s performance in more focused and reflective design exercises.

  19. Acceptability, language, and structure of text message-based behavioral interventions for high-risk adolescent females: a qualitative study.

    Science.gov (United States)

    Ranney, Megan L; Choo, Esther K; Cunningham, Rebecca M; Spirito, Anthony; Thorsen, Margaret; Mello, Michael J; Morrow, Kathleen

    2014-07-01

    To elucidate key elements surrounding acceptability/feasibility, language, and structure of a text message-based preventive intervention for high-risk adolescent females. We recruited high-risk 13- to 17-year-old females screening positive for past-year peer violence and depressive symptoms, during emergency department visits for any chief complaint. Participants completed semistructured interviews exploring preferences around text message preventive interventions. Interviews were conducted by trained interviewers, audio-recorded, and transcribed verbatim. A coding structure was iteratively developed using thematic and content analysis. Each transcript was double coded. NVivo 10 was used to facilitate analysis. Saturation was reached after 20 interviews (mean age 15.4; 55% white; 40% Hispanic; 85% with cell phone access). (1) Acceptability/feasibility themes: A text-message intervention was felt to support and enhance existing coping strategies. Participants had a few concerns about privacy and cost. Peer endorsement may increase uptake. (2) Language themes: Messages should be simple and positive. Tone should be conversational but not slang filled. (3) Structural themes: Messages may be automated but must be individually tailored on a daily basis. Both predetermined (automatic) and as-needed messages are requested. Dose and timing of content should be varied according to participants' needs. Multimedia may be helpful but is not necessary. High-risk adolescent females seeking emergency department care are enthusiastic about a text message-based preventive intervention. Incorporating thematic results on language and structure can inform development of future text messaging interventions for adolescent girls. Concerns about cost and privacy may be able to be addressed through the process of recruitment and introduction to the intervention. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. A National Early Intervention System as a Strategy to Promote Inclusion and Academic Achievement in Portugal.

    Science.gov (United States)

    Franco, Vitor; Melo, Madalena; Santos, Graça; Apolónio, Ana; Amaral, Leonor

    2017-01-01

    Early intervention with children at risk or facing developmental problems is a practice defined by three fundamental characteristics: being family-centered, being based on the community and on the child's life context, and being conducted by a team with transdisciplinary practice. In this paper we wish to present how the SNIPI-National System of Early Intervention, implemented in Portugal over the past 15 years, contributes to promote maximum development and the full inclusion of children up to 6 years of age and works to prevent school failure. The SNIPI covers the entire territory and intends to respond to the needs of children with developmental disorders or those in at risk situations. This community-based early intervention model is linked to the health, education and social care systems, involving the three responsible Ministries. In the present community case study, we present the implementation of this program in the Alentejo region, involving 31 local teams and almost 2500 children. Through the regional structure's reports and the responses of parents and professionals in impact studies, we demonstrate how the system is established and how it tackles school failure and improves the educational inclusion of these children. The impact of this Early Intervention model has been significant not only on children's developmental outcomes, but also for the health, education and social care professionals who work in a transdisciplinary perspective, as well as for the families who became more skilled at evaluating the children's needs and the support provided. This approach to implementing a family-centered Early Intervention program can contribute to full inclusion. It facilitates the transition to schooling based on a non-discriminatory approach and educational achievement by aiding development and an adapted contextualization in pre-school education. This program system introduces significant innovation within the framework of existing educational policies that

  1. Pain management interventions in the nursing home: a structured review of the literature.

    Science.gov (United States)

    Herman, Adam D; Johnson, Theodore M; Ritchie, Christine S; Parmelee, Patricia A

    2009-07-01

    Residents in nursing homes (NHs) experience pain that is underrecognized and undertreated. This pain contributes to a decline in quality of life. Although descriptive studies of pain assessment and management have been conducted, few have been published that critically evaluate interventions to improve pain management. Identification of the strengths and gaps in the current literature is required. A literature search was conducted of clinical trials that evaluated prospective interventions to improve pain management. Information on the intervention type, resident sample and setting, endpoints, and study design were extracted. Studies were classified based on a modification of Donabedian's model of healthcare quality. Four categories of interventions were identified: actor, decision support, treatment, and systems. The search strategy and selection criteria yielded 21 articles. Eleven studies used an actor intervention; of these, eight also employed a systems intervention, and one also used a treatment intervention. Two studies used a decision support intervention, seven used a treatment intervention, and one used a systems intervention. The overall quality of research was uneven in several areas: research design--nine studies were quasi-experimental in nature, endpoints measures were not consistent--three did not perform statistical analysis, and characteristics of the resident samples varied dramatically. In conclusion, the number of high-quality studies of pain management in NHs remains limited. Process endpoints are used as surrogate measures for resident endpoints. Systematic approaches are needed to understand how each type of intervention improves the quality of pain management at the resident level.

  2. Psychometrics and life history strategy: the structure and validity of the High K Strategy Scale.

    Science.gov (United States)

    Copping, Lee T; Campbell, Anne; Muncer, Steven

    2014-03-22

    In this paper, we critically review the conceptualization and implementation of psychological measures of life history strategy associated with Differential K theory. The High K Strategy Scale (HKSS: Giosan, 2006) was distributed to a large British sample (n = 809) with the aim of assessing its factor structure and construct validity in relation to theoretically relevant life history variables: age of puberty, age of first sexual encounter, and number of sexual partners. Exploratory and confirmatory factor analyses indicated that the HKSS in its current form did not show an adequate statistical fit to the data. Modifications to improve fit indicated four correlated factors (personal capital, environmental stability, environmental security, and social capital). Later puberty in women was positively associated with measures of the environment and personal capital. Among men, contrary to Differential K predictions but in line with female mate preferences, earlier sexual debut and more sexual partners were positively associated with more favorable environments and higher personal and social capital. We raise concerns about the use of psychometric indicators of lifestyle and personality as proxies for life history strategy when they have not been validated against objective measures derived from contemporary life history theory and when their status as causes, mediators, or correlates has not been investigated.

  3. Federal structures and associated behavioural interventions in prevention of cigarette smoking

    Directory of Open Access Journals (Sweden)

    Willich, Stefan N.

    2008-10-01

    Full Text Available Objectives: The recently published HTA-report “Effectiveness and cost-effectiveness of behavioural strategies in the prevention of cigarette smoking” detects a lack of high-quality publications considering the national prevention structures. Included publications do not give any information regarding current interventions in Germany. The goal of this addendum is to give an overview of the federal prevention system and associated measures for behavioural smoking prevention. Methods: Firstly, relevant tobacco prevention structures with associated tasks and activities were identified. Further, a survey of available project information was conducted in December 2007. This procedure based on systematic analysis in PrevNet-network as well as on manual search on the web sites of primary network centres (PrevNet-Knotenpunkte or other relevant federal state organisations. A written, postal questionnaire was conducted among network centres, federal state organisations and selected health insurance funds. Results: Interventions regarding primary prevention of smoking cover a variety of activities and campaigns issued by the Federal Government, several national organisations, federal and local authorities as well as health insurance funds. Institutions such as the German Ministry of Health, the Federal Centre for Health Education (BZGA, the German Cancer Research Center (DKFZ contribute to smoking prevention on national level. Diverse professional associations, workshops or authorities set up the organisational framework for coordination and planning of tobacco prevention on federal state level. Even on communal level institutional structures in terms of local professional departments and committees are established. The health insurance companies and their associations also play a major role in prevention of smoking uptake. “Rauchfrei”, “Be smart, don´ t start”, “Klasse 2000”, “ALF” or “Just be smokefree” are among the most well

  4. Experiences and perspectives of community health workers from implementing treatment for schistosomiasis using the community directed intervention strategy in an informal settlement in Kisumu City, western Kenya.

    Science.gov (United States)

    Odhiambo, Gladys O; Musuva, Rosemary M; Odiere, Maurice R; Mwinzi, Pauline N

    2016-09-15

    The Community Directed Intervention (CDI) strategy has been used to conduct various health interventions in Africa, including control of Neglected Tropical Diseases (NTDs). Although the CDI approach has shown good results in the control of onchocerciasis and lymphatic filariasis with respect to treatment coverage using community drug distributors, its utility in the control of schistosomiasis among urban poor is yet to be established. Using a longitudinal qualitative study, we explored the experiences, opportunities, challenges as well as recommendations of Community Health Workers (CHWs) after participation in annual mass drug administration (MDA) activities for schistosomiasis using the CDI approach in an urban setting. Unstructured open-ended group discussions were conducted with CHWs after completion of annual MDA activities. Narratives were obtained from CHWs using a digital audio recorder during the group discussions, transcribed verbatim and translated into English where applicable. Thematic decomposition of data was done using ATLAS.ti. software, and themes explored using the principle of interpretative phenomenological analysis (IPA). From the perspective of the CHWs, opportunities for implementing CDI in urban settings, included the presence of CHWs, their supervisory structures and their knowledge of intervention areas, and opportunity to integrate MDA with other health interventions. Several challenges were mentioned with regards to implementing MDA using the CDI strategy among them lack of incentives, fear of side effects, misconceptions regarding treatment and mistrust, difficulties working in unsanitary environmental conditions, insecurity, and insufficient time. A key recommendation in promoting more effective MDA using the CDI approach was allocation of more time to the exercise. Findings from this study support the feasibility of using CDI for implementing MDA for schistosomiasis in informal settlements of urban areas. Extensive community

  5. Oil market structures-strategies and performances of the actors of the international petroleum system

    International Nuclear Information System (INIS)

    Djermaine, Rebai

    1999-01-01

    The rises of petroleum prices as revealed by the oil crises of the 1970's are the consequences of a beside market perverse game between artificial factors. The public management and the intervention of public authorities have contributed to the unbalancing of oil markets and to the confusion of the actor's strategies in the international petroleum system. The chronical decay of the petroleum prices indicate the slow and silent come back of the economical forces (laws). The management of an exhaustible asset like petroleum, raises lot of intriguing problems. This work aims at exploring the problems linked with this type of management where the decisions of the profession, of private and public companies and of the governments are closely interfering. The study is largely inspired of the meso-economical approach which consists in examining the markets structure and their determining factors, and the strategies and results of the actors of the world petroleum system. The examination of the structures/strategies/results sequence does not neglect the relations and feedbacks between each of these elements. The economical theory of oligopoly and cartel markets is also used to examine the way how prices are determined in petroleum markets. A critical presentation of the energy models allows to show how it is possible to understand, foresee and control the evolution of these prices and the possible supply/demand equilibrium. The study takes also into consideration the debates and controversies about the 'green tax' and its impact of petroleum supply and demand. (J.S.)

  6. Do organic foodservice intervention strategies lead to changes in the availability of healthy options

    DEFF Research Database (Denmark)

    He, Chen; Mikkelsen, Bent Egberg

    2009-01-01

    Obesity and overweight among children and young people is increasing in most countries in Europe and as a result schools are increasingly taking a role in both food provision, in promoting healthy eating, and nutrition education of young people by implementing healthy policies. At the same time s...... Based Questionnaire. The results indicate that there is an association between organic food strategies and the availability of healthy meal options. But further studies are needed in order to understand the nature of this association.......Obesity and overweight among children and young people is increasing in most countries in Europe and as a result schools are increasingly taking a role in both food provision, in promoting healthy eating, and nutrition education of young people by implementing healthy policies. At the same time...... schools are implementing environmental friendly polices i.e. organic procurement strategies (Mu, 2008). It is therefore relevant to investigate the relationship between the different components of such interventions. This study carried out a survey in primary schools in Denmark and Norway through a Web...

  7. Ergonomic design intervention strategy for work tools development for women agro based workers in Northeast India.

    Science.gov (United States)

    Chakrabarti, Debkumar; Bhattachheriya, Nandita

    2012-01-01

    Strategy for finding the appropriate strategy for work tool development has become a crucial issue in occupational wellness of varied nature of women workforce of Northeast India. This paper deals with ergonomics intervention through sustainable work tool design development process. Workers who frequently shift to different activities quite often in unorganised small-scale fruit processing units where productivity is directly related to the harvesting season require different work tools relevant to specific tasks and mostly workers themselves manage work tools of their own with available local resources. Whereas in contrast the tea-leaf pluckers are engaged in a single task throughout the year, and the work schedule and work equipment is decided and supplied to them based on the corporate decision where the workers do not have any individual control. Observations confirm the need for organising participatory workshops specific to trade based occupational well-being and different work tools for different tasks in mostly private owned unorganised sector. Implementation of single variety work tool development that supports a crucial component in tea-leaf plucking for which they are engaged in full time employment; and through a corporate decision a single design with its number of users makes a good effect.

  8. Family violence against children: intervention of nurses from the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Kelianny Pinheiro Bezerra

    2012-06-01

    Full Text Available This study Aimed to analyze the performance of nurses of the Family Health Strategy by facing family violence against children and identifying actions to prevent the problem. It is a descriptive and exploratory research with qualitative feature, whose data were analyzed according to content analysis. 14 nurses from the Family Health Strategy of Mossoró-RN took part in the Study. Data were collected using a semi-structured questionnaire. Health promotion actions are educational activities developed after detecting the problem. Fear of reprisals by the offending agent, work overload, lack of managerial support and the difficulty for the accomplishment of interdisciplinarity, intersectorality and comprehensive care were mentioned as barriers to the confrontation of the problem.

  9. Principles and strategies for monitoring data collection integrity in a multi-site randomized clinical trial of a behavioral intervention.

    Science.gov (United States)

    Phillips-Salimi, Celeste R; Donovan Stickler, Molly A; Stegenga, Kristin; Lee, Melissa; Haase, Joan E

    2011-08-01

    Although treatment fidelity strategies for enhancing the integrity of behavioral interventions have been well described, little has been written about monitoring data collection integrity. This article describes the principles and strategies developed to monitor data collection integrity of the "Stories and Music for Adolescent/Young Adult Resilience During Transplant" study (R01NR008583, U10CA098543, and U10CA095861)-a multi-site Children's Oncology Group randomized clinical trial of a music therapy intervention for adolescents and young adults undergoing stem cell transplant. The principles and strategies outlined in this article provide one model for development and evaluation of a data collection integrity monitoring plan for behavioral interventions that may be adapted by investigators and may be useful to funding agencies and grant application reviewers in evaluating proposals. Copyright © 2011 Wiley Periodicals, Inc.

  10. Comparison of various decentralised structural and cavity feedback control strategies for transmitted noise reduction through a double panel structure

    NARCIS (Netherlands)

    Ho, J.; Berkhoff, Arthur P.

    This paper compares various decentralised control strategies, including structural and acoustic actuator–sensor configuration designs, to reduce noise transmission through a double panel structure. The comparison is based on identical control stability indexes. The double panel structure consists of

  11. Comparison of various decentralised structural and cavity feedback control strategies for transmitted noise reduction through a double panel structure

    NARCIS (Netherlands)

    Ho, J.H.; Berkhoff, A.P.

    2014-01-01

    This paper compares various decentralised control strategies, including structural and acoustic actuator-sensor configuration designs, to reduce noise transmission through a double panel structure. The comparison is based on identical control stability indexes. The double panel structure consists of

  12. A reorientation strategy for reducing delirium in the critically ill. Results of an interventional study.

    Science.gov (United States)

    Colombo, R; Corona, A; Praga, F; Minari, C; Giannotti, C; Castelli, A; Raimondi, F

    2012-09-01

    A wide variability in the approach towards delirium prevention and treatment in the critically ill results from the dearth of prospective randomised studies. We launched a two-stage prospective observational study to assess delirium epidemiology, risk factors and impact on patient outcome, by enrolling all patients admitted to our Intensive Care Unit (ICU) over a year. The first step - from January to June 2008 was the observational phase, whereas the second one from July to December 2008 was interventional. All the patients admitted to our ICU were recruited but those with pre-existing cognitive disorders, dementia, psychosis and disability after stroke were excluded from the data analysis. Delirium assessment was performed according with Confusion Assessment Method for the ICU twice per day after sedation interruption. During phase 2, patients underwent both a re-orientation strategy and environmental, acoustic and visual stimulation. We admitted a total of respectively 170 (I-ph) and 144 patients (II-ph). The delirium occurrence was significantly lower in (II-ph) 22% vs. 35% in (I-ph) (P=0.020). A Cox's Proportional Hazard model found the applied reorientation strategy as the strongest protective predictors of delirium: (HR 0.504, 95% C.I. 0.313-0.890, P=0.034), whereas age (HR 1.034, 95% CI: 1.013-1.056, P=0.001) and sedation with midazolam plus opiate (HR 2.145, 95% CI: 2.247-4.032, P=0.018) were negative predictors. A timely reorientation strategy seems to be correlated with significantly lower occurrence of delirium.

  13. Intervention Strategies Based on Information-Motivation-Behavioral Skills Model for Health Behavior Change: A Systematic Review

    OpenAIRE

    Chang, Sun Ju; Choi, Suyoung; Kim, Se-An; Song, Misoon

    2014-01-01

    Purpose: This study systematically reviewed research on behavioral interventions based on the information-motivation-behavioral skills (IMB) model to investigate specific intervention strategies that focus on information, motivation, and behavioral skills and to evaluate their effectiveness for people with chronic diseases. Methods: A systematic review was conducted in accordance with the guidelines of both the National Evidence-based Healthcare Collaborating Agency and Im and Chang. A lit...

  14. A review of the nature and effectiveness of nutrition interventions in adult males--a guide for intervention strategies.

    Science.gov (United States)

    Taylor, Pennie J; Kolt, Gregory S; Vandelanotte, Corneel; Caperchione, Cristina M; Mummery, W Kerry; George, Emma S; Karunanithi, Mohanraj; Noakes, Manny J

    2013-01-29

    Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1) published from January 1990 to August 2011 and 2) male only studies (≥18 years) or 3) where males contributed to >90% of the active cohort. A study must have described, (i) a significant change (pstudies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg) and/or BMI (kg/m2) changes (p≤0.05). Four studies had effective interventions (pself-monitoring and tailored feedback. Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to guide researchers in making informed decisions on how to best utilise resources in interventions to engage adult males while highlighting the need for improved reporting of intervention protocols.

  15. The process flow and structure of an integrated stroke strategy

    Directory of Open Access Journals (Sweden)

    Emma F. van Bussel

    2013-06-01

    Full Text Available Introduction: In the Canadian province of Alberta access and quality of stroke care were suboptimal, especially in remote areas. The government introduced the Alberta Provincial Stroke Strategy (APSS in 2005, an integrated strategy to improve access to stroke care, quality and efficiency which utilizes telehealth. Research question: What is the process flow and the structure of the care pathways of the APSS? Methodology: Information for this article was obtained using documentation, archival APSS records, interviews with experts, direct observation and participant observation. Results: The process flow is described. The APSS integrated evidence-based practice, multidisciplinary communication, and telestroke services. It includes regular quality evaluation and improvement. Conclusion: Access, efficiency and quality of care improved since the start of the APSS across many domains, through improvement of expertise and equipment in small hospitals, accessible consultation of stroke specialists using telestroke, enhancing preventive care, enhancing multidisciplinary collaboration, introducing uniform best practice protocols and bypass-protocols for the emergency medical services. Discussion: The APSS overcame substantial obstacles to decrease discrepancies and to deliver integrated higher quality care. Telestroke has proven itself to be safe and feasible. The APSS works efficiently, which is in line to other projects worldwide, and is, based on limited results, cost effective. Further research on cost-effectiveness is necessary.

  16. A systematic review and meta-analysis of workplace intervention strategies to reduce sedentary time in white-collar workers.

    Science.gov (United States)

    Chu, A H Y; Ng, S H X; Tan, C S; Win, A M; Koh, D; Müller-Riemenschneider, F

    2016-05-01

    Prolonged sedentary behaviour has been associated with various detrimental health risks. Workplace sitting is particularly important, providing it occupies majority of total daily sedentary behaviour among desk-based employees. The aim of this systematic review and meta-analysis was to examine the effectiveness of workplace interventions overall, and according to different intervention strategies (educational/behavioural, environmental and multi-component interventions) for reducing sitting among white-collar working adults. Articles published through December 2015 were identified in five online databases and manual searches. Twenty-six controlled intervention studies published between 2003 and 2015 of 4568 working adults were included. All 26 studies were presented qualitatively, and 21 studies with a control group without any intervention were included in the meta-analysis. The pooled intervention effect showed a significant workplace sitting reduction of -39.6 min/8-h workday (95% confidence interval [CI]: -51.7, -27.5), favouring the intervention group. Multi-component interventions reported the greatest workplace sitting reduction (-88.8 min/8-h workday; 95% CI: -132.7, -44.9), followed by environmental (-72.8 min/8-h workday; 95% CI: -104.9, -40.6) and educational/behavioural strategies -15.5 min/8-h workday (95% CI:-22.9,-8.2). Our study found consistent evidence for intervention effectiveness in reducing workplace sitting, particularly for multi-component and environmental strategies. Methodologically rigorous studies using standardized and objectively determined outcomes are warranted. © 2016 World Obesity. © 2016 World Obesity.

  17. Reframing measurement for structural health monitoring: a full-field strategy for structural identification

    Science.gov (United States)

    Dizaji, Mehrdad S.; Harris, Devin K.; Alipour, Mohamad; Ozbulut, Osman E.

    2018-03-01

    Structural health monitoring (SHM) describes a decision-making framework that is fundamentally guided by state change detection of structural systems. This framework typically relies on the use of continuous or semi-continuous monitoring of measured response to quantify this state change in structural system behavior, which is often related to the initiation of some form of damage. Measurement approaches used for traditional SHM are numerous, but most are limited to either describing localized or global phenomena, making it challenging to characterize operational structural systems which exhibit both. In addition to these limitations in sensing, SHM has also suffered from the inherent robustness inherent to most full-scale structural systems, making it challenging to identify local damage. These challenges highlight the opportunity for alternative strategies for SHM, strategies that are able to provide data suitable to translate into rich information. This paper describes preliminary results from a refined structural identification (St-ID) approach using fullfield measurements derived from high-speed 3D Digital Image Correlation (HSDIC) to characterize uncertain parameters (i.e. boundary and constitutive properties) of a laboratory scale structural component. The St-ID approach builds from prior work by supplementing full-field deflection and strain response with vibration response derived from HSDIC. Inclusion of the modal characteristics within a hybrid-genetic algorithm optimization scheme allowed for simultaneous integration of mechanical and modal response, thus enabling a more robust St-ID strategy than could be achieved with traditional sensing techniques. The use of full-field data is shown to provide a more comprehensive representation of the global and local behavior, which in turn increases the robustness of the St-Id framework. This work serves as the foundation for a new paradigm in SHM that emphasizes characterizing structural performance using a

  18. Reactome diagram viewer: data structures and strategies to boost performance.

    Science.gov (United States)

    Fabregat, Antonio; Sidiropoulos, Konstantinos; Viteri, Guilherme; Marin-Garcia, Pablo; Ping, Peipei; Stein, Lincoln; D'Eustachio, Peter; Hermjakob, Henning

    2018-04-01

    Reactome is a free, open-source, open-data, curated and peer-reviewed knowledgebase of biomolecular pathways. For web-based pathway visualization, Reactome uses a custom pathway diagram viewer that has been evolved over the past years. Here, we present comprehensive enhancements in usability and performance based on extensive usability testing sessions and technology developments, aiming to optimize the viewer towards the needs of the community. The pathway diagram viewer version 3 achieves consistently better performance, loading and rendering of 97% of the diagrams in Reactome in less than 1 s. Combining the multi-layer html5 canvas strategy with a space partitioning data structure minimizes CPU workload, enabling the introduction of new features that further enhance user experience. Through the use of highly optimized data structures and algorithms, Reactome has boosted the performance and usability of the new pathway diagram viewer, providing a robust, scalable and easy-to-integrate solution to pathway visualization. As graph-based visualization of complex data is a frequent challenge in bioinformatics, many of the individual strategies presented here are applicable to a wide range of web-based bioinformatics resources. Reactome is available online at: https://reactome.org. The diagram viewer is part of the Reactome pathway browser (https://reactome.org/PathwayBrowser/) and also available as a stand-alone widget at: https://reactome.org/dev/diagram/. The source code is freely available at: https://github.com/reactome-pwp/diagram. fabregat@ebi.ac.uk or hhe@ebi.ac.uk. Supplementary data are available at Bioinformatics online.

  19. Effective intervention strategies to improve health outcomes for cardiovascular disease patients with low health literacy skills: a systematic review.

    Science.gov (United States)

    Lee, Tae Wha; Lee, Seon Heui; Kim, Hye Hyun; Kang, Soo Jin

    2012-12-01

    Systematic studies on the relationship between health literacy and health outcomes demonstrate that as health literacy declines, patients engage in fewer preventive health and self-care behaviors and have worse disease-related knowledge. The purpose of this study was to identify effective intervention strategies to improve health outcomes in patients with cardiovascular disease and low literacy skills. This study employs the following criteria recommended by Khan Kunz, Keijnen, and Antes (2003) for systematic review: framing question, identifying relevant literature, assessing quality of the literature, summarizing the evidence, and interpreting the finding. A total of 235 articles were reviewed by the research team, and 9 articles met inclusion criteria. Although nine studies were reviewed for their health outcomes, only six studies, which had a positive quality grade evaluation were used to recommend effective intervention strategies. Interventions were categorized into three groups: tailored counseling, self-monitoring, and periodic reminder. The main strategies used to improve health outcomes of low literacy patients included tailored counseling, improved provider-patient interactions, organizing information by patient preference, self-care algorithms, and self-directed learning. Specific strategies included written materials tailored to appropriate reading levels, materials using plain language, emphasizing key points with large font size, and using visual items such as icons or color codes. With evidence-driven strategies, health care professionals can use tailored interventions to provide better health education and counseling that meets patient needs and improves health outcomes. Copyright © 2012. Published by Elsevier B.V.

  20. The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention

    Science.gov (United States)

    2013-01-01

    Background The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. Methods The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants’ characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. Results A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. Conclusions With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle

  1. The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention.

    Science.gov (United States)

    Schneider, Francine; Schulz, Daniela N; Pouwels, Loes H L; de Vries, Hein; van Osch, Liesbeth A D M

    2013-08-05

    The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants' characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle intervention, the employed proactive

  2. A review of the nature and effectiveness of nutrition interventions in adult males – a guide for intervention strategies

    Directory of Open Access Journals (Sweden)

    Taylor Pennie J

    2013-01-01

    Full Text Available Abstract Background Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. Methods A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1 published from January 1990 to August 2011 and 2 male only studies (≥18 years or 3 where males contributed to >90% of the active cohort. A study must have described, (i a significant change (p Results Nine studies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg and/or BMI (kg/m2 changes (p≤0.05. Four studies had effective interventions (p Intervention features, which appeared to be associated with better outcomes, include the delivery of quantitative information on diet and the use of self-monitoring and tailored feedback. Conclusion Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to

  3. How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults.

    Science.gov (United States)

    Gardner, Benjamin; Smith, Lee; Lorencatto, Fabiana; Hamer, Mark; Biddle, Stuart J H

    2016-01-01

    Sedentary behaviour - i.e., low energy-expending waking behaviour while seated or lying down - is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as 'very promising', 'quite promising', or 'non-promising' according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed.

  4. How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults

    Science.gov (United States)

    Gardner, Benjamin; Smith, Lee; Lorencatto, Fabiana; Hamer, Mark; Biddle, Stuart JH

    2016-01-01

    Sedentary behaviour – i.e., low energy-expending waking behaviour while seated or lying down – is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as ‘very promising’, ‘quite promising’, or ‘non-promising’ according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed. PMID:26315814

  5. A strategy to find minimal energy nanocluster structures.

    Science.gov (United States)

    Rogan, José; Varas, Alejandro; Valdivia, Juan Alejandro; Kiwi, Miguel

    2013-11-05

    An unbiased strategy to search for the global and local minimal energy structures of free standing nanoclusters is presented. Our objectives are twofold: to find a diverse set of low lying local minima, as well as the global minimum. To do so, we use massively the fast inertial relaxation engine algorithm as an efficient local minimizer. This procedure turns out to be quite efficient to reach the global minimum, and also most of the local minima. We test the method with the Lennard-Jones (LJ) potential, for which an abundant literature does exist, and obtain novel results, which include a new local minimum for LJ13 , 10 new local minima for LJ14 , and thousands of new local minima for 15≤N≤65. Insights on how to choose the initial configurations, analyzing the effectiveness of the method in reaching low-energy structures, including the global minimum, are developed as a function of the number of atoms of the cluster. Also, a novel characterization of the potential energy surface, analyzing properties of the local minima basins, is provided. The procedure constitutes a promising tool to generate a diverse set of cluster conformations, both two- and three-dimensional, that can be used as an input for refinement by means of ab initio methods. Copyright © 2013 Wiley Periodicals, Inc.

  6. Combined Home and School Obesity Prevention Interventions for Children: What Behavior Change Strategies and Intervention Characteristics Are Associated with Effectiveness?

    Science.gov (United States)

    Hendrie, Gilly A.; Brindal, Emily; Corsini, Nadia; Gardner, Claire; Baird, Danielle; Golley, Rebecca K.

    2012-01-01

    This review identifies studies describing interventions delivered across both the home and school/community setting, which target obesity and weight-related nutrition and physical activity behaviors in children. Fifteen studies, published between 1998 and 2010, were included and evaluated for effectiveness, study quality, nutrition/activity…

  7. Using Intervention Mapping as a Participatory Strategy: Development of a Cervical Cancer Screening Intervention for Hispanic Women

    Science.gov (United States)

    Byrd, Theresa L.; Wilson, Katherine M.; Smith, Judith Lee; Heckert, Andrea; Orians, Carlyn E.; Vernon, Sally W.; Fernandez-Esquer, Maria E.; Fernandez, Maria E.

    2012-01-01

    Cervical cancer is preventable with treatment of precancerous lesions and treatable at early stages. Hispanics have higher rates of cervical cancer and lower rates of screening. "Ayndando a las Mujeres con Informaccion, Guia, y Amor para su Salud" (AMIGAS) is an intervention to increase cervical cancer screening in U.S. women of Mexican…

  8. Thinking about the environment and theorising change: how could Life History Strategy Theory inform mHealth interventions in low- and middle-income countries?

    Science.gov (United States)

    Morgan, Barak; Hunt, Xanthe; Tomlinson, Mark

    2017-01-01

    There is a growing body of literature outlining the promise of mobile information and communication technologies to improve healthcare in resource-constrained contexts. We reviewed the literature related to mobile information and communication technologies which aim to improve healthcare in resource-constrained contexts, in order to glean general observations regarding the state of mHealth in high-income countries (HIC) and low- and middle-income countries (LMIC). mHealth interventions in LMIC often differ substantively from those in HIC, with the former being simpler, delivered through a single digital component (an SMS as opposed to a mobile phone application, or 'app'), and, as a result, targeting only one of the many factors which impact on the activation (or deactivation) of the target behaviour. Almost as a rule, LMIC mHealth interventions lack an explicit theory of change. We highlight the necessity, when designing mHealth interventions, of having a theory of change that encompasses multiple salient perspectives pertaining to human behaviour. To address this need, we explore whether the concept of Life History Strategy could provide the mHealth field with a useful theory of change. Life History Strategy Theory may be particularly useful in understanding some of the problems, paradoxes, and limitations of mHealth interventions found in LMIC. Specifically, this theory illuminates questions regarding 'light-weight' programmes which solely provide information, reminders, and other virtual 'nudges' that may have limited impact on behaviours governed by extrinsic structural factors.

  9. Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention.

    Science.gov (United States)

    Picon-Ruiz, Manuel; Morata-Tarifa, Cynthia; Valle-Goffin, Janeiro J; Friedman, Eitan R; Slingerland, Joyce M

    2017-09-01

    incorporation of weight loss intervention strategies into care for patients with breast cancer. CA Cancer J Clin 2017;67:378-397. © 2017 American Cancer Society. © 2017 The Authors. CA A Cancer Journal for Clinicians published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  10. The evaluation of complex interventions in palliative care: an exploration of the potential of case study research strategies.

    Science.gov (United States)

    Walshe, Catherine

    2011-12-01

    Complex, incrementally changing, context dependent and variable palliative care services are difficult to evaluate. Case study research strategies may have potential to contribute to evaluating such complex interventions, and to develop this field of evaluation research. This paper explores definitions of case study (as a unit of study, a process, and a product) and examines the features of case study research strategies which are thought to confer benefits for the evaluation of complex interventions in palliative care settings. Ten features of case study that are thought to be beneficial in evaluating complex interventions in palliative care are discussed, drawing from exemplars of research in this field. Important features are related to a longitudinal approach, triangulation, purposive instance selection, comprehensive approach, multiple data sources, flexibility, concurrent data collection and analysis, search for proving-disproving evidence, pattern matching techniques and an engaging narrative. The limitations of case study approaches are discussed including the potential for subjectivity and their complex, time consuming and potentially expensive nature. Case study research strategies have great potential in evaluating complex interventions in palliative care settings. Three key features need to be exploited to develop this field: case selection, longitudinal designs, and the use of rival hypotheses. In particular, case study should be used in situations where there is interplay and interdependency between the intervention and its context, such that it is difficult to define or find relevant comparisons.

  11. Diagnostic strategy and timing of intervention in infected necrotizing pancreatitis: an international expert survey and case vignette study

    NARCIS (Netherlands)

    van Grinsven, J. (Janneke); S. van Brunschot (Sandra); P. Fockens (Paul); J. van Grinsven (Janneke); O.J. Bakker (Olaf ); van Santvoort, H.C. (Hjalmar C.); T.L. Bollen (Thomas); M.A. Boermeester (Marja); C.H.J. van Eijck (Casper); M.G. Besselink (Marc); M.J. Bruno (Marco); C.H. Dejong (Cees); K.D. Horvath (Karen); van Eijck, C.H. (Casper H.); H. van Goor (Harry); H.G. Gooszen (Hein); Horvath, K.D. (Karen D.); K.P. van Lienden (Krijn); Abdelhafez, M.; Andersson, R.; Andren-Sandberg, A.; Ashley, S.; M.C. van Baal (Mark); Baron, T.; C. Bassi (Claudio); Bradley, E.; M.W. Buchler (M.); V.C. Cappendijk; Carter, R.; Charnley, R.; Coelho, D.; Connor, S.; Dellinger, P.; C. Dervenis (Christos); J. Devière (J.); Doctor, N.; Dudeja, V.; En-qiang, M.; Escourrou, J.; Fagenholz, P.; Farkas, G.; Forsmark, C.; Freeman, M.; P.C. Freeny (Patrick); French, J.; H. Friess; Gardner, T.; Goetzinger, P.; J.W. Haveman; S. Hofker (Sijbrand); Imrie, C.; Isaji, S.; Isenmann, R.; E. Klar (Ernst); J.S. Laméris (Johan ); M. Lerch (M.); P. Lévy (Philippe); Lillemoe, K.; Löhr, M.; J. Mayerle (Julia); Mayumi, T.; Mittal, A.; Moessner, J.; Morgan, D.; K.J. Mortele (Koenraad); Nealon, W.; J.P. Neoptolemos (John); V.B. Nieuwenhuijs (Vincent); Nordback, I.; Olah, A.; K. Oppong (K.); Padbury, R.; Papachristou, G.; Parks, R.; J.-W. Poley (Jan-Werner); Radenkovic, D.; Raraty, M.; Rau, B.; V. Rebours (Vinciane); Rische, S.; Runzi, M.; Sainani, N.; Sarr, M.; Schaapherder, S.; S. Seewald (Stefan); Seifert, H.; Shimosegawa, T.; Silverman, S.; Singh, V.; Siriwardena, A.; Steinberg, W.; Sutton, R.; Takeda, K.; R. Timmer (Robin); Vege, S.; R.P. Voermans (Rogier); J.J. De Waele (Jan J.); Wang, C. (Ch.); Warshaw, A.; J. Werner (Jens Martin); B.L. Weusten (Bas); Whitcomb, D.; Wig, J.; Windsor, J.; Zyromski, N.

    2016-01-01

    textabstractBackground The optimal diagnostic strategy and timing of intervention in infected necrotizing pancreatitis is subject to debate. We performed a survey on these topics amongst a group of international expert pancreatologists. Methods An online survey including case vignettes was sent to

  12. Consumer Acceptance of Population-Level Intervention Strategies for Healthy Food Choices: The Role of Perceived Effectiveness and Perceived Fairness

    NARCIS (Netherlands)

    Bos, C.; Lans, van der I.A.; Rijnsoever, F.J.; Trijp, van J.C.M.

    2015-01-01

    The present study investigates acceptance of intervention strategies for low-calorie snack choices that vary regarding the effect they have on consumers’ freedom of choice (providing information, guiding choice through (dis)incentives, and restricting choice). We examine the mediating effects of

  13. Primary Percutaneous Coronary Intervention as a National Reperfusion Strategy in Patients With ST-Segment Elevation Myocardial Infarction

    DEFF Research Database (Denmark)

    Terkelsen, Christian J; Jensen, Lisette O; Hansen, Hans-Henrik Tilsted

    2011-01-01

    In Denmark, primary percutaneous coronary intervention (PPCI) was chosen as a national reperfusion strategy for patients with ST-segment elevation myocardial infarction in 2003. This study describes the temporal implementation of PPCI in Western Denmark, the gradual introduction of field triage...

  14. Pre- and postharvest preventive measures and intervention strategies to control microbial food safety hazards of fresh leafy vegetables.

    Science.gov (United States)

    Gil, Maria I; Selma, Maria V; Suslow, Trevor; Jacxsens, Liesbeth; Uyttendaele, Mieke; Allende, Ana

    2015-01-01

    This review includes an overview of the most important preventive measures along the farm to fork chain to prevent microbial contamination of leafy greens. It also includes the technological and managerial interventions related to primary production, postharvest handling, processing practices, distribution, and consumer handling to eliminate pathogens in leafy greens. When the microbiological risk is already present, preventive measures to limit actual contamination events or pathogen survival are considered intervention strategies. In codes of practice the focus is mainly put on explaining preventive measures. However, it is also important to establish more focused intervention strategies. This review is centered mainly on leafy vegetables as the commodity identified as the highest priority in terms of fresh produce microbial safety from a global perspective. There is no unique preventive measure or intervention strategy that could be applied at one point of the food chain. We should encourage growers of leafy greens to establish procedures based on the HACCP principles at the level of primary production. The traceability of leafy vegetables along the chain is an essential element in ensuring food safety. Thus, in dealing with the food safety issues associated with fresh produce it is clear that a multidisciplinary farm to fork strategy is required.

  15. Bridging Research and Practice: Challenges and Successes in Implementing Evidence-Based Preventive Intervention Strategies for Child Maltreatment

    Science.gov (United States)

    Toth, Sheree L.; Manly, Jody Todd

    2011-01-01

    Child maltreatment has been associated with a wide range of negative developmental outcomes for children and families as well as significant economic consequences. While efficacious intervention strategies have been demonstrated to reduce symptoms of trauma and to improve behavioral and emotional functioning, these models have not been widely…

  16. Intervention strategies to eliminate truck-related fatalities in surface coal mining in West Virginia.

    Science.gov (United States)

    Zhang, Meng; Kecojevic, Vladislav

    2016-01-01

    The main objective of this review was to build upon a previous study on the root causes of truck-related fatalities in surface coal mining operations in West Virginia, and to develop intervention strategies to eliminate these fatalities. This review considers a two-pronged approach to accident prevention: one that is fundamental and traditional (safety regulations, training and education, and engineering of the work environment); and one that is innovative and creative (e.g., applying technological advances to better control and eliminate the root causes of accidents). Suggestions for improving current training and education system are proposed, and recommendations are provided on improving the safety of mine working conditions, specifically safety conditions on haul roads, dump sites, and loading areas. We also discuss various currently available technologies that can help prevent haul truck-related fatal accidents. The results of this review should be used by mine personnel to help create safer working conditions and decrease truck-related fatalities in surface coal mining.

  17. Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study.

    Science.gov (United States)

    Ajayi, Ikeoluwapo O; Jegede, Ayodele S; Falade, Catherine O; Sommerfeld, Johannes

    2013-10-24

    Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria. A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data. Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was

  18. Current Trends in Exercise Intervention Research, Technology, and Behavioral Change Strategies for People With Disabilities: A Scoping Review.

    Science.gov (United States)

    Lai, Byron; Young, Hui-Ju; Bickel, C Scott; Motl, Robert W; Rimmer, James H

    2017-10-01

    This review synthesized physical activity and exercise intervention literature for the past 10 yrs for people with physical and cognitive disabilities including intervention characteristics, behavior change strategies, and types of technologies used to improve targeted outcomes. Systematic searches yielded 132 eligible studies. The major disability groups were multiple sclerosis (41%), stroke (15%), and spinal cord injury (12%). Research designs primarily involved randomized controlled trials (61%) versus quasi-experimental designs (39%). Approximately 20% of the interventions used some form of the following technology: information and communication technology (48%), interactive technology (37%), or electronic gauges (30%). Eighteen percent of studies used intervention strategies based on behavioral theory, which was typically combined with technology to promote activity and increase adherence in generally larger study samples. The three prevailing theories included social cognitive theory (58%), supportive accountability theory (21%), and transtheoretical model (21%). Upon completing the intervention, studies reported primarily significant outcomes (80%). Exercise research for PWD has grown in both quantity and quality, but several gaps remain. Study findings provide a roadmap for future exercise trials on understudied populations and highlight technology and behavior change theory as drivers of future intervention research.

  19. The design of a real-time formative evaluation of the implementation process of lifestyle interventions at two worksites using a 7-step strategy (BRAVO@Work).

    Science.gov (United States)

    Wierenga, Debbie; Engbers, Luuk H; van Empelen, Pepijn; Hildebrandt, Vincent H; van Mechelen, Willem

    2012-08-07

    Worksite health promotion programs (WHPPs) offer an attractive opportunity to improve the lifestyle of employees. Nevertheless, broad scale and successful implementation of WHPPs in daily practice often fails. In the present study, called BRAVO@Work, a 7-step implementation strategy was used to develop, implement and embed a WHPP in two different worksites with a focus on multiple lifestyle interventions.This article describes the design and framework for the formative evaluation of this 7-step strategy under real-time conditions by an embedded scientist with the purpose to gain insight into whether this this 7-step strategy is a useful and effective implementation strategy. Furthermore, we aim to gain insight into factors that either facilitate or hamper the implementation process, the quality of the implemented lifestyle interventions and the degree of adoption, implementation and continuation of these interventions. This study is a formative evaluation within two different worksites with an embedded scientist on site to continuously monitor the implementation process. Each worksite (i.e. a University of Applied Sciences and an Academic Hospital) will assign a participating faculty or a department, to implement a WHPP focusing on lifestyle interventions using the 7-step strategy. The primary focus will be to describe the natural course of development, implementation and maintenance of a WHPP by studying [a] the use and adherence to the 7-step strategy, [b] barriers and facilitators that influence the natural course of adoption, implementation and maintenance, and [c] the implementation process of the lifestyle interventions. All data will be collected using qualitative (i.e. real-time monitoring and semi-structured interviews) and quantitative methods (i.e. process evaluation questionnaires) applying data triangulation. Except for the real-time monitoring, the data collection will take place at baseline and after 6, 12 and 18 months. This is one of the few

  20. The design of a real-time formative evaluation of the implementation process of lifestyle interventions at two worksites using a 7-step strategy (BRAVO@Work

    Directory of Open Access Journals (Sweden)

    Wierenga Debbie

    2012-08-01

    Full Text Available Abstract Background Worksite health promotion programs (WHPPs offer an attractive opportunity to improve the lifestyle of employees. Nevertheless, broad scale and successful implementation of WHPPs in daily practice often fails. In the present study, called BRAVO@Work, a 7-step implementation strategy was used to develop, implement and embed a WHPP in two different worksites with a focus on multiple lifestyle interventions. This article describes the design and framework for the formative evaluation of this 7-step strategy under real-time conditions by an embedded scientist with the purpose to gain insight into whether this this 7-step strategy is a useful and effective implementation strategy. Furthermore, we aim to gain insight into factors that either facilitate or hamper the implementation process, the quality of the implemented lifestyle interventions and the degree of adoption, implementation and continuation of these interventions. Methods and design This study is a formative evaluation within two different worksites with an embedded scientist on site to continuously monitor the implementation process. Each worksite (i.e. a University of Applied Sciences and an Academic Hospital will assign a participating faculty or a department, to implement a WHPP focusing on lifestyle interventions using the 7-step strategy. The primary focus will be to describe the natural course of development, implementation and maintenance of a WHPP by studying [a] the use and adherence to the 7-step strategy, [b] barriers and facilitators that influence the natural course of adoption, implementation and maintenance, and [c] the implementation process of the lifestyle interventions. All data will be collected using qualitative (i.e. real-time monitoring and semi-structured interviews and quantitative methods (i.e. process evaluation questionnaires applying data triangulation. Except for the real-time monitoring, the data collection will take place at baseline and

  1. Enhancing Documentation of Pressure Ulcer Prevention Interventions: A Quality Improvement Strategy to Reduce Pressure Ulcers.

    Science.gov (United States)

    Jacobson, Therese M; Thompson, Susan L; Halvorson, Anna M; Zeitler, Kristine

    2016-01-01

    Prevention of hospital-acquired pressure ulcers requires the implementation of evidence-based interventions. A quality improvement project was conducted to provide nurses with data on the frequency with which pressure ulcer prevention interventions were performed as measured by documentation. Documentation reports provided feedback to stakeholders, triggering reminders and reeducation. Intervention reports and modifications to the documentation system were effective both in increasing the documentation of pressure ulcer prevention interventions and in decreasing the number of avoidable hospital-acquired pressure ulcers.

  2. A strategy to compute plastic post-buckling of structures

    International Nuclear Information System (INIS)

    Combescure, A.

    1983-01-01

    All the methods presented here give in some cases, some interesting computed solutions. It has been remarked that the different strategies do not always give the same post buckling path. More foundamentally, it has been observed that the post buckling path, when buckling is unstable, is characterized by a dynamic movement. All inertial effects are neglected in all the approaches presented here. So that the post buckling load deflections curve is valid only if there is a very little kinetic energy associated with the post buckling. The method is also, as it is presented, limited to a load depending of a simple parameter lambda. The case of more than one parameter is not very clear yet. In conclusion, the method presented here gives a way to solve class of the post buckling behavior of a structure. If the post buckling occurs with a small kinetic energy (displacement controlled buckling) and if the loads depend of only one parameter. These methods should give good results even into the plastic range. If the buckling is unstable and that a large kinetic energy is involved with the post buckling these methods are not realistic. (orig./RW)

  3. The Optimal Ordering Strategy of Outsourcing Procurement of Health Education and Behavior Intervention Products

    Science.gov (United States)

    Zhou, Kai-Ge; Wu, Zhi-Fan; Sun, Xiao-Sheng

    2017-01-01

    Health communication and behavior intervention are main measures adopted in health education. Behavior intervention among these measures is the direct one to affect individual and group behaviors. Patients demand more than health information communication, but rely on health intervention service and related products. This essay starts from…

  4. A systematic review investigating healthy lifestyle interventions incorporating goal setting strategies for preventing excess gestational weight gain.

    Directory of Open Access Journals (Sweden)

    Mary Jane Brown

    Full Text Available BACKGROUND: Excess gestational weight gain (GWG is an important risk factor for long term obesity in women. However, current interventions aimed at preventing excess GWG appear to have a limited effect. Several studies have highlighted the importance of linking theory with empirical evidence for producing effective interventions for behaviour change. Theorists have demonstrated that goals can be an important source of human motivation and goal setting has shown promise in promoting diet and physical activity behaviour change within non-pregnant individuals. The use of goal setting as a behaviour change strategy has been systematically evaluated within overweight and obese individuals, yet its use within pregnancy has not yet been systematically explored. AIM OF REVIEW: To explore the use of goal setting within healthy lifestyle interventions for the prevention of excess GWG. DATA COLLECTION AND ANALYSIS: Searches were conducted in seven databases alongside hand searching of relevant journals and citation tracking. Studies were included if interventions used goal setting alongside modification of diet and/or physical activity with an aim to prevent excess GWG. The PRISMA guidelines were followed and a two-stage methodological approach was used. Stage one focused on systematically evaluating the methodological quality of included interventions. The second stage assessed intervention integrity and the implementation of key goal setting components. FINDINGS: From a total of 839 citations, 54 full-text articles were assessed for eligibility and 5 studies met the inclusion criteria. Among interventions reporting positive results a combination of individualised diet and physical activity goals, self-monitoring and performance feedback indicators were described as active components. CONCLUSION: Interventions based on goal setting appear to be useful for helping women achieve optimal weight gain during pregnancy. However, overweight and obese women may

  5. A systematic review investigating healthy lifestyle interventions incorporating goal setting strategies for preventing excess gestational weight gain.

    Science.gov (United States)

    Brown, Mary Jane; Sinclair, Marlene; Liddle, Dianne; Hill, Alyson J; Madden, Elaine; Stockdale, Janine

    2012-01-01

    Excess gestational weight gain (GWG) is an important risk factor for long term obesity in women. However, current interventions aimed at preventing excess GWG appear to have a limited effect. Several studies have highlighted the importance of linking theory with empirical evidence for producing effective interventions for behaviour change. Theorists have demonstrated that goals can be an important source of human motivation and goal setting has shown promise in promoting diet and physical activity behaviour change within non-pregnant individuals. The use of goal setting as a behaviour change strategy has been systematically evaluated within overweight and obese individuals, yet its use within pregnancy has not yet been systematically explored. To explore the use of goal setting within healthy lifestyle interventions for the prevention of excess GWG. Searches were conducted in seven databases alongside hand searching of relevant journals and citation tracking. Studies were included if interventions used goal setting alongside modification of diet and/or physical activity with an aim to prevent excess GWG. The PRISMA guidelines were followed and a two-stage methodological approach was used. Stage one focused on systematically evaluating the methodological quality of included interventions. The second stage assessed intervention integrity and the implementation of key goal setting components. From a total of 839 citations, 54 full-text articles were assessed for eligibility and 5 studies met the inclusion criteria. Among interventions reporting positive results a combination of individualised diet and physical activity goals, self-monitoring and performance feedback indicators were described as active components. Interventions based on goal setting appear to be useful for helping women achieve optimal weight gain during pregnancy. However, overweight and obese women may require more theoretically-designed interventions. Further high quality, theoretically

  6. Substituting sugar confectionery with fruit and healthy snacks at checkout – a win-win strategy for consumers and food stores? a study on consumer attitudes and sales effects of a healthy supermarket intervention

    Directory of Open Access Journals (Sweden)

    Lise L. Winkler

    2016-11-01

    Full Text Available Abstract Background The widespread use of in-store marketing strategies to induce unhealthy impulsive purchases has implications for shopping experience, food choice and possibly adverse health outcomes. The aim of this study was to examine consumer attitudes and evaluate sales effects of a healthy checkout supermarket intervention. The study was part of Project Sundhed & Lokalsamfund (Project SoL; a Danish participatory community-based health promotion intervention. Methods Consumer attitudes towards unhealthy snack exposure in supermarkets were examined in a qualitative pre-intervention study (29 short in-store interviews, 11 semi-structured interviews and three focus group interviews. Findings were presented to food retailers and informed the decision to test a healthy checkout intervention. Sugar confectionery at one checkout counter was substituted with fruit and healthy snacking items in four stores for 4 weeks. The intervention was evaluated by 48 short exit interviews on consumer perceptions of the intervention and by linear mixed model analyses of supermarket sales data from the intervention area and a matched control area. Results The qualitative pre-intervention study identified consumer concern and annoyance with placement and promotion of unhealthy snacks in local stores. Store managers were willing to respond to local consumer concern and a healthy checkout intervention was therefore implemented. Exit interviews found positive attitudes towards the intervention, while intervention awareness was modest. Most participants believed that the intervention could help other consumers make healthier choices, while fewer expected to be influenced by the intervention themselves. Statistical analyses suggested an intervention effect on sales of carrot snack packs when compared with sales before the intervention in Bornholm control stores (P < 0.05. No significant intervention effect on sales of other intervention items or sugar

  7. Financing structural interventions: going beyond HIV-only value for money assessments.

    Science.gov (United States)

    Remme, Michelle; Vassall, Anna; Lutz, Brian; Luna, Jorge; Watts, Charlotte

    2014-01-28

    Structural interventions can reduce HIV vulnerability. However, HIV-specific budgeting, based on HIV-specific outcomes alone, could lead to the undervaluation of investments in such interventions and suboptimal resource allocation. We investigate this hypothesis by examining the consequences of alternative financing approaches. We compare three approaches for deciding whether to finance a structural intervention to keep adolescent girls in school in Malawi. In the first, HIV and non-HIV budget holders participate in a cross-sectoral cost-benefit analysis and fund the intervention if the benefits outweigh the costs. In the second silo approach, each budget holder considers the cost-effectiveness of the intervention in terms of their own objectives and funds the intervention on the basis of their sector-specific thresholds of what is cost-effective or not. In the third cofinancing approach, budget holders use cost-effectiveness analysis to determine how much they would be willing to contribute towards the intervention, provided that other sectors are willing to pay for the remaining costs. In addition, we explore approaches for determining the HIV share in the cofinancing scenario. We find that efficient structural interventions may be less likely to be prioritized, financed and taken to scale where sectors evaluate their options in isolation. A cofinancing approach minimizes welfare loss and could be incorporated in a sector budgeting perspective. Structural interventions may be underimplemented and their cross-sectoral benefits foregone. Cofinancing provides an opportunity for multiple HIV, health and development objectives to be achieved simultaneously, but will require effective cross-sectoral coordination mechanisms for planning, implementation and financing.

  8. Dissemination strategies and adherence predictors for web-based interventions-how efficient are patient education sessions and email reminders?

    Science.gov (United States)

    Schweier, R; Romppel, M; Richter, C; Grande, G

    2016-06-01

    The Internet offers the potential to efficaciously deliver health interventions at a low cost and with a low threshold across any distance. However, since many web-based interventions are confronted with low use and adherence, proactive dissemination strategies are needed. We, therefore, tested the efficacy of a 1-h patient education session as part of a rehabilitation program and an email reminder 4 weeks later on the publicity and use of a web-based intervention aimed at lifestyle changes in patients with either coronary heart disease or chronic back pain (CBP) and examined adherence predictors. The website www.lebensstil-aendern.de is a cost-free, German-language website providing more than 1000 patient narratives about successful lifestyle changes. To test the efficacy of the dissemination strategies and to examine adherence predictors, we conducted a sequential controlled trial with heart and CBP patients recruited from German inpatient rehabilitation centers. The dissemination strategies were found to be efficient. Use rates, however, remained low. The email reminder and internal health locus of control emerged as notable factors in motivating patients to participate in the web-based intervention. Other factors that have been suggested to be related to nonuse, e.g. sociodemographic characteristics and medical condition, did not predict use or adherence. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  9. Intervention strategies for energy efficient municipal buildings: Influencing energy decisions throughout buildings` lifetimes

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    The current energy-related decisionmaking processes that take place during the lifetimes of municipal buildings in San Francisco do not reflect our ideal picture of energy efficiency as a part of staff awareness and standard practice. Two key problems that undermine the success of energy efficiency programs are lost opportunities and incomplete actions. These problems can be caused by technology-related issues, but often the causes are institutional barriers (organizational or procedural {open_quotes}people problems{close_quotes}). Energy efficient decisions are not being made because of a lack of awareness or policy mandate, or because financial resources are not available to decisionmakers. The Bureau of Energy Conservation (BEC) is working to solve such problems in the City & County of San Francisco through the Intervention Strategies project. In the first phase of the project, using the framework of the building lifetime, we learned how energy efficiency in San Francisco municipal buildings can be influenced through delivering services to support decisionmakers; at key points in the process of funding, designing, constructing and maintaining them. The second phase of the project involved choosing and implementing five pilot projects. Through staff interviews, we learned how decisions that impact energy use are made at various levels. We compiled information about city staff and their needs, and resources available to meet those needs. We then designed actions to deliver appropriate services to staff at these key access points. BEC implemented five pilot projects corresponding to various stages in the building`s lifetime. These were: Bond Guidelines, Energy Efficient Design Practices, Commissioning, Motor Efficiency, and Facilities Condition Monitoring Program.

  10. Hand Hygiene Intervention Strategies to Reduce Diarrhoea and Respiratory Infections among Schoolchildren in Developing Countries: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Balwani Chingatichifwe Mbakaya

    2017-04-01

    Full Text Available Effective and appropriate hand-washing practice for schoolchildren is important in preventing infectious diseases such as diarrhoea, which is the second most common cause of death among school-age children in sub-Saharan Africa. The objective of the review was to identify hand hygiene intervention strategies to reduce infectious diseases such as diarrhoea and respiratory tract infections among schoolchildren aged 6–12 years in developing countries. Published research articles were searched from databases covering a period from as far back as the creation of the databases to November 2015. Eight randomized controlled trials (RCT/CRCT from developing countries met the inclusion criteria. The Jadad Scale for appraising RCT/CRCT studies revealed methodological challenges in most studies, such that 75% (6/8 were rated as low-quality articles. The review found that hand hygiene can reduce the incidence of diarrhoea and respiratory conditions. Three hand hygiene intervention strategies utilized were training, funding and policy, with training and funding implemented more commonly than policy. These strategies were not only used in isolation but also in combination, and they qualified as multi-level interventions. Factors that influenced hand washing were contextual, psychosocial and technological. Findings can inform school health workers in categorizing and prioritizing activities into viable strategies when implementing multi-level hand-washing interventions. This review also adds to the existing evidence that multi-level hand-washing interventions can reduce the incidence of diarrhoea, respiratory infections, and school absenteeism. Further evidence-based studies are needed with improved methodological rigour in developing countries, to inform policy in this area.

  11. China's Coal Methane: Actors, Structures, Strategies and their Global Impacts

    International Nuclear Information System (INIS)

    Chen, Ke; Charnoz, Olivier

    2012-12-01

    The need for China to alleviate its energy shortage, reduce its dependence on foreign sources and mitigate its climate impact is driving a dire quest for alternative fuels. Coal Mine Methane (CMM), in this context, holds significant potential. While the 11. Five-Year Plan aimed to capture and use 10 billion m"3 per year of CMM by 2010, the country achieved less than a quarter of this. This paper enquires into this puzzling outcome, which bears consequences for the world at large. China is indeed responsible for more than 40% of the world's total un-captured CMM emissions - which act as a greenhouse gas 21 times more potent than CO_2, and whose role in global warming is often underestimated, especially in short- and medium-term climate strategies. While the Chinese central government may have incentive to work towards promoting CMM, the benefits of such policies at the sub-national level are far from self-evident. National CMM policies can have significant economic and social costs at the local level, and thus their implementation can be jeopardized. Implementation of such policies is inherently ambiguous, conflicting, and as such, political. Current research on the Chinese CMM industry has largely focused on its techno-economic aspects, with little if any politico-institutional analyses. As for policy research on the larger Chinese energy sector, this seems sturdily to embody a top-down view: it mostly ends up blaming the country's decentralized governance structure and lack of a stringent implementation chain. Such top-down approaches do not help uncover 'the sinews of war': the range of less formal mechanisms, negotiations and agreements among the local actors, without which implementation does not in fact occur at the sub-national level. Nor do top-down research approaches facilitate inquiry into the way local stakeholders re-frame the meaning, content and impact of CMM policies. More generally, the top-down approaches fail to consider the significance of

  12. Diabetes distress: understanding the hidden struggles of living with diabetes and exploring intervention strategies.

    Science.gov (United States)

    Berry, Emma; Lockhart, Sam; Davies, Mark; Lindsay, John R; Dempster, Martin

    2015-05-01

    Diabetes distress is a rational emotional response to the threat of a life-changing illness. Distinct from depression, it is conceptually rooted in the demands of diabetes management and is a product of emotional adjustment. Diabetes distress has been found to be significantly associated with glycated haemoglobin (HbA1c) level and the likelihood of an individual adopting self-care behaviours. The lack of perceived support from family, friends and healthcare professionals significantly contributes to elevated diabetes distress, and this issue tends to be overlooked when designing interventions. Pioneering large-scale research, DAWN2, gives voices to the families of those with diabetes and reaffirms the need to consider psychosocial factors in routine diabetes care. Structured diabetes education programmes are the most widely used in helping individuals cope with diabetes, but they tend not to include the psychological or interpersonal aspects of diabetes management in their curricula. The need for health practitioners, irrespective of background, to demonstrate an understanding of diabetes distress and to actively engage in discussion with individuals struggling to cope with diabetes is emphasised. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Life-Cycle Assessment of Seismic Retrofit Strategies Applied to Existing Building Structures

    Directory of Open Access Journals (Sweden)

    Umberto Vitiello

    2016-12-01

    Full Text Available In the last few years, the renovation and refurbishment of existing buildings have become the main activities of the construction industry. In particular, many studies have recently focused on the mechanical and energy performances of existing retrofitted/refurbished facilities, while some research has addressed the environmental effects of such operations. The present study aims to assess the environmental impact of some retrofit interventions on an existing reinforced concrete (RC building. Once the structural requirements have been satisfied and the environmental effects of these retrofit solutions defined, the final purpose of this study is to identify the most environmentally sustainable retrofit strategy. The environmental impact of the structural retrofit options is assessed using a life-cycle assessment (LCA. This paper sets out a systematic approach that can be adopted when choosing the best structural retrofit option in terms of sustainability performance. The final aim of the study is to also provide a tool for researchers and practitioners that reflects a deep understanding of the sustainability aspects of retrofit operations and can be used for future researches or practical activities.

  14. User Needs and Strategies in Structured Information Retrieval

    NARCIS (Netherlands)

    G. Ramirez Camps (Georgina)

    2005-01-01

    textabstractStructured information retrieval studies the combination of the content and the structure information of documents to perform different IR tasks. Different approaches make use of the structural information of documents to improve information retrieval effectiveness. However, most of

  15. The Constraints on Strategy of an Organizational Structure

    DEFF Research Database (Denmark)

    Eriksen, Bo

    2007-01-01

     Artiklen diskuterer relationen mellem organisationens struktur og dens evne til at formulere og realisere sine strategier. Hovedargumentet er skelner mellem exploration og exploitation strategier og det anføres at der er en indbygget konflikt mellem disse. Fleksible (ambidextrous) organisationer...

  16. Whom Should We Imitate? Imitation Strategy and Industry Knowledge Structure

    DEFF Research Database (Denmark)

    Posen, Hart E.; Yi, Sangyoon; Lee, Jeho

    Imitation is a common practice within and across industries. Recent research has begun to explore the potential of imitation as a purposeful strategy. But the question of what constitutes a “good” imitation strategy is as yet not well understood. This study examines the efficacy of two canonical ...

  17. The effectiveness of different intervention strategies for the prevention of zoonotic metacercariae infection in cultured fish

    DEFF Research Database (Denmark)

    Clausen, Jesper Hedegaard; Madsen, Henry; Murrell, Kenneth Darwin

    2013-01-01

    interventions was reduced 91.7% compared to before interventions. The intensity of FZT was also significantly lower in the pond management group, compared to the drug treatment group and the control group after interventions. The results demonstrate that improving farm and pond management practices can......Fish-borne zoonotic trematodes (FZT) are a major public health problem. It is estimated that in Vietnam 26,366 "disability-adjusted life years" (DALYs) are lost due to FZT. Fish from aquaculture are a main source of protein and of great economic importance in both rural and urban areas...... with two intervention groups; a drug treatment of human and animal groups and a farm management group (control of snail vectors and fecal pollution of pond). A third group (non-intervention) served as control. Fish were examined for FZT metacercariae prevalence and intensity before and after interventions...

  18. Professional, structural and organisational interventions in primary care for reducing medication errors.

    Science.gov (United States)

    Khalil, Hanan; Bell, Brian; Chambers, Helen; Sheikh, Aziz; Avery, Anthony J

    2017-10-04

    Medication-related adverse events in primary care represent an important cause of hospital admissions and mortality. Adverse events could result from people experiencing adverse drug reactions (not usually preventable) or could be due to medication errors (usually preventable). To determine the effectiveness of professional, organisational and structural interventions compared to standard care to reduce preventable medication errors by primary healthcare professionals that lead to hospital admissions, emergency department visits, and mortality in adults. We searched CENTRAL, MEDLINE, Embase, three other databases, and two trial registries on 4 October 2016, together with reference checking, citation searching and contact with study authors to identify additional studies. We also searched several sources of grey literature. We included randomised trials in which healthcare professionals provided community-based medical services. We also included interventions in outpatient clinics attached to a hospital where people are seen by healthcare professionals but are not admitted to hospital. We only included interventions that aimed to reduce medication errors leading to hospital admissions, emergency department visits, or mortality. We included all participants, irrespective of age, who were prescribed medication by a primary healthcare professional. Three review authors independently extracted data. Each of the outcomes (hospital admissions, emergency department visits, and mortality), are reported in natural units (i.e. number of participants with an event per total number of participants at follow-up). We presented all outcomes as risk ratios (RRs) with 95% confidence intervals (CIs). We used the GRADE tool to assess the certainty of evidence. We included 30 studies (169,969 participants) in the review addressing various interventions to prevent medication errors; four studies addressed professional interventions (8266 participants) and 26 studies described

  19. Compliance with Community Mitigation and Interventions in Pandemic Influenza: A Community Policing Strategy

    National Research Council Canada - National Science Library

    Alben, Sr., Timothy P

    2007-01-01

    .... Community mitigations and interventions such as school closures, event cancellations, limited travel, quarantine and work at home plans are traditional responses to slowing the spread of a virus...

  20. Musical intervention enhances infants' neural processing of temporal structure in music and speech.

    Science.gov (United States)

    Zhao, T Christina; Kuhl, Patricia K

    2016-05-10

    Individuals with music training in early childhood show enhanced processing of musical sounds, an effect that generalizes to speech processing. However, the conclusions drawn from previous studies are limited due to the possible confounds of predisposition and other factors affecting musicians and nonmusicians. We used a randomized design to test the effects of a laboratory-controlled music intervention on young infants' neural processing of music and speech. Nine-month-old infants were randomly assigned to music (intervention) or play (control) activities for 12 sessions. The intervention targeted temporal structure learning using triple meter in music (e.g., waltz), which is difficult for infants, and it incorporated key characteristics of typical infant music classes to maximize learning (e.g., multimodal, social, and repetitive experiences). Controls had similar multimodal, social, repetitive play, but without music. Upon completion, infants' neural processing of temporal structure was tested in both music (tones in triple meter) and speech (foreign syllable structure). Infants' neural processing was quantified by the mismatch response (MMR) measured with a traditional oddball paradigm using magnetoencephalography (MEG). The intervention group exhibited significantly larger MMRs in response to music temporal structure violations in both auditory and prefrontal cortical regions. Identical results were obtained for temporal structure changes in speech. The intervention thus enhanced temporal structure processing not only in music, but also in speech, at 9 mo of age. We argue that the intervention enhanced infants' ability to extract temporal structure information and to predict future events in time, a skill affecting both music and speech processing.

  1. An Action Research to Optimize the Well-Being of Older People in Nursing Homes: Challenges and Strategies for Implementing a Complex Intervention.

    Science.gov (United States)

    Bourbonnais, Anne; Ducharme, Francine; Landreville, Philippe; Michaud, Cécile; Gauthier, Marie-Andrée; Lavallée, Marie-Hélène

    2018-03-01

    Few studies have been conducted on strategies to promote the implementation of complex interventions in nursing homes (NHs). This article presents a pilot study intended to assess the strategies that would enable the optimal implementation of a complex intervention approach in NHs based on the meanings of screams of older people living with Alzheimer's disease. An action research approach was used with 19 formal and family caregivers from five NHs. Focus groups and individual interviews were held to assess different implementation strategies. A number of challenges were identified, as were strategies to overcome them. These latter included interactive training, intervention design, and external support. This study shows the feasibility of implementing a complex intervention to optimize older people's well-being. The article shares strategies that may promote the implementation of these types of interventions in NHs.

  2. Is the DOTS strategy sufficient to achieve tuberculosis control in low- and middle-income countries? 1. Need for interventions in universities and medical schools.

    Science.gov (United States)

    Caminero, J A

    2003-06-01

    Now that progress is gradually being made in the implementation of the DOTS strategy in low-income countries, we must take into account the fact that nearly 30% of all tuberculosis (TB) cases worldwide occur in middle-income countries, which usually have an adequate health infrastructure and sufficient economic resources for TB control. These countries nevertheless have other limitations that make it necessary to develop other aspects in addition to the DOTS strategy. These can be summarised in three main themes: 1) adequate coordination of all health structures involved in TB management, ensuring that they follow the basic norms of the National Tuberculosis Programme (NTP), 2) direct intervention in universities and medical schools, which are ubiquitous in such countries, and 3) specific collaboration with specialists and physicians in private practice, an important obstacle to the success of NTPs in several countries. A detailed analysis is presented of strategies that need to be implemented in different countries depending on their economic resources and their TB situation. The need to carry out specific interventions in addition to training in DOTS in universities and medical schools in order to improve TB control is discussed. A specific project in this area developed by the IUATLD in Latin America is described.

  3. Parents' Adoption of Social Communication Intervention Strategies: Families Including Children with Autism Spectrum Disorder Who are Minimally Verbal.

    Science.gov (United States)

    Shire, Stephanie Y; Goods, Kelly; Shih, Wendy; Distefano, Charlotte; Kaiser, Ann; Wright, Courtney; Mathy, Pamela; Landa, Rebecca; Kasari, Connie

    2015-06-01

    Notably absent from the intervention literature are parent training programs targeting school-aged children with autism who have limited communication skills (Tager-Flusberg and Kasari in Autism Res 6:468-478, 2013). Sixty-one children with autism age 5-8 with minimal spontaneous communication received a 6-month social communication intervention including parent training. Parent-child play interactions were coded for parents' strategy implementation and children's time jointly engaged (Adamson et al. in J Autism Dev Disord 39:84-96, 2009). Parents mastered an average of 70% of the strategies. Further analyses indicated some gains in implementation occurred from mere observation of sessions, while the greatest gains occurred in the first month of active coaching and workshops. Children's joint engagement was associated with parents' implementation success across time demonstrating parents' implementation was relevant to children's social engagement.

  4. Effectiveness of a multi-level implementation strategy for ASD interventions: study protocol for two linked cluster randomized trials.

    Science.gov (United States)

    Brookman-Frazee, Lauren; Stahmer, Aubyn C

    2018-05-09

    The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on generalizable methods to scale up these practices in the multiple service systems caring for these children has been limited and is critical to meet this growing public health need. This project includes two, coordinated studies testing the effectiveness of the Translating Evidence-based Interventions (EBI) for ASD: Multi-Level Implementation Strategy (TEAMS) model. TEAMS focuses on improving implementation leadership, organizational climate, and provider attitudes and motivation in order to improve two key implementation outcomes-provider training completion and intervention fidelity and subsequent child outcomes. The TEAMS Leadership Institute applies implementation leadership strategies and TEAMS Individualized Provider Strategies for training applies motivational interviewing strategies to facilitate provider and organizational behavior change. A cluster randomized implementation/effectiveness Hybrid, type 3, trial with a dismantling design will be used to understand the effectiveness of TEAMS and the mechanisms of change across settings and participants. Study #1 will test the TEAMS model with AIM HI (An Individualized Mental Health Intervention for ASD) in publicly funded mental health services. Study #2 will test TEAMS with CPRT (Classroom Pivotal Response Teaching) in education settings. Thirty-seven mental health programs and 37 school districts will be randomized, stratified by county and study, to one of four groups (Standard Provider Training Only, Standard Provider Training + Leader Training, Enhanced Provider Training, Enhanced Provider Training + Leader Training) to test the effectiveness of combining standard, EBI-specific training with the two TEAMS

  5. The effectiveness of technology-based strategies to promote engagement with digital interventions: a systematic review protocol.

    Science.gov (United States)

    Alkhaldi, Ghadah; Hamilton, Fiona L; Lau, Rosa; Webster, Rosie; Michie, Susan; Murray, Elizabeth

    2015-04-28

    Digital interventions provide effective and potentially cost-effective models for improving health outcomes as they deliver health information and services that are widely disseminated, confidential, and can be tailored to needs of the individual user. Digital interventions have been used successfully for health promotion, mental health, and for enabling self-management of long-term conditions. However, their effectiveness is limited by low usage rates, with non-engagement a major challenge. Hence, it is crucial to find effective strategies to increase user engagement with digital interventions. This systematic review will aim to evaluate the effectiveness of technology-based strategies to promote engagement with digital interventions. We will follow Cochrane Collaboration guidelines on systematic review methodology. The search strategy will be executed across seven e-databases (including MEDLINE, EMBASE, PsycINFO, CINAHL) using the concepts "digital intervention" and "engagement", limited by study type (randomized controlled trial). Grey literature and reference lists of included studies will be searched. Titles and abstracts will be independently screened by 2 authors. Then the full text of potentially eligible papers will be obtained and double screened. Data from eligible papers will be extracted by 1 author and checked for accuracy by another author. Bias will be assessed using the Cochrane bias assessment tool. Narrative synthesis will report on all included studies, and where appropriate, data will be pooled using meta-analysis. All findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sources of heterogeneity will be further investigated if required. Our research is in progress. The final draft of the systematic review is being written and will be submitted before the end of 2015. The review findings will inform researchers and digital intervention providers about optimal use of technology

  6. A systematic review of the implementation of recommended psychological interventions for schizophrenia: Rates, barriers, and improvement strategies.

    Science.gov (United States)

    Ince, Paul; Haddock, Gillian; Tai, Sara

    2016-09-01

    A systematic review of the literature exploring if the UK recommendations for psychological interventions for schizophrenia were being met was carried out. Rates of implementation for cognitive behavioural therapy (CBT) and family intervention (FI) were compared. The barriers against implementation and described strategies aimed at improving implementation were reviewed. A literature search of electronic bibliography databases (Psychinfo, Medline, Pubmed, AMED, CINHAL, and EMBASE), reference and citation lists, the Evaluation and Review of NICE Implementation (ERNIE) database, a manual search of Clinical Psychology Forum, governmental reports, charity, and service user group reports was conducted. Twenty-six articles met the inclusion criteria, 11 provided data on implementation rates, 13 explored the barriers to implementation, and 10 gave information about improvement strategies. Rates of implementation varied from 4% to 100% for CBT and 0% to 53% for FI, and studies varied in the methodology used and quality of the articles. Previously reported barriers to implementation were found, with organisational barriers being most commonly followed by barriers met by staff members and service users. Implementation strategies discovered included training packages for CBT, FI, and psychosocial interventions as well as empirical evidence suggesting methods for engagement with service users. Rates of implementation for CBT and FI are still below recommended levels with wide variation of rates found. This suggests inequalities in the provision of psychological interventions for schizophrenia are still present. Previously identified barriers to implementation were confirmed. Attempted implementation strategies have been met with modest success. Inequalities in the provision of psychological therapies for schizophrenia persist. Good quality cognitive behavioural therapy and FI training do not ensure implementation. Collaboration at all levels of healthcare is needed for

  7. Strategy and clinical significance of interventional management before surgical therapy for massive hemorrhage of gastrointestinal tract

    International Nuclear Information System (INIS)

    Hu Tingyang; Yu Wenqiang; Mao Yingmin; Yuan Jianhua; CChen Fanghong; Luo Zuyan; Ding Xiaonan; Zhou Bing; Ding Zhongxiang

    2009-01-01

    Objective: To discuss the clinical value of interventional management before surgical therapy for massive gastrointestinal hemorrhage, and to compare the clinical efficacy and re-bleeding rate between hypophysin infusion group and embolization group. Methods: During the period of June 1998-Apr. 2009, 31 patients with massive gastrointestinal hemorrhage in our institution underwent preoperative interventional managements before they received surgical treatment. According to DSA manifestations, the patients underwent transarterial hypophysin infusion or transcatheter embolization as interventional management. The clinical efficacy of interventional procedures and its influence on the surgery were evaluated, and the hemostasis rate and re-bleeding rate were compared the two kind of intervention managements. The numeration data were analyzed with Fisher's exact test, and the SPSS 11.0 was used as statistical software. Results: The interventional managements were successfully performed in all the 31 patients, with a total hemostasis rate of 83.9% (26/31) and a total re-bleeding rate 30.7% (8/26). The hemostasis rate and re-bleeding rate of hypophysin infusion group and embolization group were 69.2% (9/ 13), 94.4% (17/18) and 44.4% (4/9), 23.7% (4/17), respectively. All the 31 patients received surgery after interventional therapy, of which selective operation was carried out in 20. Neither surgery-related or intervention-related serious complications nor death occurred. Conclusion: Preoperative interventional managements can provide patients with massive gastrointestinal hemorrhage with valuable chance of a successful surgery, enable the physician to take a selective operation to replace an emergency one,as a result, the surgical risk will be greatly reduced. Therefore, it is worth popularizing the preoperative interventional managements in clinical practice. (authors)

  8. Experiences and perspectives of community health workers from implementing treatment for schistosomiasis using the community directed intervention strategy in an informal settlement in Kisumu City, western Kenya

    Directory of Open Access Journals (Sweden)

    Gladys O. Odhiambo

    2016-09-01

    Full Text Available Abstract Background The Community Directed Intervention (CDI strategy has been used to conduct various health interventions in Africa, including control of Neglected Tropical Diseases (NTDs. Although the CDI approach has shown good results in the control of onchocerciasis and lymphatic filariasis with respect to treatment coverage using community drug distributors, its utility in the control of schistosomiasis among urban poor is yet to be established. Using a longitudinal qualitative study, we explored the experiences, opportunities, challenges as well as recommendations of Community Health Workers (CHWs after participation in annual mass drug administration (MDA activities for schistosomiasis using the CDI approach in an urban setting. Methods Unstructured open-ended group discussions were conducted with CHWs after completion of annual MDA activities. Narratives were obtained from CHWs using a digital audio recorder during the group discussions, transcribed verbatim and translated into English where applicable. Thematic decomposition of data was done using ATLAS.ti. software, and themes explored using the principle of interpretative phenomenological analysis (IPA. Results From the perspective of the CHWs, opportunities for implementing CDI in urban settings, included the presence of CHWs, their supervisory structures and their knowledge of intervention areas, and opportunity to integrate MDA with other health interventions. Several challenges were mentioned with regards to implementing MDA using the CDI strategy among them lack of incentives, fear of side effects, misconceptions regarding treatment and mistrust, difficulties working in unsanitary environmental conditions, insecurity, and insufficient time. A key recommendation in promoting more effective MDA using the CDI approach was allocation of more time to the exercise. Conclusion Findings from this study support the feasibility of using CDI for implementing MDA for schistosomiasis in

  9. Impact of a multicomponent hand hygiene intervention strategy in reducing infection rates at a university hospital in Saudi Arabia.

    Science.gov (United States)

    Al Kuwaiti, Ahmed

    2017-09-01

    Few studies have reported the correlation between hand hygiene (HH) practices and infection rates in Saudi Arabia. This work was aimed to study the effect of a multicomponent HH intervention strategy in improving HH compliance and reducing infection rates at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia between January 2014 and December 2016. A yearlong multicomponent HH intervention, which included various strategies recommended by the World Health Organization, was introduced. HH compliance among staff and infection rates observed in the inpatient wards were assessed and compared at pre- and post-interventional phases. There was a significant increase in mean HH compliance from 50.17% to 71.75% after the intervention ( P  infection (HAI) and catheter-associated urinary tract infection (CAUTI) rates decreased from 3.37 to 2.59 and from 3.73 to 1.75, respectively ( P  infection rates. Further studies on cost-effectiveness of such a model could augment to these findings.

  10. Development and testing of an implementation strategy for a complex housing intervention: protocol for a mixed methods study.

    Science.gov (United States)

    Watson, Dennis P; Young, Jeani; Ahonen, Emily; Xu, Huiping; Henderson, Macey; Shuman, Valery; Tolliver, Randi

    2014-10-17

    There is currently a lack of scientifically designed and tested implementation strategies. Such strategies are particularly important for highly complex interventions that require coordination between multiple parts to be successful. This paper presents a protocol for the development and testing of an implementation strategy for a complex intervention known as the Housing First model (HFM). Housing First is an evidence-based practice for chronically homeless individuals demonstrated to significantly improve a number of outcomes. Drawing on practices demonstrated to be useful in implementation and e-learning theory, our team is currently adapting a face-to-face implementation strategy so that it can be delivered over a distance. Research activities will be divided between Chicago and Central Indiana, two areas with significantly different barriers to HFM implementation. Ten housing providers (five from Chicago and five from Indiana) will be recruited to conduct an alpha test of each of four e-learning modules as they are developed. Providers will be requested to keep a detailed log of their experience completing the modules and participate in one of two focus groups. After refining the modules based on alpha test results, we will test the strategy among a sample of four housing organizations (two from Chicago and two from Indiana). We will collect and analyze both qualitative and quantitative data from administration and staff. Measures of interest include causal factors affecting implementation, training outcomes, and implementation outcomes. This project is an important first step in the development of an evidence-based implementation strategy to increase scalability and impact of the HFM. The project also has strong potential to increase limited scientific knowledge regarding implementation strategies in general.

  11. A review of interventions addressing structural drivers of adolescents' sexual and reproductive health vulnerability in sub-Saharan Africa: implications for sexual health programming.

    Science.gov (United States)

    Wamoyi, Joyce; Mshana, Gerry; Mongi, Aika; Neke, Nyasule; Kapiga, Saidi; Changalucha, John

    2014-12-13

    Young people particularly women are at increased risk of undesirable sexual and reproductive health (SRH) outcomes. Structural factors have been reported as driving some of these risks. Although several interventions have targeted some of the structural drivers for adolescent's SRH risk, little has been done to consolidate such work. This would provide a platform for coordinated efforts towards adolescent's SRH. We provide a narrative summary of interventions in sub-Saharan Africa (sSA) addressing the structural drivers of adolescents' SRH risk, explore pathways of influence, and highlight areas for further work. 33 abstracts and summary reports were retrieved and perused for suitability. Fifteen documents met the inclusion criteria and were read in full. Papers and reports were manually reviewed and 15 interventions that met the criteria for inclusion were summarised in a table format. Most of the interventions addressed multiple structural factors, such as social norms, gender inequality, and poverty. Some interventions focused on reducing economic drivers that increased sexual risk behaviours. Others focused on changing social norms and thus sexual risk behaviours through communication. Social norms addressed included gender inequality, gender violence, and child socialisation. The interventions included components on comprehensive sexuality and behaviour change and communication and parenting, using different designs and evaluation methods. Important lessons from the narrative summary included the need for a flexible intervention design when addressing adolescents, the need for coordinated effort among different stakeholders. There are encouraging efforts towards addressing structural drivers among adolescents in (sSA). There is, however, a need for interventions to have a clear focus, indicate the pathways of influence, and have a rigorous evaluation strategy assessing how they work to reduce vulnerability to HIV. There is also a need for coordinated effort

  12. Cognitive strategy interventions improve word problem solving and working memory in children with math disabilities.

    Science.gov (United States)

    Swanson, H Lee

    2015-01-01

    This study investigated the role of strategy instruction and working memory capacity (WMC) on problem solving solution accuracy in children with and without math disabilities (MD). Children in grade 3 (N = 204) with and without MD subdivided into high and low WMC were randomly assigned to 1 of 4 conditions: verbal strategies (e.g., underlining question sentence), visual strategies (e.g., correctly placing numbers in diagrams), verbal + visual strategies, and an untreated control. The dependent measures for training were problem solving accuracy and two working memory transfer measures (operation span and visual-spatial span). Three major findings emerged: (1) strategy instruction facilitated solution accuracy but the effects of strategy instruction were moderated by WMC, (2) some strategies yielded higher post-test scores than others, but these findings were qualified as to whether children were at risk for MD, and (3) strategy training on problem solving measures facilitated transfer to working memory measures. The main findings were that children with MD, but high WM spans, were more likely to benefit from strategy conditions on target and transfer measures than children with lower WMC. The results suggest that WMC moderates the influence of cognitive strategies on both the targeted and non-targeted measures.

  13. Structural Intervention With School Nurses Increases Receipt of Sexual Health Care Among Male High School Students.

    Science.gov (United States)

    Dittus, Patricia J; Harper, Christopher R; Becasen, Jeffrey S; Donatello, Robin A; Ethier, Kathleen A

    2018-01-01

    Adolescent males are less likely to receive health care and have lower levels of sexual and reproductive health (SRH) knowledge than adolescent females. The purpose of this study was to determine if a school-based structural intervention focused on school nurses increases receipt of condoms and SRH information among male students. Interventions to improve student access to sexual and reproductive health care were implemented in six urban high schools with a matched set of comparison schools. Interventions included working with school nurses to improve access to sexual and reproductive health care, including the provision of condoms and information about pregnancy and sexually transmitted disease prevention and services. Intervention effects were assessed through five cross-sectional yearly surveys, and analyses include data from 13,740 male students. Nurses in intervention schools changed their interactions with male students who visited them for services, such that, among those who reported they went to the school nurse for any reason in the previous year, those in intervention schools reported significant increases in receipt of sexual health services over the course of the study compared with students in comparison schools. Further, these results translated into population-level effects. Among all male students surveyed, those in intervention schools were more likely than those in comparison schools to report increases in receipt of sexual health services from school nurses. With a minimal investment of resources, school nurses can become important sources of SRH information and condoms for male high school students. Published by Elsevier Inc.

  14. Narrative Intervention: A School-Based Counseling Strategy for Students with Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Kamali, Khosrow; Yoosefi Looyeh, Majid

    2013-01-01

    This article describes a group narrative intervention for improving the behavior of 8- to 11-year-old children with attention-deficit/hyperactivity disorder at home and school. (Contains 2 tables and 1 note.)

  15. Thinking about the environment and theorising change: how could Life History Strategy Theory inform mHealth interventions in low- and middle-income countries?

    Science.gov (United States)

    Morgan, Barak; Hunt, Xanthe; Tomlinson, Mark

    2017-01-01

    ABSTRACT Background: There is a growing body of literature outlining the promise of mobile information and communication technologies to improve healthcare in resource-constrained contexts. Methods: We reviewed the literature related to mobile information and communication technologies which aim to improve healthcare in resource-constrained contexts, in order to glean general observations regarding the state of mHealth in high-income countries (HIC) and low- and middle-income countries (LMIC). Results: mHealth interventions in LMIC often differ substantively from those in HIC, with the former being simpler, delivered through a single digital component (an SMS as opposed to a mobile phone application, or ‘app’), and, as a result, targeting only one of the many factors which impact on the activation (or deactivation) of the target behaviour. Almost as a rule, LMIC mHealth interventions lack an explicit theory of change. Conclusion: We highlight the necessity, when designing mHealth interventions, of having a theory of change that encompasses multiple salient perspectives pertaining to human behaviour. To address this need, we explore whether the concept of Life History Strategy could provide the mHealth field with a useful theory of change. Life History Strategy Theory may be particularly useful in understanding some of the problems, paradoxes, and limitations of mHealth interventions found in LMIC. Specifically, this theory illuminates questions regarding ‘light-weight’ programmes which solely provide information, reminders, and other virtual ‘nudges’ that may have limited impact on behaviours governed by extrinsic structural factors. PMID:28617198

  16. Self-care management strategies among individuals living with type 2 diabetes mellitus: nursing interventions

    OpenAIRE

    Hunt CW

    2013-01-01

    Caralise W HuntAuburn University School of Nursing, Auburn, AL, USAAbstract: Nurses provide care for individuals living with diabetes in a variety of areas. Nursing interventions assist individuals living with diabetes to manage diabetes and can positively affect outcomes. This article describes an integrated literature review conducted to evaluate and summarize nursing interventions and research in self-management of type 2 diabetes mellitus. PubMed, PsycINFO, CINAHL, and the Cochrane databa...

  17. Pragmatic Strategies and Linguistic Structures in Making ‘Suggestions’: Towards Comprehensive Taxonomies

    Directory of Open Access Journals (Sweden)

    Hossein Abolfathiasl

    2013-11-01

    Full Text Available This paper analyses and upgrades taxonomies of strategies and structures for the speech act of suggesting based on existing taxonomies and classifications in the pragmatics research literature. Previous studies have focused mainly on linguistic structures used to perform the speech act of suggesting. Thus, there seems to be a need to provide a more comprehensive set of taxonomies for structures as well as strategies that can be used in EFL/ESL classrooms and for research on the speech act of suggesting. To this end, the speech act of suggesting is defined first and the features of this speech act are discussed. Second, the most recent classifications proposed for structures and linguistic realization strategies for suggestions were analysed and contrasted and a more comprehensive taxonomy of structures and linguistic realization strategies is provided, based on previous taxonomies. Finally, taxonomy of politeness strategies in making suggestions are provided, based on recent studies in cross-cultural pragmatics research.

  18. Development and Feasibility of a COPD Self-Management Intervention Delivered with Motivational Interviewing Strategies

    Science.gov (United States)

    Benzo, Roberto; Vickers, Kristin; Ernst, Denise; Tucker, Sharon; McEvoy, Charlene; Lorig, Kate

    2013-01-01

    BACKGROUND Self-management (SM) is proposed as the standard of care in chronic obstructive pulmonary disease (COPD) but details of the process and training required to deliver effective SM are not widely available. In addition, recent data suggest that patient engagement and motivation are critical ingredients for effective self-management. This manuscript carefully describes a self-management intervention using Motivational Interviewing skills, aimed to increase engagement and commitment in severe COPD patients. METHODS The intervention was developed and pilot tested for fidelity to protocol, for patient and interventionist feedback (qualitative) and effect on quality of life. Engagement between patient and interventionists was measured by the Working Alliance Inventory. The intervention was refined based in the results of the pilot study and delivered in the active arm of a prospective randomized study. RESULTS The pilot study suggested improvements in quality of life, fidelity to theory and patient acceptability. The refined self-management intervention was delivered 540 times in the active arm of a randomized study. We observed a retention rate of 86% (patients missing or not available for only 14% the scheduled encounters). CONCLUSIONS A self-management intervention, that includes motivational interviewing as the way if guiding patient into behavior change, is feasible in severe COPD and may increase patient engagement and commitment to self-management. This provides a very detailed description of the SM process for (the specifics of training and delivering the intervention) that facilitates replicability in other settings and could be translated to cardiac rehabilitation. PMID:23434613

  19. Structured intervention for management of pain following day surgery in children

    DEFF Research Database (Denmark)

    Walther-Larsen, Søren; Aagaard, Gitte; Friis, Susanne Molin

    2016-01-01

    BACKGROUND: Ambulatory surgery forms a large part of pediatric surgical practice. Several studies indicate that postoperative pain is poorly managed with more than 30% of children having moderate to severe pain. In a busy outpatient clinic contact between healthcare professionals and the family...... is increasingly limited calling for a global and efficient pain management regime. OBJECTIVE: The aim of this prospective observational cohort study was to determine postoperative pain intensity following day surgery in children after our structured intervention for pain management. METHODS: A number...... of interventions in an effort to address barriers to effective postoperative pain management after day surgery were identified in the literature. By introducing our concept structured intervention, we aimed to address the majority if not all these barriers. Accordingly, we adapted postoperative pain management...

  20. A new combined strategy to implement a community occupational therapy intervention: designing a cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Adang Eddy

    2011-03-01

    Full Text Available Abstract Background Even effective interventions for people with dementia and their caregivers require specific implementation efforts. A pilot study showed that the highly effective community occupational therapy in dementia (COTiD program was not implemented optimally due to various barriers. To decrease these barriers and make implementation of the program more effective a combined implementation (CI strategy was developed. In our study we will compare the effectiveness of this CI strategy with the usual educational (ED strategy. Methods In this cluster randomized, single-blinded, controlled trial, each cluster consists of at least two occupational therapists, a manager, and a physician working at Dutch healthcare organizations that deliver community occupational therapy. Forty-five clusters, stratified by healthcare setting (nursing home, hospital, mental health service, have been allocated randomly to either the intervention group (CI strategy or the control group (ED strategy. The study population consists of the professionals included in each cluster and community-dwelling people with dementia and their caregivers. The primary outcome measures are the use of community OT, the adherence of OTs to the COTiD program, and the cost effectiveness of implementing the COTiD program in outpatient care. Secondary outcome measures are patient and caregiver outcomes and knowledge of managers, physicians and OTs about the COTiD program. Discussion Implementation research is fairly new in the field of occupational therapy, making this a unique study. This study does not only evaluate the effects of the CI-strategy on professionals, but also the effects of professionals' degree of implementation on client and caregiver outcomes. Clinical trials registration NCT01117285

  1. Are suppression and deterrence mechanisms enough? Examining the "pulling levers" drug market intervention strategy in Peoria, Illinois, USA.

    Science.gov (United States)

    Corsaro, Nicholas; Brunson, Rod K

    2013-03-01

    Police agencies across the globe enforce laws that prohibit drug transportation, distribution, and use with varying degrees of effectiveness. Within the United States, law enforcement strategies that rely on partnerships between criminal justice officials, neighbourhood residents, and social service providers (i.e., collaborative implementation) have shown considerable promise for reducing crime and disorder associated with open-air drug markets. The current study examines a comprehensive police enforcement strategy conducted in Peoria, Illinois (USA) designed to reduce patterns of crime and violence associated with an open-air drug market in a specific neighbourhood. Change in neighbourhood crime was assessed using Autoregressive Integrated Moving Average (ARIMA) interrupted time series analysis. Further, target area residents were surveyed to gauge their awareness of the police intervention as well as perceived changes in local crime patterns. Analyses indicate that the intervention did not produce significant changes in neighbourhood crime offense rates between pre- and post-intervention periods. In addition, the majority of surveyed residents within the target area did not demonstrate an awareness of the intervention nor did they report perceived changes in local crime patterns. Study findings suggest that police-led approaches in the absence of high levels of community awareness and involvement may have less capacity to generate crime-control when focusing on open-air drug markets. We propose that police agencies adopting this strategy invest considerable resources toward achieving community awareness and participation in order to increase the potential for attaining significant and substantive programmatic impact. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Receptor mutagenesis strategies for examination of structure-function relationships

    NARCIS (Netherlands)

    Blomenröhr, Marion; Vischer, Henry F; Bogerd, Jan

    2004-01-01

    This chapter describes three different strategies of receptor mutagenesis with their advantages, disadvantages, and limitations. Oligonucleotide-directed mutagenesis using either the Altered Sites II in vitro mutagenesis system or the GeneTailor site-directed mutagenesis system can generate base

  3. Validation of optimization strategies using the linear structured production chains

    Science.gov (United States)

    Kusiak, Jan; Morkisz, Paweł; Oprocha, Piotr; Pietrucha, Wojciech; Sztangret, Łukasz

    2017-06-01

    Different optimization strategies applied to sequence of several stages of production chains were validated in this paper. Two benchmark problems described by ordinary differential equations (ODEs) were considered. A water tank and a passive CR-RC filter were used as the exemplary objects described by the first and the second order differential equations, respectively. Considered in the work optimization problems serve as the validators of strategies elaborated by the Authors. However, the main goal of research is selection of the best strategy for optimization of two real metallurgical processes which will be investigated in an on-going projects. The first problem will be the oxidizing roasting process of zinc sulphide concentrate where the sulphur from the input concentrate should be eliminated and the minimal concentration of sulphide sulphur in the roasted products has to be achieved. Second problem will be the lead refining process consisting of three stages: roasting to the oxide, oxide reduction to metal and the oxidizing refining. Strategies, which appear the most effective in considered benchmark problems will be candidates for optimization of the mentioned above industrial processes.

  4. Addressing source-induced structural vibrations in an interventional X-ray system

    NARCIS (Netherlands)

    Van Pinxteren, J.A.W.; Vermeulen, J.P.M.B.; van Loon, R.J.A.; van Schothorst, G.; Billington, D.; Phillips, D.

    2017-01-01

    Interventional radiology is a medical discipline, in which imaging equipment is used to diagnose and treat diseases throughout the human body. Dedicated systems, based on X-ray, computed tomography and ultrasound technology, allow for 2D and 3D imaging of (contrast enhanced) physical structures.

  5. The Effect of Structured Exercise Intervention on Intensity and Volume of Total Physical Activity

    Directory of Open Access Journals (Sweden)

    Niko Wasenius

    2014-12-01

    Full Text Available This study aimed to investigate the effects of a 12-week structured exercise intervention on total physical activity and its subcategories. Twenty-three overweight or obese middle aged men with impaired glucose regulation were randomized into a 12-week Nordic walking group, a power-type resistance training group, and a non-exercise control group. Physical activity was measured with questionnaires before the intervention (1–4 weeks and during the intervention (1–12 weeks and was expressed in metabolic equivalents of task. No significant change in the volume of total physical activity between or within the groups was observed (p > 0.050. The volume of total leisure-time physical activity (structured exercises + non-structured leisure-time physical activity increased significantly in the Nordic walking group (p 0.050 compared to the control group. In both exercise groups increase in the weekly volume of total leisure-time physical activity was inversely associated with the volume of non-leisure-time physical activities. In conclusion, structured exercise intervention did not increase the volume of total physical activity. Albeit, endurance training can increase the volume of high intensity physical activities, however it is associated with compensatory decrease in lower intensity physical activities. To achieve effective personalized exercise program, individuality in compensatory behavior should be recognised.

  6. A systematic review of assessment and intervention strategies for effective clinical communication in culturally and linguistically diverse students.

    Science.gov (United States)

    Chan, Annie; Purcell, Alison; Power, Emma

    2016-09-01

    Culturally and linguistically diverse (CALD) students often experience difficulties with the clinical communication skills that are essential for successful interactions in the workplace. However, there is little evidence on the effectiveness of assessment and intervention strategies for this population. The two aims of this study were: to evaluate the effectiveness of assessment tools in identifying and describing the clinical communication difficulties of CALD health care students; and to determine whether communication programmes improved their clinical communication skills. Systematic review based on the Cochrane protocol. Articles were identified through a search of established databases using MeSH and key search terms. Studies published in English from 1990 to March 2015 were included if they described assessment strategies or a training programme for communication skills of CALD students. Studies were excluded if they did not describe implementation of a specific assessment or intervention programme. Data were extracted independently by the first author and verified by the second author. Quality was measured by the Best Evidence Medical Education guide and the Educational Interventions Critical Appraisal Tool. The Kirkpatrick hierarchy was used to measure impact. Meta-analysis was not conducted because of the heterogeneity of programme design and outcome measures. One hundred and twenty-nine articles met the criteria for full text review. Eighty-six articles were excluded. Thirteen articles addressing assessment and 30 articles reporting on communication training programmes were included in this review. Assessment tools used rubrics and rating scales effectively. Intervention studies focused on speech and language skills (n = 20), interpersonal skills (n = 7) and faculty-level support (n = 5). Although 17 studies reported positive findings on student satisfaction, only eight reported improved skills post-training. The development of effective

  7. Efficiency or equity? Simulating the impact of high-risk and population intervention strategies for the prevention of disease

    Directory of Open Access Journals (Sweden)

    Jonathan M. Platt

    2017-12-01

    Full Text Available Maximizing both efficiency and equity are core considerations for population health. These considerations can result in tension in population health science as we seek to improve overall population health while achieving equitable health distributions within populations. Limited work has explored empirically the consequences of different population health intervention strategies on the burden of disease and on within- and between-group differences in disease. To address this gap, we compared the impact of four simulated interventions using data from the National Health and Nutrition Examination Survey. In particular, we focus on assessing how population and high-risk primary prevention and population and high-risk secondary interventions efforts to reduce smoking behavior influence systolic blood pressure (SBP and hypertension, and how such strategies influence inequalities in SBP by income. The greatest reductions in SBP mean and standard deviation resulted from the population secondary prevention. High-risk primary and secondary prevention and population secondary prevention programs all yielded substantial reductions in hypertension prevalence. The effect of population primary prevention did little to decrease population SBP mean and standard deviation, as well as hypertension prevalence. Both high-risk strategies had a larger impact in the low-income population, leading to the greatest narrowing the income-related gap in disease. The population prevention strategies had a larger impact in the high-income population. Population health approaches must consider the potential impact on both the whole population and also on those with different levels of risk for disease within a population, including those in under-represented or under-served groups.

  8. Discomforts occurring in the interventional therapy for diabetic foot: analysis of causes and nursing strategy

    International Nuclear Information System (INIS)

    Li Xue; Chen Jinhua; Wang Yi; Chen Rong

    2009-01-01

    Objective: To analyze the causes of discomfort occurring in the interventional treatment of diabetic foot, to discuss the individualized nursing measures for improving the patient's comfort and cooperation, and for increasing the successful rate of the interventional procedure. Methods: The control group included 9 patients who received conventional nursing care. The study group had 13 patients who accepted individualized nursing care and nursing intervention, which was designed according to every patient's individual conditions. Results: In the control group, one patient could not endure the surgery to the end because of the long operating time. Another two patients had to take examinations repeatedly because the imaging quality was very poor, which was caused by the body movement due to uncomfortable mechanical stimulation. Urinary retention occurred in one patient. The mean operative time of the control group was 2.8 hour per surgery. The average dosage of contrast medium used was 150-300 ml per procedure. All the subjects in the study group completed the surgery successfully, the mean operative time was 2.2 hour per surgery and the average dosage of contrast medium used was 100-200 ml per procedure. Conclusion: During the perioperative period of interventional treatment for diabetic foot, the effective individualized nursing care and nursing intervention, the measures to improve patient's comfort and the cooperation, etc. can certainly increase the successful rate, saving the operating time and reducing the contrast dosage. (authors)

  9. DO INTERVENTION STRATEGIES OF WOMEN HEALTHY HEART PROJECT (WHHP IMPACT ON DIFFERENTLY ON WORKING AND HOUSEWIVES?

    Directory of Open Access Journals (Sweden)

    Masoumeh Sadeghi

    2011-03-01

    Full Text Available BACKGROUND: The purpose of this study is to evaluate the possible difference of the impact of Women Healthy Heart Project on lifestyle, as well as physical/biochemical parameters of working women and housewives.    METHODS: This was a community-based intervention study conducted over 5 years (2002-2007 in the counties of Isfahan and Najafabad (intervention areas and Arak (control. Pre-study situation analysis of women was followed by 5 years of wide-ranging interventions (educational/environmental conducted by various organizations using different methodologies. The interventions were aimed at modifying/improving lifestyle by increasing physical activity, encouraging healthy eating, and tobacco use cessation. The organizations involved in performing the interventions included the local radio and television authority, health/treatment centers, the Red Crescent Society, Municipalities, the Relief Committee, the Center for Retirees’ Welfare, and the Literacy Campaign Organization. After 5 years, final phase same as first phase was planed. The subjects studied in all phases` the pre- and post-intervention phases consisted of 10586 women aged above 18 years. Demographic data, obesity index, smoking, physical activity and eating habit were assessed before and after the study. Data were analyzed using SPSS-15 using Student’s t-test, chi-square test, the general linear model of ANOVA, and logistic regression.    RESULTS: We studied 10586 women (6105 and 4481 women, pre- and post-intervention, respectively. Mean age of working women was 34.14 ± 10.09 and 34.08 ± 9.35 years before and after the study, respectively. Mean age of housewives before and after the study was 40.05 ± 14.61 and 40.36 ± 15.32 years, respectively. Interventions conducted during 5 years improved eating habits and decreased tobacco use in working women and housewives. In every phase of the study, there was a significant age difference between housewives and working women

  10. Evaluation of the effect of human immunodeficiency virus-related structural interventions: the connect to protect project.

    Science.gov (United States)

    Ellen, Jonathan M; Greenberg, Lauren; Willard, Nancy; Korelitz, James; Kapogiannis, Bill G; Monte, Dina; Boyer, Cherrie B; Harper, Gary W; Henry-Reid, Lisa M; Friedman, Lawrence B; Gonin, René

    2015-03-01

    -risk individuals and assessed the effect of numerous structural changes related to various HIV risk factors. No structural changes as measured in this study were associated with a statistically significant reduction in risk behaviors. These null findings underscore the need for a long-term approach in evaluating structural interventions and the development of more nuanced methods of quantifying and comparing structural-change initiatives and determining the appropriate strategies for evaluating effect.

  11. Diagnoses, Intervention Strategies, and Rates of Functional Improvement in Integrated Behavioral Health Care Patients

    Science.gov (United States)

    Bridges, Ana J.; Gregus, Samantha J.; Rodriguez, Juventino Hernandez; Andrews, Arthur R.; Villalobos, Bianca T.; Pastrana, Freddie A.; Cavell, Timothy A.

    2016-01-01

    Objective Compared with more traditional mental health care, integrated behavioral health care (IBHC) offers greater access to services and earlier identification and intervention of behavioral and mental health difficulties. The current study examined demographic, diagnostic, and intervention factors that predict positive changes for IBHC patients. Method Participants were 1,150 consecutive patients (mean age = 30.10 years, 66.6% female, 60.1% Hispanic, 47.9% uninsured) seen for IBHC services at 2 primary care clinics over a 34-month period. Patients presented with depressive (23.2%), anxiety (18.6%), adjustment (11.3%), and childhood externalizing (7.6%) disorders, with 25.7% of patients receiving no diagnosis. Results The most commonly delivered interventions included behavioral activation (26.1%), behavioral medicine-specific consultation (14.6%), relaxation training (10.3%), and parent-management training (8.5%). There was high concordance between diagnoses and evidence-based intervention selection. We used latent growth curve modeling to explore predictors of baseline global assessment of functioning (GAF) and improvements in GAF across sessions, utilizing data from a subset of 117 patients who attended at least 3 behavioral health visits. Hispanic ethnicity and being insured predicted higher baseline GAF, while patients with an anxiety disorder had lower baseline GAF than patients with other diagnoses. Controlling for primary diagnosis, patients receiving behavioral activation or exposure therapy improved at faster rates than patients receiving other interventions. Demographic variables did not relate to rates of improvement. Conclusion Results suggest even brief IBHC interventions can be focused, targeting specific patient concerns with evidence-based treatment components. PMID:25774786

  12. The SPIRIT Action Framework: A structured approach to selecting and testing strategies to increase the use of research in policy.

    Science.gov (United States)

    Redman, Sally; Turner, Tari; Davies, Huw; Williamson, Anna; Haynes, Abby; Brennan, Sue; Milat, Andrew; O'Connor, Denise; Blyth, Fiona; Jorm, Louisa; Green, Sally

    2015-07-01

    The recent proliferation of strategies designed to increase the use of research in health policy (knowledge exchange) demands better application of contemporary conceptual understandings of how research shapes policy. Predictive models, or action frameworks, are needed to organise existing knowledge and enable a more systematic approach to the selection and testing of intervention strategies. Useful action frameworks need to meet four criteria: have a clearly articulated purpose; be informed by existing knowledge; provide an organising structure to build new knowledge; and be capable of guiding the development and testing of interventions. This paper describes the development of the SPIRIT Action Framework. A literature search and interviews with policy makers identified modifiable factors likely to influence the use of research in policy. An iterative process was used to combine these factors into a pragmatic tool which meets the four criteria. The SPIRIT Action Framework can guide conceptually-informed practical decisions in the selection and testing of interventions to increase the use of research in policy. The SPIRIT Action Framework hypothesises that a catalyst is required for the use of research, the response to which is determined by the capacity of the organisation to engage with research. Where there is sufficient capacity, a series of research engagement actions might occur that facilitate research use. These hypotheses are being tested in ongoing empirical work. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. A review of strategies to stimulate dental professionals to integrate smoking cessation interventions into primary care.

    NARCIS (Netherlands)

    Rosseel, J.P.; Jacobs, J.E.; Plasschaert, A.J.M.; Grol, R.P.T.M.

    2012-01-01

    OBJECTIVE: To summarise evidence regarding the effectiveness of various implementation strategies to stimulate the delivery of smoking cessation advice and support during daily dental care. BASIC RESEARCH DESIGN: Search of online medical and psychological databases, correspondence with authors and

  14. The Cycle of Reciprocity: A Social Capital Intervention Strategy for SSTR Operations

    National Research Council Canada - National Science Library

    Tolle, Glenn A

    2007-01-01

    ... strategy based primarily on an infusion of physical or human capital. The author reviews key literature of social capital and examines two cases involving a harvest initiative in Gnjilane, Kosovo (July-September 1999...

  15. Adherence support strategies for exercise interventions in people with mild cognitive impairment and dementia: A systematic review

    Directory of Open Access Journals (Sweden)

    Veronika van der Wardt

    2017-09-01

    Full Text Available Exercise-based therapy may improve health status for people with Mild Cognitive Impairment (MCI or dementia but cannot work without adherence, which has proven difficult. This review aimed to evaluate strategies to support adherence among people with MCI or Dementia and was completed in Nottingham/UK in 2017. A narrative synthesis was used to investigate the effectiveness or usefulness of adherence support strategies. Fifteen adherence support strategies were used including theoretical underpinning (programmes based on behavior change theories, individual tailoring, worksheets and exercise booklets, goal setting, phone calls or reminders, newsletters, support to overcome exercise barriers, information, adaptation periods, individual supervision, support for clinicians, group setting, music, accelerometers/pedometers and emphasis on enjoyable activities. Music was the only strategy that was investigated in a comparative design but was found to be effective only for those who were generally interested in participating in activities. A wide range of adherence support strategies are being included in exercise interventions for people with MCI or dementia, but the evidence regarding their effectiveness is limited.

  16. Ethical Guidelines for Structural Interventions to Small-Scale Historic Stone Masonry Buildings.

    Science.gov (United States)

    Hurol, Yonca; Yüceer, Hülya; Başarır, Hacer

    2015-12-01

    Structural interventions to historic stone masonry buildings require that both structural and heritage values be considered simultaneously. The absence of one of these value systems in implementation can be regarded as an unethical professional action. The research objective of this article is to prepare a guideline for ensuring ethical structural interventions to small-scale stone historic masonry buildings in the conservation areas of Northern Cyprus. The methodology covers an analysis of internationally accepted conservation documents and national laws related to the conservation of historic buildings, an analysis of building codes, especially Turkish building codes, which have been used in Northern Cyprus, and an analysis of the structural interventions introduced to a significant historic building in a semi-intact state in the walled city of Famagusta. This guideline covers issues related to whether buildings are intact or ruined, the presence of earthquake risk, the types of structural decisions in an architectural conservation project, and the values to consider during the decision making phase.

  17. Genome-based nutrition: An intervention strategy for the prevention and treatment of obesity and nonalcoholic steatohepatitis

    Science.gov (United States)

    Roman, Sonia; Ojeda-Granados, Claudia; Ramos-Lopez, Omar; Panduro, Arturo

    2015-01-01

    Obesity and nonalcoholic steatohepatitis are increasing in westernized countries, regardless of their geographic location. In Latin America, most countries, including Mexico, have a heterogeneous admixture genome with Amerindian, European and African ancestries. However, certain high allelic frequencies of several nutrient-related polymorphisms may have been achieved by past gene-nutrient interactions. Such interactions may have promoted the positive selection of variants adapted to regional food sources. At present, the unbalanced diet composition of the Mexicans has led the country to a 70% prevalence rate of overweightness and obesity due to substantial changes in food habits, among other factors. International guidelines and intervention strategies may not be adequate for all populations worldwide because they do not consider disparities in genetic and environmental factors, and thus there is a need for differential prevention and management strategies. Here, we provide the rationale for an intervention strategy for the prevention and management of obesity-related diseases such as non-alcoholic steatohepatitis based on a regionalized genome-based diet. The components required to design such a diet should focus on the specific ancestry of each population around the world and the convenience of consuming traditional ethnic food. PMID:25834309

  18. Supportive monitoring and disease management through the internet: an internet-delivered intervention strategy for recurrent depression.

    Science.gov (United States)

    Kordy, Hans; Backenstrass, Matthias; Hüsing, Johannes; Wolf, Markus; Aulich, Kai; Bürgy, Martin; Puschner, Bernd; Rummel-Kluge, Christine; Vedder, Helmut

    2013-11-01

    Major depression is a highly prevalent, disabling disorder associated with loss of quality of life and large economic burden for the society. Depressive disorders often follow a chronic or recurrent course. The risk of relapses increases with each additional episode. The internet-deliverable intervention strategy SUMMIT (SUpportive Monitoring and Disease Management over the InTernet) for patients with recurrent depression has been developed with the main objectives to prolong symptom-free phases and to shorten symptom-loaden phases. This paper describes the study design of a six-sites, three-arm, randomized clinical trial intended to evaluate the efficacy of this novel strategy compared to treatment as usual (TAU). Two hundred thirty six patients who had been treated for their (at least) third depressive episode in one of the six participating psychiatric centers were randomized into one of three groups: 1) TAU plus a twelve-month SUMMIT program participation with personal support or 2) TAU plus a twelve-month SUMMIT program participation without personal support, or 3) TAU alone. Primary outcome of this study is defined as the number of "well weeks" over 24months after index treatment assessed by blind evaluators based on the Longitudinal Interval Follow-Up Evaluation. If efficacious, the low monetary and nonmonetary expenditures of this automated, yet individualized intervention may open new avenues for providing an acceptable, convenient, and affordable long-term disease management strategy to people with a chronic mental condition such as recurrent depression. © 2013.

  19. Exploring Instructional Strategies and Learning Theoretical Foundations of eHealth and mHealth Education Interventions.

    Science.gov (United States)

    Tamim, Suha R; Grant, Michael M

    2016-05-19

    This qualitative study aimed at exploring how health professionals use theories and models from the field of education to create ehealth and mhealth education interventions in an effort to provide insights for future research and practice on the development and implementation of health promotion initiatives. A purposeful sample of 12 participants was selected, using criterion and snowballing sampling strategies. Data were collected and analyzed from semistructured interviews, planning materials, and artifacts. The findings revealed that none of the participants used a specific learning theory or an instructional model in their interventions. However, based on participants' description, three themes emerged: (1) connections to behaviorist approaches to learning, (2) connections to cognitivist approaches to learning, and (3) connections to constructivist approaches to learning. Suggested implications for practice are (1) the design of a guidebook on the interplay of learning theories, instructional models, and health education and (2) the establishment of communities of practice. Further research can (1) investigate how learning theories and models intertwine with health behavior theories and models, (2) evaluate how the different instructional strategies presented in this study affect learning outcomes and health behavior change processes, and (3) investigate factors behind the instructional strategies choices made by health professionals. © 2016 Society for Public Health Education.

  20. Structure, coercive control, and autonomy promotion: A comparison of fathers' and mothers' food parenting strategies.

    Science.gov (United States)

    Pratt, Mercedes; Hoffmann, Debra; Taylor, Maija; Musher-Eizenman, Dara

    2017-05-01

    This study explored differences in mothers' and fathers' food parenting strategies, specifically coercive control, structure, and autonomy promotion, and whether parenting style and parental responsibility for food parenting related to the use of these strategies. Parents of children aged 2.5-7.5 years ( N = 497) reported about their parenting practices and food parenting strategies. Parenting style accounted for the majority of the variance in food parenting. Fathers were more authoritarian than mothers. Authoritarian and permissive parenting practices were related to more coercive strategies. Mothers reported more food parenting responsibility. Responsibility was related to less coercive practices and more autonomy promotion and structure.

  1. Computational Strategies for the Architectural Design of Bending Active Structures

    DEFF Research Database (Denmark)

    Tamke, Martin; Nicholas, Paul

    2013-01-01

    Active bending introduces a new level of integration into the design of architectural structures, and opens up new complexities for the architectural design process. In particular, the introduction of material variation reconfigures the design space. Through the precise specification...

  2. Information Structures in Nash and Leader-Follower Strategies.

    Science.gov (United States)

    1981-01-01

    OICkASSIPICATION/ OOWNGRAOING IS. OISTNIIIUTION STATEMINT (ao tD. esPort ) * Approved for public release; distribution unlimited. 17. DISTRIBUTION STATEMENT...problems and two market models of duopoly ith this type of information structure are extensively analyzed and examined. DO jAN7, 1473 EDIION OF NV SS IS...information 3 structure is employed in both Nash games and optimal coordination problems and two market models of duopoly with this type of information

  3. Evaluability Assessment of an immunization improvement strategy in rural Burkina Faso: intervention theory versus reality, information need and evaluations.

    Science.gov (United States)

    Sanou, Aboubakary; Kouyaté, Bocar; Bibeau, Gilles; Nguyen, Vinh-Kim

    2011-08-01

    An innovative immunization improvement strategy was proposed by the CRSN (Centre de Recherche en Santé de Nouna) to improve the low coverage rate for children aged 0-11 months in the health district of Nouna in Burkina Faso. This article reports on the Evaluability Assessment (EA) study that aimed to orient decisions for its evaluation in close relationship with the information needs of the stakeholders. Various methods were used, including document reviews, individual interviews, focus group discussions, meetings, literature reviews and site visits. A description of the intervention theory and philosophy is provided with its logic models and its reality documented. Lessons on the procedure include the importance of the position of the evaluability assessor, the value of replicating some steps of the assessment and the relationships between EA and process evaluation. The evaluability study concludes that the intervention had some evaluable components. To satisfy the stakeholders' needs, the initially planned community randomized controlled trial can be maintained and complemented with a process evaluation. There is a need to provide sufficient information on the cost of the intervention. This will inform decision makers on the possibility of replicating the intervention in other contexts. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. The staying safe intervention: training people who inject drugs in strategies to avoid injection-related HCV and HIV infection.

    Science.gov (United States)

    Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria; Sandoval, Milagros; Cleland, Charles M; Jordan, Ashly; Hagan, Holly; Lune, Howard; Friedman, Samuel R

    2014-04-01

    This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks.

  5. Caregiver Coaching Strategies for Early Intervention Providers: Moving toward Operational Definitions

    Science.gov (United States)

    Friedman, Mollie; Woods, Juliann; Salisbury, Christine

    2012-01-01

    Early intervention (EI) providers increasingly coach and collaborate with caregivers to strengthen and support caregiver-child interactions. The EI providers learning to coach other adults benefit from knowing what, exactly, they should do to support caregivers. This article serves two purposes. First, it proposes an operationally defined,…

  6. Women's Self-Ratings of Skills: Issues and Strategies for Intervention.

    Science.gov (United States)

    Reixach, Deborah

    1995-01-01

    Discusses underestimation of women's skills as an issue of concern for all women and for socioeconomically disadvantaged women in particular. Factors contributing to underestimation are gender-biased expectations, socialization, gender-biased definitions of skills, discrimination, and low self-esteem. Presents interventions to increase skills…

  7. Environmental influences on physical activity among adolescents: studies on determinants and intervention strategies

    NARCIS (Netherlands)

    R.G. Prins (Richard)

    2012-01-01

    textabstractThis thesis aimed to answer two research questions: 1. How is the physical environment associated with PA behaviour among adolescents? 2. What are the effects of a computer-tailored intervention (YouRAction) that targets individual level factors and of a computer-tailored

  8. A randomized trial of three marketing strategies to disseminate a screening and brief alcohol intervention programme to general practitioners.

    Science.gov (United States)

    Lock, C A; Kaner, E F; Heather, N; McAvoy, B R; Gilvarry, E

    1999-09-01

    Research findings are of little benefit to patients or society if they do not reach the audience they are intended to influence. A dissemination strategy is needed to target new findings at its user group and encourage a process of consideration and adoption or rejection. To evaluate the effectiveness and cost-effectiveness of different marketing strategies for the dissemination of a screening and brief alcohol intervention (SBI) programme to general practitioners (GPs). Seven hundred and twenty-nine GPs, one per practice, from the former Northern and Yorkshire Regional Health Authority were randomly assigned to one of three marketing strategies: postal marketing (mailing a promotional brochure to GPs), telemarketing (following a script to market the programme over the telephone), and personal marketing (following the same script during face-to-face marketing at GPs' practices). GPs who took up the programme were asked if they would agree to use it. Outcome measures included the proportions of GPs who took up the programme and agreement to use it. Of the 614 GPs eligible for the study, 321 (52%) took the programme. There was a significant difference in the proportions of GPs from the three marketing strategies who took the programme (82% telemarketing, 68% personal marketing, and 22% postal marketing). Of the 315 GPs who took the programme and were eligible to use it, 128 (41%) agreed to use the programme for three months. GPs in the postal marketing group were more likely to agree to use the programme (55% postal marketing, 44% personal marketing, and 34% telemarketing). Personal marketing was the most effective overall dissemination strategy; however, economic analysis revealed that telemarketing was the most cost-effective strategy. Costs for dissemination per GP were: 13 Pounds telemarketing, 15 Pounds postal marketing, and 88 Pounds personal marketing. Telemarketing appeared to be the most cost-effective strategy for dissemination of SBI to GPs.

  9. Re-cycling social housing.Tools, methods, design strategies for innovating Social Housing processes and intervention models

    Directory of Open Access Journals (Sweden)

    Massimo Perriccioli

    2014-05-01

    Full Text Available The sustainable renewal of social housing can only be tackled nowadays with the help of design strategies which are able to deal with and coordinate three key issues: the transformation of housing requisites, the deployment of new operational and financial models for carrying out interventions, and the optimization of energy and material resources. The Social Housing cluster was set up a few months ago in the SITdA to coordinate multi-disciplinary research projects exploring the economic, social and environmental feasibility of experimental interventions designed to upgrade the existing built heritage in the light of the most recent energy standards, while at the same time responding to the new housing requisites emerging in the various regional contexts throughout Italy.

  10. A complex systems approach to evaluate HIV prevention in metropolitan areas: preliminary implications for combination intervention strategies.

    Science.gov (United States)

    Marshall, Brandon D L; Paczkowski, Magdalena M; Seemann, Lars; Tempalski, Barbara; Pouget, Enrique R; Galea, Sandro; Friedman, Samuel R

    2012-01-01

    hypothetical combination prevention interventions. Future work will seek to inform novel strategies that may lead to more effective and equitable HIV prevention strategies for drug-using populations.

  11. A complex systems approach to evaluate HIV prevention in metropolitan areas: preliminary implications for combination intervention strategies.

    Directory of Open Access Journals (Sweden)

    Brandon D L Marshall

    of hypothetical combination prevention interventions. Future work will seek to inform novel strategies that may lead to more effective and equitable HIV prevention strategies for drug-using populations.

  12. Corporate strategy and the organizational structure of companies in international business

    Directory of Open Access Journals (Sweden)

    Aleksić Ana

    2004-01-01

    Full Text Available The aim of this paper is to illuminate the importance of corporate strategy and organizational structure as crucial variables for successful international business. We wanted to point out that companies, in order to exploit opportunities in international environment, must develop a high level of consent between the applied strategy and the model of organizational structure. Today all organizations, no matter how big they are, are affected by the international environment and its management must consider very carefully the benefits and costs of alternative strategies and the corresponding models of organizational structure.

  13. The effect of self-regulated strategy instruction and behavioral consultation on motivation : A longitudinal study on the effect of school-based interventions in secondary education.

    NARCIS (Netherlands)

    Minnaert, Alexander; Prince, Arnout; Opdenakker, Marie

    2017-01-01

    Studies show a decrease in students’ motivation in secondary education. Hence, it was investigated whether training of teachers could stop this decline. Two interventions were implemented in prevocational secondary education, being self-regulated strategy instruction and behavioral consultation

  14. Combined Intimate Partner Violence and HIV/AIDS Prevention in Rural Uganda: Design of the SHARE Intervention Strategy

    Science.gov (United States)

    Wagman, Jennifer A.; King, Elizabeth J.; Namatovu, Fredinah; Kiwanuka, Deus; Kairania, Robert; Ssemanda, John Baptist; Nalugoda, Fred; Serwadda, David; Wawer, Maria J.; Gray, Ronald; Brahmbhatt, Heena

    2016-01-01

    Intimate partner violence (IPV) has a bidirectional relationship with HIV infection. Researchers from Rakai Health Sciences Program (RHSP), an HIV research and services organization in rural Uganda, conducted a combination IPV and HIV prevention intervention called the Safe Homes And Respect for Everyone (SHARE) Project between 2005–2009. SHARE was associated with significant declines in physical and sexual IPV and overall HIV incidence and its model could be adopted as a promising practice in other settings. In this paper we describe how SHARE’s IPV-prevention strategies were integrated into RHSP’s existing HIV programming and provide recommendations for replication of the approach. PMID:26086189

  15. Case Report: Evaluation strategies and cognitive intervention: the case of a monovular twin child affected by selective mutism.

    Science.gov (United States)

    Capobianco, Micaela; Cerniglia, Luca

    2018-01-01

    The present work describes the assessment process, evaluation strategies, and cognitive intervention on a 9 years old child with selective mutism (SM), a monovular twin of a child also affected by mutism. Currently, the cognitive behavioral multimodal treatment seems the most effective therapeutic approach for children diagnosed with selective mutism (Capobianco & Cerniglia, 2018). The illustrated case confirms the role of biological factors involved in mutacic disorder but also highlights the importance of environmental influences in the maintenance of the disorder with respect to relational and contextual dynamics (e.g. complicity between sisters, family relationships). The article discusses furthermore the importance of an early diagnosis as a predictor of positive treatment outcomes.

  16. Targeting activator protein 1 signaling pathway by bioactive natural agents: Possible therapeutic strategy for cancer prevention and intervention.

    Science.gov (United States)

    Tewari, Devesh; Nabavi, Seyed Fazel; Nabavi, Seyed Mohammad; Sureda, Antoni; Farooqi, Ammad Ahmad; Atanasov, Atanas G; Vacca, Rosa Anna; Sethi, Gautam; Bishayee, Anupam

    2018-02-01

    Activator protein 1 (AP-1) is a key transcription factor in the control of several cellular processes responsible for cell survival proliferation and differentiation. Dysfunctional AP-1 expression and activity are involved in several severe diseases, especially inflammatory disorders and cancer. Therefore, targeting AP-1 has recently emerged as an attractive therapeutic strategy for cancer prevention and therapy. This review summarizes our current understanding of AP-1 biology and function as well as explores and discusses several natural bioactive compounds modulating AP-1-associated signaling pathways for cancer prevention and intervention. Current limitations, challenges, and future directions of research are also critically discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. A National Early Intervention System as a Strategy to Promote Inclusion and Academic Achievement in Portugal

    Directory of Open Access Journals (Sweden)

    Vitor Franco

    2017-07-01

    Full Text Available Early intervention with children at risk or facing developmental problems is a practice defined by three fundamental characteristics: being family-centered, being based on the community and on the child’s life context, and being conducted by a team with transdisciplinary practice. In this paper we wish to present how the SNIPI-National System of Early Intervention, implemented in Portugal over the past 15 years, contributes to promote maximum development and the full inclusion of children up to 6 years of age and works to prevent school failure. The SNIPI covers the entire territory and intends to respond to the needs of children with developmental disorders or those in at risk situations. This community-based early intervention model is linked to the health, education and social care systems, involving the three responsible Ministries. In the present community case study, we present the implementation of this program in the Alentejo region, involving 31 local teams and almost 2500 children. Through the regional structure’s reports and the responses of parents and professionals in impact studies, we demonstrate how the system is established and how it tackles school failure and improves the educational inclusion of these children. The impact of this Early Intervention model has been significant not only on children’s developmental outcomes, but also for the health, education and social care professionals who work in a transdisciplinary perspective, as well as for the families who became more skilled at evaluating the children’s needs and the support provided. This approach to implementing a family-centered Early Intervention program can contribute to full inclusion. It facilitates the transition to schooling based on a non-discriminatory approach and educational achievement by aiding development and an adapted contextualization in pre-school education. This program system introduces significant innovation within the framework of existing

  18. Variations in Substance Use Prevalence Estimates and Need for Interventions Among Adult Emergency Department Patients Based on Different Screening Strategies Using the ASSIST

    Directory of Open Access Journals (Sweden)

    Roland C. Merchant

    2016-06-01

    Full Text Available Introduction: Among adult emergency department (ED patients, we sought to examine how estimates of substance use prevalence and the need for interventions can differ, based on the type of screening and assessment strategies employed. Methods: We estimated the prevalence of substance use and the need for interventions using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST in a secondary analysis of data from two cross-sectional studies using random samples of English- or Spanish-speaking 18-64-year-old ED patients. In addition, the test performance characteristics of three simplified screening strategies consisting of selected questions from the ASSIST (lifetime use, past three-month use, and past three-month frequency of use to identify patients in need of a possible intervention were compared against using the full ASSIST. Results: Of 6,432 adult ED patients, the median age was 37 years-old, 56.6% were female, and 61.6% were white. Estimated substance use prevalence among this population differed by how it was measured (lifetime use, past three-month use, past three-month frequency of use, or need for interventions. As compared to using the full ASSIST, the predictive value and accuracy to identify patients in need of any intervention was best for a simplified strategy asking about past three-month substance use. A strategy asking about daily/near-daily use was better in identifying patients needing intensive interventions. However, some patients needing interventions were missed when using these simplified strategies. Conclusion: Substance use prevalence estimates and identification of ED patients needing interventions differ by screening strategies used. EDs should carefully select strategies to identify patients in need of substance use interventions.

  19. Social evolution in micro-organisms and a Trojan horse approach to medical intervention strategies.

    Science.gov (United States)

    Brown, Sam P; West, Stuart A; Diggle, Stephen P; Griffin, Ashleigh S

    2009-11-12

    Medical science is typically pitted against the evolutionary forces acting upon infective populations of bacteria. As an alternative strategy, we could exploit our growing understanding of population dynamics of social traits in bacteria to help treat bacterial disease. In particular, population dynamics of social traits could be exploited to introduce less virulent strains of bacteria, or medically beneficial alleles into infective populations. We discuss how bacterial strains adopting different social strategies can invade a population of cooperative wild-type, considering public good cheats, cheats carrying medically beneficial alleles (Trojan horses) and cheats carrying allelopathic traits (anti-competitor chemical bacteriocins or temperate bacteriophage viruses). We suggest that exploitation of the ability of cheats to invade cooperative, wild-type populations is a potential new strategy for treating bacterial disease.

  20. Nonspecific non-acute low back pain and psychological interventions: A review of evidence and current strategies

    Directory of Open Access Journals (Sweden)

    Gourav Banerjee

    2015-01-01

    Full Text Available Nonspecific persistent and chronic low back pain (LBP is one of the world′s most significant burdens. Its management continues to be challenging despite advancements in medical diagnostics and therapeutics. The purpose of this narrative review is to update evidence-based, multidisciplinary assessment and treatment strategies for nonspecific non-acute LBP with special emphasis on the growing influence of psychological principles in physiotherapists′ (PT practice. An electronic literature search was performed to identify relevant clinical practice guidelines, from which an overarching summary was synthesized. All guidelines were consistent in their recommendations for the assessment of psychosocial factors and psychology-based interventions. In discussion, we underlined psychological processes and psychology-based strategies that are clinically relevant to, and within the professional competency and scope of PT practice.

  1. Generation of intervention strategy for a genetic regulatory network represented by a family of Markov Chains.

    Science.gov (United States)

    Berlow, Noah; Pal, Ranadip

    2011-01-01

    Genetic Regulatory Networks (GRNs) are frequently modeled as Markov Chains providing the transition probabilities of moving from one state of the network to another. The inverse problem of inference of the Markov Chain from noisy and limited experimental data is an ill posed problem and often generates multiple model possibilities instead of a unique one. In this article, we address the issue of intervention in a genetic regulatory network represented by a family of Markov Chains. The purpose of intervention is to alter the steady state probability distribution of the GRN as the steady states are considered to be representative of the phenotypes. We consider robust stationary control policies with best expected behavior. The extreme computational complexity involved in search of robust stationary control policies is mitigated by using a sequential approach to control policy generation and utilizing computationally efficient techniques for updating the stationary probability distribution of a Markov chain following a rank one perturbation.

  2. Effective behavioral intervention strategies using mobile health applications for chronic disease management: a systematic review.

    Science.gov (United States)

    Lee, Jung-Ah; Choi, Mona; Lee, Sang A; Jiang, Natalie

    2018-02-20

    Mobile health (mHealth) has continuously been used as a method in behavioral research to improve self-management in patients with chronic diseases. However, the evidence of its effectiveness in chronic disease management in the adult population is still lacking. We conducted a systematic review to examine the effectiveness of mHealth interventions on process measures as well as health outcomes in randomized controlled trials (RCTs) to improve chronic disease management. Relevant randomized controlled studies that were published between January 2005 and March 2016 were searched in six databases: PubMed, CINAHL, EMBASE, the Cochrane Library, PsycINFO, and Web of Science. The inclusion criteria were RCTs that conducted an intervention using mobile devices such as smartphones or tablets for adult patients with chronic diseases to examine disease management or health promotion. Of the 12 RCTs reviewed, 10 of the mHealth interventions demonstrated statistically significant improvement in some health outcomes. The most common features of mHealth systems used in the reviewed RCTs were real-time or regular basis symptom assessments, pre-programed reminders, or feedbacks tailored specifically to the data provided by participants via mHealth devices. Most studies developed their own mHealth systems including mobile apps. Training of mHealth systems was provided to participants in person or through paper-based instructions. None of the studies reported the relationship between health outcomes and patient engagement levels on the mHealth system. Findings from mHealth intervention studies for chronic disease management have shown promising aspects, particularly in improving self-management and some health outcomes.

  3. Strategies for mHealth research: lessons from 3 mobile intervention studies.

    Science.gov (United States)

    Ben-Zeev, Dror; Schueller, Stephen M; Begale, Mark; Duffecy, Jennifer; Kane, John M; Mohr, David C

    2015-03-01

    The capacity of Mobile Health (mHealth) technologies to propel healthcare forward is directly linked to the quality of mobile interventions developed through careful mHealth research. mHealth research entails several unique characteristics, including collaboration with technologists at all phases of a project, reliance on regional telecommunication infrastructure and commercial mobile service providers, and deployment and evaluation of interventions "in the wild", with participants using mobile tools in uncontrolled environments. In the current paper, we summarize the lessons our multi-institutional/multi-disciplinary team has learned conducting a range of mHealth projects using mobile phones with diverse clinical populations. First, we describe three ongoing projects that we draw from to illustrate throughout the paper. We then provide an example for multidisciplinary teamwork and conceptual mHealth intervention development that we found to be particularly useful. Finally, we discuss mHealth research challenges (i.e. evolving technology, mobile phone selection, user characteristics, the deployment environment, and mHealth system "bugs and glitches"), and provide recommendations for identifying and resolving barriers, or preventing their occurrence altogether.

  4. Child development surveillance: intervention study with nurses of the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Altamira Pereira da Silva Reichert

    2015-10-01

    Full Text Available Objective: to evaluate the effectiveness of an educational action in child development surveillance performed by nurses working in primary health care.Methods: interventional study with a before-and-after type of design, carried out with 45 nurses and 450 mothers of children under 2 years of age. Initially, it was evaluated the practices and knowledge of nurses on child development surveillance and the mothers were interviewed about these practices. Subsequently, workshops were carried out with nurses and four months later, the knowledge of nurses and the maternal information were reevaluated.Results: after intervention there was significant increase in the frequency of the following aspects: from 73% to 100%, in relation to the practice of nurses of asking the opinion of mothers about their children's development; from 42% to 91%, regarding the use of the systematized instrument of evaluation; from 91% to 100% with respect to guidance to mothers on how to stimulate child development.Conclusions: the intervention contributed to the increase of knowledge of nurses and implementation of child development surveillance, showing the importance of this initiative to improve the quality of child health care.

  5. Child development surveillance: intervention study with nurses of the Family Health Strategy.

    Science.gov (United States)

    Reichert, Altamira Pereira da Silva; Collet, Neusa; Eickmann, Sophie Helena; Lima, Marília de Carvalho

    2015-01-01

    to evaluate the effectiveness of an educational action in child development surveillance performed by nurses working in primary health care. interventional study with a before-and-after type of design, carried out with 45 nurses and 450 mothers of children under 2 years of age. Initially, it was evaluated the practices and knowledge of nurses on child development surveillance and the mothers were interviewed about these practices. Subsequently, workshops were carried out with nurses and four months later, the knowledge of nurses and the maternal information were reevaluated. after intervention there was significant increase in the frequency of the following aspects: from 73% to 100%, in relation to the practice of nurses of asking the opinion of mothers about their children's development; from 42% to 91%, regarding the use of the systematized instrument of evaluation; from 91% to 100% with respect to guidance to mothers on how to stimulate child development. the intervention contributed to the increase of knowledge of nurses and implementation of child development surveillance, showing the importance of this initiative to improve the quality of child health care.

  6. Examining the efficacy of a brief group protective behavioral strategies skills training alcohol intervention with college women.

    Science.gov (United States)

    Kenney, Shannon R; Napper, Lucy E; LaBrie, Joseph W; Martens, Matthew P

    2014-12-01

    College students' use of protective behavioral strategies (PBS; e.g., determining not to exceed a set number of drinks, avoiding drinking games) is related to lower levels of alcohol consumption and problems. The present study evaluated the efficacy of a novel brief, single-session group PBS skills training intervention aimed at increasing college students' use of PBS and reducing risky drinking and consequences. Participants (N = 226) were heavy-drinking incoming first-year college women randomized to either a PBS skills training intervention or study skills control condition. Participants attended a 45-min group session and completed online surveys pre- and postintervention (1 month and 6 months). We conducted a series of 2 × 2 × 3 repeated-measures ANCOVAs with condition and baseline mental health (anxiety/depression) as the between-subjects factors and time as the within-subjects factor. Intervention participants, relative to controls, reported significantly greater increases in PBS use and reductions in both heavy episodic drinking and alcohol consequences. The intervention was particularly effective in increasing PBS use at 1 month among participants with high anxiety. Further, tests of moderated mediation showed a significant conditional indirect effect of condition on 1-month consequences through PBS use among participants with high levels of anxiety. Findings provide preliminary support for a brief PBS-specific group intervention to reduce alcohol risk among college women, particularly anxious women. Future research is needed to strengthen the long-term effectiveness of the present approach and further explore the moderating effects of mental health.

  7. Vibration based structural assessment of the rehabilitation intervention in r.c. segmental bridge

    Directory of Open Access Journals (Sweden)

    Franchetti Paolo

    2015-01-01

    Full Text Available A vibration based structural assessment campaign was carried out on a r.c. segmental bridge in North East Italy. The bridge has a cantilever static scheme, fixed at the top of the piers and with a hinge at the centre of the span. The particular configuration of the hinge consists in a couple of steel elements, each one composed by a tongue and groove joint. Since the year 1960, the hinge was subjected to consumption and degradation, that caused a malfunctioning of the device. An intervention of rehabilitation of the bridge led to a reinforcement of the existing hinges with the coupling of new metallic devices: new tongue and groove hinges were applied, that by one side allow the horizontal displacements and rotation, by the other side strongly reduce the relative vertical displacements of the two parts of the bridge. A dynamic test campaign was set up in order to assess the effectiveness of the intervention. The principal dynamic parameters were calculated and analysed with respect to the intervention that was realized. The tests clearly showed the effectiveness of the intervention, and helped the designer to have a better understanding of the structural behaviour of the bridge.

  8. Expert Strategies in Solving Algebraic Structure Sense Problems: The Case of Quadratic Equations

    Science.gov (United States)

    Jupri, Al; Sispiyati, R.

    2017-02-01

    Structure sense, an intuitive ability towards symbolic expressions, including skills to interpret, to manipulate, and to perceive symbols in different roles, is considered as a key success in learning algebra. In this article, we report results of three phases of a case study on solving algebraic structure sense problems aiming at testing the appropriateness of algebraic structure sense tasks and at investigating expert strategies dealing with the tasks. First, we developed three tasks on quadratic equations based on the characteristics of structure sense for high school algebra. Next, we validated the tasks to seven experts. In the validation process, we requested these experts to solve each task using two different strategies. Finally, we analyzing expert solution strategies in the light of structure sense characteristics. We found that even if eventual expert strategies are in line with the characteristics of structure sense; some of their initial solution strategies used standard procedures which might pay less attention to algebraic structures. This finding suggests that experts have reconsidered their procedural work and have provided more efficient solution strategies. For further investigation, we consider to test the tasks to high school algebra students and to see whether they produce similar results as experts.

  9. The Impact of a Student-Led Pedometer Intervention Incorporating Cognitive-Behavioral Strategies on Step Count and Self-Efficacy

    Science.gov (United States)

    Raedeke, Thomas D.; Focht, Brian C.; King, Jenna S.

    2010-01-01

    This study evaluated the effectiveness of a student-led physical activity intervention that incorporated pedometers and cognitive-behavioral strategies. Undergraduate students (N = 117) enrolled in upper division exercise and sport science courses recruited participants. Participants in the cognitive-behavioral intervention condition received…

  10. Intervention Strategies to Increase the Proportion of Girls and Women Studying and Pursuing Careers in Technological Fields: A West European Overview.

    Science.gov (United States)

    Chivers, Geoff

    1986-01-01

    Reviews a range of intervention strategies which have been developed and introduced to deal with identified barriers to females' involvement with technology in Western Europe. Includes separate interventions affecting elementary school age, secondary age, older girls and young women, and older women. (ML)

  11. Children, Teachers, and Families Working Together to Prevent Childhood Obesity: Intervention Strategies

    Science.gov (United States)

    Stegelin, Dolores A.

    2008-01-01

    Obesity rates for children, adolescents, and adults continue to escalate in the United States and globally. Educators, health specialists, psychologists, and sociologists are studying the complex problems related to early obesity. Like other health problems, prevention and early detection are the most effective strategies. The causes and…

  12. Procedural pain management for neonates using nonpharmacological strategies: part 2: mother-driven interventions.

    Science.gov (United States)

    Campbell-Yeo, Marsha; Fernandes, Ananda; Johnston, Celeste

    2011-10-01

    This is the second of a 2-part series to provide an overview of our current level of knowledge related to nonpharmacological strategies to diminish the pain associated with commonly performed procedures in the NICU. In our first article we discussed the prevalence of repeated pain exposure in the NICU and the importance of nonpharmacological strategies specifically containment or facilitated tucking, swaddling, positioning, nonnutritive sucking, and sweet solutions. These strategies are generally nurse-driven and we believe their importance has been underutilized. In this article we will emphasize the importance of maternal presence as a mediator for pain relief. The efficacy of breastfeeding, maternal skin-to-skin care (often referred to as kangaroo care), and multisensorial stimulation such as auditory and olfactory recognition will be the primary focus of our discussion. In addition, although primarily mother-driven, these strategies are ultimately nurse-enabled, thus the importance of this connection cannot be under appreciated with respect to successful implementation in the NICU.

  13. Interventions with Men Who Are Violent to Their Partners: Strategies for Early Engagement

    Science.gov (United States)

    Adams, Peter J.

    2012-01-01

    Practitioners who view intimate partner violence as a set of strategies aimed at maintaining positions of power and privilege often face an engagement dilemma when men at their first contact talk of themselves as disempowered by circumstances such as separation, loss of access to children, legal problems, substance abuse issues, and their own…

  14. An investigation of the effects of interventions on problem-solving strategies and abilities

    Science.gov (United States)

    Cox, Charles Terrence, Jr.

    Problem-solving has been described as being the "heart" of the chemistry classroom, and students' development of problem-solving skills is essential for their success in chemistry. Despite the importance of problem-solving, there has been little research within the chemistry domain, largely because of the lack of tools to collect data for large populations. Problem-solving was assessed using a software package known as IMMEX (for Interactive Multimedia Exercises) which has an HTML tracking feature that allows for collection of problem-solving data in the background as students work the problems. The primary goal of this research was to develop methods (known as interventions) that could promote improvements in students' problem-solving and most notably aid in their transition from the novice to competent level. Three intervention techniques that were incorporated within the chemistry curricula: collaborative grouping (face-to-face and distance), concept mapping, and peer-led team learning. The face-to-face collaborative grouping intervention was designed to probe the factors affecting the quality of the group interaction. Students' logical reasoning abilities were measured using the Group Assessment of Logical Thinking (GALT) test which classifies students as formal, transitional, or concrete. These classifications essentially provide a basis for identifying scientific aptitude. These designations were used as the basis for forming collaborative groups of two students. The six possibilities (formal-formal, formal-transitional, etc.) were formed to determine how the group composition influences the gains in student abilities observed from collaborative grouping interventions. Students were given three assignments (an individual pre-collaborative, an individual post collaborative, and a collaborative assignment) each requiring them to work an IMMEX problem set. Similar gains in performance of 10% gains were observed for each group with two exceptions. The

  15. Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies.

    Directory of Open Access Journals (Sweden)

    Jamie T Griffin

    2010-08-01

    Full Text Available Over the past decade malaria intervention coverage has been scaled up across Africa. However, it remains unclear what overall reduction in transmission is achievable using currently available tools.We developed an individual-based simulation model for Plasmodium falciparum transmission in an African context incorporating the three major vector species (Anopheles gambiae s.s., An. arabiensis, and An. funestus with parameters obtained by fitting to parasite prevalence data from 34 transmission settings across Africa. We incorporated the effect of the switch to artemisinin-combination therapy (ACT and increasing coverage of long-lasting insecticide treated nets (LLINs from the year 2000 onwards. We then explored the impact on transmission of continued roll-out of LLINs, additional rounds of indoor residual spraying (IRS, mass screening and treatment (MSAT, and a future RTS,S/AS01 vaccine in six representative settings with varying transmission intensity (as summarized by the annual entomological inoculation rate, EIR: 1 setting with low, 3 with moderate, and 2 with high EIRs, vector-species combinations, and patterns of seasonality. In all settings we considered a realistic target of 80% coverage of interventions. In the low-transmission setting (EIR approximately 3 ibppy [infectious bites per person per year], LLINs have the potential to reduce malaria transmission to low levels (90% or novel tools and/or substantial social improvements will be required, although considerable reductions in prevalence can be achieved with existing tools and realistic coverage levels.Interventions using current tools can result in major reductions in P. falciparum malaria transmission and the associated disease burden in Africa. Reduction to the 1% parasite prevalence threshold is possible in low- to moderate-transmission settings when vectors are primarily endophilic (indoor-resting, provided a comprehensive and sustained intervention program is achieved through

  16. A dementia communication training intervention based on the VERA framework for pre-registration nurses: Part I developing and testing an implementation strategy.

    Science.gov (United States)

    Naughton, Corina; Beard, Chloe; Tzouvara, Vasiliki; Pegram, Anne; Verity, Rebecca; Eley, Rhiannon; Hingley, David

    2018-04-01

    People living with dementia experience progressive difficulty in expressing physical and emotional needs. Health care staff including student nurses require training to develop compensatory communication strategies. However, there is no standardised foundation level dementia communication training within pre-registration curricula. This article describes the theoretical underpinnings and development of a foundation level dementia communication skills training based on the VERA (Validation, Emotion, Reassurance, Activity) framework. The training strategies drew on behavioural change theory using the COM-B model and Gagné's 9 Events of Instruction. The VERA framework was operationalised using a multicomponent teaching strategy. The intervention was refined based on quality improvement Plan-Do-Study-Act cycles with feedback from people living with dementia, facilitators and student nurses. Data collection used semi-structured questionnaires (n = 51) and four focus group (n = 19) interviews with students. Data analysis involved descriptive statistics and thematic analysis. The intervention was a 2.5-hour face-to-face training session delivered at the start of students' older adult unit placement with follow-up reflection sessions during placement. Training was delivered to 51 students, all students described the training as useful and would recommend it to their peers. Elements of the training that were highly valued were: opportunities to express concerns in caring for people with dementia, applying the VERA framework using role play and outlining realistic expectations of VERA. Students recognised the need for on-going training especially for more complex patients. Combining behaviour change and education theory with stakeholder feedback strengthened the development of VERA as a foundation level dementia communication training for pre-registration nurses. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. The Impact of Text Structure Reading Strategy Instruction in a Second Language: Benefits across Languages

    Science.gov (United States)

    Schwartz, Ana Isabel; Mendoza, Laura; Meyer, Bonnie

    2017-01-01

    The goal of the present study was to examine the efficacy of learning a text structure strategy (TSS) for improving reading comprehension and recall for second language (L2) learners, as well as to test for transfer of the strategy to the native language (L1). University L2 learners of English completed a five-session course on using the TSS to…

  18. The impact of the Internet on media organisation strategies and structures

    NARCIS (Netherlands)

    Küng, L.; Leandros, N.; Picard, R.G.; Schroeder, R.; van der Wurff, R.; Küng, L.; Picard, R.G.; Towse, R.

    2008-01-01

    This chapter explores the effect on the Internet on organisations in the media sector from the perspective of theories of strategy and organisation. By extension its focus is the media organisation itself, specifically the interrelated phenomena of strategy, structure, processes and business models.

  19. An Enduring Framework for Assessing the Contributions of Force Structure to a Coercive Strategy

    National Research Council Canada - National Science Library

    Beene, Eric

    2001-01-01

    The US Department of Defense is still struggling to define itself in the post Cold War age, over a decade after the new period has begun With a strategy and force structure review occurring on average...

  20. Business strategy and financial structure: an empirical analysis of acute care hospitals.

    Science.gov (United States)

    Ginn, G O; Young, G J; Beekun, R I

    1995-01-01

    This study investigated the relationship between business strategy and financial structure in the U.S. hospital industry. We studied two dimensions of financial structure--liquidity and leverage. Liquidity was assessed by the acid ratio, and leverage was assessed using the equity funding ratio. Drawing from managerial, finance, and resource dependence perspectives, we developed and tested hypotheses about the relationship between Miles and Snow strategy types and financial structure. Relevant contextual financial and organizational variables were controlled for statistically through the Multivariate Analysis of Covariance technique. The relationship between business strategy and financial structure was found to be significant. Among the Miles and Snow strategy types, defenders were found to have relatively high liquidity and low leverage. Prospectors typically had low liquidity and high leverage. Implications for financial planning, competitive assessment, and reimbursement policy are discussed.

  1. Using intervention mapping for the development of a targeted secure web-based outreach strategy named SafeFriend, for Chlamydia trachomatis testing in young people at risk.

    Science.gov (United States)

    Theunissen, Kevin A T M; Hoebe, Christian J P A; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne K; van Bergen, Jan E A M; van der Sande, Marianne A B; Dukers-Muijrers, Nicole H T M

    2013-10-22

    Many young people at high risk for Chlamydia trachomatis (Ct) are not reached by current sexual health care systems, such as general practitioners and public sexual health care centres (sexually transmitted infection clinics).Ct is the most frequently diagnosed bacterial sexually transmitted infection (STI) among sexually active people and in particular young heterosexuals. Innovative screening strategies are needed to interrupt the transmission of Ct among young people and connect the hidden cases to care. Intervention Mapping (IM), a systematic approach to develop theory- and evidence-based interventions, was used to develop a strategy to target Ct testing towards young people who are currently hidden to care in The Netherlands. Both clinical users (i.e. sexual health care nurses) and public users (i.e., young people at risk for Ct) were closely involved in the IM process. A needs assessment study was carried out using semi-structured interviews among users (N = 21), a literature search and by taking lessons learned from existing screening programmes. Theoretical methods and practical applications to reach high risk young people and influence testing were selected and translated into specific programme components. The IM approach resulted in the development of a secure and web-based outreach Ct screening strategy, named SafeFriend. It is developed to target groups of high-risk young people who are currently hidden to care. Key methods include web-based Respondent Driven Sampling, starting from young Ct positive sexual health care centre clients, to reach and motivate peers (i.e., sex partners and friends) to get tested for Ct. Testing and the motivation of peers were proposed as the desired behavioural outcomes and the Precaution Adoption Process Model was chosen as theoretical framework. End users, i.e., young people and sexual health care nurses were interviewed and included in the development process to increase the success of implementation. IM proved useful

  2. [Perceptions of classroom goal structures, personal achievement goal orientations, and learning strategies].

    Science.gov (United States)

    Miki, Kaori; Yamauchi, Hirotsugu

    2005-08-01

    We examined the relations among students' perceptions of classroom goal structures (mastery and performance goal structures), students' achievement goal orientations (mastery, performance, and work-avoidance goals), and learning strategies (deep processing, surface processing and self-handicapping strategies). Participants were 323 5th and 6th grade students in elementary schools. The results from structural equation modeling indicated that perceptions of classroom mastery goal structures were associated with students' mastery goal orientations, which were in turn related positively to the deep processing strategies and academic achievement. Perceptions of classroom performance goal stractures proved associated with work avoidance-goal orientations, which were positively related to the surface processing and self-handicapping strategies. Two types of goal structures had a positive relation with students' performance goal orientations, which had significant positive effects on academic achievement. The results of this study suggest that elementary school students' perceptions of mastery goal structures are related to adaptive patterns of learning more than perceptions of performance goal structures are. The role of perceptions of classroom goal structure in promoting students' goal orientations and learning strategies is discussed.

  3. The Dynamics of Avian Influenza: Individual-Based Model with Intervention Strategies in Traditional Trade Networks in Phitsanulok Province, Thailand

    Directory of Open Access Journals (Sweden)

    Chaiwat Wilasang

    2016-01-01

    Full Text Available Avian influenza virus subtype H5N1 is endemic to Southeast Asia. In Thailand, avian influenza viruses continue to cause large poultry stock losses. The spread of the disease has a serious impact on poultry production especially among rural households with backyard chickens. The movements and activities of chicken traders result in the spread of the disease through traditional trade networks. In this study, we investigate the dynamics of avian influenza in the traditional trade network in Phitsanulok Province, Thailand. We also propose an individual-based model with intervention strategies to control the spread of the disease. We found that the dynamics of the disease mainly depend on the transmission probability and the virus inactivation period. This study also illustrates the appropriate virus disinfection period and the target for intervention strategies on traditional trade network. The results suggest that good hygiene and cleanliness among household traders and trader of trader areas and ensuring that any equipment used is clean can lead to a decrease in transmission and final epidemic size. These results may be useful to epidemiologists, researchers, and relevant authorities in understanding the spread of avian influenza through traditional trade networks.

  4. Strategy of the effective structure of farmers funding

    Directory of Open Access Journals (Sweden)

    Denis Y. Samygin

    2017-01-01

    Full Text Available Research objective. Scientific research raises the problem of state support of peasant farms in Russia, consisting in disproportions in the structure of the budget subsidies of farmers, showing that a significant proportion of directions and types of budgetary allocations is provided by state support for lending to agricultural production.On the one hand, this measure is directed to activization of agrarian policy on attraction of additional loan sources of financing. On the other hand, at insufficient interest of financial structures in agricultural industry, weak competitiveness of landowners with the banking sector, low availability of credit resources to the most part of producers, the specified support measures only promote growth of debt load of major agricultural firms and limit farmers in obtaining budgetary funds that does not increase their special legal status and the importance for agrarian economy, does not add social importance for rural territories, does not lead to increase in the general effectiveness in agricultural production and does not promote efficiency to use the means of support, and, therefore, demands formation basic other more effective approach to subsidizing of small farms in the village. Therefore, a research objective is justification and development of strategic models of structure optimization of the budgetary support of peasant farms, taking into account efficiency of measures, which relevance is confirmed by scientific research of the leading scientists in this subject area.Materials and methods. The study used: data of state programs on agricultural industry during 2008-2012 and 2013–2020; analytical materials of national reports of their realization; statistical information resources of the Ministry of Agriculture of the Russian Federation; consolidated, individual financial and economic reports on agricultural producers of Penza region, which are processed by the methods of logical analytics, structural

  5. The “Suicide Guard Rail”: a minimal structural intervention in hospitals reduces suicide jumps

    Directory of Open Access Journals (Sweden)

    Mohl Andreas

    2012-08-01

    Full Text Available Abstract Background Jumping from heights is a readily available and lethal method of suicide. This study examined the effectiveness of a minimal structural intervention in preventing suicide jumps at a Swiss general teaching hospital. Following a series of suicide jumps out of the hospital’s windows, a metal guard rail was installed at each window of the high-rise building. Results In the 114 months prior to the installation of the metal guard rail, 10 suicides by jumping out of the hospital’s windows occurred among 119,269 inpatients. This figure was significantly reduced to 2 fatal incidents among 104,435 inpatients treated during the 78 months immediately following the installation of the rails at the hospital’s windows (χ2 = 4.34, df = 1, p = .037. Conclusions Even a minimal structural intervention might prevent suicide jumps in a general hospital. Further work is needed to examine the effectiveness of minimal structural interventions in preventing suicide jumps.

  6. The "Suicide Guard Rail": a minimal structural intervention in hospitals reduces suicide jumps.

    Science.gov (United States)

    Mohl, Andreas; Stulz, Niklaus; Martin, Andrea; Eigenmann, Franz; Hepp, Urs; Hüsler, Jürg; Beer, Jürg H

    2012-08-04

    Jumping from heights is a readily available and lethal method of suicide. This study examined the effectiveness of a minimal structural intervention in preventing suicide jumps at a Swiss general teaching hospital. Following a series of suicide jumps out of the hospital's windows, a metal guard rail was installed at each window of the high-rise building. In the 114 months prior to the installation of the metal guard rail, 10 suicides by jumping out of the hospital's windows occurred among 119,269 inpatients. This figure was significantly reduced to 2 fatal incidents among 104,435 inpatients treated during the 78 months immediately following the installation of the rails at the hospital's windows (χ2 = 4.34, df = 1, p = .037). Even a minimal structural intervention might prevent suicide jumps in a general hospital. Further work is needed to examine the effectiveness of minimal structural interventions in preventing suicide jumps.

  7. Economic evaluation of a Child Health Days strategy to deliver multiple maternal and child health interventions in Somalia.

    Science.gov (United States)

    Vijayaraghavan, Maya; Wallace, Aaron; Mirza, Imran Raza; Kamadjeu, Raoul; Nandy, Robin; Durry, Elias; Everard, Marthe

    2012-03-01

    Child Health Days (CHDs) are increasingly used by countries to periodically deliver multiple maternal and child health interventions as time-limited events, particularly to populations not reached by routine health services. In countries with a weak health infrastructure, this strategy could be used to reach many underserved populations with an integrated package of services. In this study, we estimate the incremental costs, impact, cost-effectiveness, and return on investment of 2 rounds of CHDs that were conducted in Somalia in 2009 and 2010. We use program costs and population estimates reported by the World Health Organization and United Nations Children's Fund to estimate the average cost per beneficiary for each of 9 interventions delivered during 2 rounds of CHDs implemented during the periods of December 2008 to May 2009 and August 2009 to April 2010. Because unstable areas were unreachable, we calculated costs for targeted and accessible beneficiaries. We model the impact of the CHDs on child mortality using the Lives Saved Tool, convert these estimates of mortality reduction to life years saved, and derive the cost-effectiveness ratio and the return on investment. The estimated average incremental cost per intervention for each targeted beneficiary was $0.63, with the cost increasing to $0.77 per accessible beneficiary. The CHDs were estimated to save the lives of at least 10,000, or 500,000 life years for both rounds combined. The CHDs were cost-effective at $34.00/life year saved. For every $1 million invested in the strategy, an estimated 615 children's lives, or 29,500 life years, were saved. If the pentavalent vaccine had been delivered during the CHDs instead of diphtheria-pertussis-tetanus vaccine, an additional 5000 children's lives could have been saved. Despite high operational costs, CHDs are a very cost-effective service delivery strategy for addressing the leading causes of child mortality in a conflict setting like Somalia and compare

  8. A multicontroller structure for teaching and designing predictive control strategies

    International Nuclear Information System (INIS)

    Hodouin, D.; Desbiens, A.

    1999-01-01

    The paper deals with the unification of the existing linear control algorithms in order to facilitate their transfer to the engineering students and to industry's engineers. The resulting control algorithm is the Global Predictive Control (GlobPC), which is now taught at the graduate and continuing education levels. GlobPC is based on an internal model framework where three independent control criteria are minimized: one for tracking, one for regulation and one for feedforward. This structure allows to obtain desired tracking, regulation and feedforward behaviors in an optimal way while keeping them perfectly separated. It also cleanly separates the deterministic and stochastic predictions of the process model output. (author)

  9. Semi-decentralized Strategies in Structural Vibration Control

    Directory of Open Access Journals (Sweden)

    F. Palacios-Quiñonero

    2011-04-01

    Full Text Available In this work, the main ideas involved in the design of overlapping and multi-overlapping controllers via the Inclusion Principle are discussed and illustrated in the context of the Structural Vibration Control of tall buildings under seismic excitation. A detailed theoretical background on the Inclusion Principle and the design of overlapping controllers is provided. Overlapping and multi-overlapping LQR controllers are designed for a simplified five-story building model. Numerical simulations are conducted to asses the performance of the proposed semi-decentralized controllers with positive results.

  10. Antithrombotic strategies in patients undergoing percutaneous coronary intervention for acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Son V Pham

    2010-09-01

    Full Text Available Son V Pham1, Phuong-Chi T Pham2, Phuong-Mai T Pham3, Jeffrey M Miller4, Phuong-Thu T Pham5, Phuong-Anh T Pham61Bay Pines VA Medical Center, Department of Cardiology, Bay Pines, FL, USA; 2Department of Medicine, Nephrology Division, UCLA-Olive View Medical Center, 3Department of Medicine, Greater Los Angeles VA Medical Center, 4Department of Medicine, Hematology-Oncology Division, UCLA-Olive View Medical Center, 5Department of Medicine, Nephrology Division, Kidney and Pancreas Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; 6Mercy General Hospital, Heart and Vascular Institute, Department of Cardiology, Sacramento, CA, USAAbstract: In patients undergoing percutaneous coronary intervention (PCI for acute coronary syndrome (ACS, both periprocedural acute myocardial infarction and bleeding complications have been shown to be associated with early and late mortality. Current standard antithrombotic therapy after coronary stent implantation consists of lifelong aspirin and clopidogrel for a variable period depending in part on the stent type. Despite its well-established efficacy in reducing cardiac-related death, myocardial infarction, and stroke, dual antiplatelet therapy with aspirin and clopidogrel is not without shortcomings. While clopidogrel may be of little beneficial effect if administered immediately prior to PCI and may even increase major bleeding risk if coronary artery bypass grafting is anticipated, early discontinuation of the drug may result in insufficient antiplatelet coverage with thrombotic complications. Optimal and rapid inhibition of platelet activity to suppress ischemic and thrombotic events while minimizing bleeding complications is an important therapeutic goal in the management of patients undergoing percutaneous coronary intervention. In this article we present an overview of the literature on clinical trials evaluating the different aspects of antithrombotic therapy in patients

  11. Patient selection, echocardiographic screening and treatment strategies for interventional tricuspid repair using the edge-to-edge repair technique.

    Science.gov (United States)

    Hausleiter, Jörg; Braun, Daniel; Orban, Mathias; Latib, Azeem; Lurz, Philipp; Boekstegers, Peter; von Bardeleben, Ralph Stephan; Kowalski, Marek; Hahn, Rebecca T; Maisano, Francesco; Hagl, Christian; Massberg, Steffen; Nabauer, Michael

    2018-04-24

    Severe tricuspid regurgitation (TR) has long been neglected despite its well known association with mortality. While surgical mortality rates remain high in isolated tricuspid valve surgery, interventional TR repair is rapidly evolving as an alternative to cardiac surgery in selected patients at high surgical risk. Currently, interventional edge-to-edge repair is the most frequently applied technique for TR repair even though the device has not been developed for this particular indication. Due to the inherent differences in tricuspid and mitral valve anatomy and pathology, percutaneous repair of the tricuspid valve is challenging due to a variety of factors including the complexity and variability of tricuspid valve anatomy, echocardiographic visibility of the valve leaflets, and device steering to the tricuspid valve. Furthermore, it remains to be clarified which patients are suitable for a percutaneous tricuspid repair and which features predict a successful procedure. On the basis of the available experience, we describe criteria for patient selection including morphological valve features, a standardized process for echocardiographic screening, and a strategy for clip placement. These criteria will help to achieve standardization of valve assessment and the procedural approach, and to further develop interventional tricuspid valve repair using either currently available devices or dedicated tricuspid edge-to-edge repair devices in the future. In summary, this manuscript will provide guidance for patient selection and echocardiographic screening when considering edge-to-edge repair for severe TR.

  12. Selection of energy source and evolutionary stable strategies for power plants under financial intervention of government

    Science.gov (United States)

    Hafezalkotob, Ashkan; Mahmoudi, Reza

    2017-09-01

    Currently, many socially responsible governments adopt economic incentives and deterrents to manage environmental impacts of electricity suppliers. Considering the Stackelberg leadership of the government, the government's role in the competition of power plants in an electricity market is investigated. A one-population evolutionary game model of power plants is developed to study how their production strategy depends on tariffs levied by the government. We establish that a unique evolutionary stable strategy (ESS) for the population exists. Numerical examples demonstrate that revenue maximization and environment protection policies of the government significantly affect the production ESS of competitive power plants. The results reveal that the government can introduce a green energy source as an ESS of the competitive power plants by imposing appropriate tariffs.

  13. Occupational sitting: practitioner perceptions of health risks, intervention strategies and influences.

    Science.gov (United States)

    Gilson, Nicholas; Straker, Leon; Parry, Sharon

    2012-12-01

    Workplace practitioners are well placed to provide practical insights on sedentary behaviour issues in the workplace. This study consulted occupational health and safety (OHS) practitioners, examining their perceptions of sedentary health risks and views on strategies and influences to reduce and break prolonged occupational sitting. Three focus groups were conducted with convenience samples of OHS practitioners (n=34; 6 men; 46.4 ± 9.6 years) attending an Australian national conference in November 2010. Open-ended questions concerning health risks, sitting reduction strategies and influences were posed by lead researchers and practitioners invited to express opinions, viewpoints and experiences. Audio-recordings and summary notes of focus group discussions were reviewed by researchers to identify key response themes. OHS practitioners were well informed about the chronic disease and musculoskeletal risks associated with prolonged occupational sitting, but noted the importance of not replacing one workplace health issue (too much sitting) with another (too much standing). Ideas for strategies were diverse and explored the dichotomy between providing choices for employees to stand and move more (e.g. sit-stand desks), as opposed to obligating change through adapting job and office design (e.g. centralising printers and scanners). Productivity concerns were cited as a major influence for change. OHS practitioners also highlighted the value of using cross-disciplinary expertise to bridge the gap between research and practice. This study identified that OHS practitioners in Australia have a good understanding of the risks of prolonged occupational sitting and potential strategies to manage these risks.

  14. Improving Search Strategies of Auditors – A Focus Group on Reflection Interventions

    OpenAIRE

    Fessl, Angela; Pammer, Viktoria; Wiese, Michael; Thalmann, Stefan

    2017-01-01

    Financial auditors routinely search internal as well as public knowledge bases as part of the auditing process. Efficient search strategies are crucial for knowledge workers in general and for auditors in particular. Modern search technology quickly evolves; and features beyond keyword search like fac-etted search or visual overview of knowledge bases like graph visualisations emerge. It is therefore desirable for auditors to learn about new innovations and to explore and experiment with such...

  15. Built to last? The sustainability of health system improvements, interventions and change strategies: a study protocol for a systematic review.

    Science.gov (United States)

    Braithwaite, Jeffrey; Testa, Luke; Lamprell, Gina; Herkes, Jessica; Ludlow, Kristiana; McPherson, Elise; Campbell, Margie; Holt, Joanna

    2017-11-12

    The sustainability of healthcare interventions and change programmes is of increasing importance to researchers and healthcare stakeholders interested in creating sustainable health systems to cope with mounting stressors. The aim of this protocol is to extend earlier work and describe a systematic review to identify, synthesise and draw meaning from studies published within the last 5 years that measure the sustainability of interventions, improvement efforts and change strategies in the health system. The protocol outlines a method by which to execute a rigorous systematic review. The design includes applying primary and secondary data collection techniques, consisting of a comprehensive database search complemented by contact with experts, and searching secondary databases and reference lists, using snowballing techniques. The review and analysis process will occur via an abstract review followed by a full-text screening process. The inclusion criteria include English-language, peer-reviewed, primary, empirical research articles published after 2011 in scholarly journals, for which the full text is available. No restrictions on location will be applied. The review that results from this protocol will synthesise and compare characteristics of the included studies. Ultimately, it is intended that this will help make it easier to identify and design sustainable interventions, improvement efforts and change strategies. As no primary data were collected, ethical approval was not required. Results will be disseminated in conference presentations, peer-reviewed publications and among policymaker bodies interested in creating sustainable health systems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. MARKET CAPACITY AND STRUCTURE AS INDICATORS FOR CORPORATE STRATEGY

    Directory of Open Access Journals (Sweden)

    LIVIU NEAMTU

    2017-11-01

    Full Text Available In the management practice, in order to create a competitive strategic system of business, for each level of decision will be used those strategic combinations and alternatives that are consistent with the company's interests and possibilities and with current conditions each market. For it there is continuous process consisting of analysis in various aspects of the market based on its size and continuing with structure, sensitivity and its dynamics, a process that allow having enough data to determine business objectives, specify options for actions and establish implementing measures. However, in this study we aim to highlight a correlation between the various decision-making needs of the company and the various features that can be analyzed at a market.

  17. An interference cancellation strategy for broadcast in hierarchical cell structure

    KAUST Repository

    Yang, Yuli

    2014-12-01

    In this paper, a hierarchical cell structure is considered, where public safety broadcasting is fulfilled in a femtocell located within a macrocell. In the femtocell, also known as local cell, an access point broadcasts to each local node (LN) over an orthogonal frequency sub-band independently. Since the local cell shares the spectrum licensed to the macrocell, a given LN is interfered by transmissions of the macrocell user (MU) in the same sub-band. To improve the broadcast performance in the local cell, a novel scheme is proposed to mitigate the interference from the MU to the LN while achieving diversity gain. For the sake of performance evaluation, ergodic capacity of the proposed scheme is quantified and a corresponding closed-form expression is obtained. By comparing with the traditional scheme that suffers from the MU\\'s interference, numerical results substantiate the advantage of the proposed scheme and provide a useful tool for the broadcast design in hierarchical cell systems.

  18. An interference cancellation strategy for broadcast in hierarchical cell structure

    KAUST Repository

    Yang, Yuli; Aï ssa, Sonia; Eltawil, Ahmed M.; Salama, Khaled N.

    2014-01-01

    In this paper, a hierarchical cell structure is considered, where public safety broadcasting is fulfilled in a femtocell located within a macrocell. In the femtocell, also known as local cell, an access point broadcasts to each local node (LN) over an orthogonal frequency sub-band independently. Since the local cell shares the spectrum licensed to the macrocell, a given LN is interfered by transmissions of the macrocell user (MU) in the same sub-band. To improve the broadcast performance in the local cell, a novel scheme is proposed to mitigate the interference from the MU to the LN while achieving diversity gain. For the sake of performance evaluation, ergodic capacity of the proposed scheme is quantified and a corresponding closed-form expression is obtained. By comparing with the traditional scheme that suffers from the MU's interference, numerical results substantiate the advantage of the proposed scheme and provide a useful tool for the broadcast design in hierarchical cell systems.

  19. A Structural View on Medicinal Chemistry Strategies against Drug Resistance.

    Science.gov (United States)

    Agnello, Stefano; Brand, Michael; Chellat, Mathieu F; Gazzola, Silvia; Riedl, Rainer

    2018-05-30

    The natural phenomenon of drug resistance represents a generic impairment that hampers the benefits of drugs in all major clinical indications. Antibacterials and antifungals are affected as well as compounds for the treatment of cancer, viral infections or parasitic diseases. Despite the very diverse set of biological targets and organisms involved in the development of drug resistance, underlying molecular processes have been identified to understand the emergence of resistance and to overcome this detrimental mechanism. Detailed structural information of the root causes for drug resistance is nowadays frequently available to design next generation drugs anticipated to suffer less from resistance. This knowledge-based approach is a prerequisite in the fight against the inevitable occurrence of drug resistance to secure the achievements of medicinal chemistry in the future. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Organizational models as configurations of structure, culture, leadership, control, and change strategy

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    Janićijević Nebojša

    2017-01-01

    Full Text Available Starting from the axioms of consistency, stability, contingency, and configuration, research on organizational structure, culture, control, leadership, and change management strategy has shown that their typical configurations, or models, can be differentiated according to the same two criteria: distribution of power and dominant organizational dimension. On the one hand there are models of structure, culture, control, leadership, and change management strategy that are based on an unequal, or authoritarian, distribution of power within organizations, while on the other hand there are models that are based on democratic, or equal, distribution of power. Also, on the one hand there are models of structure, culture, control, leadership, and change strategy that are based on work structure and tasks, while on the other hand there are models of these organizational components that are based on social structure, people, and their relationships. Harmonization of typical configurations of organizational structure, culture, control, leadership, and change strategy occurs due to the harmonization of the differentiation criteria. Based on this harmonization, four organizational models have been identified as typical configurations of structure, culture, control, leadership, and change strategy: the autocratic, bureaucratic, innovative, and task models. Each of these models is effective in a different environmental contingency.

  1. Changes in Structural Connectivity Following a Cognitive Intervention in Children With Traumatic Brain Injury.

    Science.gov (United States)

    Yuan, Weihong; Treble-Barna, Amery; Sohlberg, McKay M; Harn, Beth; Wade, Shari L

    2017-02-01

    Structural connectivity analysis based on graph theory and diffusion tensor imaging tractography is a novel method that quantifies the topological characteristics in the brain network. This study aimed to examine structural connectivity changes following the Attention Intervention and Management (AIM) program designed to improve attention and executive function (EF) in children with traumatic brain injury (TBI). Seventeen children with complicated mild to severe TBI (13.66 ± 2.68 years; >12 months postinjury) completed magnetic resonance imaging (MRI) and neurobehavioral measures at time 1, 10 of whom completed AIM and assessment at time 2. Eleven matched healthy comparison (HC) children (13.37 ± 2.08 years) completed MRI and neurobehavioral assessment at both time points, but did not complete AIM. Network characteristics were analyzed to quantify the structural connectivity before and after the intervention. Mixed model analyses showed that small-worldness was significantly higher in the TBI group than the HC group at time 1, and both small-worldness and normalized clustering coefficient decreased significantly at time 2 in the TBI group whereas the HC group remained relatively unchanged. Reductions in mean local efficiency were significantly correlated with improvements in verbal inhibition and both parent- and child-reported EF. Increased normalized characteristic path length was significantly correlated with improved sustained attention. The results provide preliminary evidence suggesting that graph theoretical analysis may be a sensitive tool in pediatric TBI for detecting ( a) abnormalities of structural connectivity in brain network and ( b) structural neuroplasticity associated with neurobehavioral improvement following a short-term intervention for attention and EF.

  2. Comparative effectiveness and safety of a catheterization laboratory-only eptifibatide dosing strategy in patients undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Gurm, Hitinder S; Hosman, Carrie; Bates, Eric R; Share, David; Hansen, Ben B

    2015-02-01

    Eptifibatide, a small-molecule glycoprotein IIb/IIIa inhibitor, is conventionally administered as a bolus plus infusion. A growing number of clinicians are using a strategy of catheterization laboratory-only eptifibatide (an off-label use) as procedural pharmacotherapy for patients undergoing percutaneous coronary intervention although the comparative effectiveness of this approach is unknown. We compared the in-hospital outcome of patients undergoing percutaneous coronary intervention across 47 hospitals and treated with eptifibatide bolus plus infusion with those treated with a catheterization laboratory-only regimen. We used optimal matching to link the use of catheterization laboratory-only eptifibatide with clinical outcomes, including mortality, myocardial infarction, bleeding, and need for transfusion. Of the 84 678 percutaneous coronary interventions performed during 2010 to 2011, and meeting our inclusion criteria, eptifibatide was administered to 21 296 patients. Of these, a catheterization laboratory-only regimen was used in 4511 patients, whereas 16 785 patients were treated with bolus plus infusion. In the optimally matched analysis, compared with bolus plus infusion, a catheterization laboratory-only regimen was associated with a reduction in bleeding (optimally matched adjusted odds ratio, 0.74; 95% confidence interval, 0.58-0.93; P=0.014) and need for transfusion (optimally matched adjusted odds ratio, 0.70; 95% confidence interval, 0.52-0.92; P=0.012), with no difference in mortality or myocardial infarction. A catheterization laboratory-only eptifibatide regimen is commonly used in clinical practice and is associated with a significant reduction in bleeding complications in patients undergoing contemporary percutaneous coronary intervention. © 2015 American Heart Association, Inc.

  3. The longitudinal effects of a lifestyle physical activity intervention and a structured exercise intervention on physical self-perceptions and self-esteem in older adults.

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    Opdenacker, Joke; Delecluse, Christophe; Boen, Filip

    2009-12-01

    The objectives of this study were (1) to evaluate the long-term effects of a lifestyle physical activity intervention (n = 60) and a structured exercise intervention (n = 60) on physical self-perceptions and self-esteem in older adults compared with a control group (n = 66), and (2) to test the longitudinal fit of the exercise and self-esteem model (EXSEM). Immediately after the 11-month interventions, the lifestyle group showed significant improvements in self-perceived physical condition, sport competence, body attractiveness, and physical self-worth. In the structured group, significant effects were found on physical condition and sport competence. One year later, the lifestyle program had significant effects on body attractiveness and global self-esteem, while the structured group showed significant improvements in physical condition, sport competence, and body attractiveness. Path analyses revealed a good fit for the EXSEM across the 2-year period.

  4. Effective strategies to recruit young adults into an online wellbeing intervention

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    Gaston Antezana

    2015-09-01

    Objectives This paper will describe the outcomes of different methods for recruiting young adults (16-25 to the ‘Online Wellbeing Centre’, an online resource to assess wellbeing and access apps for mental health and general wellbeing. Methods Online and community strategies, which were of paid and unpaid nature, were utilised for recruiting participants aged between 16-25. Online paid strategies included 9 Facebook ads, 2 Twitter ads, 2 Google ads, and 1 YouTube ad. Online unpaid channels included Facebook and Twitter posts on the official pages of selected partner organisations, links on the websites of selected partner organisations, tailored messages and link via a University student learning portal, and bulk emails to various networks of young people. Unpaid community based recruitment strategies included a bulk email to various community contacts, and face-to-face contact via meetings and presentations in schools and mental health services. The one paid community based strategy was the use of a recruitment agency. All ads and posts were designed with final user input following principles of participatory methodology. All recruited participants were asked to complete a self-assessment of mood, energy levels, and sleep quality presented via visual analog scales, and also the Mental Health Continuum-Short Form assessment survey. Recruitment success via each of the strategies was descriptively analysed. Univariate analysis of variance was conducted to explore if self reported measures varied between paid and unpaid channels of recruitment. Results A total of 378 participants were recruited over a timeframe of 10 months. 26.7% of recruited participants were from paid channels with the recruitment agency and Facebook ads accounting for 15.6% and 8.5% respectively. Least effective paid strategies included Google ads and YouTube ads, each accounting for only 0.5% of participants. The average cost per participant recruited through paid channels was 85 AUD. Amongst

  5. The Structural Engineering Strategy for Photonic Material Research and Device Development

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    Yalin Lu

    2007-01-01

    Full Text Available A new structural engineering strategy is introduced for optimizing the fabrication of arrayed nanorod materials, optimizing superlattice structures for realizing a strong coupling, and directly developing nanophotonic devices. The strategy can be regarded as “combinatorial” because of the high efficiency in optimizing structures. In this article, this strategy was applied to grow ZnO nanorod arrays, and to develop a new multifunctional photodetector using such nanorod arrays, which is able to simultaneously detect power, energy, and polarization of an incident ultraviolet radiation. The strategy was also used to study the extraordinary dielectric behavior of relaxor ferroelectric lead titanate doped lead magnesium niobate heterophase superlattices in the terahertz frequencies, in order to investigate their dielectric polariton physics and the potential to be integrated with tunable surface resonant plasmonics devices.

  6. Europeana communication bug: which intervention strategy for a better cooperation with Creative Industry?

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    Giovanni Ragone

    2016-09-01

    Full Text Available In aggiunta all'obiettivo principale di diffondere la conoscenza sui beni culturali, Europeana e diversi MAB (Musei, Archivi e Biblioteche sono impegnati nello sviluppo di nuove strategie volte a rendere i contenuti digitali riusabili dalle imprese creative. Ciò nonostante, tali iniziative hanno successo solo in casi sporadici, dal momento che un approccio comunicativo scorretto può minare gli sforzi fatti in questo senso. L'articolo descrive un caso di studio che propone interconnessioni efficaci tra Europeana, MAB e imprese creative nel contesto della promozione e del miglioramento del patrimonio digitale sul cibo e le bevande.

  7. Opportunities for Intervention Strategies for Weight Management: Global Actions on Fluid Intake Patterns

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    Max Lafontan

    2015-01-01

    Full Text Available Summary: Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity, water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols.

  8. Group of family companions of hospitalized patients: an occupational therapy intervention strategy in a general hospital

    Directory of Open Access Journals (Sweden)

    Daniel Ferreira Dahdah

    2013-08-01

    Full Text Available There is a consensus in the literature that the company of a family member during the hospitalization period increases patient recovery. However, this can have some negative effects on the caregiver’s health. With the purpose of reducing these negatives effects, it is useful to let family members express themselves. The State Hospital of Ribeirão Preto created a Group of Family Companions coordinated by the Occupational Therapy and Social Service. This study focuses on the assistance offered in a general hospital to families that undergo the whole illness and hospitalization process of their family member, suffering the impacts of this process in their daily lives, and on the intervention of Occupational Therapy in these cases.

  9. Opportunities for Intervention Strategies for Weight Management: Global Actions on Fluid Intake Patterns

    Science.gov (United States)

    Lafontan, Max; Visscher, Tommy L.S.; Farpour-Lambert, Nathalie; Yumuk, Volkan

    2015-01-01

    Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity), water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols. PMID:25765164

  10. Comparing strategies to assess multiple behavior change in behavioral intervention studies.

    Science.gov (United States)

    Drake, Bettina F; Quintiliani, Lisa M; Sapp, Amy L; Li, Yi; Harley, Amy E; Emmons, Karen M; Sorensen, Glorian

    2013-03-01

    Alternatives to individual behavior change methods have been proposed, however, little has been done to investigate how these methods compare. To explore four methods that quantify change in multiple risk behaviors targeting four common behaviors. We utilized data from two cluster-randomized, multiple behavior change trials conducted in two settings: small businesses and health centers. Methods used were: (1) summative; (2) z-score; (3) optimal linear combination; and (4) impact score. In the Small Business study, methods 2 and 3 revealed similar outcomes. However, physical activity did not contribute to method 3. In the Health Centers study, similar results were found with each of the methods. Multivitamin intake contributed significantly more to each of the summary measures than other behaviors. Selection of methods to assess multiple behavior change in intervention trials must consider study design, and the targeted population when determining the appropriate method/s to use.

  11. Modeling the Effects of Multiple Intervention Strategies on Controlling Foot-and-Mouth Disease

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    Steady Mushayabasa

    2015-01-01

    Full Text Available Foot-and-mouth disease (FMD is a threat to economic security and infrastructure as well as animal health, in both developed and developing countries. We propose and analyze an optimal control problem where the control system is a mathematical model for FMD that incorporates vaccination and culling of infectious animals. The control functions represent the fraction of animals that are vaccinated during an outbreak, infectious symptomatic animals that are detected and culled, and infectious nonsymptomatic animals that are detected and culled. Our aim was to study how these control measures should be implemented for a certain time period, in order to reduce or eliminate FMD in the community, while minimizing the interventions implementation costs. A cost-effectiveness analysis is carried out, to compare the application of each one of the control measures, separately or in combination.

  12. Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: a non-randomized controlled trial.

    Science.gov (United States)

    Nathan, Nicole; Wolfenden, Luke; Bell, Andrew C; Wyse, Rebecca; Morgan, Philip J; Butler, Michelle; Sutherland, Rachel; Milat, Andrew J; Hector, Debra; Wiggers, John

    2012-08-13

    Limited evidence exists describing the effectiveness of strategies in facilitating the implementation of vegetable and fruit programs by schools on a population wide basis. The aim of this study was to examine the effectiveness of a multi-strategy intervention in increasing the population-wide implementation of vegetable and fruit breaks by primary schools and to determine if intervention effectiveness varied by school characteristics. A quasi-experimental study was conducted in primary schools in the state of New South Wales, Australia. All primary schools in one region of the state (n = 422) received a multi-strategy intervention. A random sample of schools (n = 406) in the remainder of the state served as comparison schools. The multi-strategy intervention to increase vegetable and fruit breaks involved the development and provision of: program consensus and leadership; staff training; program materials; incentives; follow-up support; and implementation feedback. Comparison schools had access to routine information-based Government support. Data to assess the prevalence of vegetable and fruit breaks were collected by telephone from Principals of the intervention and comparison schools at baseline (2006-2007) and 11 to 15 months following the commencement of the intervention (2009-2010). GEE analysis was used to examine the change in the prevalence of vegetable and fruit breaks in intervention schools compared to comparison schools. At follow-up, prevalence of vegetable and fruit breaks increased significantly in both intervention (50.3% to 82.0%, p strategy intervention can significantly increase the implementation of vegetable and fruit breaks by a large number of Australian primary schools.

  13. Evolutionary fate of memory-one strategies in repeated prisoner's dilemma game in structured populations

    Science.gov (United States)

    Liu, Xu-Sheng; Wu, Zhi-Xi; Chen, Michael Z. Q.; Guan, Jian-Yue

    2017-07-01

    We study evolutionary spatial prisoner's dilemma game involving a one-step memory mechanism of the individuals whenever making strategy updating. In particular, during the process of strategy updating, each individual keeps in mind all the outcome of the action pairs adopted by himself and each of his neighbors in the last interaction, and according to which the individuals decide what actions they will take in the next round. Computer simulation results imply that win-stay-lose-shift like strategy win out of the memory-one strategy set in the stationary state. This result is robust in a large range of the payoff parameter, and does not depend on the initial state of the system. Furthermore, theoretical analysis with mean field and quasi-static approximation predict the same result. Thus, our studies suggest that win-stay-lose-shift like strategy is a stable dominant strategy in repeated prisoner's dilemma game in homogeneous structured populations.

  14. Cardiovascular disease risk factor patterns and their implications for intervention strategies in Vietnam.

    Science.gov (United States)

    Nguyen, Quang Ngoc; Pham, Son Thai; Do, Loi Doan; Nguyen, Viet Lan; Wall, Stig; Weinehall, Lars; Bonita, Ruth; Byass, Peter

    2012-01-01

    Background. Data on cardiovascular disease risk factors (CVDRFs) in Vietnam are limited. This study explores the prevalence of each CVDRF and how they cluster to evaluate CVDRF burdens and potential prevention strategies. Methods. A cross-sectional survey in 2009 (2,130 adults) was done to collect data on behavioural CVDRF, anthropometry and blood pressure, lipidaemia profiles, and oral glucose tolerance tests. Four metabolic CVDRFs (hypertension, dyslipidaemia, diabetes, and obesity) and five behavioural CVDRFs (smoking, excessive alcohol intake, unhealthy diet, physical inactivity, and stress) were analysed to identify their prevalence, cluster patterns, and social predictors. Framingham scores were applied to estimate the global 10-year CVD risks and potential benefits of CVD prevention strategies. Results. The age-standardised prevalence of having at least 2/4 metabolic, 2/5 behavioural, or 4/9 major CVDRF was 28%, 27%, 13% in women and 32%, 62%, 34% in men. Within-individual clustering of metabolic factors was more common among older women and in urban areas. High overall CVD risk (≥20% over 10 years) identified 20% of men and 5% of women-especially at higher ages-who had coexisting CVDRF. Conclusion. Multiple CVDRFs were common in Vietnamese adults with different clustering patterns across sex/age groups. Tackling any single risk factor would not be efficient.

  15. The Syndemic of Opioid Misuse, Overdose, HCV, and HIV: Structural-Level Causes and Interventions.

    Science.gov (United States)

    Perlman, David C; Jordan, Ashly E

    2018-04-01

    This article reviews the case for recognizing (1) the epidemics of opioid misuse, overdose, hepatitis C virus, and HIV as a syndemic and (2) the importance of examining and addressing structural factors in responses to this syndemic. We focus on the current syndemic in the US, but also consider data from other locations to highlight the issues existing and arising in various contexts. Advances in multi-level theory and statistical methods allow sound ecologic and multi-level analyses of the impact of structural factors on the syndemic. Studies of opioid misuse, overdoses, hepatitis C virus, and HIV demonstrate that area-level access to healthcare, medication-assisted treatment of opioid use disorders, sterile injection equipment, and overdose prevention with naloxone, as well as factors such as opioid marketing, income inequality, intensity of policing activities, and health care policies, are related to the prevalence of substance misuse, overdoses, infection risk, and morbidity. Structural variables can predict area-level vulnerability to the syndemic. The implementation of combined prevention and treatment interventions can control and reverse components of the syndemic. Recognizing and monitoring potent structural factors can facilitate the identification of areas at risk of vulnerability to the syndemic. Further, many structural factors are modifiable through intervention and policy to reduce structural vulnerability and create health-enabling environments. Evidence supports the immediate implementation of broader HCV and HIV testing and substance use screening, medication-assisted treatment, needle/syringe exchange programs, naloxone programs, increased population-level implementation of HCV treatment, and further attention to structural-level factors predicting, and contributing to, area-level vulnerability, such as degrees of opioid marketing, distribution, and prescribing.

  16. Relative Effects of Three Questioning Strategies in Ill-Structured, Small Group Problem Solving

    Science.gov (United States)

    Byun, Hyunjung; Lee, Jung; Cerreto, Frank A.

    2014-01-01

    The purpose of this research is to investigate the relative effectiveness of using three different question-prompt strategies on promoting metacognitive skills and performance in ill-structured problem solving by examining the interplay between peer interaction and cognitive scaffolding. An ill-structured problem-solving task was given to three…

  17. Interventional strategies to decrease nursing student anxiety in the clinical learning environment.

    Science.gov (United States)

    Moscaritolo, Linda M

    2009-01-01

    The clinical setting is a significant learning environment for undergraduate nursing students. However, the learning that occurs in this environment presents challenges that may cause students to experience stress and anxiety. High levels of anxiety can affect students' clinical performance, presenting a clear threat to success in a clinical rotation. It is crucial for clinical nursing faculty to foster a supportive learning environment conducive to undergraduate nursing student learning. The purpose of this article is to provide clinical nursing faculty with the current literature related to humor, peer instructors and mentors, and mindfulness training as strategies to decrease undergraduate student nurse anxiety in the clinical setting. The Neuman Systems Model is used as a theoretical framework, and the application of this model to humor, peer instructors and mentors, and mindfulness training is examined.

  18. Testing for strategy-structure fit and its importance for performance

    Directory of Open Access Journals (Sweden)

    Ana Aleksić

    2017-01-01

    Full Text Available Understanding different organizational elements, their mutual influence and creating congruence among them has been recognized as an important determinant of organizational performance. These complex interrelationships, and necessity of creating a fit between them, raises the question of how to align different organizational elements to contribute to overall organizational performance. In that sense, this paper addresses the issue of fit and, more specifically, analyses the presence and influence of strategy-structure fit on organizational performance. By using Miles and Snow typology, our goal was to capture and determine the pattern of relationships between strategy, structure, and strategy implementation processes and their influence on organizational performance. This paper presents results of a cross-sectional field research on a sample of 113 organizations in order to gain a better understanding of strategy-structure fit and its relation to performance. Results reinforce the existing literature and confirm the importance of fit among strategy, structure and strategy implementation process for higher levels of organizational performance.

  19. Exploring ischemia-induced vascular lesions and potential pharmacological intervention strategies.

    Science.gov (United States)

    Aliev, G; Obrenovich, M E; Seyidova, D; de la Torre, J C

    2005-01-01

    Structural changes in vessels under the influence of ischemia play an important role in the pathogenesis of many diseases, most important of which are stroke and myocardial infarction or myocardial insult. Over the years, information has been gathered, which implicate a role for ischemic vascular changes in the pathogenesis of crush-syndrome, atherosclerosis and other vascular diseases. When blood vessels are damaged they become unresponsive to a stimulus, which normally elicits vasodilatation and can lead to intraluminal thrombosis and ischemic events. The aim of this review is to explore the structural changes seen in vessels affected by ischemia reperfusion injury. With ischemia, the development of observable changes to vascular structure is multifactorial. One key factor is reperfusion ischemic injury. Moreover, the duration of the ischemic event is an important factor when determining both the prognosis and the type of morphological change that is observable in affected vessel walls. In this regard, the deleterious progression of blood flow impairment and its severity depends on the specific organ involved and the type of tissue affected. Further, there are regional differences within affected tissues and the degree of microvascular injury is well correlated with differences in the nature and severity of the ischemic event. Any method aimed at preventing and treating ischemic reperfusion injuries in vessels, based on these investigations, should likewise be able to decrease the early signs of brain, cerebrovascular and heart injury and preserve normal cellular architecture.

  20. Pulmonary Arterial Hypertension in Adults: Novel Drugs and Catheter Ablation Techniques Show Promise? Systematic Review on Pharmacotherapy and Interventional Strategies

    Directory of Open Access Journals (Sweden)

    Salvatore Rosanio

    2014-01-01

    Full Text Available This systematic review aims to provide an update on pharmacological and interventional strategies for the treatment of pulmonary arterial hypertension in adults. Currently US Food and Drug Administration approved drugs including prostanoids, endothelin-receptor antagonists, phosphodiesterase type-5 inhibitors, and soluble guanylate-cyclase stimulators. These agents have transformed the prognosis for pulmonary arterial hypertension patients from symptomatic improvements in exercise tolerance ten years ago to delayed disease progression today. On the other hand, percutaneous balloon atrioseptostomy by using radiofrequency perforation, cutting balloon dilatation, or insertion of butterfly stents and pulmonary artery catheter-based denervation, both associated with very low rate of major complications and death, should be considered in combination with specific drugs at an earlier stage rather than late in the progression of pulmonary arterial hypertension and before the occurrence of overt right-sided heart failure.

  1. Ten-Structure as Strategy of Addition 1-20 by Involving Spatial Structuring Ability for First Grade Students

    Science.gov (United States)

    Salmah, Ummy; Putri, Ratu Ilma Indra; Somakim

    2015-01-01

    The aim of this study is to design learning activities that can support students to develop strategies for the addition of number 1 to 20 in the first grade by involving students' spatial structuring ability. This study was conducted in Indonesia by involving 27 students. In this paper, one of three activities is discussed namely ten-box activity.…

  2. Intranasal naloxone and related strategies for opioid overdose intervention by nonmedical personnel: a review

    Directory of Open Access Journals (Sweden)

    Lewis CR

    2017-10-01

    Full Text Available Christa R Lewis,1,2 Hoa T Vo,1 Marc Fishman1,3 1Maryland Treatment Centers, Baltimore, MD, USA; 2Department of Psychology, Towson University, Towson, MD, USA; 3Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA Abstract: Deaths due to prescription and illicit opioid overdose have been rising at an alarming rate, particularly in the USA. Although naloxone injection is a safe and effective treatment for opioid overdose, it is frequently unavailable in a timely manner due to legal and practical restrictions on its use by laypeople. As a result, an effort spanning decades has resulted in the development of strategies to make naloxone available for layperson or “take-home” use. This has included the development of naloxone formulations that are easier to administer for nonmedical users, such as intranasal and autoinjector intramuscular delivery systems, efforts to distribute naloxone to potentially high-impact categories of nonmedical users, as well as efforts to reduce regulatory barriers to more widespread distribution and use. Here we review the historical and current literature on the efficacy and safety of naloxone for use by nonmedical persons, provide an evidence-based discussion of the controversies regarding the safety and efficacy of different formulations of take-home naloxone, and assess the status of current efforts to increase its public distribution. Take-home naloxone is safe and effective for the treatment of opioid overdose when administered by laypeople in a community setting, shortening the time to reversal of opioid toxicity and reducing opioid-related deaths. Complementary strategies have together shown promise for increased dissemination of take-home naloxone, including 1 provision of education and training; 2 distribution to critical populations such as persons with opioid addiction, family members, and first responders; 3 reduction of prescribing barriers to access; and 4 reduction of legal

  3. Analysis of intervention strategies for inhalation exposure to polycyclic aromatic hydrocarbons and associated lung cancer risk based on a Monte Carlo population exposure assessment model.

    Science.gov (United States)

    Zhou, Bin; Zhao, Bin

    2014-01-01

    It is difficult to evaluate and compare interventions for reducing exposure to air pollutants, including polycyclic aromatic hydrocarbons (PAHs), a widely found air pollutant in both indoor and outdoor air. This study presents the first application of the Monte Carlo population exposure assessment model to quantify the effects of different intervention strategies on inhalation exposure to PAHs and the associated lung cancer risk. The method was applied to the population in Beijing, China, in the year 2006. Several intervention strategies were designed and studied, including atmospheric cleaning, smoking prohibition indoors, use of clean fuel for cooking, enhancing ventilation while cooking and use of indoor cleaners. Their performances were quantified by population attributable fraction (PAF) and potential impact fraction (PIF) of lung cancer risk, and the changes in indoor PAH concentrations and annual inhalation doses were also calculated and compared. The results showed that atmospheric cleaning and use of indoor cleaners were the two most effective interventions. The sensitivity analysis showed that several input parameters had major influence on the modeled PAH inhalation exposure and the rankings of different interventions. The ranking was reasonably robust for the remaining majority of parameters. The method itself can be extended to other pollutants and in different places. It enables the quantitative comparison of different intervention strategies and would benefit intervention design and relevant policy making.

  4. Analysis of intervention strategies for inhalation exposure to polycyclic aromatic hydrocarbons and associated lung cancer risk based on a Monte Carlo population exposure assessment model.

    Directory of Open Access Journals (Sweden)

    Bin Zhou

    Full Text Available It is difficult to evaluate and compare interventions for reducing exposure to air pollutants, including polycyclic aromatic hydrocarbons (PAHs, a widely found air pollutant in both indoor and outdoor air. This study presents the first application of the Monte Carlo population exposure assessment model to quantify the effects of different intervention strategies on inhalation exposure to PAHs and the associated lung cancer risk. The method was applied to the population in Beijing, China, in the year 2006. Several intervention strategies were designed and studied, including atmospheric cleaning, smoking prohibition indoors, use of clean fuel for cooking, enhancing ventilation while cooking and use of indoor cleaners. Their performances were quantified by population attributable fraction (PAF and potential impact fraction (PIF of lung cancer risk, and the changes in indoor PAH concentrations and annual inhalation doses were also calculated and compared. The results showed that atmospheric cleaning and use of indoor cleaners were the two most effective interventions. The sensitivity analysis showed that several input parameters had major influence on the modeled PAH inhalation exposure and the rankings of different interventions. The ranking was reasonably robust for the remaining majority of parameters. The method itself can be extended to other pollutants and in different places. It enables the quantitative comparison of different intervention strategies and would benefit intervention design and relevant policy making.

  5. A Systematic Review of Promising Strategies of Faith-Based Cancer Education and Lifestyle Interventions Among Racial/Ethnic Minority Groups.

    Science.gov (United States)

    Hou, Su-I; Cao, Xian

    2017-09-13

    Church-based interventions have been used to reach racial/ethnic minorities. In order to develop effective programs, we conducted a comprehensive systematic review of faith-based cancer prevention studies (2005~2016) to examine characteristics and promising strategies. Combination terms "church or faith-based or religion," "intervention or program," and "cancer education or lifestyle" were used in searching the five major databases: CINAHL; ERIC; Health Technology Assessments; MEDLINE; and PsycInfo. A total of 20 studies met study criteria. CDC's Community Guide was used to analyze and review group interventions. Analyses were organized by two racial groups: African American (AA) and Latino/Hispanic American groups. Results showed most studies reviewed focused on breast cancer alone or in combination with other cancers. Studies of Latino/Hispanic groups targeted more on uninsured, Medicare, or Medicaid individuals, whereas AA studies generally did not include specific insurance criteria. The sample sizes of the AA studies were generally larger. The majority of these studies reviewed used pre-post, posttest only with control group, or quasi-experience designs. The Health Belief Model was the most commonly used theory in both groups. Community-based participatory research and empowerment/ecological frameworks were also used frequently in the Latino/Hispanic studies. Small media and group education were the top two most popular intervention strategies in both groups. Although one-on-one strategy was used in some Latino studies, neither group used reducing client out-of-pocket costs strategy. Client reminders could also be used more in both groups as well. Current review showed church-based cancer education programs were effective in changing knowledge, but not always screening utilization. Results show faith-based cancer educational interventions are promising. To maximize intervention impact, future studies might consider using stronger study designs, incorporating a

  6. Effects of an intervention strategy for school children aimed at reducing overweight and obesity within the State of Mexico.

    Science.gov (United States)

    Morales-Ruán, María del Carmen; Shamah-Levy, Teresa; Amaya-Castellanos, Claudia Isabel; Salazar-Coronel, Araceli Apolonia; Jiménez-Aguilar, Alejandra; Amaya-Castellanos, Maritza Alejandra; Méndez-Gómez Humarán, Ignacio

    2014-01-01

    This study explored the intervention effect of the "Nutrition on the Go" strategy on the prevalence of overweight and obesity (OW+O), according to the role played by different patterns. Pattern Groups (PG) were determined based on schools' food availability and other variables at individual level: nutrition knowledge, physical activity, socioeconomic level and self-efficacy, using an ecological approach. The PG classification was achieved using Ward's cluster method. The prevalence of OW+O was higher in PGI (intermediate food availability and high socioeconomic index [SEI]) compared to PG 2 (high availability of food and lower SEI) and PG 3 (low availability of food and medium SEI) with a lower prevalence (p<0.00I). The PG-intervention interaction showed differences for PG 3 (p=0.066), the stage-PG interaction showed differences between PGs I and 3 (p=0.014) and between PGs 2 and 3 (p=0.055). Differences between PGs have important implications for the prevalence of OW+O.

  7. Sustainability of Physical Activity Promoting Environments and Influences on Sustainability Following a Structural Intervention in Residential Children's Homes

    Science.gov (United States)

    Dominick, Gregory M.; Tudose, Alina; Pohlig, Ryan T.; Saunders, Ruth P.

    2016-01-01

    Research examining sustainability of health promotion programs within organizational settings is limited. The Environmental Interventions in Residential Children's Homes (ENRICH) was a structural intervention that trained Wellness Teams (WTs) within residential children's homes (RCH) to target environmental changes that promote physical activity…

  8. Cardiovascular Disease Risk Factor Patterns and Their Implications for Intervention Strategies in Vietnam

    Directory of Open Access Journals (Sweden)

    Quang Ngoc Nguyen

    2012-01-01

    Methods. A cross-sectional survey in 2009 (2,130 adults was done to collect data on behavioural CVDRF, anthropometry and blood pressure, lipidaemia profiles, and oral glucose tolerance tests. Four metabolic CVDRFs (hypertension, dyslipidaemia, diabetes, and obesity and five behavioural CVDRFs (smoking, excessive alcohol intake, unhealthy diet, physical inactivity, and stress were analysed to identify their prevalence, cluster patterns, and social predictors. Framingham scores were applied to estimate the global 10-year CVD risks and potential benefits of CVD prevention strategies. Results. The age-standardised prevalence of having at least 2/4 metabolic, 2/5 behavioural, or 4/9 major CVDRF was 28%, 27%, 13% in women and 32%, 62%, 34% in men. Within-individual clustering of metabolic factors was more common among older women and in urban areas. High overall CVD risk (≥20% over 10 years identified 20% of men and 5% of women—especially at higher ages—who had coexisting CVDRF. Conclusion. Multiple CVDRFs were common in Vietnamese adults with different clustering patterns across sex/age groups. Tackling any single risk factor would not be efficient.

  9. Intervention strategies for cesarean section–induced alterations in the microbiota-gut-brain axis

    Science.gov (United States)

    Moya-Pérez, Angela; Luczynski, Pauline; Renes, Ingrid B.; Wang, Shugui; Borre, Yuliya; Anthony Ryan, C.; Knol, Jan; Stanton, Catherine; Dinan, Timothy G.

    2017-01-01

    Microbial colonization of the gastrointestinal tract is an essential process that modulates host physiology and immunity. Recently, researchers have begun to understand how and when these microorganisms colonize the gut and the early-life factors that impact their natural ecological establishment. The vertical transmission of maternal microbes to the offspring is a critical factor for host immune and metabolic development. Increasing evidence also points to a role in the wiring of the gut-brain axis. This process may be altered by various factors such as mode of delivery, gestational age at birth, the use of antibiotics in early life, infant feeding, and hygiene practices. In fact, these early exposures that impact the intestinal microbiota have been associated with the development of diseases such as obesity, type 1 diabetes, asthma, allergies, and even neurodevelopmental disorders. The present review summarizes the impact of cesarean birth on the gut microbiome and the health status of the developing infant and discusses possible preventative and restorative strategies to compensate for early-life microbial perturbations. PMID:28379454

  10. An Efficient Modal Control Strategy for the Active Vibration Control of a Truss Structure

    Directory of Open Access Journals (Sweden)

    Ricardo Carvalhal

    2007-01-01

    Full Text Available In this paper an efficient modal control strategy is described for the active vibration control of a truss structure. In this approach, a feedback force is applied to each mode to be controlled according to a weighting factor that is determined by assessing how much each mode is excited by the primary source. The strategy is effective provided that the primary source is at a fixed position on the structure, and that the source is stationary in the statistical sense. To test the effectiveness of the control strategy it is compared with an alternative, established approach namely, Independent Modal Space Control (IMSC. Numerical simulations show that with the new strategy it is possible to significantly reduce the control effort required, with a minimal reduction in control performance.

  11. Vibration based structural assessment of the rehabilitation intervention in r.c. segmental bridge

    OpenAIRE

    Franchetti Paolo; Frizzarin Michele; Leonardi Andrea; Zeni Fabio

    2015-01-01

    A vibration based structural assessment campaign was carried out on a r.c. segmental bridge in North East Italy. The bridge has a cantilever static scheme, fixed at the top of the piers and with a hinge at the centre of the span. The particular configuration of the hinge consists in a couple of steel elements, each one composed by a tongue and groove joint. Since the year 1960, the hinge was subjected to consumption and degradation, that caused a malfunctioning of the device. An intervention ...

  12. The “Suicide Guard Rail”: a minimal structural intervention in hospitals reduces suicide jumps

    OpenAIRE

    Mohl, Andreas; Stulz, Niklaus; Martin, Andrea; Eigenmann, Franz; Hepp, Urs; Hüsler, Jürg; Beer, Jürg H

    2012-01-01

    Abstract Background Jumping from heights is a readily available and lethal method of suicide. This study examined the effectiveness of a minimal structural intervention in preventing suicide jumps at a Swiss general teaching hospital. Following a series of suicide jumps out of the hospital’s windows, a metal guard rail was installed at each window of the high-rise building. Results In the 114 months prior to the installation of the metal guard rail, 10 suicides by jumping out of the hospital’...

  13. Outcome Evidence for Structured Pediatric to Adult Health Care Transition Interventions: A Systematic Review.

    Science.gov (United States)

    Gabriel, Phabinly; McManus, Margaret; Rogers, Katherine; White, Patience

    2017-09-01

    To identify statistically significant positive outcomes in pediatric-to-adult transition studies using the triple aim framework of population health, consumer experience, and utilization and costs of care. Studies published between January 1995 and April 2016 were identified using the CINAHL, Ovid MEDLINE, PubMed, Scopus, and Web of Science databases. Included studies evaluated pre-evaluation and postevaluation data, intervention and comparison groups, and randomized clinic trials. The methodological strength of each study was assessed using the Effective Public Health Practice Project Quality Assessment Tool. Out of a total of 3844 articles, 43 met our inclusion criteria. Statistically significant positive outcomes were found in 28 studies, most often related to population health (20 studies), followed by consumer experience (8 studies), and service utilization (9 studies). Among studies with moderate to strong quality assessment ratings, the most common positive outcomes were adherence to care and utilization of ambulatory care in adult settings. Structured transition interventions often resulted in positive outcomes. Future evaluations should consider aligning with professional transition guidance; incorporating detailed intervention descriptions about transition planning, transfer, and integration into adult care; and measuring the triple aims of population health, experience, and costs of care. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Restoring water quality in the polluted Turag-Tongi-Balu river system, Dhaka: Modelling nutrient and total coliform intervention strategies.

    Science.gov (United States)

    Whitehead, Paul; Bussi, Gianbattista; Hossain, Mohammed Abed; Dolk, Michaela; Das, Partho; Comber, Sean; Peters, Rebecca; Charles, Katrina J; Hope, Rob; Hossain, Md Sarwar

    2018-08-01

    River water quality in rapidly urbanising Asian cities threatens to damage the resource base on which human health, economic growth and poverty reduction all depend. Dhaka reflects the challenges and opportunities for balancing these dynamic and complex trade-offs which goals can be achieved through effective policy interventions. There is a serious problem of water pollution in central Dhaka, in the Turag-Tongi-Balu River system in Bangladesh with the river system being one of the most polluted in the world at the moment. A baseline survey of water chemistry and total coliforms has been undertaken and shows dissolved oxygen close to zero in the dry season, high organic loading together with extreme levels of Ammonium-N and total coliform in the water. Models have been applied to assess hydrochemical processes in the river and evaluate alternative strategies for policy and the management of the pollution issues. In particular models of flow, Nitrate-N, Ammonium-N and indicator bacteria (total coliforms) are applied to simulate water quality in the river system. Various scenarios are explored to clean up the river system, including flow augmentation and improved effluent treatment. The model results indicate that improved effluent treatment is likely to have a more significant impact on reducing Ammonium-N and total coliforms than flow augmentation, but a combined strategy would greatly reduce the pollution problems in the Turag-Tongi-Balu River System. Copyright © 2018. Published by Elsevier B.V.

  15. Fitting in and standing out: increasing the use of alcohol protective behavioral strategies with a deviance regulation intervention.

    Science.gov (United States)

    Dvorak, Robert D; Pearson, Matthew R; Neighbors, Clayton; Martens, Matthew P

    2015-06-01

    Heavy alcohol use remains a consistent public health concern on college campuses. The current pilot study used deviance regulation theory (DRT) to modify protective behavioral strategies (PBS) among college student drinkers to reduce alcohol use and alcohol-related consequences. The sample was comprised of current college student drinkers (n = 76; 53.95% female) ranging in age from 18-24 (M = 19.29, SD = 1.42). Participants were randomly assigned to receive a positively or negatively framed message. They then reported on use of alcohol PBS (via the Protective Behavioral Strategies Scale), alcohol consumption (via the Modified Daily Drinking Questionnaire), and alcohol-related consequences (via the Young Adult Alcohol Consequences Questionnaire) each week for 6 weeks. Among drinkers with low PBS use norms, a positively, versus a negatively, framed message resulted in increased PBS use and consequently less alcohol consumption and fewer alcohol-related consequences. Among drinkers with high PBS use norms, a negatively, versus positively, framed message resulted in increased PBS use and consequently lower alcohol consumption and fewer alcohol-related consequences. However, these effects were only relevant among those who strongly believed the DRT frame. Findings suggest assigning drinkers to frames based on perceived PBS use norms and increasing belief in the frame may be 1 approach to increasing responsible drinking patterns among college students. Furthermore, the current data suggests important boundary conditions for norm-based interventions. (c) 2015 APA, all rights reserved).

  16. An Overview of Dietary Interventions and Strategies to Optimize the Management of Non-Alcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Brandon J. Perumpail

    2017-10-01

    Full Text Available Aim: To investigate the efficacy of lifestyle adjustment strategies as a preventive measure and/or treatment of obesity-related non-alcoholic fatty liver disease in adults. Method: A systematic review of literature through 1 July 2017 on the PubMed Database was performed. A comprehensive search was conducted using key terms, such as non-alcoholic fatty liver disease (NAFLD, combined with lifestyle intervention, diet, and exercise. All of the articles and studies obtained from the search were reviewed. Redundant literature was excluded. Results: Several types of dietary compositions and exercise techniques were identified. Most studies concluded and recommended reduction in the intake of saturated and trans fatty acids, carbohydrates, and animal-based protein, and increased intake of polyunsaturated fatty acids (PUFAs, monounsaturated fatty acids (MUFAs, plant-based proteins, antioxidants, and other nutrients was recommended. The Mediterranean and Paleo diet both seem to be promising schemes for NAFLD patients to follow. Exercise was also encouraged, but the type of exercise did not affect its efficacy as a NAFLD treatment when the duration is consistent. Conclusions: Although these different dietary strategies and exercise regimens can be adopted to treat NAFLD, current literature on the topic is limited in scope. Further research should be conducted to truly elucidate which lifestyle adjustments individually, and in combination, may facilitate patients with obesity-related NAFLD.

  17. An Overview of Dietary Interventions and Strategies to Optimize the Management of Non-Alcoholic Fatty Liver Disease.

    Science.gov (United States)

    Perumpail, Brandon J; Cholankeril, Rosann; Yoo, Eric R; Kim, Donghee; Ahmed, Aijaz

    2017-10-22

    Aim : To investigate the efficacy of lifestyle adjustment strategies as a preventive measure and/or treatment of obesity-related non-alcoholic fatty liver disease in adults. Method : A systematic review of literature through 1 July 2017 on the PubMed Database was performed. A comprehensive search was conducted using key terms, such as non-alcoholic fatty liver disease (NAFLD), combined with lifestyle intervention, diet, and exercise. All of the articles and studies obtained from the search were reviewed. Redundant literature was excluded. Results : Several types of dietary compositions and exercise techniques were identified. Most studies concluded and recommended reduction in the intake of saturated and trans fatty acids, carbohydrates, and animal-based protein, and increased intake of polyunsaturated fatty acids (PUFAs), monounsaturated fatty acids (MUFAs), plant-based proteins, antioxidants, and other nutrients was recommended. The Mediterranean and Paleo diet both seem to be promising schemes for NAFLD patients to follow. Exercise was also encouraged, but the type of exercise did not affect its efficacy as a NAFLD treatment when the duration is consistent. Conclusions : Although these different dietary strategies and exercise regimens can be adopted to treat NAFLD, current literature on the topic is limited in scope. Further research should be conducted to truly elucidate which lifestyle adjustments individually, and in combination, may facilitate patients with obesity-related NAFLD.

  18. [A Survey of the Factors of Influence and Interventional Strategies for Breast Cancer Survivors' Transition Care Across Multiple Theoretical Perspectives].

    Science.gov (United States)

    Chao, Yu-Huan; Lee, Tzu-I; Sheu, Shuh-Jen

    2018-02-01

    Breast cancer significantly threatens the life of women, while the adverse effects of cancer treatment degrade quality of life and psychological well-being. The quality of transitional care following the completion of treatment significantly affects the ability of breast cancer patients to transition successfully into survivorship. This paper introduces multiple theoretical perspectives and provides an overview of the tenets of each in order to identify the positions of breast cancer survivors and to highlight the factors and strategies that influence their transitional care. The theoretical perspectives that are introduced include the social-ecological model, transition theory, and the strengths perspective. In order to improve the holistic care of women with breast cancer, factors relevant to transition are categorized into the individual, interpersonal, organizational, community, and policy levels. Furthermore, empirical interventions, which are based on the respective advantages of the various levels of the social-ecological model, are proposed in order to conform to the sociocultural context and clinical practices. Healthcare providers should leverage the strengths and resources at each level to develop feasible strategies and to provide quality of care in order to assist breast cancer patients to transition successfully from treatment to survivorship and to holistically improve their subsequent quality of life and function.

  19. Biomechanical Diversity of Mating Structures among Harvestmen Species Is Consistent with a Spectrum of Precopulatory Strategies.

    Directory of Open Access Journals (Sweden)

    Mercedes Burns

    Full Text Available Diversity in reproductive structures is frequently explained by selection acting at individual to generational timescales, but interspecific differences predicted by such models (e.g., female choice or sexual conflict are often untestable in a phylogenetic framework. An alternative approach focuses on clade- or function-specific hypotheses that predict evolutionary patterns in terms neutral to specific modes of sexual selection. Here we test a hypothesis that diversity of reproductive structures in leiobunine harvestmen (daddy longlegs of eastern North America reflects two sexually coevolved but non-overlapping precopulatory strategies, a primitive solicitous strategy (females enticed by penis-associated nuptial gifts, and a multiply derived antagonistic strategy (penis exerts mechanical force against armature of the female pregenital opening. Predictions of sexual coevolution and fidelity to precopulatory categories were tested using 10 continuously varying functional traits from 28 species. Multivariate analyses corroborated sexual coevolution but failed to partition species by precopulatory strategy, with multiple methods placing species along a spectrum of mechanical antagonistic potential. These findings suggest that precopulatory features within species reflect different co-occurring levels of solicitation and antagonism, and that gradualistic evolutionary pathways exist between extreme strategies. The ability to quantify antagonistic potential of precopulatory structures invites comparison with ecological variables that may promote evolutionary shifts in precopulatory strategies.

  20. AAR at Hydro-Quebec : a review of field cases and intervention strategies

    Energy Technology Data Exchange (ETDEWEB)

    Durand, B. [Hydro-Quebec, Varennes, PQ (Canada). IREQ

    2006-07-01

    Hydro-Quebec owns and operates more than 560 dams, including 200 dams that are classified as large dams. By 2010, approximately 150 of the concrete dams will be at least 50 years old, and nearly 100 of the dams will be 70 years old. The current condition of these structures reflects the influence of several factors that have promoted aging, such as initial shrinkage causing latent microcracking; expansion and contraction related to temperature cycles; larger infiltration entailing increased uplift; leaching and deposition of calcium salts that clog joints and drains; hydric swelling; freezing and thawing cycles; erosion; sulfation; and, alkali-aggregate reactions (AAR). This paper focused on the swelling due to AAR, since more than 20 dams have been affected by this condition. Hydro-Quebec's approach to prevent AAR was described. In response to Canadian Standards Association (CSA) concrete expansion tests, Hydro-Quebec no longer allows admixtures for its concrete structures. Rather, non-reactive aggregates are used in the concrete. This paper also discussed the evaluation of residual expansion time caused by the alkali-silica reaction (ASR), which has affected the dam at La Tuque in the Mauricie Region. Results of laboratory expansion tests have been compared with the average expansion rate measured at the La Tuque dam. It was estimated that the concrete should continue to swell for at least 20 years at the same rate as measured since 1979. After that, expansion may possibly slow down due to self-confinement in the concrete. However, if confinement increases in 2 directions, it is probable that the expansion accelerates in the third direction. 26 refs., 3 tabs., 8 figs.

  1. Stance and strategy: post-structural perspective and post-colonial engagement to develop nursing knowledge.

    Science.gov (United States)

    Sochan, Anne M

    2011-07-01

    How should nursing knowledge advance? This exploration contextualizes its evolution past and present. In addressing how it evolved in the past, a probable historical evolution of its development draws on the perspectives of Frank & Gills's World System Theory, Kuhn's treatise on Scientific Revolutions, and Foucault's notions of Discontinuities in scientific knowledge development. By describing plausible scenarios of how nursing knowledge evolved, I create a case for why nursing knowledge developers should adopt a post-structural stance in prioritizing their research agenda(s). Further, by adopting a post-structural stance, I create a case on how nurses can advance their disciplinary knowledge using an engaging post-colonial strategy. Given an interrupted history caused by influence(s) constraining nursing's knowledge development by power structures external, and internal, to nursing, knowledge development can evolve in the future by drawing on post-structural interpretation, and post-colonial strategy. The post-structural writings of Deleuze & Guattari's understanding of 'Nomadology' as a subtle means to resist being constrained by existing knowledge development structures, might be a useful stance to understanding the urgency of why nursing knowledge should advance addressing the structural influences on its development. Furthermore, Bhabha's post-colonial elucidation of 'Hybridity' as an equally discreet means to change the culture of those constraining structures is an appropriate strategy to enact how nursing knowledge developers can engage with existing power structures, and simultaneously influence that engagement. Taken together, 'post-structural stance' and 'post-colonial strategy' can refocus nursing scholarship to learn from its past, in order to develop relevant disciplinary knowledge in its future. © 2011 Blackwell Publishing Ltd.

  2. The effect of a structural intervention for syphilis control among 3597 female sex workers: a demonstration study in South China.

    Science.gov (United States)

    Wang, Baoxi; Wang, Qian-Qiu; Yin, Yue-Ping; Liang, Guo-Jun; Jiang, Ning; Gong, Xiang-Dong; Yang, Bin; Zhou, Yue-Jiao; Liu, Qiao; Huan, Xi-Ping; Yang, Li-Gang; Tan, Guang-Jie; Pei, Dong-Nu; Tucker, Joseph D; Chen, Xiang-Sheng

    2012-09-15

    Syphilis has made a rapid resurgence in China, especially among high-risk groups including female sex workers (FSWs). Two cities in each of 3 provinces in South China were chosen and allocated to intervention or control arms. The intervention consisted of enhancing community-based syphilis screening outreach intervention with comprehensive sexually transmitted infection services at designated clinics while the control maintained routine intervention activities. Generalized linear modeling was used to examine effect of the intervention on incident syphilis infection. A total of 8275 women were eligible, and 3597 women enrolled (n = 2011 in control arm, n = 1586 in intervention arm) in the study. The median follow-up duration was 375 days (interquartile range, 267–475). Syphilis incidence density in the intervention group was reduced by 70% (95% confidence interval, 53%–81%) compared with the incidence in the control arm. The syphilis prevention intervention benefits were robust among FSWs at low-tier venues, individuals with less than high school education, migrants, and women who did not report condom use during the last episode of sex. Integrated sexually transmitted infection and human immunodeficiency virus prevention strategies substantially reduce syphilis incidence among FSWs, especially among those at low-tier venues. This intervention suggests the need for scaling up comprehensive FSW programs in China.

  3. Feasibility and Preliminary Effectiveness of the Homework Intervention Strategy (eHIS) Program to Enhance Male Condom Use: Research Protocol.

    Science.gov (United States)

    Glowacka, Marta; Yardley, Lucy; Stone, Nicole; Graham, Cynthia A

    2018-01-02

    Although condoms are effective in reducing the risk of sexually transmitted infections (STIs) and unintended pregnancy, they are still often not used consistently and correctly. Negative impact on sensation and pleasure, ruining the mood, causing problems with maintaining erection, and condom slippage or breakage are some of the reasons given by men explaining why they do not want to use condoms. Although many interventions promoting condom use exist, some of them delivered online are complex and time- and resource-intensive. The Homework Intervention Strategy (eHIS) program, adapted from the existing face-to-face Kinsey Institute Homework Intervention Strategy (KIHIS) program, aims to address these issues by encouraging men to focus on sensation and pleasure when trying different types of condoms and lubricants in a low-pressure situation (on their own, without a partner present). The objectives of this study are to assess the feasibility, acceptability, and users' engagement with the eHIS program, its preliminary effectiveness in increasing condom use frequency and consistency, as well as the feasibility of the program's evaluation approach, including choice of measures and participant recruitment and retaining strategies (primary outcomes). Secondary outcomes include condom use experience, condom use attitudes, condom use self-efficacy, condom use errors and problems, and condom fit-and-feel. All of these will be analyzed in the context of participants' demographics, sexual history, and previous condom use. The study has a pre-post-test, within-subjects design. Men aged 18 to 69 and living in the United Kingdom are recruited through posters, leaflets, social media, and emails. Study participants are asked to complete T1 (baseline) measures before entering the eHIS website. After completing the T1 measures, they can order a free condoms and lubricants kit and have access to the eHIS website for 4 weeks. During that time they are asked to practice using different

  4. Temporal Trends of Reperfusion Strategies and Hospital Mortality for Patients With STEMI in Percutaneous Coronary Intervention-Capable Hospitals.

    Science.gov (United States)

    Tran, Dat T; Welsh, Robert C; Ohinmaa, Arto; Thanh, Nguyen X; Kaul, Padma

    2017-04-01

    The aim of this study was to examine temporal trends and provincial variations in reperfusion strategies and in-hospital mortality among patients presenting with ST-segment elevation myocardial infarction (STEMI) at hospitals in Canada capable of performing percutaneous coronary intervention (PCI). We included patients aged ≥ 20 years who were hospitalized between fiscal years 2009 and 2013 in all provinces except Quebec. We categorized patients as receiving fibrinolysis (lysis), primary PCI (pPCI), or no reperfusion. Patients undergoing lysis were further categorized as (1) lysis + PCI ≤ 90 minutes, (2) lysis + PCI > 90 minutes, and (3) lysis only. Patients undergoing pPCI were further categorized as (1) pPCI ≤ 90 minutes and (2) pPCI > 90 minutes. We used logistic regression to examine the baseline-adjusted association between reperfusion strategy and in-hospital mortality. Among 44,650 STEMI episodes in 44,373 patients, 66.3% received pPCI (annual increase of 7.8%; P 90 minutes (adjusted odds ratio of 0.42; 95% confidence interval, 0.32-0.55 compared with pPCI ≤ 90 minutes). The use of pPCI in STEMI has increased significantly in Canada; however, significant interprovincial variation remains. Changes in reperfusion strategies do not appear to have had an impact on in-hospital mortality rates. Patients who underwent lysis followed by PCI in a systematic fashion had the lowest mortality. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  5. Structured Dietary Interventions in the Treatment of Severe Pediatric Obesity: A Pilot Study.

    Science.gov (United States)

    Kalarchian, Melissa A; Levine, Michele D; Marcus, Marsha D

    2013-06-01

    Structured dietary interventions have been associated with improved outcomes in adult weight-control programs, but virtually no research has focused on children. Thus, we conducted an uncontrolled pilot study to determine the potential utility of structured approaches to enhance the dietary component of family-based treatment of severe pediatric obesity (body mass index [BMI] >97th percentile for age and sex). Children aged 8-12 years participated with a parent or guardian. Individualized menu plans were provided (MENU, n =12) alone, or along with meals and snacks for the child (MENU+MEAL, n =6). All families received up to $30/week reimbursement for foods included in the menus. Median BMI change was -1.2 kg/m 2 for MENU ( n =12), and -1.8 kg/m 2 for MENU+MEAL ( n =6). Both approaches were associated with significant reductions in BMI ( p obesity are acceptable to families and warrant further development.

  6. International trade shows: Structure, strategy and performance of exhibitors at individual booths vs. joint booths

    DEFF Research Database (Denmark)

    Hansen, Kåre

    2000-01-01

    This paper examines differences in exhibitors who participate at international trade shows at joint booths and those who participate at individual booths. The structure, strategy, and trade show performance of exhibitors at joint booths and those at individual booths are analysed. The analysis...... implications for exhibitors at interna-tional trade shows and export marketing programmes and other marketing programmes offering services to international trade show exhibitors....... of exhibitors at the international food shows SIAL (Paris) and ANUGA (Cologne) showed several significant differences with regard to structure and strategy. However, no significant differences in the performance assessments between the two partici-pation modes were found. The findings have important...

  7. Helping struggling learners of English as an additional language succeed with interactive multisensory structured strategies

    Directory of Open Access Journals (Sweden)

    Schneider, Elke

    2016-01-01

    Full Text Available Based on cross-linguistic and interdisciplinary research of several decades that bridges learning an additional language with the field of learning differences/disabilities, this article shares research-evidenced practices to effectively address the needs of struggling foreign and second language learners of English in Brazil. These multisensory structured strategies enhance pronunciation, listening, reading and writing skills and strengthen grammar and vocabulary competencies of struggling learners. The selected multisensory structured metacognitive strategies can easily be infused into existing English as a foreign/second language curricula

  8. Prevalence of risk factors for tail biting on commercial farms and intervention strategies.

    Science.gov (United States)

    Taylor, Nina R; Parker, Richard M A; Mendl, Michael; Edwards, Sandra A; Main, David C J

    2012-10-01

    A husbandry advisory tool (HAT) was devised to help pig producers and their advisors identify and minimise possible risk factors for tail biting in finishing pigs. The prevalence of 83 risk factors identified from the literature and expert opinion was recorded on 65 commercial pig farms in England between May 2007 and July 2009. Those considered most important were associated with atmosphere/environment, environmental enrichment, the provision of food/drink and animal health factors. Forty-six farms received advice on minimising these risks and, of these, 27 also received a financial incentive to encourage the uptake of advice. A reduction in risk factors was observed on 42/57 farms visited at the end of the study, with the greatest reduction occurring on the farms that had been incentivised. However, farms not receiving advice also had reduced risk factors associated with atmosphere/environment and stocking density over the course of the study. In conclusion, while some risk factors are structural and require substantial capital investment to change, a significant reduction in the risk of tail biting can be achieved on many farms through the systematic evaluation and modification of management practices. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Cerebral Perfusion Enhancing Interventions: A New Strategy for the Prevention of Alzheimer Dementia.

    Science.gov (United States)

    de la Torre, Jack C

    2016-09-01

    Cardiovascular and cerebrovascular diseases are major risk factors in the development of cognitive impairment and Alzheimer's disease (AD). These cardio-cerebral disorders promote a variety of vascular risk factors which in the presence of advancing age are prone to markedly reduce cerebral perfusion and create a neuronal energy crisis. Long-term hypoperfusion of the brain evolves mainly from cardiac structural pathology and brain vascular insufficiency. Brain hypoperfusion in the elderly is strongly associated with the development of mild cognitive impairment (MCI) and both conditions are presumed to be precursors of Alzheimer dementia. A therapeutic target to prevent or treat MCI and consequently reduce the incidence of AD aims to elevate cerebral perfusion using novel pharmacological agents. As reviewed here, the experimental pharmaca include the use of Rho kinase inhibitors, neurometabolic energy boosters, sirtuins and vascular growth factors. In addition, a compelling new technique in laser medicine called photobiomodulation is reviewed. Photobiomodulation is based on the use of low level laser therapy to stimulate mitochondrial energy production non-invasively in nerve cells. The use of novel pharmaca and photobiomodulation may become important tools in the treatment or prevention of cognitive decline that can lead to dementia. © 2016 International Society of Neuropathology.

  10. Perinatal morbidity and mortality in substance using families: effects and intervention strategies.

    Science.gov (United States)

    Finnegan, L P

    1994-01-01

    The epidemic of drug abuse has overwhelmed men, women and children and caused incalculable damage to an honoured structure in human civilization--the family. Moreover, during the past decade, increasing numbers of pregnant drug-dependent women have been presenting themselves to medical facilities, some to receive ongoing prenatal care, but others only to deliver their babies without the benefit of any medical services. The present chapter reviews the current literature, as well as the experiences of the author, with regard to the sociomedical characteristics of pregnant, drug-dependent women. The effects of substances of abuse on pregnancy, the foetus and the newborn with respect to morbidity and mortality are presented. Recommendations for management of both the pregnant drug-dependent women and her child, on the basis of clinical research, are also outlined. Although overall medical advances have escalated during the past three decades, there is still much to learn with regard to the effects of drugs of abuse upon families. Moreover, methods of prevention and treatment still need considerable study. By re-evaluating the areas of strength and weakness in the body of available knowledge, future research will be able to enhance the ability to help those unfortunate families that are effected by substance abuse.

  11. The structural model of pain, cognitive strategies, and negative emotions in functional gastrointestinal disorders

    Directory of Open Access Journals (Sweden)

    Mina Mazaheri

    2016-01-01

    Full Text Available Background: Patients with functional gastrointestinal disorders (FGIDs may use specific coping strategies. We intend to provide a mediating role of the relationship between pain (intensity and acceptance, cognitive emotion regulation strategies, and negative emotions in patients with FGIDs. Materials and Methods: Participants were 176 inpatients, all experiencing significant FGIDs symptomatology as confirmed by gastroenterologists. Patients completed data on cognitive emotion regulation questionnaire, short form of depression, anxiety, stress scale, chronic pain acceptance questionnaire-revised, and pain intensity scale. Data were analyzed using structural equation modeling method. Results: The pain intensity had significantly direct effect on cognitive emotion regulation strategies and indirect effect on negative emotions. Besides, the mediating role of negative emotions in the relationship between the strategies and pain acceptance were supported, whereas indirect relationships between pain intensity and acceptance through cognitive strategies were not confirmed. Conclusion: The results of the study emphasize the role of pain intensity in the development of negative emotions through cognitive strategies and the role of the strategies in pain acceptance through negative emotions. In fact, cognitive strategies to be related to pain and emotions.

  12. Office-based physical activity and nutrition intervention: barriers, enablers, and preferred strategies for workplace obesity prevention, Perth, Western Australia, 2012.

    Science.gov (United States)

    Blackford, Krysten; Jancey, Jonine; Howat, Peter; Ledger, Melissa; Lee, Andy H

    2013-09-12

    Workplace health promotion programs to prevent overweight and obesity in office-based employees should be evidence-based and comprehensive and should consider behavioral, social, organizational, and environmental factors. The objective of this study was to identify barriers to and enablers of physical activity and nutrition as well as intervention strategies for health promotion in office-based workplaces in the Perth, Western Australia, metropolitan area in 2012. We conducted an online survey of 111 employees from 55 organizations. The online survey investigated demographics, individual and workplace characteristics, barriers and enablers, intervention-strategy preferences, and physical activity and nutrition behaviors. We used χ(2) and Mann-Whitney U statistics to test for differences between age and sex groups for barriers and enablers, intervention-strategy preferences, and physical activity and nutrition behaviors. Stepwise multiple regression analysis determined factors that affect physical activity and nutrition behaviors. We identified several factors that affected physical activity and nutrition behaviors, including the most common barriers ("too tired" and "access to unhealthy food") and enablers ("enjoy physical activity" and "nutrition knowledge"). Intervention-strategy preferences demonstrated employee support for health promotion in the workplace. The findings provide useful insights into employees' preferences for interventions; they can be used to develop comprehensive programs for evidence-based workplace health promotion that consider environmental and policy influences as well as the individual.

  13. Slum upgrading strategies involving physical environment and infrastructure interventions and their effects on health and socio-economic outcomes.

    Science.gov (United States)

    Turley, Ruth; Saith, Ruhi; Bhan, Nandita; Rehfuess, Eva; Carter, Ben

    2013-01-31

    Slums are densely populated, neglected parts of cities where housing and living conditions are exceptionally poor. In situ slum upgrading, at its basic level, involves improving the physical environment of the existing area, such as improving and installing basic infrastructure like water, sanitation, solid waste collection, electricity, storm water drainage, access roads and footpaths, and street lighting, as well as home improvements and securing land tenure. To explore the effects of slum upgrading strategies involving physical environment and infrastructure interventions on the health, quality of life and socio-economic wellbeing of urban slum dwellers in low and middle income countries (LMIC). Where reported, data were collected on the perspectives of slum dwellers regarding their needs, preferences for and satisfaction with interventions received. We searched for published and unpublished studies in 28 bibliographic databases including multidisciplinary (for example Scopus) and specialist databases covering health, social science, urban planning, environment and LMIC topics. Snowballing techniques included searching websites, journal handsearching, contacting authors and reference list checking. Searches were not restricted by language or publication date. We included studies examining the impact of slum upgrading strategies involving physical environment or infrastructure improvements (with or without additional co-interventions) on the health, quality of life and socio-economic wellbeing of LMIC urban slum dwellers. Randomised controlled trials (RCTs), controlled before and after studies (CBAs) and interrupted time series (ITS) were eligible for the main analysis. Controlled studies with only post-intervention data (CPI) and uncontrolled before and after (UBA) studies were included in a separate narrative to examine consistency of results and to supplement evidence gaps in the main analysis. Two authors independently extracted data and assessed risk of bias

  14. THE RESOURCE POTENTIAL AND THE DEVELOPMENT STRATEGY OF COMPETITIVE ADVANTAGES IN BUSINESS STRUCTURE

    Directory of Open Access Journals (Sweden)

    Okolnishnikova Irina Yurievna

    2013-02-01

    Full Text Available The aim of the research is the development of theoretical approaches to the study of the essence and structure of the resource potential of entrepreneurship in the context of the development strategy of the competitive advantages in business structure. As the research methodology the complex of principles and tools of system and axiological approaches is used. According to the results of the conducted research, possessing the scientific novelty, the conceptual apparatus is clarified and the author's definition of the resource potential of the enterprise is given, a model of the resource potential structure in commercial organization is analyzed and the mechanism of strategy formation for sustainable competitive advantages provision of the organization on the basis of the effective use of its resource potential is identified. Area of application of the research results is the control of competitiveness in general and resource potential of entrepreneurial structures, in particular at all levels of the socio-economic system of society.

  15. A Survey of the Relation Between Capital Structure and Corporate Strategy

    Directory of Open Access Journals (Sweden)

    M. La Rocca

    2008-06-01

    Full Text Available This paper responds to the general call for integration between finance and strategy researchby examining how financial decisions are related to corporate strategy. In particular, the paperfocuses on the link between capital structure and strategy. Corporate strategies complementtraditional finance paradigms and extend our insight into a firm’s decisions regarding capitalstructure. Equity and debt must be considered as financial instruments as well as strategicinstruments of corporate governance (Williamson 1988. Debt subordinates governanceactivities to stricter management, while equity allows for greater flexibility and decisionmakingpower.The literature on finance and strategy analyzes how the strategic actions of key players(managers, shareholders, debtholders, competitors, workers, suppliers, etc affect firm valueand the allocation of value between claimholders. Specifically, financing decisions canconcern value creation process (1 influencing efficient investments decisions according to theexistence of conflict of interest between managers and firm’s financial stakeholders(shareholders and debtholders and (2 affecting the relationship with non-financialstakeholders, as suppliers, competitors, customers.To summarize, the potential interaction between managers, financial stakeholders, and nonfinancialstakeholders influences capital structure, corporate governance activities, and valuecreation processes. These in turn, may give rise to inefficient managerial decisions or theymay shape the industry’s competitive dynamics to achieve a competitive advantage. A goodintegration between strategy and finance dimensions can be tantamount to a competitiveweapon.

  16. The effectiveness of strategies and interventions that aim to assist the transition from student to newly qualified nurse.

    Science.gov (United States)

    Edwards, Deborah; Hawker, Clare; Carrier, Judith; Rees, Colin

    2011-01-01

    Background: The transition period from student to newly qualified nurse where nurses are adjusting to their new role and consolidating their knowledge and skills can be stressful. It is a time when many newly qualified nurses are left feeling inadequately prepared. A variety of strategies to ease the transition process have been reported, which aim to increase confidence, competence, sense of belonging of new graduates, improve recruitment and retention and reduce turnover costs. To synthesise the best available evidence on the effectiveness of support strategies and interventions aimed for newly qualified nurses. A comprehensive search was undertaken on major electronic databases to identify both published and unpublished studies from 2000 to the present date. Reference lists of retrieved papers were searched and authors contacted. Only quantitative studies published in English language were considered.Methodological quality and data extraction: Two reviewers independently assessed methodological quality and extracted data from the included studies. A third reviewer resolved any disagreements through discussion. The review did not identify comparable Randomised Controlled Trials (RCTs), and as such meta-analysis of the data was not appropriate. The data extracted from the included studies were synthesized into a narrative summary. Thirty three studies were included in the review: RCT (1), Quasi-experimental (3) and observational/descriptive studies (29). Countries of origin were: USA (25), Australia (4), England (2), New Zealand (1) and Thailand (1). Studies were categorised according to the type of programme or support strategy provided: nurse internship/residency programmes (14) and graduate nurse orientation programmes (7), preceptorship (4), simulation (3) and mentoring (2), final year nursing students transition programs (2) and externship (1).Outcomes were categorised as being important to the employer (recruitment, retention, turnover rates, competence

  17. Comparison of various decentralised structural and cavity feedback control strategies for transmitted noise reduction through a double panel structure

    Science.gov (United States)

    Ho, Jen-Hsuan; Berkhoff, Arthur

    2014-03-01

    This paper compares various decentralised control strategies, including structural and acoustic actuator-sensor configuration designs, to reduce noise transmission through a double panel structure. The comparison is based on identical control stability indexes. The double panel structure consists of two panels with air in between and offers the advantages of low sound transmission at high frequencies, low heat transmission, and low weight. The double panel structure is widely used, such as in the aerospace and automotive industries. Nevertheless, the resonance of the cavity and the poor sound transmission loss at low frequencies limit the double panel's noise control performance. Applying active structural acoustic control to the panels or active noise control to the cavity has been discussed in many papers. In this paper, the resonances of the panels and the cavity are considered simultaneously to further reduce the transmitted noise through an existing double panel structure. A structural-acoustic coupled model is developed to investigate and compare various structural control and cavity control methods. Numerical analysis and real-time control results show that structural control should be applied to both panels. Three types of cavity control sources are presented and compared. The results indicate that the largest noise reduction is obtained with cavity control by loudspeakers modified to operate as incident pressure sources.

  18. Strategy for 100-year life of the ACR-1000 concrete containment structure

    International Nuclear Information System (INIS)

    Abrishami, H.; Elgohary, M.

    2006-01-01

    The purpose of this paper is to present the Plant Life Management (PLiM) strategy for the concrete containment structure of the ACR-1000 (Advanced CANDU Reactor) designed by AECL. The ACR-1000 is designed for 100-year plant life including 60-year operating life and additional 40-year decommissioning period of time. The approach adopted for the PLiM strategy of the concrete containment structure is a preventive one, key areas being: 1) design methodology, 2) material performance and 3) life cycle management and ageing management program. In the design phase, in addition to strength and serviceability, durability is a major requirement during the service life and decommissioning phase of the ACR structure. Parameters affecting durability design include: a) concrete performance, b) structural application, and c) environmental conditions. Due to the complex nature of the environmental effects acting on structures during the service life of project, it is considered that true improved performance during the service life can be achieved by improving the material characteristics. Many recent innovations in advanced concrete materials technology have made it possible to produce modern concrete such as high-performance concrete with exceptional performance characteristics. In this paper, the PLiM strategy for the ACR-1000 concrete containment is presented. In addition to addressing the design methodology and material performance areas, a systematic approach for ageing management program for the concrete containment structure is presented. (author)

  19. Impact of a social network-based intervention promoting diabetes self-management in socioeconomically deprived patients: a qualitative evaluation of the intervention strategies

    NARCIS (Netherlands)

    Vissenberg, C.; Stronks, K.; Nijpels, G.; Uitewaal, P. J. M.; Middelkoop, B. J. C.; Kohinor, M. J. E.; Hartman, M. A.; Nierkens, V.

    2016-01-01

    There is a need for effective interventions that improve diabetes self-management (DSM) among socioeconomically deprived patients with type 2 diabetes. The group-based intervention Powerful Together with Diabetes (PTWD) aimed to increase social support for DSM and decrease social influences

  20. Prevention and Control Strategies to Counter Zika Virus, a Special Focus on Intervention Approaches against Vector Mosquitoes—Current Updates

    Directory of Open Access Journals (Sweden)

    Raj K. Singh

    2018-02-01

    Full Text Available Zika virus (ZIKV is the most recent intruder that acquired the status of global threat creating panic and frightening situation to public owing to its rapid spread, attaining higher virulence and causing complex clinical manifestations including microcephaly in newborns and Guillain Barré Syndrome. Alike other flaviviruses, the principal mode of ZIKV transmission is by mosquitoes. Advances in research have provided reliable diagnostics for detecting ZIKV infection, while several drug/therapeutic targets and vaccine candidates have been identified recently. Despite these progresses, currently there is neither any effective drug nor any vaccine available against ZIKV. Under such circumstances and to tackle the problem at large, control measures of which mosquito population control need to be strengthened following appropriate mechanical, chemical, biological and genetic control measures. Apart from this, several other known modes of ZIKV transmission which have gained importance in recent past such as intrauterine, sexual intercourse, and blood-borne spread need to be checked and kept under control by adopting appropriate precautions and utmost care during sexual intercourse, blood transfusion and organ transplantation. The virus inactivation by pasteurization, detergents, chemicals, and filtration can effectively reduce viral load in plasma-derived medicinal products. Added to this, strengthening of the surveillance and monitoring of ZIKV as well as avoiding travel to Zika infected areas would aid in keeping viral infection under check. Here, we discuss the salient advances in the prevention and control strategies to combat ZIKV with a focus on highlighting various intervention approaches against the vector mosquitoes of this viral pathogen along with presenting an overview regarding human intervention measures to counter other modes of ZIKV transmission and spread. Additionally, owing to the success of vaccines for a number of infections

  1. The Performance Implications of Fit among Environment, Strategy, Structure, Control System and Social Performance

    Directory of Open Access Journals (Sweden)

    Hasan Fauzi

    2009-12-01

    domain will be contingent upon strategic behaviors, which are behaviors of members in an organization. The paper integrates the contextual variables including business environment, strategy, organization structure, and control system with corporate performance by using corporate social performance as moderating variable by means of a recent literatures study from strategic management and accounting field.

  2. Innovation Vouchers and LEP Structural Funds Strategies. Innovation and Growth Factsheet Series. No. 1

    Science.gov (United States)

    Universities UK, 2014

    2014-01-01

    This factsheet, the first in a series on innovation and growth, provides an overview of the benefits of innovation vouchers, and gives some examples of how universities and Local Enterprise Partnerships (LEPs) are including them in their European Structural and Investment Funds (ESIF) strategies. [For the second factsheet in the series,…

  3. Teaching Mathematical Word Problem Solving: The Quality of Evidence for Strategy Instruction Priming the Problem Structure

    Science.gov (United States)

    Jitendra, Asha K.; Petersen-Brown, Shawna; Lein, Amy E.; Zaslofsky, Anne F.; Kunkel, Amy K.; Jung, Pyung-Gang; Egan, Andrea M.

    2015-01-01

    This study examined the quality of the research base related to strategy instruction priming the underlying mathematical problem structure for students with learning disabilities and those at risk for mathematics difficulties. We evaluated the quality of methodological rigor of 18 group research studies using the criteria proposed by Gersten et…

  4. The Role of Classroom Goal Structure in Students' Use of Self-Handicapping Strategies.

    Science.gov (United States)

    Urdan, Tim; Midgley, Carol; Anderman, Eric M.

    1998-01-01

    Surveyed 656 fifth graders on their use of self-handicapping strategies and examined predictors of self-handicapping. Boys used handicapping more than girls did, and grade point average and perceived academic competence were negatively related to handicapping. Ability goal structure and teaching practices highlighting relative ability were…

  5. Structural and congenital heart disease interventions: the role of three-dimensional printing.

    Science.gov (United States)

    Meier, L M; Meineri, M; Qua Hiansen, J; Horlick, E M

    2017-02-01

    Advances in catheter-based interventions in structural and congenital heart disease have mandated an increased demand for three-dimensional (3D) visualisation of complex cardiac anatomy. Despite progress in 3D imaging modalities, the pre- and periprocedural visualisation of spatial anatomy is relegated to two-dimensional flat screen representations. 3D printing is an evolving technology based on the concept of additive manufacturing, where computerised digital surface renders are converted into physical models. Printed models replicate complex structures in tangible forms that cardiovascular physicians and surgeons can use for education, preprocedural planning and device testing. In this review we discuss the different steps of the 3D printing process, which include image acquisition, segmentation, printing methods and materials. We also examine the expanded applications of 3D printing in the catheter-based treatment of adult patients with structural and congenital heart disease while highlighting the current limitations of this technology in terms of segmentation, model accuracy and dynamic capabilities. Furthermore, we provide information on the resources needed to establish a hospital-based 3D printing laboratory.

  6. Structural racism and health inequities in the USA: evidence and interventions.

    Science.gov (United States)

    Bailey, Zinzi D; Krieger, Nancy; Agénor, Madina; Graves, Jasmine; Linos, Natalia; Bassett, Mary T

    2017-04-08

    Despite growing interest in understanding how social factors drive poor health outcomes, many academics, policy makers, scientists, elected officials, journalists, and others responsible for defining and responding to the public discourse remain reluctant to identify racism as a root cause of racial health inequities. In this conceptual report, the third in a Series on equity and equality in health in the USA, we use a contemporary and historical perspective to discuss research and interventions that grapple with the implications of what is known as structural racism on population health and health inequities. Structural racism refers to the totality of ways in which societies foster racial discrimination through mutually reinforcing systems of housing, education, employment, earnings, benefits, credit, media, health care, and criminal justice. These patterns and practices in turn reinforce discriminatory beliefs, values, and distribution of resources. We argue that a focus on structural racism offers a concrete, feasible, and promising approach towards advancing health equity and improving population health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Modeling the contamination of lettuce with Escherichia coli 157:H7 from manure-amended soil and the effect of intervention strategies

    NARCIS (Netherlands)

    Franz, E.; Semenov, A.V.; Bruggen, van A.H.C.

    2008-01-01

    Aims: A growing number of foodborne illnesses has been associated with the consumption of fresh produce. In this study, the probability of lettuce contamination with Escherichia coli O157:H7 from manure-amended soil and the effect of intervention strategies was determined. Methods and Results:

  8. Strategies to Overcome Barriers to Implementation of Alcohol Screening and Brief Intervention in General Practice: a Delphi Study Among Healthcare Professionals and Addiction Prevention Experts

    NARCIS (Netherlands)

    L. Abidi; A. Oenema (Anke); P. Nilsen; P.D. Anderson (Peter); H. van de Mheen (Dike)

    2016-01-01

    textabstractDespite the evidence base, alcohol screening and brief intervention (ASBI) have rarely been integrated into routine clinical practice. The aim of this study is to identify strategies that could tackle barriers to ASBI implementation in general practice by involving primary healthcare

  9. Moving beyond the treatment package approach to developing behavioral interventions: addressing questions that arose during an application of the Multiphase Optimization Strategy (MOST).

    Science.gov (United States)

    Wyrick, David L; Rulison, Kelly L; Fearnow-Kenney, Melodie; Milroy, Jeffrey J; Collins, Linda M

    2014-09-01

    Given current pressures to increase the public health contributions of behavioral interventions, intervention scientists may wish to consider moving beyond the classical treatment package approach that focuses primarily on achieving statistical significance. They may wish also to focus on goals directly related to optimizing public health impact. The Multiphase Optimization Strategy (MOST) is an innovative methodological framework that draws on engineering principles to achieve more potent behavioral interventions. MOST is increasingly being adopted by intervention scientists seeking a systematic framework to engineer an optimized intervention. As with any innovation, there are challenges that arise with early adoption. This article describes the solutions to several critical questions that we addressed during the first-ever iterative application of MOST. Specifically, we describe how we have applied MOST to optimize an online program (myPlaybook) for the prevention of substance use among college student-athletes. Our application of MOST can serve as a blueprint for other intervention scientists who wish to design optimized behavioral interventions. We believe using MOST is feasible and has the potential to dramatically improve program effectiveness thereby advancing the public health impact of behavioral interventions.

  10. Minimally invasive or interventional repair of atrial septal defects in children: experience in 171 cases and comparison with conventional strategies.

    Science.gov (United States)

    Formigari, R; Di Donato, R M; Mazzera, E; Carotti, A; Rinelli, G; Parisi, F; Pasquini, L; Ballerini, L

    2001-05-01

    The goal of this study was to evaluate percutaneous interventional and minimally invasive surgical closure of secundum atrial septal defect (ASD) in children. Concern has surrounded abandoning conventional midline sternotomy in favor of the less invasive approaches pursuing a better cosmetic result and a more rational resource utilization. A retrospective analysis was performed on the patients treated from June 1996 to December 1998. One hundred seventy-one children (median age 5.8 years, median weight 22.1 kg) underwent 52 device implants, 72 minimally invasive surgical operations and 50 conventional sternotomy operations. There were no deaths and no residual left to right shunt in any of the groups. The overall complication rate causing delayed discharge was 12.6% for minimally invasive surgery, 12.0% for midline sternotomy and 3.8% for transcatheter device closure (p appeal of the percutaneous and minimally invasive approaches must be weighed against their greater exposure to technical pitfalls. Adequate training is needed if a strategy of surgical or percutaneous minimally invasive closure of ASD in children is planned in place of conventional surgery.

  11. Designing, implementing and monitoring social impact mitigation strategies: Lessons from Forest Industry Structural Adjustment Packages

    International Nuclear Information System (INIS)

    Loxton, Edwina A.; Schirmer, Jacki; Kanowski, Peter

    2013-01-01

    Social impact mitigation strategies are implemented by the proponents of policies and projects with the intent of reducing the negative, and increasing the positive social impacts of their activities, and facilitating the achievement of policy/project goals. Evaluation of mitigation strategies is critical to improving their future success and cost-effectiveness. This paper evaluates two Forest Industry Structural Adjustment Packages (FISAP) implemented in Australia in the 1990s to 2000s as part of broader policy changes that reduced access to timber from publicly owned native forests. It assesses the effectiveness of the structure, design, implementation and monitoring of the FISAPs, and highlights the interactions between these four elements and their influence on social impacts. The two FISAPs were found to be effective in terms of reducing negative impacts, encouraging positive impacts and contributing towards policy goals, although they did not mitigate negative impacts in all cases, and sometimes interacted with external factors and additional policy changes to contribute to significant short and long term negative impacts. -- Highlights: ► Mitigation strategies aim to reduce negative and enhance positive social impacts ► Mitigation strategy design, implementation, and monitoring are critical to success ► Effective mitigation enhanced the capacity of recipients to respond to change ► Mitigation strategies influenced multiple interacting positive and negative impacts ► Success required good communication, transparency, support, resources and timing

  12. Structure-based feeding strategies: A key component of child nutrition.

    Science.gov (United States)

    Taylor, Maija B; Emley, Elizabeth; Pratt, Mercedes; Musher-Eizenman, Dara R

    2017-07-01

    This study examined the relationship between structure, autonomy promotion, and control feeding strategies and parent-reported child diet. Participants (N = 497) were parents of children ages 2.5 to 7.5 recruited from Amazon Mechanical Turk. This sample was a Caucasian (79%), educated sample (61% college graduates) with most reports from mothers (76%). Online survey including measures of parent feeding strategies and child dietary intake. Use of structure-based feeding strategies explained 21% of the variance in child consumption of added sugar, 12% of the variance in child intake of added sugar from sugar-sweetened beverages, and 16% of the variance in child consumption of fruits and vegetables. Higher unhealthy food availability and permissive feeding uniquely predicted higher child added sugar intake and child consumption of added sugar from sugar-sweetened beverages. Greater healthy food availability uniquely predicted higher child fruit and vegetable intake. and Future Directions: In Caucasian educated families, structure-based feeding strategies appear to be a relatively stronger correlate of parent-reported child intake of added sugar and fruits and vegetables as compared to autonomy promotion and control feeding strategies. Longitudinal research may be needed in order to reveal the relationships between autonomy promotion and control feeding strategies with child diet. If future studies have similar findings to this study's results, researchers may want to focus more heavily on investigating the impact of teaching parents stimulus-control techniques and feeding-related assertiveness skills on child dietary intake. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Wetland management strategies lead to tradeoffs in ecological structure and function

    Directory of Open Access Journals (Sweden)

    Ariane L. Peralta

    2017-12-01

    Full Text Available Anthropogenic legacy effects often occur as a consequence of land use change or land management and can leave behind long-lasting changes to ecosystem structure and function. This legacy is described as a memory in the form of ecological structure or ecological interactions that remains at a location from a previous condition. We examined how forested floodplain restoration strategy, based on planting intensity, influenced wetland community structure and soil chemical and physical factors after 15 years. The site was divided into 15 strips, and strips were assigned to one of five restoration treatments: plantings of acorns, 2-year-old seedlings, 5-ft bareroot trees, balled and burlapped trees, and natural seed bank regeneration. Our community composition survey revealed that plots planted with bareroot or balled and burlapped trees developed closed tree canopies with little herbaceous understory, while acorn plantings and natural colonization plots developed into dense stands of the invasive species reed canary grass (RCG; 'Phalaris arundinacea'. Restoration strategy influenced bacterial community composition but to a lesser degree compared to the plant community response, and riverine hydrology and restoration strategy influenced wetland soil conditions. Soil ammonium concentrations and pH were similar across all wetland restoration treatments, while total organic carbon was highest in forest and RCG-dominated plots compared to mixed patches of trees and open areas. The differences in restoration strategy and associated economic investment resulted in ecological tradeoffs. The upfront investment in larger, more mature trees (i.e., bareroot, balled and burlapped led to floodplain forested communities, while cheaper, more passive planting strategies (i.e., seedlings, seedbank, or acorns resulted in dense stands of invasive RCG, despite the similar floodplain hydrology across all sites. Therefore, recovery of multiple ecosystem services that

  14. METHODOLOGICAL BASES OF THE OPTIMIZATION OF ORGANIZATIONAL MANAGEMENT STRUCTURE AT IMPLEMENTING THE MAJOR CONSTRUCTION ENTERPRISE STRATEGY

    Directory of Open Access Journals (Sweden)

    Rodionova Svetlana Vladimirovna

    2015-09-01

    Full Text Available Planning and implementation of innovations on the microlevel of management and on the higher levels is a process of innovative projects portfolio implementation. Project management is aimed at some goal; therefore, defining the mission and aims of implementation is of primary importance. These are the part of the notion of development strategy of an enterprise. Creating a strategy for big construction holding companies is complicated by the necessity to account for different factors effecting each business-block and subsidiary companies. The authors specify an algorithm of development and implementation of the activity strategy of a big construction enterprise. A special importance of the correspondence of organizational management structure to the implemented strategy is shown. The innovative character of organizational structure change is justified. The authors offer methods to optimize the organizational management structure based on communication approach with the use of the elements graph theory. The offered methodological provisions are tested on the example of the Russian JSC “RZhDstroy”.

  15. COGNITIVE LEARNING STRATEGIES OF NON-ENGLISH DEPARTMENT STUDENTS ON NOUN STRUCTURE

    Directory of Open Access Journals (Sweden)

    Shierly Novalita Yappy

    2006-01-01

    Full Text Available Learning English for non-English department students is not as easy as it seems. Besides, as much as it is necessary to know how successful learners learn, not less important is to know how less successful learners learn. Using think aloud method, this study aims at finding out the cognitive strategies used by the engineering department students in answering incorrectly problems on TOEFL noun structure-the grammar point in which students made the most errors. Findings uncover the students' strategies and reasoning upon which pedagogical implications can be put forth so that more effective and fruitful instruction can be tailored.

  16. Implications of structural genomics target selection strategies: Pfam5000, whole genome, and random approaches

    Energy Technology Data Exchange (ETDEWEB)

    Chandonia, John-Marc; Brenner, Steven E.

    2004-07-14

    The structural genomics project is an international effort to determine the three-dimensional shapes of all important biological macromolecules, with a primary focus on proteins. Target proteins should be selected according to a strategy which is medically and biologically relevant, of good value, and tractable. As an option to consider, we present the Pfam5000 strategy, which involves selecting the 5000 most important families from the Pfam database as sources for targets. We compare the Pfam5000 strategy to several other proposed strategies that would require similar numbers of targets. These include including complete solution of several small to moderately sized bacterial proteomes, partial coverage of the human proteome, and random selection of approximately 5000 targets from sequenced genomes. We measure the impact that successful implementation of these strategies would have upon structural interpretation of the proteins in Swiss-Prot, TrEMBL, and 131 complete proteomes (including 10 of eukaryotes) from the Proteome Analysis database at EBI. Solving the structures of proteins from the 5000 largest Pfam families would allow accurate fold assignment for approximately 68 percent of all prokaryotic proteins (covering 59 percent of residues) and 61 percent of eukaryotic proteins (40 percent of residues). More fine-grained coverage which would allow accurate modeling of these proteins would require an order of magnitude more targets. The Pfam5000 strategy may be modified in several ways, for example to focus on larger families, bacterial sequences, or eukaryotic sequences; as long as secondary consideration is given to large families within Pfam, coverage results vary only slightly. In contrast, focusing structural genomics on a single tractable genome would have only a limited impact in structural knowledge of other proteomes: a significant fraction (about 30-40 percent of the proteins, and 40-60 percent of the residues) of each proteome is classified in small

  17. An intersectional approach for understanding the vulnerabilities of English-speaking heterosexual Caribbean youth to HIV/AIDS and sexually transmitted infections: Prevention and intervention strategies

    Science.gov (United States)

    Sutherland, Marcia Elizabeth

    2016-01-01

    Caribbean youth comprise about 30 percent of the English-speaking Caribbean population, and about 81,000 Caribbean and Latin American youth are HIV infected. AIDS is the leading cause of death for 15- to 24-year-old English-speaking Caribbean youth. This article relies on intersectionality theory in the assessment of the macro-level, or structural variables, and micro-level, or individual level, variables that influence the risk-taking sexual behaviors of heterosexual English-speaking Caribbean youth and increase their vulnerability to HIV/sexually transmitted infections. This article offers macro- and micro-level prevention/intervention strategies for reducing the prevalence of sexually transmitted infections in English-speaking Caribbean youth, including the promotion of condom use, voluntary male circumcision, and HIV testing and counseling. Suggestions are offered for future research investigations to explore the contributing factors to youth’s vulnerability to sexually transmitted infections and to empirically verify the relationship between and among variables that account for desired outcomes, including decreases in risky sexual behaviors. PMID:28070411

  18. An intersectional approach for understanding the vulnerabilities of English-speaking heterosexual Caribbean youth to HIV/AIDS and sexually transmitted infections: Prevention and intervention strategies

    Directory of Open Access Journals (Sweden)

    Marcia Elizabeth Sutherland

    2016-11-01

    Full Text Available Caribbean youth comprise about 30 percent of the English-speaking Caribbean population, and about 81,000 Caribbean and Latin American youth are HIV infected. AIDS is the leading cause of death for 15- to 24-year-old English-speaking Caribbean youth. This article relies on intersectionality theory in the assessment of the macro-level, or structural variables, and micro-level, or individual level, variables that influence the risk-taking sexual behaviors of heterosexual English-speaking Caribbean youth and increase their vulnerability to HIV/sexually transmitted infections. This article offers macro- and micro-level prevention/intervention strategies for reducing the prevalence of sexually transmitted infections in English-speaking Caribbean youth, including the promotion of condom use, voluntary male circumcision, and HIV testing and counseling. Suggestions are offered for future research investigations to explore the contributing factors to youth’s vulnerability to sexually transmitted infections and to empirically verify the relationship between and among variables that account for desired outcomes, including decreases in risky sexual behaviors.

  19. Guidance strategies for a participatory ergonomic intervention to increase the use of ergonomic measures of workers in construction companies: a study design of a randomised trial

    Science.gov (United States)

    2014-01-01

    Background More than seven out of 10 Dutch construction workers describe their work as physically demanding. Ergonomic measures can be used to reduce these physically demanding work tasks. To increase the use of ergonomic measures, employers and workers have to get used to other working methods and to maintaining them. To facilitate this behavioural change, participatory ergonomics (PE) interventions could be useful. For this study a protocol of a PE intervention is adapted in such a way that the intervention can be performed by an ergonomics consultant through face-to-face contacts or email contacts. The objective of this study is to evaluate the effectiveness of the face-to-face guidance strategy and the e-guidance strategy on the primary outcome measure: use of ergonomic measures by individual construction workers, and on the secondary outcome measures: the work ability, physical functioning and limitations due to physical problems of individual workers. Methods/Design The present study is a randomised intervention trial of six months in 12 companies to establish the effects of a PE intervention guided by four face-to-face contacts (N = 6) or guided by 13 email contacts (N = 6) on the primary and secondary outcome measures at baseline and after six months. Construction companies are randomly assigned to one of the guidance strategies with the help of a computer generated randomisation table. In addition, a process evaluation for both strategies will be performed to determine reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change to find possible barriers and facilitators for both strategies. A cost-benefit analysis will be performed to establish the financial consequences of both strategies. The present study is in accordance with the CONSORT statement. Discussion The outcome of this study will help to 1) evaluate the effect of both guidance strategies, and 2) find barriers to and facilitators of both guidance

  20. Guidance strategies for a participatory ergonomic intervention to increase the use of ergonomic measures of workers in construction companies: a study design of a randomised trial.

    Science.gov (United States)

    Visser, Steven; van der Molen, Henk F; Sluiter, Judith K; Frings-Dresen, Monique H W

    2014-04-17

    More than seven out of 10 Dutch construction workers describe their work as physically demanding. Ergonomic measures can be used to reduce these physically demanding work tasks. To increase the use of ergonomic measures, employers and workers have to get used to other working methods and to maintaining them. To facilitate this behavioural change, participatory ergonomics (PE) interventions could be useful. For this study a protocol of a PE intervention is adapted in such a way that the intervention can be performed by an ergonomics consultant through face-to-face contacts or email contacts. The objective of this study is to evaluate the effectiveness of the face-to-face guidance strategy and the e-guidance strategy on the primary outcome measure: use of ergonomic measures by individual construction workers, and on the secondary outcome measures: the work ability, physical functioning and limitations due to physical problems of individual workers. The present study is a randomised intervention trial of six months in 12 companies to establish the effects of a PE intervention guided by four face-to-face contacts (N = 6) or guided by 13 email contacts (N = 6) on the primary and secondary outcome measures at baseline and after six months. Construction companies are randomly assigned to one of the guidance strategies with the help of a computer generated randomisation table. In addition, a process evaluation for both strategies will be performed to determine reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change to find possible barriers and facilitators for both strategies. A cost-benefit analysis will be performed to establish the financial consequences of both strategies. The present study is in accordance with the CONSORT statement. The outcome of this study will help to 1) evaluate the effect of both guidance strategies, and 2) find barriers to and facilitators of both guidance strategies. When these strategies are

  1. The Effect of a Multi-Strategy Workplace Physical Activity Intervention Promoting Pedometer Use and Step Count Increase

    Science.gov (United States)

    De Cocker, Katrien A.; De Bourdeaudhuij, Ilse M.; Cardon, Greet M.

    2010-01-01

    Pedometer use and step count goals have become popular in physical activity (PA) interventions in different settings. Previous pedometer-based workplace interventions were short term, uncontrolled and executed outside Europe. This European quasi-experimental study evaluated the effects of a 20-week pedometer-based PA workplace intervention.…

  2. School Counselors' and School Psychologists' Bullying Prevention and Intervention Strategies: A Look into Real-World Practices

    Science.gov (United States)

    Lund, Emily M.; Blake, Jamilia J.; Ewing, Heidi K.; Banks, Courtney S.

    2012-01-01

    A sample of 560 school psychologists and school counselors completed a Web-based survey regarding bullying in their schools, related training, and interventions used. Few school-based mental health professionals used evidence-based bullying interventions or were involved in the selection of interventions for their school, and administrators were…

  3. Balancing Power Output and Structural Fatigue of Wave Energy Converters by Means of Control Strategies

    Directory of Open Access Journals (Sweden)

    Francesco Ferri

    2014-04-01

    Full Text Available In order to reduce the cost of electricity produced by wave energy converters (WECs, the benefit of selling electricity as well as the investment costs of the structure has to be considered. This paper presents a methodology for assessing the control strategy for a WEC with respect to both energy output and structural fatigue loads. Different active and passive control strategies are implemented (proportional (P controller, proportional-integral (PI controller, proportional-integral-derivative with memory compensation (PID controller, model predictive control (MPC and maximum energy controller (MEC, and load time-series resulting from numerical simulations are used to design structural parts based on fatigue analysis using rain-flow counting, Stress-Number (SN curves and Miner’s rule. The objective of the methodology is to obtain a cost-effective WEC with a more comprehensive analysis of a WEC based on a combination of well known control strategies and standardised fatigue methods. The presented method is then applied to a particular case study, the Wavestar WEC, for a specific location in the North Sea. Results, which are based on numerical simulations, show the importance of balancing the gained power against structural fatigue. Based on a simple cost model, the PI controller is shown as a viable solution.

  4. Associations between Culturally Relevant Recruitment Strategies and Participant Interest, Enrollment and Generalizability in a Weight-loss Intervention for African American Families.

    Science.gov (United States)

    Huffman, Lauren E; Wilson, Dawn K; Kitzman-Ulrich, Heather; Lyerly, Jordan E; Gause, Haylee M; Resnicow, Ken

    2016-07-21

    Culturally relevant recruitment strategies may be an important approach for recruiting ethnic minorities for interventions. Previous research has examined associations between recruitment strategies and enrollment of African Americans (AA), but has not explored more deeply the role of incorporating sociocultural values into recruitment strategies. Our current study explores whether sociocultural recruitment mediums were associated with demographics, interest and enrollment in a weight-loss intervention. Sociocultural mediums included community partnerships, culturally relevant ads, sociocultural events, or word-of-mouth. Non-sociocultural mediums included community/school events that did not specifically target AAs. Analyses examined whether demographics of enrolled families differed by recruitment strategy and if recruitment strategy predicted scheduling a baseline visit, enrolling in a run-in phase, and enrolling in the intervention program. Families recruited from culturally relevant ads, sociocultural events, or word-of-mouth were 1.96 times more likely to schedule a baseline visit (OR=1.96, 95% CI=1.05, 3.68) than families recruited from non-sociocultural mediums. No differences were found for sociocultural mediums on enrolling in the run-in phase or the intervention. However, among enrolled families, those recruited from sociocultural mediums were less likely to be employed (X(2) [1, N=142] =5.53, P<.05) and more likely to have lower income (X(2) [1, N=142] =13.57, P<.05). Sociocultural mediums were associated with scheduling a baseline visit, but not enrollment. They were, however, effective in recruiting a more generalizable sample among enrolled participants based on demographic characteristics. Integrating sociocultural values into recruitment methods may be a valuable strategy for increasing interest in participation among underrepresented AA families.

  5. Temporal variation in bat-fruit interactions: Foraging strategies influence network structure over time

    Science.gov (United States)

    Zapata-Mesa, Natalya; Montoya-Bustamante, Sebastián; Murillo-García, Oscar E.

    2017-11-01

    Mutualistic interactions, such as seed dispersal, are important for the maintenance of structure and stability of tropical communities. However, there is a lack of information about spatial and temporal variation in plant-animal interaction networks. Thus, our goal was to assess the effect of bat's foraging strategies on temporal variation in the structure and robustness of bat-fruit networks in both a dry and a rain tropical forest. We evaluated monthly variation in bat-fruit networks by using seven structure metrics: network size, average path length, nestedness, modularity, complementary specialization, normalized degree and betweenness centrality. Seed dispersal networks showed variations in size, species composition and modularity; did not present nested structures and their complementary specialization was high compared to other studies. Both networks presented short path lengths, and a constantly high robustness, despite their monthly variations. Sedentary bat species were recorded during all the study periods and occupied more central positions than nomadic species. We conclude that foraging strategies are important structuring factors that affect the dynamic of networks by determining the functional roles of frugivorous bats over time; thus sedentary bats are more important than nomadic species for the maintenance of the network structure, and their conservation is a must.

  6. Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case study on multilevel strategies to reduce sugar-sweetened beverage intake.

    Science.gov (United States)

    Chi, Donald L

    2013-01-01

    Tooth decay is the most common paediatric disease and there is a serious paediatric tooth decay epidemic in Alaska Native communities. When untreated, tooth decay can lead to pain, infection, systemic health problems, hospitalisations and in rare cases death, as well as school absenteeism, poor grades and low quality-of-life. The extent to which population-based oral health interventions have been conducted in Alaska Native paediatric populations is unknown. To conduct a systematic review of oral health interventions aimed at Alaska Native children below age 18 and to present a case study and conceptual model on multilevel intervention strategies aimed at reducing sugar-sweetened beverage (SSB) intake among Alaska Native children. Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement, the terms "Alaska Native", "children" and "oral health" were used to search Medline, Embase, Web of Science, GoogleScholar and health foundation websites (1970-2012) for relevant clinical trials and evaluation studies. Eighty-five studies were found in Medline, Embase and Web of Science databases and there were 663 hits in GoogleScholar. A total of 9 publications were included in the qualitative review. These publications describe 3 interventions that focused on: reducing paediatric tooth decay by educating families and communities; providing dental chemotherapeutics to pregnant women; and training mid-level dental care providers. While these approaches have the potential to improve the oral health of Alaska Native children, there are unique challenges regarding intervention acceptability, reach and sustainability. A case study and conceptual model are presented on multilevel strategies to reduce SSB intake among Alaska Native children. Few oral health interventions have been tested within Alaska Native communities. Community-centred multilevel interventions are promising approaches to improve the oral and systemic health of Alaska Native

  7. Understanding how different recruitment strategies impact parent engagement with an iPad-based intervention to provide personalized information about adolescent vaccines.

    Science.gov (United States)

    Dempsey, Amanda F; Maertens, Julie; Beaty, Brenda L; O'Leary, Sean T

    2015-05-01

    Inadequate provider time for addressing parents' questions and concerns about adolescent vaccines is a barrier to vaccine utilization. We sought to determine how different recruitment strategies impact the degree of engagement with an intervention that provided this information via an iPad placed in a clinical setting. We provided to three pediatric practices in the Denver area the "Teen VaxScene" web site that generates individually customized information for parents about adolescent vaccines. Three recruitment strategies were assessed for their impact on parental use of the intervention as follows: passive recruitment using posters to advertise a "kiosk" version of the intervention; posters plus a $10 incentive for using the kiosk; and posters plus a $10 incentive plus decoupling the iPad from the kiosks to enable "roving." We assessed the engagement with the intervention at multiple levels including log in, consent, and completion of a baseline survey and viewing individually tailored web pages. Surveys were used to assess barriers to using the intervention. During the 14-month study period, 693 people had contact with the iPad, 199 consented, and 48 completed the survey to enable creation of tailored content; and 42 used the tailored site. Five times as many parents (n = 40) consented to participation during the 2 months when the intervention was "roving" than during the 10-month "passive" recruitment period. Engagement with the tailored material was low, with most users viewing only the "table of contents" pages. Utilizers and nonutilizers of the intervention had similar demographic characteristics. Enabling the iPad to "rove" in the clinic greatly increased the proportion of parents consenting to use the intervention. However, meaningful engagement with the material was low. Further research is needed to understand the most effective and time efficient ways to provide vaccine-related educational information to parents of adolescents. Copyright © 2015 Society

  8. Impact of a social network-based intervention promoting diabetes self-management in socioeconomically deprived patients: a qualitative evaluation of the intervention strategies.

    Science.gov (United States)

    Vissenberg, C; Stronks, K; Nijpels, G; Uitewaal, P J M; Middelkoop, B J C; Kohinor, M J E; Hartman, M A; Nierkens, V

    2016-04-13

    There is a need for effective interventions that improve diabetes self-management (DSM) among socioeconomically deprived patients with type 2 diabetes. The group-based intervention Powerful Together with Diabetes (PTWD) aimed to increase social support for DSM and decrease social influences hindering DSM (eg, peer pressure, social norms) in patients living in deprived neighbourhoods. Through a qualitative process evaluation, this paper aims to study whether this intervention changed social support and social influences, and which elements of the intervention contributed to this. The intervention group (IG) was compared with a standard group-based educational intervention (control group, CG). 27 qualitative in-depth interviews with participants (multiethnic sample) and 24 interviews with group leaders were conducted. Interviews were coded and analysed using MAXQDA according to framework analysis. Patients in the IG experienced more emotional support from group members and more instrumental and appraisal support from relatives than those in the CG. Also, they were better able to recognise and cope with influences that hinder their DSM, exhibited more positive norms towards DSM and increased their priority regarding DSM and their adherence. Finally, the engagement in DSM by relatives of participants increased. Creating trust between group members, skills training, practising together and actively involving relatives through action plans contributed to these changes. A group-based intervention aimed at creating trust, practising together and involving relatives has the potential to increase social support and diminish social influences hindering DSM in socioeconomically deprived patients with diabetes. Promising elements of the intervention were skills training and providing feedback using role-playing exercises in group sessions with patients, as well as the involvement of patients' significant others in self-management tasks, and actively involving them in making an

  9. Store-directed price promotions and communications strategies improve healthier food supply and demand: impact results from a randomized controlled, Baltimore City store-intervention trial.

    Science.gov (United States)

    Budd, Nadine; Jeffries, Jayne K; Jones-Smith, Jessica; Kharmats, Anna; McDermott, Ann Yelmokas; Gittelsohn, Joel

    2017-12-01

    Small food store interventions show promise to increase healthy food access in under-resourced areas. However, none have tested the impact of price discounts on healthy food supply and demand. We tested the impact of store-directed price discounts and communications strategies, separately and combined, on the stocking, sales and prices of healthier foods and on storeowner psychosocial factors. Factorial design randomized controlled trial. Twenty-four corner stores in low-income neighbourhoods of Baltimore City, MD, USA. Stores were randomized to pricing intervention, communications intervention, combined pricing and communications intervention, or control. Stores that received the pricing intervention were given a 10-30 % price discount by wholesalers on selected healthier food items during the 6-month trial. Communications stores received visual and interactive materials to promote healthy items, including signage, taste tests and refrigerators. All interventions showed significantly increased stock of promoted foods v. There was a significant treatment effect for daily unit sales of healthy snacks (β=6·4, 95 % CI 0·9, 11·9) and prices of healthy staple foods (β=-0·49, 95 % CI -0·90, -0·03) for the combined group v. control, but not for other intervention groups. There were no significant intervention effects on storeowner psychosocial factors. All interventions led to increased stock of healthier foods. The combined intervention was effective in increasing sales of healthier snacks, even though discounts on snacks were not passed to the consumer. Experimental research in small stores is needed to understand the mechanisms by which store-directed price promotions can increase healthy food supply and demand.

  10. The structure of common emotion regulation strategies: A meta-analytic examination.

    Science.gov (United States)

    Naragon-Gainey, Kristin; McMahon, Tierney P; Chacko, Thomas P

    2017-04-01

    Emotion regulation has been examined extensively with regard to important outcomes, including psychological and physical health. However, the literature includes many different emotion regulation strategies but little examination of how they relate to one another, making it difficult to interpret and synthesize findings. The goal of this meta-analysis was to examine the underlying structure of common emotion regulation strategies (i.e., acceptance, behavioral avoidance, distraction, experiential avoidance, expressive suppression, mindfulness, problem solving, reappraisal, rumination, worry), and to evaluate this structure in light of theoretical models of emotion regulation. We also examined how distress tolerance-an important emotion regulation ability -relates to strategy use. We conducted meta-analyses estimating the correlations between emotion regulation strategies (based on 331 samples and 670 effect sizes), as well as between distress tolerance and strategies. The resulting meta-analytic correlation matrix was submitted to confirmatory and exploratory factor analyses. None of the confirmatory models, based on prior theory, was an acceptable fit to the data. Exploratory factor analysis suggested that 3 underlying factors best characterized these data. Two factors-labeled Disengagement and Aversive Cognitive Perseveration-emerged as strongly correlated but distinct factors, with the latter consisting of putatively maladaptive strategies. The third factor, Adaptive Engagement, was a less unified factor and weakly related to the other 2 factors. Distress tolerance was most closely associated with low levels of repetitive negative thought and experiential avoidance, and high levels of acceptance and mindfulness. We discuss the theoretical implications of these findings and applications to emotion regulation assessment. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. Moderation and Mediation in Structural Equation Modeling: Applications for Early Intervention Research

    Science.gov (United States)

    Hopwood, Christopher J.

    2007-01-01

    Second-generation early intervention research typically involves the specification of multivariate relations between interventions, outcomes, and other variables. Moderation and mediation involve variables or sets of variables that influence relations between interventions and outcomes. Following the framework of Baron and Kenny's (1986) seminal…

  12. EXPLORATORY DATA ANALYSIS AND MULTIVARIATE STRATEGIES FOR REVEALING MULTIVARIATE STRUCTURES IN CLIMATE DATA

    Directory of Open Access Journals (Sweden)

    2016-12-01

    Full Text Available This paper is on data analysis strategy in a complex, multidimensional, and dynamic domain. The focus is on the use of data mining techniques to explore the importance of multivariate structures; using climate variables which influences climate change. Techniques involved in data mining exercise vary according to the data structures. The multivariate analysis strategy considered here involved choosing an appropriate tool to analyze a process. Factor analysis is introduced into data mining technique in order to reveal the influencing impacts of factors involved as well as solving for multicolinearity effect among the variables. The temporal nature and multidimensionality of the target variables is revealed in the model using multidimensional regression estimates. The strategy of integrating the method of several statistical techniques, using climate variables in Nigeria was employed. R2 of 0.518 was obtained from the ordinary least square regression analysis carried out and the test was not significant at 5% level of significance. However, factor analysis regression strategy gave a good fit with R2 of 0.811 and the test was significant at 5% level of significance. Based on this study, model building should go beyond the usual confirmatory data analysis (CDA, rather it should be complemented with exploratory data analysis (EDA in order to achieve a desired result.

  13. Teaching mathematical word problem solving: the quality of evidence for strategy instruction priming the problem structure.

    Science.gov (United States)

    Jitendra, Asha K; Petersen-Brown, Shawna; Lein, Amy E; Zaslofsky, Anne F; Kunkel, Amy K; Jung, Pyung-Gang; Egan, Andrea M

    2015-01-01

    This study examined the quality of the research base related to strategy instruction priming the underlying mathematical problem structure for students with learning disabilities and those at risk for mathematics difficulties. We evaluated the quality of methodological rigor of 18 group research studies using the criteria proposed by Gersten et al. and 10 single case design (SCD) research studies using criteria suggested by Horner et al. and the What Works Clearinghouse. Results indicated that 14 group design studies met the criteria for high-quality or acceptable research, whereas SCD studies did not meet the standards for an evidence-based practice. Based on these findings, strategy instruction priming the mathematics problem structure is considered an evidence-based practice using only group design methodological criteria. Implications for future research and for practice are discussed. © Hammill Institute on Disabilities 2013.

  14. Adaptation and translation of mental health interventions in Middle Eastern Arab countries: a systematic review of barriers to and strategies for effective treatment implementation.

    Science.gov (United States)

    Gearing, Robin E; Schwalbe, Craig S; MacKenzie, Michael J; Brewer, Kathryne B; Ibrahim, Rawan W; Olimat, Hmoud S; Al-Makhamreh, Sahar S; Mian, Irfan; Al-Krenawi, Alean

    2013-11-01

    All too often, efficacious psychosocial evidence-based interventions fail when adapted from one culture to another. International translation requires a deep understanding of the local culture, nuanced differences within a culture, established service practices, and knowledge of obstacles and promoters to treatment implementation. This research investigated the following objectives to better facilitate cultural adaptation and translation of psychosocial and mental health treatments in Arab countries: (1) identify barriers or obstacles; (2) identify promoting strategies; and (3) provide clinical and research recommendations. This systematic review of 22 psychosocial or mental health studies in Middle East Arab countries identified more barriers (68%) than promoters (32%) to effective translation and adaptation of empirically supported psychosocial interventions. Identified barriers include obstacles related to acceptability of the intervention within the cultural context, community and system difficulties, and problems with clinical engagement processes. Whereas identified promoter strategies centre on the importance of partnering and working within the local and cultural context, the need to engage with acceptable and traditional intervention characteristics, and the development of culturally appropriate treatment strategies and techniques. Although Arab cultures across the Middle East are unique, this article provides a series of core clinical and research recommendations to assist effective treatment adaptation and translation within Arab communities in the Middle East.

  15. Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part II: Background to a research strategy.

    Science.gov (United States)

    Bragge, P; Piccenna, L; Middleton, J; Williams, S; Creasey, G; Dunlop, S; Brown, D; Gruen, R

    2015-10-01

    Literature review/semi-structured interviews. To develop a spinal cord injury (SCI) research strategy for Australia and New Zealand. Australia. The National Trauma Research Institute Forum approach of structured evidence review and stakeholder consultation was employed. This involved gathering from published literature and stakeholder consultation the information necessary to properly consider the challenge, and synthesising this into a briefing document. A research strategy 'roadmap' was developed to define the major steps and key planning questions to consider; next, evidence from published SCI research strategy initiatives was synthesised with information from four one-on-one semi-structured interviews with key SCI research stakeholders to create a research strategy framework, articulating six key themes and associated activities for consideration. These resources, combined with a review of SCI prioritisation literature, were used to generate a list of draft principles for discussion in a structured stakeholder dialogue meeting. The research strategy roadmap and framework informed discussion at a structured stakeholder dialogue meeting of 23 participants representing key SCI research constituencies, results of which are published in a companion paper. These resources could also be of value in other research strategy or planning exercises. This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand Spinal Cord Injury Network.

  16. Capital Structure and Diversification Strategies - A Study of Swedish Real Estate Companies Over Time

    OpenAIRE

    Hertéus, Robin; Hilmgård, Simon

    2016-01-01

    This thesis’ aim is to study four Swedish real estate companies between the years 2006-2015 to see whether their capital structure and investment strategies have changed over the years. The data upon which the thesis is based, is gathered from the four companies’ annual reports. These years are of interest due to the changing economic environment, both in Sweden and the world, during this time period. The time period includes one financial crisis and a never before experienced interest rate e...

  17. Study on the Chinese Goods Market Structure and Related Integrated Marketing Strategy

    OpenAIRE

    Qishen Zhou; Mingxing Yang

    2013-01-01

    This study aims to investigate the Chinese goods market structure and related integrated marketing strategy. In recent years, it is becoming more and more popular for Chinese consumers to go on luxury consuming in a variety of large cities in China, showing the increasing demand of luxury for Chinese people possessed relatively high fortune. Further, dozens of international famous luxury brands are pouring into the Chinese market such as LVMH and Gucci, recognizing the huge consumption demand...

  18. 76 FR 50719 - Models for a Governance Structure for the National Strategy for Trusted Identities in Cyberspace...

    Science.gov (United States)

    2011-08-16

    ...-02] Models for a Governance Structure for the National Strategy for Trusted Identities in Cyberspace... comments regarding the governance structure for the National Strategy for Trusted Identities in Cyberspace... June 14, 2011, the National Institute of Standards and Technology (NIST) announced that it was...

  19. GARN: Sampling RNA 3D Structure Space with Game Theory and Knowledge-Based Scoring Strategies.

    Science.gov (United States)

    Boudard, Mélanie; Bernauer, Julie; Barth, Dominique; Cohen, Johanne; Denise, Alain

    2015-01-01

    Cellular processes involve large numbers of RNA molecules. The functions of these RNA molecules and their binding to molecular machines are highly dependent on their 3D structures. One of the key challenges in RNA structure prediction and modeling is predicting the spatial arrangement of the various structural elements of RNA. As RNA folding is generally hierarchical, methods involving coarse-grained models hold great promise for this purpose. We present here a novel coarse-grained method for sampling, based on game theory and knowledge-based potentials. This strategy, GARN (Game Algorithm for RNa sampling), is often much faster than previously described techniques and generates large sets of solutions closely resembling the native structure. GARN is thus a suitable starting point for the molecular modeling of large RNAs, particularly those with experimental constraints. GARN is available from: http://garn.lri.fr/.

  20. Predicting algal growth inhibition toxicity: three-step strategy using structural and physicochemical properties.

    Science.gov (United States)

    Furuhama, A; Hasunuma, K; Hayashi, T I; Tatarazako, N

    2016-05-01

    We propose a three-step strategy that uses structural and physicochemical properties of chemicals to predict their 72 h algal growth inhibition toxicities against Pseudokirchneriella subcapitata. In Step 1, using a log D-based criterion and structural alerts, we produced an interspecies QSAR between algal and acute daphnid toxicities for initial screening of chemicals. In Step 2, we categorized chemicals according to the Verhaar scheme for aquatic toxicity, and we developed QSARs for toxicities of Class 1 (non-polar narcotic) and Class 2 (polar narcotic) chemicals by means of simple regression with a hydrophobicity descriptor and multiple regression with a hydrophobicity descriptor and a quantum chemical descriptor. Using the algal toxicities of the Class 1 chemicals, we proposed a baseline QSAR for calculating their excess toxicities. In Step 3, we used structural profiles to predict toxicity either quantitatively or qualitatively and to assign chemicals to the following categories: Pesticide, Reactive, Toxic, Toxic low and Uncategorized. Although this three-step strategy cannot be used to estimate the algal toxicities of all chemicals, it is useful for chemicals within its domain. The strategy is also applicable as a component of Integrated Approaches to Testing and Assessment.

  1. Damage detection strategies for aircraft shell-like structures based on propagation guided elastic waves

    International Nuclear Information System (INIS)

    Zak, A; Ostachowicz, W; Krawczuk, M

    2011-01-01

    Damage of aircraft structural elements in any form always present high risks. Failures of these elements can be caused by various reasons including material fatigue or impact leading to damage initiation and growth. Detection of these failures at their earliest stage of development, estimation of their size and location, are one of the most crucial factors for each damage detection method. Structural health monitoring strategies based on propagation of guided elastic waves in structures and wave interaction with damage related discontinuities are very promising tools that offer not only damage detection capabilities, but are also meant to provide precise information about the state of the structures and their remaining lifetime. Because of that various techniques are employed to simulate and mimic the wave-discontinuity interactions. The use of various types of sensors, their networks together with sophisticated contactless measuring techniques are investigated both numerically and experimentally. Certain results of numerical simulations obtained by the use of the spectral finite element method are presented by the authors and related with propagation of guided elastic waves in shell-type aircraft structures. Two types of structures are considered: flat 2D panels with or without stiffeners and 3D shell structures. The applicability of two different damage detection approaches is evaluated in order to detect and localise damage in these structures. Selected results related with the use of laser scanning vibrometry are also presented and discussed by the authors.

  2. Large fog collectors: New strategies for collection efficiency and structural response to wind pressure

    Science.gov (United States)

    Holmes, Robert; Rivera, Juan de Dios; de la Jara, Emilio

    2015-01-01

    Most studies of large fog collectors (LFC) have focused on the collection efficiency, the amount of water collected, or economic and social aspects, but have not addressed the effects of strong winds on the system. Wind pressure is directly related to fog water collection efficiency but on the other hand may cause serious damage on the structure of LFCs. This study focuses in the effects of wind pressure on the components of the LFC as an integral system, and the ways to face strong winds with no significant damage. For this purpose we analysed cases of mechanical failure of LFCs both in our experimental station at Peña Blanca in Chile and elsewhere. The effects of wind pressure can be described as a sequence of physical processes, starting with the mesh deformation as a way of adapting to the induced stresses. For a big enough pressure, local stress concentrations generate a progressive rupture of the mesh. In cases where the mesh is sufficiently strong the wind force causes the partial or total collapse of the structure. Usually the weakest part is the mesh, especially close to where it is attached to the structure. The way the mesh is attached to the frame or cable of the structure is particularly important since it can induce significant stress concentrations. Mesh failure before the structure failure may be considered as a mechanical fuse, since it is cheaper to repair. However, more practical mechanical fuses can be conceived. In relation to structural performance and water collection efficiency, we propose a new design strategy that considers a three-dimensional spatial display of the collection screen, oblique incidence angle of wind on mesh and small mesh area between the supporting frame. The proposed design strategies consider both the wind pressure on mesh and structure and the collection efficiency as an integral solution for the LFC. These new design strategies are the final output of this research. Applying these strategies a multi-funnel LFC is

  3. Targeting strategies of mHealth interventions for maternal health in low and middle-income countries: a systematic review protocol.

    Science.gov (United States)

    Ilozumba, Onaedo; Abejirinde, Ibukun-Oluwa Omolade; Dieleman, Marjolein; Bardají, Azucena; Broerse, Jacqueline E W; Van Belle, Sara

    2018-02-24

    Recently, there has been a steady increase in mobile health (mHealth) interventions aimed at improving maternal health of women in low-income and middle-income countries. While there is evidence indicating that these interventions contribute to improvements in maternal health outcomes, other studies indicate inconclusive results. This uncertainty has raised additional questions, one of which pertains to the role of targeting strategies in implementing mHealth interventions and the focus on pregnant women and health workers as target groups. This review aims to assess who is targeted in different mHealth interventions and the importance of targeting strategies in maternal mHealth interventions. We will search for peer-reviewed, English-language literature published between 1999 and July 2017 in PubMed, Web of Knowledge (Science Direct, EMBASE) and Cochrane Central Registers of Controlled Trials. The study scope is defined by the Population, Intervention, Comparison and Outcomes framework: P, community members with maternal or reproductive needs; I, electronic health or mHealth programmes geared at improving maternal or reproductive health; C, other non-electronic health or mHealth-based interventions; O, maternal health measures including family planning, antenatal care attendance, health facility delivery and postnatal care attendance. This study is a review of already published or publicly available data and needs no ethical approval. Review results will be published in a peer-reviewed journal and presented at international conferences. CRD42017072280. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Saltelli Global Sensitivity Analysis and Simulation Modelling to Identify Intervention Strategies to Reduce the Prevalence of Escherichia coli O157 Contaminated Beef Carcasses.

    Directory of Open Access Journals (Sweden)

    Victoria J Brookes

    Full Text Available Strains of Shiga-toxin producing Escherichia coli O157 (STEC O157 are important foodborne pathogens in humans, and outbreaks of illness have been associated with consumption of undercooked beef. Here, we determine the most effective intervention strategies to reduce the prevalence of STEC O157 contaminated beef carcasses using a modelling approach.A computational model simulated events and processes in the beef harvest chain. Information from empirical studies was used to parameterise the model. Variance-based global sensitivity analysis (GSA using the Saltelli method identified variables with the greatest influence on the prevalence of STEC O157 contaminated carcasses. Following a baseline scenario (no interventions, a series of simulations systematically introduced and tested interventions based on influential variables identified by repeated Saltelli GSA, to determine the most effective intervention strategy.Transfer of STEC O157 from hide or gastro-intestinal tract to carcass (improved abattoir hygiene had the greatest influence on the prevalence of contaminated carcases. Due to interactions between inputs (identified by Saltelli GSA, combinations of interventions based on improved abattoir hygiene achieved a greater reduction in maximum prevalence than would be expected from an additive effect of single interventions. The most effective combination was improved abattoir hygiene with vaccination, which achieved a greater than ten-fold decrease in maximum prevalence compared to the baseline scenario.Study results suggest that effective interventions to reduce the prevalence of STEC O157 contaminated carcasses should initially be based on improved abattoir hygiene. However, the effect of improved abattoir hygiene on the distribution of STEC O157 concentration on carcasses is an important information gap-further empirical research is required to determine whether reduced prevalence of contaminated carcasses is likely to result in reduced

  5. Impact of a Structural Intervention to Address Alcohol Use Among Gay Bar Patrons in San Francisco: The PACE Study.

    Science.gov (United States)

    Charlebois, Edwin D; Plenty, Albert H; Lin, Jessica; Ayala, Alicia; Hecht, Jennifer

    2017-11-01

    We evaluated the impact on alcohol intake and blood alcohol concentration (BAC) of a multi-level structural intervention to increase the availability of free water, coupled with messaging on pacing alcohol intake and normative feedback of blood alcohol concentration in a convenience sample of gay bars in San Francisco. Participants (n = 1,293) were recruited among exiting patrons of four gay bars (two intervention bars and two control bars). Participants were surveyed on alcohol intake and BAC was measured by breathalyzer. Prior to the intervention there were no significant differences in baseline alcohol measures between intervention and control bars. Post-intervention there were significant differences on objective and subjective measures of alcohol consumption: 30% of intervention bar participants had BAC% levels over the legal driving limit (0.08%) compared to 43% of control bar participants, p < 0.0001 and 78% of intervention bar participants were above the AUDIT-C cut-off for hazardous drinking compared to 87% in control bars, p < 0.001.

  6. The KnowRISK project: Tools and strategies to reduce non-structural damage

    Science.gov (United States)

    Sousa Oliveira, Carlos; Lopes, Mário; Mota de Sá, Francisco; Amaral Ferreia, Mónica; Candeias, Paulo; Campos Costa, Alfredo; Rupakhety, Rajesh; Meroni, Fabrizio; Azzaro, Raffaele; D'Amico, Salvatore; Langer, Horst; Musacchio, Gemma; Sousa Silva, Delta; Falsaperla, Susanna; Scarfì, Luciano; Tusa, Giuseppina; Tuvé, Tiziana

    2016-04-01

    The project KnowRISK (Know your city, Reduce seISmic risK through non-structural elements) is financed by the European Commission to develop prevention measures that may reduce non-structural damage in urban areas. Pilot areas of the project are within the three European participating countries, namely Portugal, Iceland and Italy. Non-structural components of a building include all those components that are not part of the structural system, more specifically the architectural, mechanical, electrical, and plumbing systems, as well as furniture, fixtures, equipment, and contents. Windows, partitions, granite veneer, piping, ceilings, air conditioning ducts and equipment, elevators, computer and hospital equipment, file cabinets, and retail merchandise are all examples of non-structural components that are vulnerable to earthquake damage. We will use the experience gained during past earthquakes, which struck in particular Iceland, Italy and Portugal (Azores). Securing the non-structural elements improves the safety during an earthquake and saves lives. This paper aims at identifying non-structural seismic protection measures in the pilot areas and to develop a portfolio of good practices for the most common and serious non-structural vulnerabilities. This systematic identification and the portfolio will be achieved through a "cross-knowledge" strategy based on previous researches, evidence of non-structural damage in past earthquakes. Shake table tests of a group of non-structural elements will be performed. These tests will be filmed and, jointly with portfolio, will serve as didactic supporting tools to be used in workshops with building construction stakeholders and in risk communication activities. A Practical Guide for non-structural risk reduction will be specifically prepared for citizens on the basis of the outputs of the project, taking into account the local culture and needs of each participating country.

  7. Fast-slow continuum and reproductive strategies structure plant life-history variation worldwide.

    Science.gov (United States)

    Salguero-Gómez, Roberto; Jones, Owen R; Jongejans, Eelke; Blomberg, Simon P; Hodgson, David J; Mbeau-Ache, Cyril; Zuidema, Pieter A; de Kroon, Hans; Buckley, Yvonne M

    2016-01-05

    The identification of patterns in life-history strategies across the tree of life is essential to our prediction of population persistence, extinction, and diversification. Plants exhibit a wide range of patterns of longevity, growth, and reproduction, but the general determinants of this enormous variation in life history are poorly understood. We use demographic data from 418 plant species in the wild, from annual herbs to supercentennial trees, to examine how growth form, habitat, and phylogenetic relationships structure plant life histories and to develop a framework to predict population performance. We show that 55% of the variation in plant life-history strategies is adequately characterized using two independent axes: the fast-slow continuum, including fast-growing, short-lived plant species at one end and slow-growing, long-lived species at the other, and a reproductive strategy axis, with highly reproductive, iteroparous species at one extreme and poorly reproductive, semelparous plants with frequent shrinkage at the other. Our findings remain consistent across major habitats and are minimally affected by plant growth form and phylogenetic ancestry, suggesting that the relative independence of the fast-slow and reproduction strategy axes is general in the plant kingdom. Our findings have similarities with how life-history strategies are structured in mammals, birds, and reptiles. The position of plant species populations in the 2D space produced by both axes predicts their rate of recovery from disturbances and population growth rate. This life-history framework may complement trait-based frameworks on leaf and wood economics; together these frameworks may allow prediction of responses of plants to anthropogenic disturbances and changing environments.

  8. Recruitment Strategies and Costs Associated With Enrolling People With Insomnia and High Blood Pressure Into an Online Behavioral Sleep Intervention: A Single-Site Pilot Study.

    Science.gov (United States)

    Routledge, Faye S; Davis, Tara D; Dunbar, Sandra B

    Recruitment in clinical research is a common challenge and source of study failure. The reporting of recruitment methods and costs in hypertension trials is limited especially for smaller, single-site trials, online intervention trials, and trials using newer online recruitment strategies. The aims of this study are to describe and examine the feasibility of newer online-e-mail recruitment strategies and traditional recruitment strategies used to enroll participants with insomnia and high blood pressure into an online behavioral sleep intervention study (Sleeping for Heart Health). The 16 online-e-mail-based and traditional recruitment strategies used are described. Recruitment strategy feasibility was examined by study interest and enrollee yields, conversion rates, and costs (direct, remuneration, labor, and cost per enrollee). From August 2014 to October 2015, 183 people were screened and 58 (31.7%) enrolled in the study (51.1 ± 12.9 years, 63.8% female, 72.4% African American, 136 ± 12/88 ± 7 mm Hg, 87.9% self-reported hypertension, 67.2% self-reported antihypertensive medication use). The recruitment strategies yielding the highest enrollees were the university hospital phone waiting message system (25.4%), Craigslist (22.4%), and flyers (20.3%) at a per enrollee cost of $42.84, $98.90, and $128.27, respectively. The university hospital phone waiting message system (55.6%) and flyers (54.5%) had the highest interested participant to enrolled participant conversion rate of all recruitment strategies. Approximately 70% of all enrolled participants were recruited from the university hospital phone waiting message system, Craigslist, or flyers. Given the recruitment challenges that most researchers face, we encourage the documenting, assessing, and reporting of detailed recruitment strategies and associated recruitment costs so that other researchers may benefit.

  9. Design for a Crane Metallic Structure Based on Imperialist Competitive Algorithm and Inverse Reliability Strategy

    Science.gov (United States)

    Fan, Xiao-Ning; Zhi, Bo

    2017-07-01

    Uncertainties in parameters such as materials, loading, and geometry are inevitable in designing metallic structures for cranes. When considering these uncertainty factors, reliability-based design optimization (RBDO) offers a more reasonable design approach. However, existing RBDO methods for crane metallic structures are prone to low convergence speed and high computational cost. A unilevel RBDO method, combining a discrete imperialist competitive algorithm with an inverse reliability strategy based on the performance measure approach, is developed. Application of the imperialist competitive algorithm at the optimization level significantly improves the convergence speed of this RBDO method. At the reliability analysis level, the inverse reliability strategy is used to determine the feasibility of each p