Models meet data: Challenges and opportunities in implementing land management in Earth system models.

Science.gov (United States)

Pongratz, Julia; Dolman, Han; Don, Axel; Erb, Karl-Heinz; Fuchs, Richard; Herold, Martin; Jones, Chris; Kuemmerle, Tobias; Luyssaert, Sebastiaan; Meyfroidt, Patrick; Naudts, Kim

2018-04-01

As the applications of Earth system models (ESMs) move from general climate projections toward questions of mitigation and adaptation, the inclusion of land management practices in these models becomes crucial. We carried out a survey among modeling groups to show an evolution from models able only to deal with land-cover change to more sophisticated approaches that allow also for the partial integration of land management changes. For the longer term a comprehensive land management representation can be anticipated for all major models. To guide the prioritization of implementation, we evaluate ten land management practices-forestry harvest, tree species selection, grazing and mowing harvest, crop harvest, crop species selection, irrigation, wetland drainage, fertilization, tillage, and fire-for (1) their importance on the Earth system, (2) the possibility of implementing them in state-of-the-art ESMs, and (3) availability of required input data. Matching these criteria, we identify "low-hanging fruits" for the inclusion in ESMs, such as basic implementations of crop and forestry harvest and fertilization. We also identify research requirements for specific communities to address the remaining land management practices. Data availability severely hampers modeling the most extensive land management practice, grazing and mowing harvest, and is a limiting factor for a comprehensive implementation of most other practices. Inadequate process understanding hampers even a basic assessment of crop species selection and tillage effects. The need for multiple advanced model structures will be the challenge for a comprehensive implementation of most practices but considerable synergy can be gained using the same structures for different practices. A continuous and closer collaboration of the modeling, Earth observation, and land system science communities is thus required to achieve the inclusion of land management in ESMs. © 2017 John Wiley & Sons Ltd.

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

Directory of Open Access Journals (Sweden)

Ann Scheck McAlearney

2016-08-01

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

Dosimetry challenges for implementing emerging technologies

Energy Technology Data Exchange (ETDEWEB)

Yin Fangfang; Oldham, Mark; Cai Jing; Wu Qiuwen, E-mail: Fangfang.yin@duke.ed [Department of Radiation Oncology Duke University Medical Center, Durham, NC 27516 (United States)

2010-11-01

During the last 10 years, radiation therapy technologies have gone through major changes, mainly related introduction of sophisticated delivery and imaging techniques to improve the target localization accuracy and dose conformity. While implementation of these emerging technologies such as image-guided SRS/SBRT, IMRT/IMAT, IGRT, 4D motion management, and special delivery technologies showed substantial clinical gains for patient care, many other factors, such as training/quality, efficiency/efficacy, and cost/effectiveness etc. remain to be challenging. This talk will address technical challenges for dosimetry verification of implementing these emerging technologies in radiation therapy.

Implementing EHR in a developing country: potential challenges and benefits

OpenAIRE

Tanko, Abdulai

2009-01-01

Developing countries are slow adopters of new technologies, particularly with regards to the health services of these countries. This study explores the data collection and management challenges in a Ghanaian hospital using an interpretative case study approach and proposes implementing an Electronic Health Record (EHR) system as a solution to these challenges. The Technology Acceptance Model (TAM), Actor Network Theory (ANT) and Computer Supported Cooperative Work (CSCW) are used in discussi...

The Impacts of Demographic Variables on Technological and Contextual Challenges of E-learning Implementation

Science.gov (United States)

Aldowah, Hanan; Ghazal, Samar; Naufal Umar, Irfan; Muniandy, Balakrishnan

2017-09-01

Information technology has achieved robust growth which has made it possible for learning to occur quickly. The rapid development of information, communication and technologies (ICT) has initiated an unparalleled transformation in universities all over the world. This development of technology and learning is offering new techniques to represent knowledge, new practices, and new global communities of learners. As a result, today’s economic and social changes force universities to try to find new learning approaches and systems. E-learning seems to be an appropriate approach in this aspect. However, the implementation of e-learning systems in universities is not an easy task because of some challenges related to context, technology, and other challenges. This paper studied the impacts of demographic data and reported the critical points for the decision makers to consider when planning and implementing e-learning in universities. A quantitative approach was used to study the effects of technological and contextual challenges on e-learning implementation in which a questionnaire was used for the data collection. According to the findings of the study, the most important challenges of the implementation of e-learning are related either to organizational (Contextual) and technological (technical) issues. The demographic variables have been found to play a direct and indirect role with the technological and contextual challenges of implementing e-learning. This paper showed that there are some significant differences in the two challenges faced by instructors in terms of the demographic variables. The result revealed that some significant differences exist between demographic variables and the two challenges of e-learning in terms of gender, age, teaching experience, ICT experience and e-learning experience. However, there is no significant difference in terms of e-learning experience. The obtained data, from such study, can provide information about what academic

Successful Enterprise System Re-Implementation

DEFF Research Database (Denmark)

Svejvig, Per

2017-01-01

Achieving success in enterprise systems (ES) implementations is challenging. The success rate is not high in view of the sums invested by many organizations in these companywide systems. The literature is charged with reasons for unsuccessful implementations, such as a lack of top management...... support and insufficient change management. Contrary to this research, empirical data from an ES re-implementation in a Scandinavian high-tech company shows successful implementation despite many problematic shifts in outsourcing partners. Therefore, it is natural to ask: why was the re......-implementation of the ES at SCANDI successful despite the major troubles encountered during the project? Building an analysis based on ten Critical Success Factors (CSFs) combined with an investigation into the institutional structures at play, we present several reasons for the successful implementation. The CSF analysis...

Enterprise Implementation of Digital Pathology: Feasibility, Challenges, and Opportunities.

Science.gov (United States)

Hartman, D J; Pantanowitz, L; McHugh, J S; Piccoli, A L; OLeary, M J; Lauro, G R

2017-10-01

Digital pathology is becoming technically possible to implement for routine pathology work. At our institution, we have been using digital pathology for second opinion intraoperative consultations for over 10 years. Herein, we describe our experience in converting to a digital pathology platform for primary pathology diagnosis. We implemented an incremental rollout for digital pathology on subspecialty benches, beginning with cases that contained small amounts of tissue (biopsy specimens). We successfully scanned over 40,000 slides through our digital pathology system. Several lessons (both challenges and opportunities) were learned through this implementation. A successful conversion to digital pathology requires pre-imaging adjustments, integrated software and post-imaging evaluations.

Activity-Based Management System Implementation in Higher Education Institution: Benefits and Challenges

Science.gov (United States)

Ismail, Noor Azizi

2010-01-01

Purpose: The purpose of this paper is to discuss how activity-based costing (ABC) technique can be applied in the context of higher education institutions. It also discusses the obstacles and challenges to the successful implementation of activity-based management (ABM) in the higher education environment. Design/methodology/approach: This paper…

Pilot Implementation of Health Information Systems

DEFF Research Database (Denmark)

Bansler, Jørgen P.; Havn, Erling C.

2009-01-01

Pilot implementation is a powerful and widely used approach in identifying design flaws and implementation issues before the full-scale deployment of new health information systems. However, pilot implementations often fail in the sense that they say little about the usability and usefulness...... of the proposed system designs. This calls for studies that seek to uncover and analyze the reasons for failure, so that guidelines for conducting such pilots can be developed. In this paper, we present a qualitative field study of an ambitious, but unsuccessful pilot implementation of a Danish healthcare...... information system. Based on the findings from this study, we identify three main challenges: (1) defining an appropriate scope for pilot implementation, (2) managing the implementation process, and (3) ensuring commitment to the pilot. Finally, recommendations for future research and implications...

The Politico-Economic Challenges of Ghana's National Health Insurance Scheme Implementation.

Science.gov (United States)

Fusheini, Adam

2016-04-27

National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS requires political stewardship. Political

Implementing electronic health care predictive analytics: considerations and challenges.

Science.gov (United States)

Amarasingham, Ruben; Patzer, Rachel E; Huesch, Marco; Nguyen, Nam Q; Xie, Bin

2014-07-01

The use of predictive modeling for real-time clinical decision making is increasingly recognized as a way to achieve the Triple Aim of improving outcomes, enhancing patients' experiences, and reducing health care costs. The development and validation of predictive models for clinical practice is only the initial step in the journey toward mainstream implementation of real-time point-of-care predictions. Integrating electronic health care predictive analytics (e-HPA) into the clinical work flow, testing e-HPA in a patient population, and subsequently disseminating e-HPA across US health care systems on a broad scale require thoughtful planning. Input is needed from policy makers, health care executives, researchers, and practitioners as the field evolves. This article describes some of the considerations and challenges of implementing e-HPA, including the need to ensure patients' privacy, establish a health system monitoring team to oversee implementation, incorporate predictive analytics into medical education, and make sure that electronic systems do not replace or crowd out decision making by physicians and patients. Project HOPE—The People-to-People Health Foundation, Inc.

Overcoming the Challenges of BeiDou Receiver Implementation

Directory of Open Access Journals (Sweden)

Mohammad Zahidul H. Bhuiyan

2014-11-01

Full Text Available Global Navigation Satellite System (GNSS-based positioning is experiencing rapid changes. The existing GPS and the GLONASS systems are being modernized to better serve the current challenging applications under harsh signal conditions. These modernizations include increasing the number of transmission frequencies and changes to the signal components. In addition, the Chinese BeiDou Navigation Satellite system (BDS and the European Galileo are currently under development for global operation. Therefore, in view of these new upcoming systems the research and development of GNSS receivers has been experiencing a new upsurge. In this article, the authors discuss the main functionalities of a GNSS receiver in view of BDS. While describing the main functionalities of a software-defined BeiDou receiver, the authors also highlight the similarities and differences between the signal characteristics of the BeiDou B1 open service signal and the legacy GPS L1 C/A signal, as in general they both exhibit similar characteristics. In addition, the authors implement a novel acquisition technique for long coherent integration in the presence of NH code modulation in BeiDou D1 signal. Furthermore, a simple phase-preserved coherent integration based acquisition scheme is implemented for BeiDou GEO satellite acquisition. Apart from the above BeiDou-specific implementations, a novel Carrier-to-Noise-density ratio estimation technique is also implemented in the software receiver, which does not necessarily require bit synchronization prior to estimation. Finally, the authors present a BeiDou-only position fix with the implemented software-defined BeiDou receiver considering all three satellite constellations from BDS. In addition, a true multi-GNSS position fix with GPS and BDS systems is also presented while comparing their performances for a static stand-alone code phase-based positioning.

Electronic health records challenges in design and implementation

CERN Document Server

Sittig, Dean F

2013-01-01

This book provides an overview of the challenges in electronic health records (EHR) design and implementation along with an introduction to the best practices that have been identified over the past several years. The book examines concerns surrounding EHR use and proposes eight examples of proper EHR use. It discusses the complex strategic planning that accompanies the systemic organizational changes associated with EHR programs and highlights key lessons learned regarding health information-including technology errors and risk management concerns.

The value of information: Current challenges in surveillance implementation.

Science.gov (United States)

Stärk, Katharina D C; Häsler, Barbara

2015-11-01

Animal health surveillance is a complex activity that involves multiple stakeholders and provides decision support across sectors. Despite progress in the design of surveillance systems, some technical challenges remain, specifically for emerging hazards. Surveillance can also be impacted by political interests and costly consequences of case reporting, particularly in relation to international trade. Constraints on surveillance can therefore be of technical, economic and political nature. From an economic perspective, both surveillance and intervention are resource-using activities that are part of a mitigation strategy. Surveillance provides information for intervention decisions and thereby helps to offset negative effects of animal disease and to reduce the decision uncertainty associated with choices on disease control. It thus creates monetary and non-monetary benefits, both of which may be challenging to quantify. The technical relationships between surveillance, intervention and loss avoidance have not been established for most hazards despite being important consideration for investment decisions. Therefore, surveillance cannot just be maximised to minimise intervention costs. Economic appraisals of surveillance need to be done on a case by case basis for any hazard considering both surveillance and intervention performance, the losses avoided and the values attached to them. This can be achieved by using an evaluation approach which provides a systematic investigation of the worth or merit of surveillance activities. Evaluation is driven by a specific evaluation question which for surveillance systems commonly considers effectiveness, efficiency, implementation and/or compliance issues. More work is needed to provide guidance on the appropriate selection of evaluation attributes and general good practice in surveillance evaluation. Due to technical challenges, economic constraints and variable levels of capacity, the implementation of surveillance systems

Critical challenges in ERP implementation: A qualitative case study in the Canadian oil and gas industry

Science.gov (United States)

Menon, Sreekumar A.

This exploratory qualitative single-case study examines critical challenges encountered during ERP implementation based on individual perspectives in four project roles: senior leaders, project managers, project team members, and business users, all specifically in Canadian oil and gas industry. Data was collected by interviewing participants belonging to these categories, and by analyzing project documentation about ERP implementation. The organization for the case study was a leading multinational oil and gas company having a substantial presence in the energy sector in Canada. The study results were aligned with the six management questions regarding critical challenges in ERP: (a) circumstances to implement ERP, (b) benefits and process improvements achieved, (c) best practices implemented, (d) critical challenges encountered, (e) strategies and mitigating actions used, and (f) recommendations to improve future ERP implementations. The study results highlight six key findings. First, the study provided valid circumstances for implementing ERP systems. Second, the study underscored the importance of benefits and process improvements in ERP implementation. Third, the study highlighted that adoption of best practices is crucial for ERP Implementation. Fourth, the study found that critical challenges are encountered in ERP Implementation and are significant during ERP implementation. Fifth, the study found that strategies and mitigating actions can overcome challenges in ERP implementation. Finally, the study provided ten major recommendations on how to improve future ERP implementations.

Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.

Science.gov (United States)

Sperber, Nina R; Carpenter, Janet S; Cavallari, Larisa H; J Damschroder, Laura; Cooper-DeHoff, Rhonda M; Denny, Joshua C; Ginsburg, Geoffrey S; Guan, Yue; Horowitz, Carol R; Levy, Kenneth D; Levy, Mia A; Madden, Ebony B; Matheny, Michael E; Pollin, Toni I; Pratt, Victoria M; Rosenman, Marc; Voils, Corrine I; W Weitzel, Kristen; Wilke, Russell A; Ryanne Wu, R; Orlando, Lori A

2017-05-22

To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies. We describe challenges and strategies in an implementation framework and typology to enable consistent definitions and cross-case comparisons. Strategies were linked to challenges based on expert review and shared themes. Three challenges were identified by all six projects, and strategies to address these challenges varied across the projects. One common challenge was to increase the relative priority of integrating genomics within the health system electronic health record (EHR). Four projects used data warehousing techniques to accomplish the integration. The second common challenge was to strengthen clinicians' knowledge and beliefs about genomic medicine. To overcome this challenge, all projects developed educational materials and conducted meetings and outreach focused on genomic education for clinicians. The third challenge was engaging patients in the genomic medicine projects. Strategies to overcome this challenge included use of mass media to spread the word, actively involving patients in implementation (e.g., a patient advisory board), and preparing patients to be active participants in their healthcare decisions. This is the first collaborative evaluation focusing on the description of genomic medicine innovations implemented in multiple real-world clinical settings. Findings suggest that strategies to facilitate integration of genomic

Implementation Challenges for Multivariable Control: What You Did Not Learn in School

Science.gov (United States)

Garg, Sanjay

2008-01-01

Multivariable control allows controller designs that can provide decoupled command tracking and robust performance in the presence of modeling uncertainties. Although the last two decades have seen extensive development of multivariable control theory and example applications to complex systems in software/hardware simulations, there are no production flying systems aircraft or spacecraft, that use multivariable control. This is because of the tremendous challenges associated with implementation of such multivariable control designs. Unfortunately, the curriculum in schools does not provide sufficient time to be able to provide an exposure to the students in such implementation challenges. The objective of this paper is to share the lessons learned by a practitioner of multivariable control in the process of applying some of the modern control theory to the Integrated Flight Propulsion Control (IFPC) design for an advanced Short Take-Off Vertical Landing (STOVL) aircraft simulation.

The challenge of implementation

DEFF Research Database (Denmark)

Andersen, Karen Heide Hauge

2016-01-01

of the paper: which factors influence the degree of implementation of innovation and entrepreneurship in the individual lecturers’ daily teaching? The paper questions the common approach taken by higher educational institutions whereby lecturers are urged to teach innovation and entrepreneurship with minor...... these concepts in daily teaching, as it is strongly encouraged by policy makers and educations. This paper aims to discuss how lecturers experience the challenge of teaching their own discipline while being imposed to embrace and promote innovation and entrepreneurship teaching. Through a single study case...... of the BATCoM education at VIA University College, Denmark, the paper shows that the knowledge, use and implementation of the concepts is far from anchored in the lecturers’ daily practices. Through qualitative interviews the paper highlights different aspects considered, to determine the research question...

Electronic health systems: challenges faced by hospital-based providers.

Science.gov (United States)

Agno, Christina Farala; Guo, Kristina L

2013-01-01

The purpose of this article is to discuss specific challenges faced by hospitals adopting the use of electronic medical records and implementing electronic health record (EHR) systems. Challenges include user and information technology support; ease of technical use and software interface capabilities; compliance; and financial, legal, workforce training, and development issues. Electronic health records are essential to preventing medical errors, increasing consumer trust and use of the health system, and improving quality and overall efficiency. Government efforts are focused on ways to accelerate the adoption and use of EHRs as a means of facilitating data sharing, protecting health information privacy and security, quickly identifying emerging public health threats, and reducing medical errors and health care costs and increasing quality of care. This article will discuss physician and nonphysician staff training before, during, and after implementation; the effective use of EHR systems' technical features; the selection of a capable and secure EHR system; and the development of collaborative system implementation. Strategies that are necessary to help health care providers achieve successful implementation of EHR systems will be addressed.

The Politico-Economic Challenges of Ghana’s National Health Insurance Scheme Implementation

Directory of Open Access Journals (Sweden)

Adam Fusheini

2016-09-01

Full Text Available Background National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs as a vehicle to universal health coverage (UHC and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI legislation (ACT 650 in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Methods Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two and Northern (two Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Results Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. Conclusion The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under

Safeguards Implementation in Kazakhstan: Experience and Challenges

International Nuclear Information System (INIS)

Zhantikin, T.

2015-01-01

Experience of Kazakhstan joined the NPT in 1993, just after desintegration of USSR, and enforced Safeguards Agreement in 1995 can be interesting in implementation of safeguards in non-standard cases. Having weapon materials and test infrastructure legacy, the country together with IAEA and several donor countries found acceptable approaches to meet NPT provisions. One of challenges was to provide protection of sensitive information that could be accidentally disclosed in safeguards activities. With support of several weapon countries in close cooperation with the IAEA Kazakhstan liquidated test infrastructure in Semipalatinsk, implemented projects on elimination and minimization of use of HEU in civil sector, decommissioning of BN-350 fast breeder reactor. Now the IAEA LEU Bank is going to be established in Kazakhstan, and more challenges are coming in implementation of safeguards. Some technical and organizational details will be described from the experience of Kazakhstan in these projects. (author)

Dealing with the challenges of curriculum implementation: Lessons ...

African Journals Online (AJOL)

The article suggests solutions to the educational challenges experienced by rural schoolteachers in implementing the national curriculum policy statements. The results should be of interest to curriculum developers, administrators, and evaluators responsible for solving implementation problems. Este estudo pretende ...

Implementation of genomics research in Africa: challenges and recommendations.

Science.gov (United States)

Adebamowo, Sally N; Francis, Veronica; Tambo, Ernest; Diallo, Seybou H; Landouré, Guida; Nembaware, Victoria; Dareng, Eileen; Muhamed, Babu; Odutola, Michael; Akeredolu, Teniola; Nerima, Barbara; Ozumba, Petronilla J; Mbhele, Slee; Ghanash, Anita; Wachinou, Ablo P; Ngomi, Nicholas

2018-01-01

There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations. The purpose of this article is to describe important challenges affecting genomics research implementation in Africa. The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions. Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards. The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings.

Challenges and potential solutions for big data implementations in developing countries.

Science.gov (United States)

Luna, D; Mayan, J C; García, M J; Almerares, A A; Househ, M

2014-08-15

The volume of data, the velocity with which they are generated, and their variety and lack of structure hinder their use. This creates the need to change the way information is captured, stored, processed, and analyzed, leading to the paradigm shift called Big Data. To describe the challenges and possible solutions for developing countries when implementing Big Data projects in the health sector. A non-systematic review of the literature was performed in PubMed and Google Scholar. The following keywords were used: "big data", "developing countries", "data mining", "health information systems", and "computing methodologies". A thematic review of selected articles was performed. There are challenges when implementing any Big Data program including exponential growth of data, special infrastructure needs, need for a trained workforce, need to agree on interoperability standards, privacy and security issues, and the need to include people, processes, and policies to ensure their adoption. Developing countries have particular characteristics that hinder further development of these projects. The advent of Big Data promises great opportunities for the healthcare field. In this article, we attempt to describe the challenges developing countries would face and enumerate the options to be used to achieve successful implementations of Big Data programs.

Implementing integrated coastal management in a sector-based governance system

CSIR Research Space (South Africa)

Taljaard, Susan

2012-10-01

Full Text Available of cooperative governance early on, ICM implementation still faces the challenge that governance systems remain largely sector-based. In this paper we explore the implementation of ICM within a sector-based governance system in South Africa. First, we draw...

Successes and challenges from formation to implementation of eleven broad-extent conservation programs

Science.gov (United States)

Beever, Erik A.; Bradford, John B.; Germino, Matthew J.; Mattsson, Brady J.; Post van der Burg, Max; Brunson, Mark

2014-01-01

Integration of conservation partnerships across geographic, biological, and administrative boundaries is increasingly relevant because drivers of change, such as climate shifts, transcend these boundaries. We explored successes and challenges of established conservation programs that span multiple watersheds and consider both social and ecological concerns. We asked representatives from a diverse set of 11 broadextent conservation partnerships in 29 countries 17 questions that pertained to launching and maintaining partnerships for broad-extent conservation, specifying ultimate management objectives, and implementation and learning. Partnerships invested more funds in implementing conservation actions than any other aspect of conservation, and a program’s context (geographic extent, United States vs. other countries, developed vs. developing nation) appeared to substantially affect program approach. Despite early successes of these organizations and benefits of broad-extent conservation, specific challenges related to uncertainties in scaling up information and to coordination in the face of diverse partner governance structures, conflicting objectives, and vast uncertainties regarding future system dynamics hindered long-term success, as demonstrated by the focal organizations. Engaging stakeholders, developing conservation measures, and implementing adaptive management were dominant challenges. To inform future research on broad-extent conservation, we considered several challenges when we developed detailed questions, such as what qualities of broad-extent partnerships ensure they complement, integrate, and strengthen, rather than replace, local conservation efforts and which adaptive management processes yield actionable conservation strategies that account explicitly for dynamics and uncertainties regarding multiscale governance, environmental conditions, and knowledge of the system?

Shared Electronic Health Record Systems: Key Legal and Security Challenges.

Science.gov (United States)

Christiansen, Ellen K; Skipenes, Eva; Hausken, Marie F; Skeie, Svein; Østbye, Truls; Iversen, Marjolein M

2017-11-01

Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.

Implementation of genomics research in Africa: challenges and recommendations

Science.gov (United States)

Adebamowo, Sally N.; Francis, Veronica; Tambo, Ernest; Diallo, Seybou H.; Landouré, Guida; Nembaware, Victoria; Dareng, Eileen; Muhamed, Babu; Odutola, Michael; Akeredolu, Teniola; Nerima, Barbara; Ozumba, Petronilla J.; Mbhele, Slee; Ghanash, Anita; Wachinou, Ablo P.; Ngomi, Nicholas

2018-01-01

ABSTRACT Background: There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations. Objective: The purpose of this article is to describe important challenges affecting genomics research implementation in Africa. Methods: The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions. Results: Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards. Conclusions: The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings. PMID:29336236

Information systems in logistics - transition challenges

Directory of Open Access Journals (Sweden)

Nikolay Dragomirov

2016-03-01

Full Text Available The implementation of information systems in business organizations does not consist of just buying software products and installing them on the servers. Most of these systems are important for the development of the organizations concerned and in some cases are very expensive. Therefore, their success requires a properly managed process of implementation, which seeks a balance between the aims of the systems and the financial and technical capabilities of the organization. The implementation problem becomes greater when the emphasis is on the logistics function in the context of the supply chain management. Last, but not least, these initiatives are related to something much more challenging, namely the adoption of the new information system by the users, which involves a change of habits in the organization. It is no secret that a new system may be rejected by its users and this will make it useless. All this requires finding adequate solutions to analyze these problems and to ensure the effective use of information systems in logistics.

Implementing non-invasive prenatal testing for aneuploidy in a national healthcare system: global challenges and national solutions.

Science.gov (United States)

van Schendel, Rachèl V; van El, Carla G; Pajkrt, Eva; Henneman, Lidewij; Cornel, Martina C

2017-09-19

Since the introduction of non-invasive prenatal testing (NIPT) in 2011, mainly by commercial companies, a growing demand for NIPT from the public and healthcare professionals has been putting pressure on the healthcare systems of various countries. This study identifies the challenges of establishing a responsible implementation of NIPT for aneuploidy in prenatal healthcare, by looking at the Netherlands. A mixed methods approach involving 13 stakeholder interviews, document analysis and (participatory) observations of the Dutch NIPT Consortium meetings were used. The Diffusion of Innovation Theory and a Network of Actors model were used to interpret the findings. Implementation of NIPT was facilitated by several factors. The set-up of a national NIPT Consortium enabled discussion and collaboration between stakeholders. Moreover, it led to the plan to offer NIPT through a nationwide research setting (TRIDENT studies), which created a learning phase for careful implementation. The Dutch legal context was perceived as a delaying factor, but eventually gave room for the parties involved to organise themselves and their practices. This study shows that implementing advanced technologies with profound effects on prenatal care benefit from a learning phase that allows time to carefully evaluate the technical performance and women's experiences and to enable public debate. Such a coordinated learning phase, involving all stakeholders, will stimulate the process of responsible and sustainable implementation.

Successes and challenges from formation to implementation of eleven broad-extent conservation programs.

Science.gov (United States)

Beever, Erik A; Mattsson, Brady J; Germino, Matthew J; Burg, Max Post Van Der; Bradford, John B; Brunson, Mark W

2014-04-01

Integration of conservation partnerships across geographic, biological, and administrative boundaries is increasingly relevant because drivers of change, such as climate shifts, transcend these boundaries. We explored successes and challenges of established conservation programs that span multiple watersheds and consider both social and ecological concerns. We asked representatives from a diverse set of 11 broad-extent conservation partnerships in 29 countries 17 questions that pertained to launching and maintaining partnerships for broad-extent conservation, specifying ultimate management objectives, and implementation and learning. Partnerships invested more funds in implementing conservation actions than any other aspect of conservation, and a program's context (geographic extent, United States vs. other countries, developed vs. developing nation) appeared to substantially affect program approach. Despite early successes of these organizations and benefits of broad-extent conservation, specific challenges related to uncertainties in scaling up information and to coordination in the face of diverse partner governance structures, conflicting objectives, and vast uncertainties regarding future system dynamics hindered long-term success, as demonstrated by the focal organizations. Engaging stakeholders, developing conservation measures, and implementing adaptive management were dominant challenges. To inform future research on broad-extent conservation, we considered several challenges when we developed detailed questions, such as what qualities of broad-extent partnerships ensure they complement, integrate, and strengthen, rather than replace, local conservation efforts and which adaptive management processes yield actionable conservation strategies that account explicitly for dynamics and uncertainties regarding multiscale governance, environmental conditions, and knowledge of the system? © 2014 Society for Conservation Biology.

Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon.

Science.gov (United States)

Gelmon, Sherril; Bouranis, Nicole; Sandberg, Billie; Petchel, Shauna

2018-01-01

Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics. Between 2015 and 2016, semistructured interviews and focus groups were completed with 85 key informants. Clinics reported similar challenges implementing the PCPCH model, including shifting patterns of care use, fidelity to the PCPCH model, and refining care processes. The following ten implementation strategies emerged: expanding access through care teams, preventing unnecessary emergency department visits through patient outreach, improved communication and referral tracking with outside providers, prioritization of selected program metrics, implementing patient-centered practices, developing continuous improvement capacity through committees and "champions," incorporating preventive services and chronic disease management, standardization of workflows, customizing electronic health records, and integration of mental health. Clinic leaders benefited from understanding the local context in which they were operating. Despite differences in size, ownership, geography, and population, all clinic leaders were observed to be proponents of strategies commonly associated with a "learning organization": systems thinking, personal mastery, mental models, shared vision, and team. Clinics can draw on their own characteristics, use state resources, and look to established PCMHs to build the evidence base for implementation in primary care. © Copyright 2018 by the American Board of Family Medicine.

Clinical pharmacogenetics implementation: approaches, successes, and challenges.

Science.gov (United States)

Weitzel, Kristin W; Elsey, Amanda R; Langaee, Taimour Y; Burkley, Benjamin; Nessl, David R; Obeng, Aniwaa Owusu; Staley, Benjamin J; Dong, Hui-Jia; Allan, Robert W; Liu, J Felix; Cooper-Dehoff, Rhonda M; Anderson, R David; Conlon, Michael; Clare-Salzler, Michael J; Nelson, David R; Johnson, Julie A

2014-03-01

Current challenges exist to widespread clinical implementation of genomic medicine and pharmacogenetics. The University of Florida (UF) Health Personalized Medicine Program (PMP) is a pharmacist-led, multidisciplinary initiative created in 2011 within the UF Clinical Translational Science Institute. Initial efforts focused on pharmacogenetics, with long-term goals to include expansion to disease-risk prediction and disease stratification. Herein we describe the processes for development of the program, the challenges that were encountered and the clinical acceptance by clinicians of the genomic medicine implementation. The initial clinical implementation of the UF PMP began in June 2012 and targeted clopidogrel use and the CYP2C19 genotype in patients undergoing left heart catheterization and percutaneous-coronary intervention (PCI). After 1 year, 1,097 patients undergoing left heart catheterization were genotyped preemptively, and 291 of those underwent subsequent PCI. Genotype results were reported to the medical record for 100% of genotyped patients. Eighty patients who underwent PCI had an actionable genotype, with drug therapy changes implemented in 56 individuals. Average turnaround time from blood draw to genotype result entry in the medical record was 3.5 business days. Seven different third party payors, including Medicare, reimbursed for the test during the first month of billing, with an 85% reimbursement rate for outpatient claims that were submitted in the first month. These data highlight multiple levels of success in clinical implementation of genomic medicine. © 2014 Wiley Periodicals, Inc.

Work–life balance policies: Challenges and benefits associated with implementing flexitime

Directory of Open Access Journals (Sweden)

Caroline Downes

2011-10-01

Research purpose: The aim of this article is to report on the challenges and benefits associated with implementing flexitime as a work–life balance policy. Motivation for the study: Organisations must develop and implement work–life balance policies. This requires human resource practitioners to investigate and understand experiences and perceptions about the challenges and benefits of flexitime. Research design, approach and method: The researcher used a qualitative research design with an exploratory approach. She drew a nonprobability purposive and voluntary sample (n = 15 from the financial sector. She used semi-structured in-depth interviews to collect the data and conducted content analyses to analyse and interpret them. Main findings: The researcher extracted four main themes (individual and general challenges, the aspects organisations need to implement flexitime effectively and the benefits that would follow its implementation from the data. Its benefits vary from work–life balance to employee loyalty and commitment. Some challenges are maintaining productivity, a shortage of critical resources and understanding flexitime. Practical/managerial implications: The research identified requirements that human resource practitioners should attend to in order to ensure that organisations use flexitime more effectively. Contribution/value-add: The researcher obtained unique findings about the minimum requirements for implementing flexitime effectively. They could assist organisations to address the challenges that employees face.

The implementation of mindfulness in healthcare systems: a theoretical analysis.

Science.gov (United States)

Demarzo, M M P; Cebolla, A; Garcia-Campayo, J

2015-01-01

Evidence regarding the efficacy of mindfulness-based interventions (MBIs) is increasing exponentially; however, there are still challenges to their integration in healthcare systems. Our goal is to provide a conceptual framework that addresses these challenges in order to bring about scholarly dialog and support health managers and practitioners with the implementation of MBIs in healthcare. This is an opinative narrative review based on theoretical and empirical data that address key issues in the implementation of mindfulness in healthcare systems, such as the training of professionals, funding and costs of interventions, cost effectiveness and innovative delivery models. We show that even in the United Kingdom, where mindfulness has a high level of implementation, there is a high variability in the access to MBIs. In addition, we discuss innovative approaches based on "complex interventions," "stepped-care" and "low intensity-high volume" concepts that may prove fruitful in the development and implementation of MBIs in national healthcare systems, particularly in Primary Care. In order to better understand barriers and opportunities for mindfulness implementation in healthcare systems, it is necessary to be aware that MBIs are "complex interventions," which require innovative approaches and delivery models to implement these interventions in a cost-effective and accessible way. Copyright © 2015 Elsevier Inc. All rights reserved.

Addressing the challenges to health sector decentralization in Nepal: an inquiry into the policy and implementation processes.

Science.gov (United States)

Dhakal, R; Ratanawijitrasin, S; Srithamrongsawat, S

2009-09-01

The objective of the study was to analyze the status and explore the challenges to decentralization policy implementation in Nepal. Thirty seven key informants rich in experience and knowledge, seven focus group discussions, observation of six health facilities and analysis of about 25 key policy documents provided the data for this study. The study identified the challenges to the implementation of decentralization reforms in the public health sector as: (i) centralised and weak management and programming practices of the government; (ii) weak legal and institutional framework; (iii) conflicting policy objectives; (iv) lack of implementation strategy; (v) poor financial and human resource management system; (vi) lack of adequate preparation for managing the reform; (vii) weak capacity at all levels; (viii) political instability. It was revealed that the implementation of the policy in Nepal was extremely poor as many of the important policy measures were either never initiated or they were only partially implemented. The challenges lie both at - policy design and implementation phase. Clear policy objectives, appropriate structure, sound planning, financing and human resources policy, adequate capacity, responsive information system, defined service packages, active participation of stakeholders and a conducive socio-political environment are considered imperative for successful implementation of the policy. Preparation for managing reform implementation at national and district levels is prerequisite for decentralization to work. Pushing for decentralization in a politically fragile environment may rather lead to further fragmentation, instead of strengthening government legitimacy.

Design and implementation of a terrorist fraud resilient distance bounding system

NARCIS (Netherlands)

Ranganathan, A.; Tippenhauer, N.O.; Skoric, B.; Singelée, D.; Capkun, S.; Foresti, S.; Yung, M.; Martinelli, F.

2012-01-01

Given the requirements of fast processing and the complexity of RF ranging systems, distance bounding protocols have been challenging to implement so far; only few designs have been proposed and implemented. Currently, the most efficient implementation of distance bounding protocols uses analog

Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, Implementation Strategy for a Distribution Management System

Energy Technology Data Exchange (ETDEWEB)

Singh, Ravindra [Argonne National Lab. (ANL), Argonne, IL (United States); Reilly, James T. [Reilly Associates, Pittston, PA (United States); Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States)

2017-03-01

Electric distribution utilities encounter many challenges to successful deployment of Distribution Management Systems (DMSs). The key challenges are documented in this report, along with suggestions for overcoming them. This report offers a recommended list of activities for implementing a DMS. It takes a strategic approach to implementing DMS from a project management perspective. The project management strategy covers DMS planning, procurement, design, building, testing, Installation, commissioning, and system integration issues and solutions. It identifies the risks that are associated with implementation and suggests strategies for utilities to use to mitigate them or avoid them altogether. Attention is given to common barriers to successful DMS implementation. This report begins with an overview of the implementation strategy for a DMS and proceeds to put forward a basic approach for procuring hardware and software for a DMS; designing the interfaces with external corporate computing systems such as EMS, GIS, OMS, and AMI; and implementing a complete solution.

Progress and challenges in implementing the women, peace and ...

African Journals Online (AJOL)

This article provides an initial overview of the African Union's progress and challenges in implementing the Women, Peace and Security (WPS) agenda in its peace and security architecture. It reviews implementation in relation to representation, programming and in peacekeeping. The article contends that the WPS agenda ...

Implementation Challenges of the New Geography Diploma ...

African Journals Online (AJOL)

The study focused on implementation challenges of the new Geography Diploma Syllabus in Tanzania. The study used Korogwe and Dakawa Teachers' Training Colleges as a case. Dakawa teachers' training college is located in Morogoro region while Korogwe teachers' training college is based in Korogwe district, ...

Implementing a regional oncology information system: approach and lessons learned.

Science.gov (United States)

Evans, W K; Ashbury, F D; Hogue, G L; Smith, A; Pun, J

2014-10-01

Paper-based medical record systems are known to have major problems of inaccuracy, incomplete data, poor accessibility, and challenges to patient confidentiality. They are also an inefficient mechanism of record-sharing for interdisciplinary patient assessment and management, and represent a major problem for keeping current and monitoring quality control to facilitate improvement. To address those concerns, national, regional, and local health care authorities have increased the pressure on oncology practices to upgrade from paper-based systems to electronic health records. Here, we describe and discuss the challenges to implementing a region-wide oncology information system across four independent health care organizations, and we describe the lessons learned from the initial phases that are now being applied in subsequent activities of this complex project. The need for change must be shared across centres to increase buy-in, adoption, and implementation. It is essential to establish physician leadership, commitment, and engagement in the process. Work processes had to be revised to optimize use of the new system. Culture change must be included in the change management strategy. Furthermore, training and resource requirements must be thoroughly planned, implemented, monitored, and modified as required for effective adoption of new work processes and technology. Interfaces must be established with multiple existing electronic systems across the region to ensure appropriate patient flow. Periodic assessment of the existing project structure is necessary, and adjustments are often required to ensure that the project meets its objectives. The implementation of region-wide oncology information systems across different health practice locations has many challenges. Leadership is essential. A strong, collaborative information-sharing strategy across the region and with the supplier is essential to identify, discuss, and resolve implementation problems. A structure

Managing the Challenges of Leadership in ERP Implementations: An Exploratory Study of the Leadership Challenges Encountered by Project Managers Involved in ERP Implementation Projects

Science.gov (United States)

Wanjagi, James K.

2013-01-01

Increasingly, organizations are conducting more Enterprise Resource Planning (ERP) projects in order to promote organizational efficiencies. Meanwhile, minimal research has been conducted on the leadership challenges faced by project managers during the ERP project implementations and how these challenges are managed. The existing project…

Challenges to implementing a National Health Information System in Cameroon: perspectives of stakeholders

Directory of Open Access Journals (Sweden)

Emmanuel Ngwakongnwi

2014-03-01

Full Text Available In the early 90s, the Cameroon Ministry of Health implemented a National Health Information System (NHIS based on a bottom- up approach of manually collecting and reporting health data. Little is known about the implementation and functioning of the NHIS. The purpose of this study was to assess the implementation of the NHIS by documenting experiences of individual stakeholders, and to suggest recommendations for improvement. We reviewed relevant documents and conducted face-to-face interviews (N=4 with individuals directly involved with data gathering, reporting and storage. Content analysis was used to analyze textual data. We found a stalled and inefficient NHIS characterized by general lack of personnel, a labor-intensive process, delay in reporting data, much reliance on field staff, and lack of incentives. A move to an electronic health information system without involving all stakeholders and adequately addressing the issues plaguing the current system is premature.

Cervical cancer data and data systems in limited-resource settings: Challenges and opportunities.

Science.gov (United States)

Drummond, Jennifer L; Were, Martin C; Arrossi, Silvina; Wools-Kaloustian, Kara

2017-07-01

Appropriate collection and use of health information is critical to the planning, scaling up, and improvement of cervical cancer programs. The health information systems implementation landscape is unique to each country; however, systems serving cervical cancer programs in low-resource settings share characteristics that present common challenges. In response, many programs have taken innovative approaches to generating the quality information needed for decision making. Recent advances in health information technology also provide feasible solutions to challenges. This article draws from the experiences of the authors and from current literature to describe outstanding challenges and promising practices in the implementation of cervical cancer data systems, and to make recommendations for next steps. Recommendations include engaging all stakeholders-including providers, program managers, implementing partners, and donors-in promoting national, district, and community information systems; building on existing systems and processes, as well as introducing new technologies; and evolving data collection and data systems as programs advance. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana.

Science.gov (United States)

Mupara, Lucia U; Lubbe, Johanna C

2016-01-01

Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana

Directory of Open Access Journals (Sweden)

Lucia U. Mupara

2016-02-01

Full Text Available Background: Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. Design: A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. Results: The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. Conclusions: The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

The main challenges for manufacturing companies in implementing and utilizing configurators

DEFF Research Database (Denmark)

Kristjansdottir, Katrin; Shafiee, Sara; Hvam, Lars

2018-01-01

Companies providing customized products increasingly apply configurators in supporting sales and design activities, thus improving lead-times, quality, cost, benefits perceived by customers, and customer satisfaction. While configurator advantages have been substantially investigated....... Finally, it is investigated whether the importance of the main categories of challenges varies according to a number of potential context variables. The results of the survey, which studies manufacturing companies that use configurators in providing customized products, offer new insights......, the challenges of implementing and utilizing configurators have less often been considered. By reviewing relevant literature, the present study first categorizes the main challenges faced by manufacturing companies when implementing and utilizing configurators. Six main categories of challenges are identified...

Experiences from the implementation of a biosafety system in Slovenia.

Science.gov (United States)

Milavec, Mojca; Racman, Darja Stanic

2007-09-01

The development and implementation of an effective national biosafety system is important for several key reasons: to ensure safe access to products of modern biotechnology, to build public confidence, to encourage the growth of domestic modern biotechnology, and to comply with international standards and agreements. There is no single best approach in the development and implementation of a national biosafety system and each country is faced with unique challenges. Slovenia is a small country and a new EU Member State. However, it has developed and implemented an efficient national biosafety system. The key elements of this system are administrative procedure, risk assessment, enforcement, and public participation and information.

Challenges of Implementing Mobile Learning in Distance Learning ...

African Journals Online (AJOL)

Challenges of Implementing Mobile Learning in Distance Learning in Tanzania. ... A sample of 450 students were interviewed by using both questionnaire and ... the biggest advantage of M-learning technology- when used, is that it can be ...

Application of Customer Relationship Management Systems in Business: Challenges and Opportunities

OpenAIRE

K. Liagkouras; K. Metaxiotis

2014-01-01

Customer relationship management (CRM) systems in business are a reality of the contemporary business world for the last decade or so. Still, there are grey areas regarding the successful implementation and operation of CRM systems in business. This paper, through the systematic study of the CRM implementation paradigm, attempts to identify the most important challenges and opportunities that the CRM systems face in a rapidly changing business world.

Implementation status of accrual accounting system in health sector.

Science.gov (United States)

Mehrolhassani, Mohammad Hossien; Khayatzadeh-Mahani, Akram; Emami, Mozhgan

2014-07-29

Management of financial resources in health systems is one of the major issues of concern for policy makers globally. As a sub-set of financial management, accounting system is of paramount importance. In this paper, which presents part of the results of a wider research project on transition process from a cash accounting system to an accrual accounting system, we look at the impact of components of change on implementation of the new system. Implementing changes is fraught with many obstacles and surveying these challenges will help policy makers to better overcome them. The study applied a quantitative manner in 2012 at Kerman University of Medical Science in Iran. For the evaluation, a teacher made valid questionnaire with Likert scale was used (Cranach's alpha of 0.89) which included 7 change components in accounting system. The study population was 32 subordinate units of Kerman University of Medical Sciences and for data analysis, descriptive and inferential statistics and correlation coefficient in SPSS version 19 were used. Level of effect of all components on the implementation was average downward (5.06±1.86), except for the component "management & leadership (3.46±2.25)" (undesirable from external evaluators' viewpoint) and "technology (6.61±1.92) and work processes (6.35±2.19)" (middle to high from internal evaluators' viewpoint). Results showed that the establishment of accrual accounting system faces infrastructural challenges, especially the components of leadership and management and followers. As such, developing effective measures to overcome implementation obstacles should target these components.

Implementing an electronic hand hygiene monitoring system: Lessons learned from community hospitals.

Science.gov (United States)

Edmisten, Catherine; Hall, Charles; Kernizan, Lorna; Korwek, Kimberly; Preston, Aaron; Rhoades, Evan; Shah, Shalin; Spight, Lori; Stradi, Silvia; Wellman, Sonia; Zygadlo, Scott

2017-08-01

Measuring and providing feedback about hand hygiene (HH) compliance is a complicated process. Electronic HH monitoring systems have been proposed as a possible solution; however, there is little information available about how to successfully implement and maintain these systems for maximum benefit in community hospitals. An electronic HH monitoring system was implemented in 3 community hospitals by teams at each facility with support from the system vendor. Compliance rates were measured by the electronic monitoring system. The implementation challenges, solutions, and drivers of success were monitored within each facility. The electronic HH monitoring systems tracked on average more than 220,000 compliant HH events per facility per month, with an average monthly compliance rate >85%. The sharing of best practices between facilities was valuable in addressing challenges encountered during implementation and maintaining a high rate of use. Drivers of success included a collaborative environment, leadership commitment, using data to drive improvement, consistent and constant messaging, staff empowerment, and patient involvement. Realizing the full benefit of investments in electronic HH monitoring systems requires careful consideration of implementation strategies, planning for ongoing support and maintenance, and presenting data in a meaningful way to empower and inspire staff. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The challenge of benchmarking health systems: is ICT innovation capacity more systemic than organizational dependent?

Science.gov (United States)

Lapão, Luís Velez

2015-01-01

The article by Catan et al. presents a benchmarking exercise comparing Israel and Portugal on the implementation of Information and Communication Technologies in the healthcare sector. Special attention was given to e-Health and m-Health. The authors collected information via a set of interviews with key stakeholders. They compared two different cultures and societies, which have reached slightly different implementation outcomes. Although the comparison is very enlightening, it is also challenging. Benchmarking exercises present a set of challenges, such as the choice of methodologies and the assessment of the impact on organizational strategy. Precise benchmarking methodology is a valid tool for eliciting information about alternatives for improving health systems. However, many beneficial interventions, which benchmark as effective, fail to translate into meaningful healthcare outcomes across contexts. There is a relationship between results and the innovational and competitive environments. Differences in healthcare governance and financing models are well known; but little is known about their impact on Information and Communication Technology implementation. The article by Catan et al. provides interesting clues about this issue. Public systems (such as those of Portugal, UK, Sweden, Spain, etc.) present specific advantages and disadvantages concerning Information and Communication Technology development and implementation. Meanwhile, private systems based fundamentally on insurance packages, (such as Israel, Germany, Netherlands or USA) present a different set of advantages and disadvantages - especially a more open context for innovation. Challenging issues from both the Portuguese and Israeli cases will be addressed. Clearly, more research is needed on both benchmarking methodologies and on ICT implementation strategies.

Mind the gap: implementation challenges break the link between HIV/AIDS research and practice

Directory of Open Access Journals (Sweden)

Sarah MacCarthy

Full Text Available Abstract: Sampling strategies such as respondent-driven sampling (RDS and time-location sampling (TLS offer unique opportunities to access key populations such as men who have sex with men (MSM and transgender women. Limited work has assessed implementation challenges of these methods. Overcoming implementation challenges can improve research quality and increase uptake of HIV services among key populations. Drawing from studies using RDS in Brazil and TLS in Peru, we summarize challenges encountered in the field and potential strategies to address them. In Brazil, study site selection, cash incentives, and seed selection challenged RDS implementation with MSM. In Peru, expansive geography, safety concerns, and time required for study participation complicated TLS implementation with MSM and transgender women. Formative research, meaningful participation of key populations across stages of research, and transparency in study design are needed to link HIV/AIDS research and practice. Addressing implementation challenges can close gaps in accessing services among those most burdened by the epidemic.

Mind the gap: implementation challenges break the link between HIV/AIDS research and practice.

Science.gov (United States)

MacCarthy, Sarah; Reisner, Sari; Hoffmann, Michael; Perez-Brumer, Amaya; Silva-Santisteban, Alfonso; Nunn, Amy; Bastos, Leonardo; Vasconcellos, Mauricio Teixeira Leite de; Kerr, Ligia; Bastos, Francisco Inácio; Dourado, Inês

2016-11-03

Sampling strategies such as respondent-driven sampling (RDS) and time-location sampling (TLS) offer unique opportunities to access key populations such as men who have sex with men (MSM) and transgender women. Limited work has assessed implementation challenges of these methods. Overcoming implementation challenges can improve research quality and increase uptake of HIV services among key populations. Drawing from studies using RDS in Brazil and TLS in Peru, we summarize challenges encountered in the field and potential strategies to address them. In Brazil, study site selection, cash incentives, and seed selection challenged RDS implementation with MSM. In Peru, expansive geography, safety concerns, and time required for study participation complicated TLS implementation with MSM and transgender women. Formative research, meaningful participation of key populations across stages of research, and transparency in study design are needed to link HIV/AIDS research and practice. Addressing implementation challenges can close gaps in accessing services among those most burdened by the epidemic.

Mind the gap: implementation challenges break the link between HIV/AIDS research and practice

Science.gov (United States)

MacCarthy, Sarah; Reisner, Sari; Hoffmann, Michael; Perez-Brumer, Amaya; Silva-Santisteban, Alfonso; Nunn, Amy; Bastos, Leonardo; de Vasconcellos, Mauricio Teixeira Leite; Kerr, Ligia; Bastos, Francisco Inácio; Dourado, Inês

2018-01-01

Sampling strategies such as respondent-driven sampling (RDS) and time-location sampling (TLS) offer unique opportunities to access key populations such as men who have sex with men (MSM) and transgender women. Limited work has assessed implementation challenges of these methods. Overcoming implementation challenges can improve research quality and increase uptake of HIV services among key populations. Drawing from studies using RDS in Brazil and TLS in Peru, we summarize challenges encountered in the field and potential strategies to address them. In Brazil, study site selection, cash incentives, and seed selection challenged RDS implementation with MSM. In Peru, expansive geography, safety concerns, and time required for study participation complicated TLS implementation with MSM and transgender women. Formative research, meaningful participation of key populations across stages of research, and transparency in study design are needed to link HIV/AIDS research and practice. Addressing implementation challenges can close gaps in accessing services among those most burdened by the epidemic. PMID:27828609

How change management can prevent the failure of information systems implementation among Malaysian government hospitals?

Science.gov (United States)

ChePa, Noraziah; Jasin, Noorhayati Md; Bakar, Nur Azzah Abu

2017-10-01

Fail to prevent or control challenges of Information System (IS) implementation have led to the failure of its implementation. Successful implementation of IS has been a challenging task to any organization including government hospitals. Government has invested a big amount of money on information system (IS) projects to improve service delivery in healthcare. However, several of them failed to be implemented successfully due to several factors. This article proposes a prevention model which incorporated Change Management (CM) concepts to avoid the failure of IS implementation, hence ensuring the success of it. Challenges of IS implementation in government hospitals have been discovered. Extensive literature review and deep interview approaches were employed to discover these challenges. A prevention model has been designed to cater the challenges. The model caters three main phases of implementation; pre-implementation, during implementation, and post-implementation by adopting CM practices of Lewin's, Kotter's and Prosci's CM model. Six elements of CM comprising thirteen sub-elements adopted from the three CM models have been used to handle CFFs of Human and Support issues; guiding team, resistance avoidance, IS adoption, enforcement, monitoring, and IS sustainability. Successful practice of the proposed mapping is expected to prevent CFFs to occur, hence ensuring a successful implementation of IS in the hospitals. The proposed model has been presented and successfully evaluated by the domain experts from the selected hospitals. The proposed model is believed to be beneficial for top management, IT practitioners and medical practitioners in preventing IS implementation failure among government hospitals towards ensuring the success implementation.

Challenges for Cooperative Learning Implementation: Reports from Elementary School Teachers

Science.gov (United States)

Buchs, Céline; Filippou, Dimitra; Pulfrey, Caroline; Volpé, Yann

2017-01-01

Despite the well-established benefits of cooperative learning, implementation remains a challenge. This research aims to document these challenges at the elementary school level, drawing on teachers' beliefs regarding learning as well as the difficulties teachers report. Results indicate that the most frequent instructional strategies reported are…

IWRM and developing countries: Implementation challenges in Ghana

NARCIS (Netherlands)

Agyenim, J.B.; Gupta, J.

2012-01-01

Since 1990, there has been growing theoretical consensus on the need for integrated water resource management. At the same time, there is growing empirical evidence that challenges the scientific consensus and the practical implications of implementing IWRM in the developed and the developing

Corporate Social Responsibility in China : Implementations and challenges

NARCIS (Netherlands)

Graafland, J.J.; Zhang, L.

Corporate social responsibility (CSR) is becoming increasingly important in China. This paper investigates the implementation of instruments for dimensions of CSR that are relevant for the Chinese context and the challenges that Chinese companies face. Based on a survey among 109 Chinese companies,

IMPLEMENTING THE COMPUTER-BASED NATIONAL EXAMINATION IN INDONESIAN SCHOOLS: THE CHALLENGES AND STRATEGIES

Directory of Open Access Journals (Sweden)

Heri Retnawati

2017-12-01

Full Text Available In line with technological development, the computer-based national examination (CBNE has become an urgent matter as its implementation faces various challenges, especially in developing countries. Strategies in implementing CBNE are thus needed to face the challenges. The aim of this research was to analyse the challenges and strategies of Indonesian schools in implementing CBNE. This research was qualitative phenomenological in nature. The data were collected through a questionnaire and a focus group discussion. The research participants were teachers who were test supervisors and technicians at junior high schools and senior high schools (i.e. Level 1 and 2 and vocational high schools implementing CBNE in Yogyakarta, Indonesia. The data were analysed using the Bogdan and Biklen model. The results indicate that (1 in implementing CBNE, the schools should initially make efforts to provide the electronic equipment supporting it; (2 the implementation of CBNE is challenged by problems concerning the Internet and the electricity supply; (3 the test supervisors have to learn their duties by themselves and (4 the students are not yet familiar with the beneficial use of information technology. To deal with such challenges, the schools employed strategies by making efforts to provide the standard electronic equipment through collaboration with the students’ parents and improving the curriculum content by adding information technology as a school subject.

Technical challenges related to implementation of a formula one real time data acquisition and analysis system in a paediatric intensive care unit.

Science.gov (United States)

Matam, B Rajeswari; Duncan, Heather

2018-06-01

Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded. McLaren Electronic Systems expertise used to continually monitor and analyse the data from F1 racing cars in real time was utilised to implement a similar real-time data recording platform system adapted with real time analytics to suit the requirements of the intensive care environment. We encountered many technical (hardware and software) implementation challenges. However there were many advantages of the system once it was operational. They include: (1) The ability to store the data for long periods of time enabling access to historical physiological data. (2) The ability to alter the time axis to contract or expand periods of interest. (3) The ability to store and review ECG morphology retrospectively. (4) Detailed post event (cardiac/respiratory arrest or other clinically significant deteriorations in patients) data can be reviewed clinically as opposed to trend data providing valuable clinical insight. Informed mortality and morbidity reviews can be conducted. (5) Storage of waveform data capture to use for algorithm development for adaptive early warning systems. Recording data from bed-side monitors in intensive care/wards is feasible. It is possible to set up real time data recording and long term storage systems. These systems in future can be improved with additional patient specific metrics which predict the status of a patient thus paving the way for real time predictive monitoring.

Implementation Status of Accrual Accounting System in Health Sector

Science.gov (United States)

Mehrolhassani, Mohammad Hossien; Khayatzadeh-Mahani, Akram; Emami, Mozhgan

2015-01-01

Introduction: Management of financial resources in health systems is one of the major issues of concern for policy makers globally. As a sub-set of financial management, accounting system is of paramount importance. In this paper, which presents part of the results of a wider research project on transition process from a cash accounting system to an accrual accounting system, we look at the impact of components of change on implementation of the new system. Implementing changes is fraught with many obstacles and surveying these challenges will help policy makers to better overcome them. Methods: The study applied a quantitative manner in 2012 at Kerman University of Medical Science in Iran. For the evaluation, a teacher made valid questionnaire with Likert scale was used (Cranach’s alpha of 0.89) which included 7 change components in accounting system. The study population was 32 subordinate units of Kerman University of Medical Sciences and for data analysis, descriptive and inferential statistics and correlation coefficient in SPSS version 19 were used. Results: Level of effect of all components on the implementation was average downward (5.06±1.86), except for the component “management & leadership (3.46±2.25)” (undesirable from external evaluators’ viewpoint) and “technology (6.61±1.92) and work processes (6.35±2.19)” (middle to high from internal evaluators’ viewpoint). Conclusions: Results showed that the establishment of accrual accounting system faces infrastructural challenges, especially the components of leadership and management and followers. As such, developing effective measures to overcome implementation obstacles should target these components. PMID:25560337

Implementing the Rock Challenge: Teacher Perspectives on a Performing Arts Programme

Science.gov (United States)

Jones, Mathew; Murphy, Simon; Salmon, Debra; Kimberlee, Richard; Orme, Judy

2004-01-01

The Rock Challenge is a school-based performing arts programme that aims to promote healthy lifestyles amongst secondary school students. This paper reports on teacher perspectives on the implementation of The Rock Challenge in nine English schools. This study highlights how performing arts programmes, such as The Rock Challenge, are unlikely to…

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

Science.gov (United States)

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

2016-01-01

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

Benefits and challenges of cloud ERP systems – A systematic literature review

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Mohamed A. Abd Elmonem

2016-12-01

Full Text Available Enterprise Resource Planning (ERP systems provide extensive benefits and facilities to the whole enterprise. ERP systems help the enterprise to share and transfer data and information across all functions units inside and outside the enterprise. Sharing data and information between enterprise departments helps in many aspects and aims to achieve different objectives. Cloud computing is a computing model which takes place over the internet and provides scalability, reliability, availability and low cost of computer reassures. Implementing and running ERP systems over the cloud offers great advantages and benefits, in spite of its many difficulties and challenges. In this paper, we follow the Systematic Literature Review (SLR research method to explore the benefits and challenges of implementing ERP systems over a cloud environment.

Strengthening Performance Management System Implementation in South African Municipalities

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Malefetsane Mofolo

2012-06-01

Full Text Available Adoption of a performance management system in municipalities presented a serious challenge for its implementation. This scenario is implicitly manifesting itself in the reports of the Auditor-General on the financial statements and performance of municipalities, as well as in the state of local government in South Africa overview report (2009. These reports called for the conceptualisation of a model that to strengthen the implementation in municipalities of a performance management system that is efficient and effective. And most importantly, this model could be beneficial for growth, development and effective service delivery.

A methodology for Manufacturing Execution Systems (MES) implementation

Science.gov (United States)

Govindaraju, Rajesri; Putra, Krisna

2016-02-01

Manufacturing execution system is information systems (IS) application that bridges the gap between IS at the top level, namely enterprise resource planning (ERP), and IS at the lower levels, namely the automation systems. MES provides a media for optimizing the manufacturing process as a whole in a real time basis. By the use of MES in combination with the implementation of ERP and other automation systems, a manufacturing company is expected to have high competitiveness. In implementing MES, functional integration -making all the components of the manufacturing system able to work well together, is the most difficult challenge. For this, there has been an industry standard that specifies the sub-systems of a manufacturing execution systems and defines the boundaries between ERP systems, MES, and other automation systems. The standard is known as ISA-95. Although the advantages from the use of MES have been stated in some studies, not much research being done on how to implement MES effectively. The purpose of this study is to develop a methodology describing how MES implementation project should be managed, utilising the support of ISA- 95 reference model in the system development process. A proposed methodology was developed based on a general IS development methodology. The developed methodology were then revisited based on the understanding about the specific charateristics of MES implementation project found in an Indonesian steel manufacturing company implementation case. The case study highlighted the importance of applying an effective requirement elicitation method during innitial system assessment process, managing system interfaces and labor division in the design process, and performing a pilot deployment before putting the whole system into operation.

Implementing Environmental Management Accounting: Status and Challenges

DEFF Research Database (Denmark)

Cost Accounting - and its Interaction with Eco-Efficiency Performance Measurement and Indicators; Stefan Schaltegger and Marcus Wagner. 4. Environmental Accounting Dimensions: Pros and Cons of Trajectory Convergence and Increased Efficiency; Pontus Cerin and Staffan Laestadius. 5. Process and Content......Table of contents Preface. 1. Environmental Management Accounting: Innovation or Managerial Fad?; Pall Rikhardsson, Martin Bennett, Jan Jaap Bouma and Stefan Schaltegger. Section 1 Progress. 2. Challenges for Environmental Management Accounting; Roger L. Burritt 3. Current Trends in Environmental......: Visualizing the Policy Challenges of Environmental Management Accounting; Dick Osborn. Section 2 Exploring EMA implementation issues. 6. Environmental Performance and the Quality of Corporate Environmental Reports: The Role of Environmental Management Accounting; Marcus Wagner. 7. Environmental Risk...

Doing implementation research on health governance: a frontline researcher's reflexive account of field-level challenges and their management.

Science.gov (United States)

Patel, Gupteswar; Garimella, Surekha; Scott, Kerry; Mondal, Shinjini; George, Asha; Sheikh, Kabir

2017-11-15

Implementation Research (IR) in and around health systems comes with unique challenges for researchers including implementation, multi-layer governance, and ethical issues. Partnerships between researchers, implementers, policy makers and community members are central to IR and come with additional challenges. In this paper, we elaborate on the challenges faced by frontline field researchers, drawing from experience with an IR study on Village Health Sanitation and Nutrition Committees (VHSNCs). The IR on VHSNC took place in one state/province in India over an 18-month research period. The IR study had twin components; intervention and in-depth research. The intervention sought to strengthen the VHSNC functioning, and concurrently the research arm sought to understand the contextual factors, pathways and mechanism affecting VHSNC functions. Frontline researchers were employed for data collection and a research assistant was living in the study sites. The frontline research assistant experienced a range of challenges, while collecting data from the study sites, which were documented as field memos and analysed using inductive content analysis approach. Due to the relational nature of IR, the challenges coalesced around two sets of relationships (a) between the community and frontline researchers and (b) between implementers and frontline researchers. In the community, the frontline researcher was viewed as the supervisor of the intervention and was perceived by the community to have power to bring about beneficial changes with public services and facilities. Implementers expected help from the frontline researcher in problem-solving in VHSNCs, and feedback on community mobilization to improve their approaches. A concerted effort was undertaken by the whole research team to clarify and dispel concerns among the community and implementers through careful and constant communication. The strategies employed were both managerial, relational and reflexive in nature

Corporate Wellness Programs: Implementation Challenges in the Modern American Workplace

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Bahaudin G. Mujtaba

2013-01-01

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

Challenges in Implementing the TVET Curriculum in Technical ...

African Journals Online (AJOL)

This study aimed at examining the challenges in implementing the Technical and Vocational Education and Training (TVET) curriculum in technical colleges in Southern Nigeria. It sought to respond to three research questions and was guided by one research hypothesis. A questionnaire with 14 items was used to collect ...

Restructuring Principal Preparation in Illinois: Perspectives on Implementation Successes, Challenges, and Future Outlook. IERC 2015-3

Science.gov (United States)

Klostermann, Brenda K.; Pareja, Amber Stitziel; Hart, Holly; White, Bradford R.; Huynh, Michelle Hanh

2015-01-01

The goals of the current mixed methods study--the Illinois Principal Preparation Implementation Review Project (I-PREP)--are to describe how the new policy is being implemented, learning which aspects of the implementation have been challenging and why they present challenges, and how programs are addressing challenges and realizing improvements…

Approaches and Challenges of Engineering Implantable Microelectromechanical Systems (MEMS Drug Delivery Systems for in Vitro and in Vivo Applications

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Ken-Tye Yong

2012-11-01

Full Text Available Despite the advancements made in drug delivery systems over the years, many challenges remain in drug delivery systems for treating chronic diseases at the personalized medicine level. The current urgent need is to develop novel strategies for targeted therapy of chronic diseases. Due to their unique properties, microelectromechanical systems (MEMS technology has been recently engineered as implantable drug delivery systems for disease therapy. This review examines the challenges faced in implementing implantable MEMS drug delivery systems in vivo and the solutions available to overcome these challenges.

Supply Chain Management on IBS Implementation in Klang Valley Construction Industry: Challenges and Issues

Science.gov (United States)

Azrizal Fauzi, Mohd; Hasim, Sulaiman; Awang, Anizah; Ridzuan, Ahmad Ruslan Mohd; Nur Yunus, Juzailah

2017-12-01

Industrialized Building System (IBS) is a system where the components of the building are manufactured in a factory and it will be transported to the site to form the structures. The supply chain management (SCM) is a system where the delivery flows of the IBS products from manufacturers to the site. The aim of this research is to identify the major challenges and to analyze the issues on IBS implementation in SCM in Klang Valley from the manufacturers perspective. The methodology used in this paper is based on primary data through questionnaire and interview. Questionnaires were sent to the Manufacturers. It can be concluded that this paper attempts to present more on the challenges and issues that those companies of manufacturers faced during their success journey in finding integration in their supply chain. The main contributions of this paper are integrating all the supply chain integration challenges and issues on IBS. Therefore, these contributions will be helpful for the organization of manufacturers and IBS players that establish the integration in their SCM.

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

Science.gov (United States)

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

2015-01-01

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

WiMAX OFDM system simulation and sub-system FPGA implementation

International Nuclear Information System (INIS)

Elaskary, A.M.F.

2009-01-01

Orthogonal frequency division multiplexing (OFDM) has been used in many wireless communication systems also it is gaining a lot of attention for the next generations of mobile communication systems. OFDM is considered a good candidate for wireless systems because it has high bandwidth efficiency and can transmit at very high data rate in multi path, interference , and fading environment. in general OFDM has widely been studied and implemented to combat transmission channel impairments, but some challenges still facing OFDM in transmission system implementation especially for recent and future applications. One of these important applications is the worldwide interoperability for microwave access (WiMAX) system. According to the IEEE 802.16 standards, WiMAX is considered as a good solution for last mile connection at crowded areas and a high-speed internet connection to mobile vehicles with speed of up to 300 km/h. This thesis studies OFDM system in details and proposes simulink models for simulating OFDM impairments and its effects on system performance. This study has been used for building up system level and end to end WiMAX OFDM transmitter/receiver which follows published specifications in IEEE 802.16 standards using mat lab/simulink.

Implementation of Hepatitis Information Management System in Iran.

Science.gov (United States)

Reza, Safdari; Jebraeil, Farzi; Akbar, Nasiri Ali; Marjan, Ghazisaeedi; Reza, Taghavi Mohammad; Mehdi, Afshari; Mahlagha, Sargolzaee; Farhad, Taji

2015-11-17

Nowadays, hepatitis is of the most important health priorities around the world, where information plays a very significant role in specialized diseases prevention planning, and policy- and decision-making processes. Thus, this study addressed challenges of hepatitis information management and investigated the outcomes of establishing a hepatitis information management system to overcome such challenges. To this end, this research intended to study the implementation of an Electronic hepatitis information management system. This is an applied-developmental study with following specifications and procedures: preparation of study proposal and design, justification of the design's stakeholders, approval of the design by the Postgraduate Education Council of Faculty, determination of pilot hepatitis control center, software development, deciding on control, prevention, and treatment centers, and finally development of a network-based system for collecting and managing hepatitis information. Results indicated that the inconsistency and lack of integrity of data, as well as the lack of communication between related units prevented timely information register of viral hepatic patients and services that are provided to them. This inhibited the possibility of considering a follow-up process. However, the implementation of this system and involvement of relevant units greatly solved these problems. Results show that the implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure is capable in providing desired services to all laboratories, counseling and health centers, specialized clinics, and physicians connected to the hepatitis network. This enables them to follow up and monitor patients' conditions. That mentioned system paves the way for the analysis of gathered information, managers' and specialists' access in different regions to

Opportunities and challenges in the implementation of Quality Assurance for Auditing in Kosovo

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Edona Perjuci

2012-04-01

Full Text Available This study examines the international requirements of audit quality assurance and focuses on the challenges faced by the newest economy in the region, Kosovo, in implementation of same. This study focuses on the monitoring of compliance by business organizations in Kosovo with the International Financial Reporting Standards and Kosovo Accounting Standards as appropriate , and the impact that this compliance or non compliance has in the economy. In addition this study examines compliance with International Standards of Auditing by auditors and reviews the quality of the audit process in the broader context of the requirements for audit quality assurance. It is found that there are weaknesses in almost all elements of Kosovo’s corporate financial reporting and auditing regime, which is not dissimilar, linked to larger challenges faced by all former Yugoslav economies in transitioning to the new market economic system. The economies of former Yugoslavia face similar challenges in integration with the European Union’s economic and financial system, because of the unique shared characteristics of the former Yugoslav system. In parallel with the economic transitional reforms undertaken within the region, the global financial reporting and auditing system has been changed, with a convergence to International financial reporting standards, international standards of auditing and a new emphasis on audit quality assurance and external oversight mechanisms to sustain it. Though Kosovo is not alone within the region in addressing the reforms required to integrate the economy fully into the EU system, the study reveals both opportunities and challenges unique to Kosovo and makes recommendations for reform.

Integration of treatment innovation planning and implementation: strategic process models and organizational challenges.

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Lehman, Wayne E K; Simpson, D Dwayne; Knight, Danica K; Flynn, Patrick M

2011-06-01

Sustained and effective use of evidence-based practices in substance abuse treatment services faces both clinical and contextual challenges. Implementation approaches are reviewed that rely on variations of plan-do-study-act (PDSA) cycles, but most emphasize conceptual identification of core components for system change strategies. A two-phase procedural approach is therefore presented based on the integration of Texas Christian University (TCU) models and related resources for improving treatment process and program change. Phase 1 focuses on the dynamics of clinical services, including stages of client recovery (cross-linked with targeted assessments and interventions), as the foundations for identifying and planning appropriate innovations to improve efficiency and effectiveness. Phase 2 shifts to the operational and organizational dynamics involved in implementing and sustaining innovations (including the stages of training, adoption, implementation, and practice). A comprehensive system of TCU assessments and interventions for client and program-level needs and functioning are summarized as well, with descriptions and guidelines for applications in practical settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Big Data Analytics Solutions: The Implementation Challenges in the Financial Services Industry

Science.gov (United States)

Ojo, Michael O.

2016-01-01

The challenges of Big Data (BD) and Big Data Analytics (BDA) have attracted disproportionately less attention than the overwhelmingly espoused benefits and game-changing promises. While many studies have examined BD challenges across multiple industry verticals, very few have focused on the challenges of implementing BDA solutions. Fewer of these…

Implementing information systems with project teams using ethnographic-action research

NARCIS (Netherlands)

Hartmann, Timo; Fischer, Martin; Haymaker, John

2009-01-01

Architecture, engineering, and construction (AEC) projects are characterized by a large variation in requirements and work routines. Therefore, it is difficult to develop and implement information systems to support projects. To address these challenges, this paper presents a project-centric

UK community health visiting: challenges faced during lean implementation

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Carr SM

2012-01-01

Full Text Available Susan M Carr1,2, Pauline Pearson1, Lesley Young-Murphy3, Barbara Cleghorn41Centre for Community Health & Education Studies Research & Enterprise, Northumbria University, Newcastle upon Tyne, UK; 2School of Health, University of New England, Armidale, New South Wales, Australia; 3NHS North of Tyne, Newcastle upon Tyne, UK, 4Newcastle PCT, Newcastle upon Tyne, UKAbstract: This paper presents an overview of the challenges and potential of lean implementation for the health visiting service in England and examines the rhetoric and the reality of the situation. It is coauthored by academic researchers and senior service providers so as to embrace the multidimensional issues impacting on this subject. If lean thinking is to be implemented in relation to health visiting, it is important to understand how it is likely to be viewed by practitioners and line managers in settings where it is used. In order to contextualize the discussion, an introduction to the roles, systems, and structures of health visiting are provided. The literature on what lean implementation is, what it means, and in particular the application and potential of the approach to primary care and public health services is reviewed. The process and findings from a focus group convened within a large primary care organization in the National Health Service during their lean implementation is reported. The paper concludes that it is important for staff at all levels to see a clear link between strategic aims and objectives and the planning processes operated by providers and commissioners. It appears that the successful introduction of lean thinking should focus more on productive working and thereby reducing waste. This has the potential to refresh workforce models to ensure that health visiting and other practitioners liberate the use of their specialist knowledge and skills. In a context of enhanced partnership working, the stage is then set for providers to add value to the whole

Resilience of Infrastructure Systems to Sea-Level Rise in Coastal Areas: Impacts, Adaptation Measures, and Implementation Challenges

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Beatriz Azevedo de Almeida

2016-11-01

Full Text Available Expansive areas of low elevation in many densely populated coastal areas are at elevated risk of storm surges and flooding due to torrential precipitation, as a result of sea level rise. These phenomena could have catastrophic impacts on coastal communities and result in the destruction of critical infrastructure, disruption of economic activities and salt water contamination of the water supply. The objective of the study presented in this paper was to identify various impacts of sea level rise on civil infrastructures in coastal areas and examine the adaptation measures suggested in the existing literature. To this end, a systemic review of the existing literature was conducted in order to identify a repository of studies addressing sea level rise impacts and adaptation measures in the context of infrastructure systems. The study focused on three infrastructure sectors: water and wastewater, energy, and road transportation. The collected information was then analyzed in order to identify different categories of sea level rise impacts and corresponding adaptation measures. The findings of the study are threefold: (1 the major categories of sea level rise impacts on different infrastructure systems; (2 measures for protection, accommodation, and retreat in response to sea level rise impacts; and (3 challenges related to implementing adaptation measures.

Work-life balance policies: challenges and benefits associated with implementing flexitime

OpenAIRE

Downes, Caroline; Koekemoer, Frieda Eileen

2011-01-01

Orientation: Helping employees to balance their work and family lives is a business imperative. Work–life balance policies (like flexitime) aim to support employees to do so. However, implementing these policies is problematic. Research purpose: The aim of this article is to report on the challenges and benefits associated with implementing flexitime as a work–life balance policy. Motivation for the study: Organisations must develop and implement work–life balance policies. This r...

Sustainable manufacturing challenges, solutions and implementation perspectives

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Seliger, Günther; Bonvoisin, Jérémy

2017-01-01

Sustainability imposes an unprecedented challenge on society and has become the driving force of an urgent search for innovative solutions in all branches of economy. Manufacturing plays a key role in many areas of human living, and it is both part of the problem and of the solution. This book offers an overview of the broad field of research on sustainability in manufacturing with a particular focus on manufacturing technology and management. It summarizes the current challenges, describes best in class methods for development of sustainable manufacturing solutions and offers implementation perspectives. This volume covers areas of research such as production processes, product development, business model and corporate development, macro economy and education. The target audience primarily comprises research experts and practitioners in the field of manufacturing, but the book may also be beneficial for graduate students. .

Challenges and Success Factors of ERP Systems in Australian SMEs

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Sitalakshmi Venkatraman

2016-05-01

Full Text Available Today, great potential is envisaged for ERP systems in small and medium-sized enterprises (SMEs, and software vendors have been repackaging their ERP systems for SMEs with a recent focus on cloud-based systems. While cloud ERP offers the best solution for SMEs without the overheads of the huge investment and management costs that are associated with traditional ERP systems, the SME sector faces many challenges in their adoption. Traditional ERP studies have predominantly focused on large organizations, and gaps in the literature indicate that both vendor and consumer perspectives require more understanding with new technology offerings for SMEs. This paper describes some of the common challenges, such as cost effectiveness, alignment between software and business processes, customized governance and training, which form the major SME constraints for ERP system adoption. Due to the dynamic nature of SME businesses, best practice guidelines for an SME’s ERP implementation could be arrived at through closer investigation of its business requirements in order to avoid misfits. This forms the main objective of the study. We identify key success factors of ERP implementation in an Australian SME as a case study. These target success factors are then compared to the actual outcomes achieved. Factors such as business process alignment with the ERP system, meeting customer and stakeholder needs and reducing recurring and maintenance costs were key to the success of ERP implementation for the Australian SME. In particular, the IT and business strategy alignment with a customer focus and flexible reporting features of ERP systems has resulted in business agility.

Implementation of a Simplified State Estimator for Wind Turbine Monitoring on an Embedded System

DEFF Research Database (Denmark)

Rasmussen, Theis Bo; Yang, Guangya; Nielsen, Arne Hejde

2017-01-01

system, including individual DER, is time consuming and numerically challenging. This paper presents the approach and results of implementing a simplified state estimator onto an embedded system for improving DER monitoring. The implemented state estimator is based on numerically robust orthogonal......The transition towards a cyber-physical energy system (CPES) entails an increased dependency on valid data. Simultaneously, an increasing implementation of renewable generation leads to possible control actions at individual distributed energy resources (DERs). A state estimation covering the whole...

Building a Global Earth Observation System of Systems (GEOSS) and Its Interoperability Challenges

Science.gov (United States)

Ryan, B. J.

2015-12-01

Launched in 2005 by industrialized nations, the Group on Earth Observations (GEO) began building the Global Earth Observation System of Systems (GEOSS). Consisting of both a policy framework, and an information infrastructure, GEOSS, was intended to link and/or integrate the multitude of Earth observation systems, primarily operated by its Member Countries and Participating Organizations, so that users could more readily benefit from global information assets for a number of society's key environmental issues. It was recognized that having ready access to observations from multiple systems was a prerequisite for both environmental decision-making, as well as economic development. From the very start, it was also recognized that the shear complexity of the Earth's system cannot be captured by any single observation system, and that a federated, interoperable approach was necessary. While this international effort has met with much success, primarily in advancing broad, open data policies and practices, challenges remain. In 2014 (Geneva, Switzerland) and 2015 (Mexico City, Mexico), Ministers from GEO's Member Countries, including the European Commission, came together to assess progress made during the first decade (2005 to 2015), and approve implementation strategies and mechanisms for the second decade (2016 to 2025), respectively. The approved implementation strategies and mechanisms are intended to advance GEOSS development thereby facilitating the increased uptake of Earth observations for informed decision-making. Clearly there are interoperability challenges that are technological in nature, and several will be discussed in this presentation. There are, however, interoperability challenges that can be better characterized as economic, governmental and/or political in nature, and these will be discussed as well. With the emergence of the Sustainable Development Goals (SDGs), the World Conference on Disaster Risk Reduction (WCDRR), and the United Nations

Implementing Practical Based Courses under Open and Distance Learning System: A Study of the Perception of Learners and Counsellors

Science.gov (United States)

Basantia, Tapan Kumar

2018-01-01

Implementing practical based courses under Open and Distance Learning (ODL) system is a very difficult and challenging task as the teaching of practical based courses involves intensive practical work. For removing the difficulties and challenges in implementing the practical based courses under ODL system, there is a need to study the existing…

Connectivity and discontinuity in social work practice: Challenges and opportunities of the implementation of an e-social work system in Romania

Directory of Open Access Journals (Sweden)

Anca Mihai

2016-12-01

Full Text Available To increase the efficiency of the social work system in Romania, “investments in improving the current IT system in order to build an efficient electronic social work system” (Romanian Government, 2015b, 85 and the “development of a modern payment system” (Romanian Government, 2015b, 85 are key-points in the National Strategy concerning Social Inclusion and Poverty Reduction for the period 2015-2020. Among other utilisations, the e-social work system is meant to be used by potential clients when submitting a request to benefit of means-tested measures. The current level of digitalisation of the Romanian society, particularly among vulnerable groups, leaves room for constructive debate regarding the feasibility and the potential challenges of such a project. The purpose of this paper is to identify the challenges posed to social workers’ daily practice by the introduction of digitalisation in the work place, as well as its potential effects on the social worker-client professional relationship. We discuss based on the national strategies and data provided by the Digital Economy and Society Index (DESI (connectivity infrastructure and quality, digital skills of human capital, use of internet by citizens, integration and digital technology, and digital public services. We identify gaps between the aims and the proposed solutions concerning the e-social work system. Our study contributes to understanding the potential changes in social workers’ traditional roles brought forth by the implementation of a digitized social work system.

Obstacles and Challenges to Gender Parity. Political Violence, Electoral System and Interculturalism

Directory of Open Access Journals (Sweden)

Laura Albaine

2015-05-01

Full Text Available This study is a contribution to the debate about the adoption of gender parity policies in Latin America analyzing particular obstacles and challenges related to the implementation of this principle. Electoral systems tend to either optimize or reduce the impact of such gender parity measures. As well as with quotas, the size of the electoral district and the kind of electoral list system are the two variables that most influence the effective implementation of these measures. At the same time, the socio-cultural context also influences the process of implementation of gender parity measures. In patriarchal societies –with high levels of gender-based violence– electoral processes are often characterized by gender-based harassment and political violence, one of the greatest obstacles for increasing women’s political participation. These situations are further complicated in societies which are also characterized by ethnic and cultural diversity, presenting the challenge of including women who are also discriminated against for their ethno-cultural identity.

A successful enterprise system re-implementation against all odds – A multisourcing case study

DEFF Research Database (Denmark)

Svejvig, Per

2011-01-01

Achieving success in enterprise systems (ES) implementations is challenging. The success rate is not high in view of the sums invested by many organizations in these companywide systems. The literature is charged with reasons for unsuccessful implementations, such as a lack of top management supp...... support and insufficient change management. Contrary to this research, empirical data from an ES re-implementation in a Scandinavian high-tech company shows successful implementation despite many problematic shifts in outsourcing partners. Therefore, it is natural to ask: why was the re...

Post engineered nanomaterials lifespan: nanowastes classification, legislative development/implementation challenges, and proactive approaches

CSIR Research Space (South Africa)

Musee, N

2012-05-01

Full Text Available -1 NANOLCA Symposium, "Safety issues and regulatory challenges of nanomaterials", San Sebastian, Spain, 3-4 May 2012 Post engineered nanomaterials lifespan: nanowastes classification, legislative development/implementation challenges, and proactive...

ERP System Implementation: An Oil and Gas Exploration Sector Perspective

Science.gov (United States)

Mishra, Alok; Mishra, Deepti

Enterprise Resource Planning (ERP) systems provide integration and optimization of various business processes which leads to improved planning and decision quality, smoother coordination between business units resulting in higher efficiency, and quicker response time to customer demands and inquiries. This paper reports challenges, opportunities and outcome of ERP implementation in Oil & Gas exploration sector. This study will facilitate in understanding transition, constraints and implementation of ERP in this sector and also provide guidelines from lessons learned in this regard.

Characterising Extrinsic Challenges Linked to the Design and Implementation of Inquiry-Based Practical Work

Science.gov (United States)

Akuma, Fru Vitalis; Callaghan, Ronel

2017-11-01

Inquiry-based science education has been incorporated in science curricula internationally. In this regard, however, many teachers encounter challenges. The challenges have been characterised into those linked to the personal characteristics of these teachers (intrinsic challenges) and others associated with contextual factors (extrinsic challenges). However, this level of characterisation is inadequate in terms of appreciating the complexity of the challenges, tracking of their development, and discovering knowledge within specific categories. Against this background, the purpose of the research presented here was to characterise extrinsic challenges linked to the design and implementation of inquiry-based practical work. In order to do so, we used a conceptual framework of teaching challenges based on Bronfenbrenner's ecological theory of human development. The data gathered using a multi-method case study of practical work in two South African high schools, was analysed by combining the data-driven inductive approach and the deductive a priori template of codes approach in thematic analysis. On this basis, the extrinsic challenges linked to the design and implementation of inquiry-based practical work that participants are confronted with, were found to consist of macrosystem challenges (such as a restrictive curriculum) and microsystem challenges. At the latter level, the challenges are material-related (e.g., lack of science education equipment and materials) or non-material-related (such as time constraints and the lack of access to interactive computer simulations). We have discussed the theory-, practice- and research-based implications of these results in relation to the design and implementation of inquiry-based practical work in South Africa and internationally.

Precision Medicine and PET/Computed Tomography: Challenges and Implementation.

Science.gov (United States)

Subramaniam, Rathan M

2017-01-01

Precision Medicine is about selecting the right therapy for the right patient, at the right time, specific to the molecular targets expressed by disease or tumors, in the context of patient's environment and lifestyle. Some of the challenges for delivery of precision medicine in oncology include biomarkers for patient selection for enrichment-precision diagnostics, mapping out tumor heterogeneity that contributes to therapy failures, and early therapy assessment to identify resistance to therapies. PET/computed tomography offers solutions in these important areas of challenges and facilitates implementation of precision medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

Basel III implementation: Issues and challenges for Indian banks

Directory of Open Access Journals (Sweden)

M. Jayadev

2013-06-01

Full Text Available The Basel III framework, whose main thrust has been enhancing the banking sector's safety and stability, emphasises the need to improve the quality and quantity of capital components, leverage ratio, liquidity standards, and enhanced disclosures. This article first lays the context of Basel III and then incorporates the views of senior executives of Indian banks and risk management experts on addressing the challenges of implementing the Basel III framework, especially in areas such as augmentation of capital resources, growth versus financial stability, challenges for enhanced profitability, deposit pricing, cost of credit, maintenance of liquidity standards, and strengthening of risk architecture.

Environmental and Social Management System Implementation Handbook : Animal Production

OpenAIRE

International Finance Corporation

2014-01-01

Environmental and social responsibility is becoming more and more important in todayapos;s global economy. There are thousands of environmental and social codes and standards in the world today. The codes and standards define the rules and the objectives. But the challenge is in the implementation. An environmental and social management system (ESMS) helps companies to integrate the ru...

Implementing a Reentry Framework at a Correctional Facility: Challenges to the Culture

Science.gov (United States)

Rudes, Danielle S.; Lerch, Jennifer; Taxman, Faye S.

2011-01-01

Implementation research is emerging in the field of corrections, but few studies have examined the complexities associated with implementing change among frontline workers embedded in specific organizational cultures. Using a mixed methods approach, the authors examine the challenges faced by correctional workers in a work release correctional…

E-Governance and Its Implementation Challenges in the Nigerian Public Service

Directory of Open Access Journals (Sweden)

Ugochukwu David ABASILIM

2015-09-01

Full Text Available E-governance has become one of the reform tools geared towards effective public service delivery, which is premised on the assumption that the appreciable use of Information and Communication Technologies (ICT method in the day to day activities of government will bring effective service delivery. However, there are lots of challenges that hamper the effective implementation of e-governance in Nigerian public service. It is based on this, that this article identifies some of the challenges to e-governance implementation in Nigerian public service. Although, no robust statistical analysis was done, as the article relied on archival analysis of relevant literature on the subject matter and inferences drawn from it. Based on its findings, it was concluded that e-governance remain the best in encouraging transparency and accountability in government business. The paper therefore, recommends that, government should be more committed to the implementation e-governance as well as embark on adequate enlightenment about the concept.

Restructuring Principal Preparation in Illinois: Perspectives on Implementation Successes, Challenges, and Future Outlook. Executive Summary. IERC 2015-3

Science.gov (United States)

Klostermann, Brenda K.; Pareja, Amber Stitziel; Hart, Holly; White, Bradford R.; Huynh, Michelle Hanh

2015-01-01

The goals of the current mixed methods study--the Illinois Principal Preparation Implementation Review Project (I-PREP)--are to describe how the new policy is being implemented, learning which aspects of the implementation have been challenging and why they present challenges, and how programs are addressing challenges and realizing improvements…

Challenges of Implementing E-Learning in Kenya: A Case of Kenyan Public Universities

Science.gov (United States)

Tarus, John K.; Gichoya, David; Muumbo, Alex

2015-01-01

In this paper, we discuss the challenges experienced by Kenyan public universities in implementation of e-learning and recommend possible solutions towards its successful implementation. In the last few years, most Kenyan public universities have adopted e-learning as a new approach to teaching and learning. However, the implementation challenges…

The challenge of greening energy systems

International Nuclear Information System (INIS)

Joseph, A.; Hughes, L.

2006-01-01

The current state of world energy supply and demand was examined along with future challenges facing population growth, economic growth, energy-demand growth, fossil energy supply, technology improvements, renewable energy solutions, and conservation measures. It was suggested that in order to implement cleaner and greener energy technology, it is important to understand the nature of global energy systems. The challenge of defining the related ideologies of green energy and sustainability was discussed. In this paper, green energy was defined as indicating environmental compatibility with little or no negative environmental impact. This differs from the concept of sustainability, which was defined as an action that can be repeated continuously without depleting or diminishing resources. In general, green energy options include most technologies that do not involve fossil fuels. However, this paper considered a spectrum of shades of green with some options being low-impact and cleaner, and others having high environmental impacts. As an example, the authors presented the ongoing debate over nuclear energy and hydro power. Although both energy sources can be sustainable over hundreds of years, they may or may not be environmentally compatible because they are often considered to have problematic attributes. Energy from renewable sources currently accounts for less than 20 per cent of world primary energy supply because price and implementation challenges in the renewables sector do not generally compare well to other energy sources. With high energy-demands beginning to strain finite fossil-energy supplies, the energy sector is now subject to more frequent disruptions and price fluctuations. Future growth from emerging economies will demand more energy and resources. This paper also emphasized that the proportion of green sources of energy has not increased substantially in the past 3 decades, and despite many technological advances, there continue to be significant

The challenge of greening energy systems

Energy Technology Data Exchange (ETDEWEB)

Joseph, A.; Hughes, L. [Dalhousie Univ., Halifax, NS (Canada). Dept. of Electrical and Computer Engineering, Energy Research Group

2006-07-01

The current state of world energy supply and demand was examined along with future challenges facing population growth, economic growth, energy-demand growth, fossil energy supply, technology improvements, renewable energy solutions, and conservation measures. It was suggested that in order to implement cleaner and greener energy technology, it is important to understand the nature of global energy systems. The challenge of defining the related ideologies of green energy and sustainability was discussed. In this paper, green energy was defined as indicating environmental compatibility with little or no negative environmental impact. This differs from the concept of sustainability, which was defined as an action that can be repeated continuously without depleting or diminishing resources. In general, green energy options include most technologies that do not involve fossil fuels. However, this paper considered a spectrum of shades of green with some options being low-impact and cleaner, and others having high environmental impacts. As an example, the authors presented the ongoing debate over nuclear energy and hydro power. Although both energy sources can be sustainable over hundreds of years, they may or may not be environmentally compatible because they are often considered to have problematic attributes. Energy from renewable sources currently accounts for less than 20 per cent of world primary energy supply because price and implementation challenges in the renewables sector do not generally compare well to other energy sources. With high energy-demands beginning to strain finite fossil-energy supplies, the energy sector is now subject to more frequent disruptions and price fluctuations. Future growth from emerging economies will demand more energy and resources. This paper also emphasized that the proportion of green sources of energy has not increased substantially in the past 3 decades, and despite many technological advances, there continue to be significant

Norne -- The organization challenge/implementing change

International Nuclear Information System (INIS)

Adlam, J.

1995-01-01

Faced with the need to drastically improve performance in both the development and operating of new fields Statoil has used the Norne development as a pilot project to investigate means of achieving this goal. The paper will describe the challenge that faced the Norne leadership and the organizational and attitude improvement actions implemented to overcome them and to motivate the organization to achieve significant goals. Emphasize is placed on integration not only of the project and operations organizations but the client and contractor teams as well. Contract forms most suited to produce the max. life cycle results were investigated and applied. The development of a ''learning'' organization is seen as a key factor

Challenges with the introduction of radio-frequency identification systems into a manufacturer's supply chain - a pilot study

Science.gov (United States)

Kumar, Sameer; Kadow, Brooke B.; Lamkin, Melissa K.

2011-05-01

As radio-frequency identification (RFID) implementation becomes more widespread it is important for managers to consider if this technology is right for their businesses. This study examines challenges of RFID implementation along with a cost-benefit analysis of a pharmaceuticals manufacturer's supply chain. Research was gathered from a variety of sources on the topic of RFID to provide an in-depth analysis of challenges and benefits found with RFID systems. Furthermore, the study reviews the real case applications of the RFID technology in healthcare and customer services. Many of the challenges with RFID stem from improper planning of the synchronisation of the supply chain and the integration of RFID technology into facilities and software systems. Customer privacy, excess information and obsolete technology are also of concern to companies considering RFID. Benefits such as increased information sharing, product visibility and real-time information help to offset these challenges. In addition, pharmaceuticals manufacturer real case application showed cost savings from reducing labour and decreased opportunities for lost product counteract the expense to implement an RFID system. This study will be of value to managers who are attempting to implement RFID technology in their companies. It is intended that readers, both academics and practitioners, will be able to identify possible challenges and mitigate them as the RFID technology is put into practice.

Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa

Directory of Open Access Journals (Sweden)

Leon Natalie

2012-11-01

Full Text Available Abstract Background Mobile phone technology has demonstrated the potential to improve health service delivery, but there is little guidance to inform decisions about acquiring and implementing mHealth technology at scale in health systems. Using the case of community-based health services (CBS in South Africa, we apply a framework to appraise the opportunities and challenges to effective implementation of mHealth at scale in health systems. Methods A qualitative study reviewed the benefits and challenges of mHealth in community-based services in South Africa, through a combination of key informant interviews, site visits to local projects and document reviews. Using a framework adapted from three approaches to reviewing sustainable information and communication technology (ICT, the lessons from local experience and elsewhere formed the basis of a wider consideration of scale up challenges in South Africa. Results Four key system dimensions were identified and assessed: government stewardship and the organisational, technological and financial systems. In South Africa, the opportunities for successful implementation of mHealth include the high prevalence of mobile phones, a supportive policy environment for eHealth, successful use of mHealth for CBS in a number of projects and a well-developed ICT industry. However there are weaknesses in other key health systems areas such as organisational culture and capacity for using health information for management, and the poor availability and use of ICT in primary health care. The technological challenges include the complexity of ensuring interoperability and integration of information systems and securing privacy of information. Finally, there are the challenges of sustainable financing required for large scale use of mobile phone technology in resource limited settings. Conclusion Against a background of a health system with a weak ICT environment and limited implementation capacity, it remains

[Sustainability and excellence of the Catalan health system. New paradigms, challenges and responses].

Science.gov (United States)

Fernández i Alegre, Roser; Argenter i Giralt, Miquel; Rodríguez i Guasch, Xavier

2015-11-01

The aim of a health system and the priority of any government is to anticipate problems before they appear, provide an innovative response to these new needs and healthcare models, improve access of the general public and patients to health care, especially care for the most vulnerable groups, improve healthcare results and implement the structural reforms necessary to maintain a viable and sustainable quality public healthcare system for everyone. In the current environment, health systems are facing new economic, demographic, care, social, technological and political paradigms to which health policy must respond. Faced with these challenges, health systems, especially in the case of Catalonia, are challenged to take decisions on how best to approach the implementation of structural reform designed to facilitate the necessary economic and fiscal sustainability in the service of fresh and innovative health policies and patient-centred care within a system marked by excellence and equity. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Challenges of implementing routine health behavior change support in a children's hospital setting.

Science.gov (United States)

Elwell, Laura; Powell, Jane; Wordsworth, Sharon; Cummins, Carole

2014-07-01

Evidence indicates that health behavior change initiatives are often not implemented successfully. This qualitative study aims to understand the barriers and facilitators to implementation of health behavior change brief advice into routine practice in an acute children's hospital setting. Semi-structured interviews were conducted with health professionals working at a UK children's hospital (n=33). Participants were purposively sampled to incorporate a range of specialties, job roles and training. An inductive thematic framework analysis identified two emergent themes. These capture the challenges of implementing routine health behavior change support in a children's hospital setting: (1) 'health professional knowledge, beliefs and behaviors' and (2) 'patient and family related challenges'. This study enhances findings from previous research by outlining the challenges pediatric health professionals face in relation to supporting health behavior change. Challenges include failure to assume responsibility, low confidence, prioritization of the health provider relationship with patients and families, health provider and patient knowledge, and low patient and family motivation. Skills-based behavior change training is needed for pediatric health professionals to effectively support health behavior change. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Are We There Yet? Human Factors Knowledge and Health Information Technology - the Challenges of Implementation and Impact.

Science.gov (United States)

Turner, P; Kushniruk, A; Nohr, C

2017-08-01

Objective: To review the developments in human factors (HF) research on the challenges of health information technology (HIT) implementation and impact given the continuing incidence of usability problems and unintended consequences from HIT development and use. Methods: A search of PubMed/Medline and Web of Science® identified HF research published in 2015 and 2016. Electronic health records (EHRs) and patient-centred HIT emerged as significant foci of recent HF research. The authors selected prominent papers highlighting ongoing HF and usability challenges in these areas. This selective rather than systematic review of recent HF research highlights these key challenges and reflects on their implications on the future impact of HF research on HIT. Results: Research provides evidence of continued poor design, implementation, and usability of HIT, as well as technology-induced errors and unintended consequences. The paper highlights support for: (i) strengthening the evidence base on the benefits of HF approaches; (ii) improving knowledge translation in the implementation of HF approaches during HIT design, implementation, and evaluation; (iii) increasing transparency, governance, and enforcement of HF best practices at all stages of the HIT system development life cycle. Discussion and Conclusion: HF and usability approaches are yet to become embedded as integral components of HIT development, implementation, and impact assessment. As HIT becomes ever-more pervasive including with patients as end-users, there is a need to expand our conceptualisation of the problems to be addressed and the suite of tactics and strategies to be used to calibrate our pro-active involvement in its improvement. Georg Thieme Verlag KG Stuttgart.

Implementing national strategies on antimicrobial resistance in Thailand: potential challenges and solutions.

Science.gov (United States)

Sommanustweechai, A; Tangcharoensathien, V; Malathum, K; Sumpradit, N; Kiatying-Angsulee, N; Janejai, N; Jaroenpoj, S

2018-04-01

Thailand has developed a national strategic plan on antimicrobial resistance (NSP-AMR) and endorsed by the Cabinet in August 2016. This study reviewed the main contents of the NSP-AMR and the mandates of relevant implementing agencies and identified challenges and recommends actions to mitigate implementation gaps. This study analysed the contents of NSP-AMR, reviewed institutional mandates and assessed the implementation gaps among agencies responsible for NSP-AMR. Two of six strategies are related to monitoring and surveillance of AMR and antimicrobial consumption in human and animal. Two other strategies aim to improve antibiotic stewardship and control the spread of AMR in both clinical and farm settings. The remaining two strategies aim to increase knowledge and public awareness on AMR and establish national governance for inter-sectoral actions. Strategies to overcome implementation challenges are sustaining cross-sectoral policy commitments, effective cross-sectoral coordination using One Health approach, generating evidence which guides policy implementation, and improving enforcement capacities in regulatory authorities. To address AMR, Thailand requires significant improvements in implementation capacities in two dimensions. First, technical capacities among implementing agencies are needed to translate policies into practice. Second, governance and organizational capacities enable effective multi-sectoral actions across human, animal, and environmental sectors. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Design and Implementation of the ATLAS Detector Control System

CERN Document Server

Boterenbrood, H; Cook, J; Filimonov, V; Hallgren, B I; Heubers, W P J; Khomoutnikov, V; Ryabov, Yu; Varela, F

2004-01-01

The overall dimensions of the ATLAS experiment and its harsh environment, due to radiation and magnetic field, represent new challenges for the implementation of the Detector Control System. It supervises all hardware of the ATLAS detector, monitors the infrastructure of the experiment, and provides information exchange with the LHC accelerator. The system must allow for the operation of the different ATLAS sub-detectors in stand-alone mode, as required for calibration and debugging, as well as the coherent and integrated operation of all sub-detectors for physics data taking. For this reason, the Detector Control System is logically arranged to map the hierarchical organization of the ATLAS detector. Special requirements are placed onto the ATLAS Detector Control System because of the large number of distributed I/O channels and of the inaccessibility of the equipment during operation. Standardization is a crucial issue for the design and implementation of the control system because of the large variety of e...

Next Generation Surveillance System (NGSS): Field Implementation & Associated Developments

International Nuclear Information System (INIS)

Hadfi, G.; John, M.; Liguori, C.; Moeslinger, M.; Murray, J.; Rocchi, S.

2015-01-01

The NGSS is the product of more than five years of development between the IAEA, other Inspectorates, Member State Support Programmes, and commercial vendors. The product of these efforts has now matured into the field implementation stage. This paper details the goals, achievements and challenges experienced during the implementation phase and associated developments of the project. NGSS procurement was subject to the IAEA's stringent procurement policies involving independent third party assessments to assure supplier reliability and competitive pricing controls. More than 1200 surveillance cameras currently installed in facilities worldwide will be replaced by NGSS within the next 4 to 5 years. Joint use procedures have been established taking advantage of the technical capabilities integrated within the design of the NGSS which allow for multiple inspectorates and States to securely and independently share and review data. Utilization of outdated facility infrastructure poses many challenges to implementation efforts; these were met with innovative technical solutions to take advantage of cost benefits allowed in its re-utilization. New partnerships were established with Member States, regulatory bodies and nuclear power plant operators for new nuclear facilities under construction, to address infrastructural requirements spanning the next half century. The utilization of the IAEA's well-established PKI infrastructure enhances data security features and usability with regard to data sharing, key management and joint use of the NGSS system data. Embedded inventory reporting capability aids electronic inventory verification of safeguards equipment, simplifying accountability, configuration control and troubleshooting of installed systems. Current developments ongoing within the project include the design of hardware and software components for use of the system in special applications (e.g., underwater and outdoor installations, mechanism to

Promises and Challenges of Thorium Implementation for Transuranic Transmutation - 13550

Energy Technology Data Exchange (ETDEWEB)

Franceschini, F.; Lahoda, E.; Wenner, M. [Westinghouse Electric Company LLC, Cranberry Township, PA (United States); Lindley, B. [University of Cambridge (United Kingdom); Fiorina, C. [Polytechnic of Milan (Italy); Phillips, C. [Energy Solutions, Richland, WA (United States)

2013-07-01

This paper focuses on the challenges of implementing a thorium fuel cycle for recycle and transmutation of long-lived actinide components from used nuclear fuel. A multi-stage reactor system is proposed; the first stage consists of current UO{sub 2} once-through LWRs supplying transuranic isotopes that are continuously recycled and burned in second stage reactors in either a uranium (U) or thorium (Th) carrier. The second stage reactors considered for the analysis are Reduced Moderation Pressurized Water Reactors (RMPWRs), reconfigured from current PWR core designs, and Fast Reactors (FRs) with a burner core design. While both RMPWRs and FRs can in principle be employed, each reactor and associated technology has pros and cons. FRs have unmatched flexibility and transmutation efficiency. RMPWRs have higher fuel manufacturing and reprocessing requirements, but may represent a cheaper solution and the opportunity for a shorter time to licensing and deployment. All options require substantial developments in manufacturing, due to the high radiation field, and reprocessing, due to the very high actinide recovery ratio to elicit the claimed radiotoxicity reduction. Th reduces the number of transmutation reactors, and is required to enable a viable RMPWR design, but presents additional challenges on manufacturing and reprocessing. The tradeoff between the various options does not make the choice obvious. Moreover, without an overarching supporting policy in place, the costly and challenging technologies required inherently discourage industrialization of any transmutation scheme, regardless of the adoption of U or Th. (authors)

Health system capacity: maternal health policy implementation in the state of Gujarat, India

Directory of Open Access Journals (Sweden)

Linda Sanneving

2013-03-01

Full Text Available Introduction: The Government of Gujarat has for the past couple of decades continuously initiated several interventions to improve access to care for pregnant and delivering women within the state. Data from the last District Family Heath survey in Gujarat in 2007–2008 show that 56.4% of women had institutional deliveries and 71.5% had at least one antenatal check-up, indicating that challenges remain in increasing use of and access to maternal health care services. Objective: To explore the perceptions of high-level stakeholders on the process of implementing maternal health interventions in Gujarat. Method: Using the policy triangle framework developed by Walt and Gilson, the process of implementation was approached using in-depth interviews and qualitative content analysis. Result: Based on the analysis, three themes were developed: lack of continuity; the complexity of coordination; and lack of confidence and underutilization of the monitoring system. The findings suggest that decisions made and actions advocated and taken are more dependent on individual actors than on sustainable structures. The findings also indicate that the context in which interventions are implemented is challenged in terms of weak coordination and monitoring systems that are not used to evaluate and develop interventions on maternal health. Conclusions: The implementation of interventions on maternal health is dependent on the capacity of the health system to implement evidence-based policies. The capacity of the health system in Gujarat to facilitate implementation of maternal health interventions needs to be improved, both in terms of the role of actors and in terms of structures and processes.

Implementing the theories: A fully integrated project control system that's implemented and works

International Nuclear Information System (INIS)

Harris, R.E.

1994-01-01

Using the theories presented in DOE Orders 4700.1, 1332.1A, and Notice 4700.5 as the basis for system design, the Fernald Environmental Restoration Management Corporation (FERMCO) has developed and implemented a Project Control System (PCS) that complies with requirements and provides DOE and FERMCO management with timely performance measurement information. To this extent, the FERMCO PCS probably is similar to the systems of the majority of the contractors in the DOE complex. In fact. this facet of the FERMCO PCS generally mirrors those used on projects around the world by FERMCO's parent company, Fluor Daniel. Starting with this open-quotes platformclose quotes, the vision and challenge of creating a fully integrated system commenced. An open-architecture systems approach is the factor that most greatly influenced and enabled the successful development and implementation of the Project Control System for the Fernald Environmental Management Project. All aspects of a fully integrated system were considered during the design phase. The architecture of the FERMCO system enables seamless, near real-time, transfer of data both from and to the Project Control System with all other related systems. The primary systems that provide and share data with the Project Control System include those used by the Payroll, Accounting, Procurement, and Human Resources organizations. To enable data linking with these organizations, the resource codes were designed to map many-to-one from their detailed codes to the summarized codes used in the PCS

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

Science.gov (United States)

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

2017-01-01

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

The Grand Challenges of WCRP and the Climate Observing System of the Future

Science.gov (United States)

Brasseur, G. P.

2017-12-01

The successful implementation the Paris agreement on climate change (COP21) calls for a well-designed global monitoring system of essential climate variables, climate processes and Earth system budgets. The Grand Challenges implemented by the World Climate Research Programme (WCRP) provide an opportunity to investigate issues of high societal relevance, directly related to sea level rise, droughts, floods, extreme heat events, food security, and fresh water availability. These challenges would directly benefit from a well-designed suite of systematic climate observations. Quantification of the evolution of the global energy, water and carbon budgets as well as the development and the production of near-term and regional climate predictions require that a comprehensive, focused, multi-platform observing system (satellites, ground-based and in situ observations) be established in an international context. This system must be accompanied by the development of climate services that should translate and disseminate scientific outcomes as actionable information for users and stakeholders.

Using Runtime Systems Tools to Implement Efficient Preconditioners for Heterogeneous Architectures

Directory of Open Access Journals (Sweden)

Roussel Adrien

2016-11-01

Full Text Available Solving large sparse linear systems is a time-consuming step in basin modeling or reservoir simulation. The choice of a robust preconditioner strongly impact the performance of the overall simulation. Heterogeneous architectures based on General Purpose computing on Graphic Processing Units (GPGPU or many-core architectures introduce programming challenges which can be managed in a transparent way for developer with the use of runtime systems. Nevertheless, algorithms need to be well suited for these massively parallel architectures. In this paper, we present preconditioning techniques which enable to take advantage of emerging architectures. We also present our task-based implementations through the use of the HARTS (Heterogeneous Abstract RunTime System runtime system, which aims to manage the recent architectures. We focus on two preconditoners. The first is ILU(0 preconditioner implemented on distributing memory systems. The second one is a multi-level domain decomposition method implemented on a shared-memory system. Obtained results are then presented on corresponding architectures, which open the way to discuss on the scalability of such methods according to numerical performances while keeping in mind that the next step is to propose a massively parallel implementations of these techniques.

Using iKidTools™ Software Support Systems to Develop and Implement Self-Monitoring Interventions

Science.gov (United States)

Patti, Angela L.; Miller, Kevin J.

2011-01-01

Educational teams often are faced with the task of developing and implementing Behavioral Intervention Plans (BIPs) for students who present challenging and/or disruptive behaviors. This article describes the steps used to develop and implement a self-monitoring BIP that incorporated an innovative software system, iKidTools™. An authentic case…

Patterns of enterprise system implementation - the case of Chinese aerospace corporate transformation

NARCIS (Netherlands)

Ma, Xiaofeng

2008-01-01

This dissertation aims to identify patterns in the managerial processes during an enterprise system implementation (ESI) period. An ESI remains a notorious challenge. In most cases, it concurrently involves business strategy change, organizational change, and technical innovation. This dissertation

Rehabilitation in Madagascar: Challenges in implementing the World Health Organization Disability Action Plan.

Science.gov (United States)

Khan, Fary; Amatya, Bhasker; Mannan, Hasheem; Burkle, Frederick M; Galea, Mary P

2015-09-01

To provide an update on rehabilitation in Madagascar by using local knowledge to outline the potential barriers and facilitators for implementation of the World Health Organization (WHO) Disability Action Plan (DAP). A 14-day extensive workshop programme (September-October 2014) was held at the University Hospital Antananarivo and Antsirabe, with the Department of Health Madagascar, by rehabilitation staff from Royal Melbourne Hospital, Australia. Attendees were rehabilitation professionals (n=29) from 3 main rehabilitation facilities in Madagascar, who identified various challenges faced in service provision, education and attitudes/approaches to people with disabilities. Their responses and suggested barriers/facilitators were recorded following consensus agreement, using objectives listed in the DAP. The barriers and facilitators outlined by participants in implementing the DAP objectives include: engagement of health professionals and institutions using a multi-sectoral approach, new partnerships, strategic collaboration, provision of technical assistance, future policy directions, and research and development. Other challenges for many basic policies included: access to rehabilitation services, geographical coverage, shortage of skilled work-force, limited info-technology systems; lack of care-models and facility/staff accreditation standards; limited health services infrastructure and "disconnect" between acute and community-based rehabilitation. The DAP summary actions were useful planning tools to improve access, strengthen rehabilitation services and community-based rehabilitation, and collate data for outcome research.

Implementation of Service-Learning in Business Education: Issues and Challenges

Science.gov (United States)

Poon, Patrick; Chan, Tsang Sing; Zhou, Lianxi

2011-01-01

This paper examines the issues and challenges in the implementation of service-learning in undergraduate business education. It also provides an assessment of the students' learning efficacy and outcomes over time through the service-learning participation. Service-learning is a pedagogical approach that integrates academic learning and community…

EVALUATION OF SUSTAINABLE DEVELOPMENT FRAMEWORK FOR VOCATIONAL COLLEGES: IMPLEMENTATION AND CHALLENGES

OpenAIRE

Minghat, Asnul Dahar; Safie, Siti Nadia Mohd; Mustakim, Siti Salina

2018-01-01

The main purpose of this study was to explore the extensive growth of courses among the Vocational Colleges developed by the Ministry of Education since 2012. In order to determine the sustainability of the development, this study specifically seeks to explore the scope and quality of Vocational Colleges’ Curriculum Standard implementation via the integration of sustainability development among educators, and to investigate challenges occurred during the implementation of the college ever sin...

Implementation challenges of a motor operated valve program

International Nuclear Information System (INIS)

Ferguson, T.L.

1995-01-01

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

The challenges of integrating multiple safeguards systems in a large nuclear facility

International Nuclear Information System (INIS)

Lavietes, A.; Liguori, C.; Pickrell, M.; Plenteda, R.; Sweet, M.

2009-01-01

Full-text: Implementing safeguards in a cost-effective manner in large nuclear facilities such as fuel conditioning, fuel reprocessing, and fuel fabrication plants requires the extensive use of instrumentation that is operated in unattended mode. The collected data is then periodically reviewed by the inspectors either on-site at a central location in the facility or remotely in the IAEA offices. A wide variety of instruments are deployed in large facilities, including video surveillance cameras, electronic sealing devices, non-destructive assay systems based on gamma ray and neutron detection, load cells for mass measurement, ID-readers, and other process-specific monitors. The challenge to integrate these different measurement instruments into an efficient, reliable, and secure system requires implementing standardization at various levels throughout the design process. This standardization includes the data generator behaviour and interface, networking solutions, and data security approaches. This standardization will provide a wide range of savings, including reduced training for inspectors and technicians, reduced periodic technical maintenance, reduced spare parts inventory, increased system robustness, and more predictive system behaviour. The development of standard building blocks will reduce the number of data generators required and allow implementation of simplified architectures that do not require local collection computers but rather utilize transmission of the acquired data directly to a central server via Ethernet connectivity. This approach will result in fewer system components and therefore reduced maintenance efforts and improved reliability. This paper discusses in detail the challenges and the subsequent solutions in the various areas that the IAEA Department of Safeguards has committed to pursue as the best sustainable way of maintaining the ability to implement reliable safeguards systems. (author)

Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

Science.gov (United States)

Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

2018-04-18

complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa. ©Naomi Muinga, Steve Magare, Jonathan Monda, Onesmus Kamau, Stuart Houston, Hamish Fraser, John Powell, Mike English, Chris Paton. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 18.04.2018.

Wind of Change or Wind of Challenges: Implementation factors regarding wind energy development, an international perspective

Directory of Open Access Journals (Sweden)

Victoria Gartman

2014-12-01

Full Text Available Countries promoting renewable energies encounter a variety of phenomena that can challenge the implementation of further onshore wind energy development. Those challenges can be observed in many multi-level governance systems, as exhibited in the U.S., Germany, and Mexico, where various regulatory and institutional levels must agree on goals and responsibilities. This is a challenge, as both forms of governance (top-down and bottom-up dominated are present in wind energy planning and policy. (1 Political and market phenomena, (2 siting issues, (3 the green vs. green dilemma, and (4 social acceptance are selected challenges within the different levels of decision-making processes in wind energy implementation. (1 Political and financial factors can influence the development by implementing incentive- and market-based policies, command-and-control policies, and feed-in tariffs. However, success of these policy designs for renewable energies is based on different political environments, and their electricity markets nationally, regionally, or statewide. (2 Spatial limitations in planning are created based on limited land availability due to conflicts with other land uses such as aviation, nature reserves, residential areas, their respective buffers. (3 The "green vs. green" dilemma involves the incoherent relationship between policies promoting renewable energies with policies protection species and their environments, becoming a major point of concern during siting and operations of wind energy. (4 Lastly, while there is a general overall support for wind energy, social acceptance on a local level is influenced by institutional settings i.e. information availability, as well as public and stakeholder concerns. Involvement in decision-making as well as financial participation (e.g. community-ownership affects public participation and acceptance. This paper goes into detail on these phenomena and discusses case studies in Europe and North America

Methods and metrics challenges of delivery-system research

Directory of Open Access Journals (Sweden)

Alexander Jeffrey A

2012-03-01

Full Text Available Abstract Background Many delivery-system interventions are fundamentally about change in social systems (both planned and unplanned. This systems perspective raises a number of methodological challenges for studying the effects of delivery-system change--particularly for answering questions related to whether the change will work under different conditions and how the change is integrated (or not into the operating context of the delivery system. Methods The purpose of this paper is to describe the methodological and measurement challenges posed by five key issues in delivery-system research: (1 modeling intervention context; (2 measuring readiness for change; (3 assessing intervention fidelity and sustainability; (4 assessing complex, multicomponent interventions; and (5 incorporating time in delivery-system models to discuss recommendations for addressing these issues. For each issue, we provide recommendations for how research may be designed and implemented to overcome these challenges. Results and conclusions We suggest that a more refined understanding of the mechanisms underlying delivery-system interventions (treatment theory and the ways in which outcomes for different classes of individuals change over time are fundamental starting points for capturing the heterogeneity in samples of individuals exposed to delivery-system interventions. To support the research recommendations outlined in this paper and to advance understanding of the "why" and "how" questions of delivery-system change and their effects, funding agencies should consider supporting studies with larger organizational sample sizes; longer duration; and nontraditional, mixed-methods designs. A version of this paper was prepared under contract with the Agency for Healthcare Research and Quality (AHRQ, US Department of Health and Human Services for presentation and discussion at a meeting on "The Challenge and Promise of Delivery System Research," held in Sterling, VA, on

Pre-Ebola virus disease laboratory system and related challenges in Liberia

Directory of Open Access Journals (Sweden)

Stephen B. Kennedy

2016-10-01

Full Text Available Prior to the Ebola virus disease outbreak in Liberia, the laboratory system was duplicativefragmented and minimally coordinated. The National Reference Laboratory was conceptualisedto address the existing challenges by promoting the implementation of effective and sustainablelaboratory services in Liberia. However, in a resource-limited environment such as Liberiaprogress regarding the rebuilding of the health system can be relatively slow, while efforts tosustain the transient gains remain a key challenge for the Ministry of Health. In this paper, wedescribe the pre-Ebola virus disease laboratory system in Liberia and its prevailing efforts toaddress future emerging infectious diseases, as well as current Infectious diseases, all of whichare exacerbated by poverty. We conclude that laboratory and diagnostic services in Liberiahave encountered numerous challenges regarding its efforts to strengthen the healthcaredelivery system. These challenges include limited trained human resource capacity, inadequateinfrastructure, and a lack of coordination. As with most countries in sub-Saharan Africa, whencomparing urban and rural settings, diagnostic and clinical services are generally skewedtoward urban health facilities and private, faith-based health facilities. We recommend thatstructured policy be directed at these challenges for national institutions to develop guidelinesto improve, strengthen and sustain diagnostic and curative laboratory services to effectivelyaddress current infectious diseases and prepare for future emerging and re-emerging infectiousdiseases.

Implementing Active Learning Reform in the Maldives: Challenges and Opportunities

Science.gov (United States)

Di Biase, Rhonda

2009-01-01

Many countries are adopting child-centered active learning reforms as they strive to improve the quality of primary education. Consistent challenges can be found in the implementation of similar, global reforms. These issues are discussed here within the following framework: the cultural appropriateness of such reforms; the extent to which active…

Smart wearable systems: current status and future challenges.

Science.gov (United States)

Chan, Marie; Estève, Daniel; Fourniols, Jean-Yves; Escriba, Christophe; Campo, Eric

2012-11-01

Extensive efforts have been made in both academia and industry in the research and development of smart wearable systems (SWS) for health monitoring (HM). Primarily influenced by skyrocketing healthcare costs and supported by recent technological advances in micro- and nanotechnologies, miniaturisation of sensors, and smart fabrics, the continuous advances in SWS will progressively change the landscape of healthcare by allowing individual management and continuous monitoring of a patient's health status. Consisting of various components and devices, ranging from sensors and actuators to multimedia devices, these systems support complex healthcare applications and enable low-cost wearable, non-invasive alternatives for continuous 24-h monitoring of health, activity, mobility, and mental status, both indoors and outdoors. Our objective has been to examine the current research in wearable to serve as references for researchers and provide perspectives for future research. Herein, we review the current research and development of and the challenges facing SWS for HM, focusing on multi-parameter physiological sensor systems and activity and mobility measurement system designs that reliably measure mobility or vital signs and integrate real-time decision support processing for disease prevention, symptom detection, and diagnosis. For this literature review, we have chosen specific selection criteria to include papers in which wearable systems or devices are covered. We describe the state of the art in SWS and provide a survey of recent implementations of wearable health-care systems. We describe current issues, challenges, and prospects of SWS. We conclude by identifying the future challenges facing SWS for HM. Copyright © 2012 Elsevier B.V. All rights reserved.

What Are the Professional, Political, and Ethical Challenges of Co-Creating Health Care Systems?

Science.gov (United States)

Singh, Guddi; Owens, John; Cribb, Alan

2017-11-01

Co-creation is seen by many as a means of meeting the multiple challenges facing contemporary health care systems by involving institutions, professionals, patients, and stakeholders in new roles, relationships, and collaborative practices. While co-creation has the potential to positively transform health care systems, it generates a number of political and ethical challenges that should not be overlooked. We suggest that those involved in envisioning and implementing co-creation initiatives pay close attention to significant questions of equity, power, and justice and to the fundamental challenge of securing a common vision of the aims of and agendas for health care systems. While such initiatives present significant opportunities for improvement, they need to be viewed in light of their accompanying professional, political, and ethical challenges. © 2017 American Medical Association. All Rights Reserved.

The Challenge of City-Level Data-Gathering for Implementing SDG 11 in Africa

Science.gov (United States)

Elias, P. O.

2017-12-01

Implementing sustainable development goal 11 in Africa which includes measuring and monitoring social and economic welfare indicators at the city-level requires data of the best quality. In recent years, there have been progress in national statistics and censuses survey yet data gathering in many African countries are not accurate, timely, disaggregated and widely usable. This often diminish the capability of governments to tackle urban development challenges, which are particularly exacerbated by inequality, poverty and uncontrolled development especially in cities. To support knowledge driven decisions and policies there is need to improve data-gathering systems about health, education, and safety, economy and poverty, land, housing and environment, trade and commerce, population and demography. Also, the underlying dynamics, processes, distributions, patterns, trends or disparities inherent in African cities require the breaking down of aggregated data into their component parts or smaller units, which underscores urban data revolution towards achieving SDG 11. In Africa, the process of bringing together diverse data communities to embrace a diverse range of data sources, tools, and innovative technologies, to provide disaggregated data for decision-making, service delivery and citizen engagement is still emerging. Several factors are inhibiting urban data revolution and need to be overturned before we can provide more evidence, more data and more certainty for decision makers towards achieving urban development targets and sustainable cities for Africa. The paper examines the challenge of city-level data-gathering for implementing SDG 11 in Africa. Specifically, it examines the role of cities in implementing SDG 11 in Africa and the need to disaggregate data at city-level; it assesses existing data sources, compilation and dissemination channels as well as the challenges of deploying innovative techniques and strategies including digital and social media

Environmental and Social Management System Implementation Handbook : Food and Beverage

OpenAIRE

International Finance Corporation

2014-01-01

Environmental and social responsibility is becoming more and more important in today’s global economy. There are thousands of environmental and social codes and standards in the world today. The codes and standards define the rules and the objectives. But the challenge is in the implementation. An environmental and social management system (ESMS) helps companies to integrate the rules and ...

Integrated Financial Management Information Systems: Guidelines for effective implementation by the public sector of South Africa

Directory of Open Access Journals (Sweden)

Christoffel J. Hendriks

2012-12-01

Full Text Available Background: Integrated Financial Management Information Systems (IFMIS can improve public sector management by providing real-time financial information to managers in order to enhance their decision-making capabilities. The South African Public Service is currently busy with the implementation of an IFMIS. However, the implementation of such a project has proved to be a very demanding undertaking and has not been met with resounding success.Objectives: The research was conducted in order to identify the challenges and risks that are involved in the implementation of the IFMIS in South Africa. After identification of the challenges and risks, solutions or guidelines were developed that may make the implementation more successful.Method: The methodology that was used is that of a literature study where theories were explored and used to solve a research problem. Based on the theoretical research, solutions and guidelines were developed to solve challenges and risks experienced.Results: The results indicated that there are a number of challenges involved with the implementation of an IFMIS. A set of best practice guidelines was developed that may make the implementation more successful.Conclusion: The sheer size and complexity of an IFMIS poses significant challenges and a number of risks to the implementation process. There are, however, critical success factors or best practices that can be used for the project to succeed. It is recommended that these best practices be used by the South African Public Service.

How to Disable Mortal Loops of Enterprise Resource Planning (ERP Implementation: A System Dynamics Analysis

Directory of Open Access Journals (Sweden)

Kaveh M. Cyrus

2018-01-01

Full Text Available Successful Enterprise Resource Planning (ERP implementation depends upon various factors known as critical success factors (CSFs. This study developed a system dynamics model of ERP implementation based on CSFs to discuss ERP implementation complexities, which identifies the effect of CSF interrelations on different aspects of ERP project failure. Based on the model hypothesis, CSF interrelations include many causal loop dependencies. Some of these causal loops are called mortal loops, because they may cause the failure of risk reduction efforts to a more severe failure in effect of lack of system thinking on CSFs interrelations. This study discusses how system thinking works as a leverage point for overcoming ERP implementation challenges.

Design Innovations and Implementation Challenges - A Case of Smart Textiles in Future Hospital Interiors

DEFF Research Database (Denmark)

Mogensen, Jeppe; Jørgensen, Poul-Erik; Poulsen, Søren Bolvig

2014-01-01

Concerned with the overall challenges of implementing design innovations, this paper relates to the specific case of applying smart textiles in future hospital interiors. The methodological approach is inspired by design thinking and implementation processes, and through the scope of a developed ...

Challenges Encountered by Connecticut Partner School Districts when Implementing Legislatively Required District Improvement Plans: An Exploratory Study

Science.gov (United States)

Martins, Meghan G.

2010-01-01

This research developed a survey that measures the degree to which challenges are experienced by school and district leaders, and teachers, when attempting to implement legislatively required District Improvement Plans (DIPs). The data indicate that there are certainly challenges when implementing DIPs and that teachers report experiencing a…

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.

Securing a control system: experiences from ISO 27001 implementation

International Nuclear Information System (INIS)

Vuppala, V.; Vincent, J.; Kusler, J.; Davidson, K.

2012-01-01

Recent incidents of breaches, in control systems in specific and information systems in general, have emphasized the importance of security and operational continuity in achieving the quality objectives of an organization, and the safety of its personnel and infrastructure. However, security and disaster recovery are either completely ignored or given a low priority during the design and development of an accelerator control system, the underlying technologies, and the overlaid applications. This leads to an operational facility that is easy to breach, and difficult to recover. Retrofitting security into a control system becomes much more difficult during operations. In this paper we describe our experiences with implementing ISO/IEC 27001 Standard for information security at the Electronics Department of the National Superconducting Cyclotron Laboratory (NSCL) located on the campus of Michigan State University. We describe our risk assessment methodology, the identified risks, the selected controls, their implementation, and our documentation structure. We also report the current status of the project. We conclude with the challenges faced and the lessons learnt. (authors)

Critical value factors in business intelligence systems implementation success: An empirical analysis of system and information quality

OpenAIRE

Hackney, RA; Dooley, P; Levvy, Y; Parrish, J

2015-01-01

Business Intelligence (BI) systems have been rated as a leading technology for the last several years. However, organizations have struggled to ensure that high quality information is provided to and from BI systems. This suggests that organizations have recognized the value of information and the potential opportunities available but are challenged by the lack of success in Business Intelligence Systems Implementation (BISI). Therefore, our research addresses the preponderance of failed BI s...

The Challenge of Implementing an ERP System in a Small and Medium Enterprise--A Teaching Case of ERP Project Management

Science.gov (United States)

Xu, Hongjiang; Rondeau, Patrick J.; Mahenthiran, Sakthi

2011-01-01

Enterprise Resource Planning (ERP) system implementation projects are notoriously risky. While large-scale ERP cases continue to be developed, relatively few new ERP cases have been published that further ERP implementation education in small to medium size firms. This case details the implementation of a new ERP system in a medium sized…

The Challenges of Implementing Next Generation Sequencing Across a Large Healthcare System, and the Molecular Epidemiology and Antibiotic Susceptibilities of Carbapenemase-Producing Bacteria in the Healthcare System of the U.S. Department of Defense.

Directory of Open Access Journals (Sweden)

Emil Lesho

Full Text Available We sought to: 1 provide an overview of the genomic epidemiology of an extensive collection of carbapenemase-producing bacteria (CPB collected in the U.S. Department of Defense health system; 2 increase awareness of the public availability of the sequences, isolates, and customized antimicrobial resistance database of that system; and 3 illustrate challenges and offer mitigations for implementing next generation sequencing (NGS across large health systems.Prospective surveillance and system-wide implementation of NGS.288-hospital healthcare network.All phenotypically carbapenem resistant bacteria underwent CarbaNP® testing and PCR, followed by NGS. Commercial (Newbler and Geneious, on-line (ResFinder, and open-source software (Btrim, FLASh, Bowtie2, an Samtools were used for assembly, SNP detection and clustering. Laboratory capacity, throughput, and response time were assessed.From 2009 through 2015, 27,000 multidrug-resistant Gram-negative isolates were submitted. 225 contained carbapenemase-encoding genes (most commonly blaKPC, blaNDM, and blaOXA23. These were found in 15 species from 146 inpatients in 19 facilities. Genetically related CPB were found in more than one hospital. Other clusters or outbreaks were not clonal and involved genetically related plasmids, while some involved several unrelated plasmids. Relatedness depended on the clustering algorithm used. Transmission patterns of plasmids and other mobile genetic elements could not be determined without ultra-long read, single-molecule real-time sequencing. 80% of carbapenem-resistant phenotypes retained susceptibility to aminoglycosides, and 70% retained susceptibility to fluoroquinolones. However, among the CPB-confirmed genotypes, fewer than 25% retained susceptibility to aminoglycosides or fluoroquinolones.Although NGS is increasingly acclaimed to revolutionize clinical practice, resource-constrained environments, large or geographically dispersed healthcare networks, and

The Challenges of Implementing Next Generation Sequencing Across a Large Healthcare System, and the Molecular Epidemiology and Antibiotic Susceptibilities of Carbapenemase-Producing Bacteria in the Healthcare System of the U.S. Department of Defense.

Science.gov (United States)

Lesho, Emil; Clifford, Robert; Onmus-Leone, Fatma; Appalla, Lakshmi; Snesrud, Erik; Kwak, Yoon; Ong, Ana; Maybank, Rosslyn; Waterman, Paige; Rohrbeck, Patricia; Julius, Michael; Roth, Amanda; Martinez, Joshua; Nielsen, Lindsey; Steele, Eric; McGann, Patrick; Hinkle, Mary

2016-01-01

We sought to: 1) provide an overview of the genomic epidemiology of an extensive collection of carbapenemase-producing bacteria (CPB) collected in the U.S. Department of Defense health system; 2) increase awareness of the public availability of the sequences, isolates, and customized antimicrobial resistance database of that system; and 3) illustrate challenges and offer mitigations for implementing next generation sequencing (NGS) across large health systems. Prospective surveillance and system-wide implementation of NGS. 288-hospital healthcare network. All phenotypically carbapenem resistant bacteria underwent CarbaNP® testing and PCR, followed by NGS. Commercial (Newbler and Geneious), on-line (ResFinder), and open-source software (Btrim, FLASh, Bowtie2, an Samtools) were used for assembly, SNP detection and clustering. Laboratory capacity, throughput, and response time were assessed. From 2009 through 2015, 27,000 multidrug-resistant Gram-negative isolates were submitted. 225 contained carbapenemase-encoding genes (most commonly blaKPC, blaNDM, and blaOXA23). These were found in 15 species from 146 inpatients in 19 facilities. Genetically related CPB were found in more than one hospital. Other clusters or outbreaks were not clonal and involved genetically related plasmids, while some involved several unrelated plasmids. Relatedness depended on the clustering algorithm used. Transmission patterns of plasmids and other mobile genetic elements could not be determined without ultra-long read, single-molecule real-time sequencing. 80% of carbapenem-resistant phenotypes retained susceptibility to aminoglycosides, and 70% retained susceptibility to fluoroquinolones. However, among the CPB-confirmed genotypes, fewer than 25% retained susceptibility to aminoglycosides or fluoroquinolones. Although NGS is increasingly acclaimed to revolutionize clinical practice, resource-constrained environments, large or geographically dispersed healthcare networks, and military or

BARRIERS AND CHALLENGES OF BUILDING INFORMATION MODELLING IMPLEMENTATION IN JORDANIAN CONSTRUCTION INDUSTRY

OpenAIRE

Mohammed A.KA. AL-Btoush*, Ahmad Tarmizi Haron

2017-01-01

Construction companies are faced with the need to innovatively integrate the construction process and address project development challenges. One way of doing that is the integration of building information modelling (BIM) in the building design and development cycles. However, due to the lack of clear understanding and the absence of a holistic implementation guideline, many companies are unable to fully achieve BIM potentials or implement BIM in their project and building lifecycle. BIM imp...

Challenges for Rule Systems on the Web

Science.gov (United States)

Hu, Yuh-Jong; Yeh, Ching-Long; Laun, Wolfgang

The RuleML Challenge started in 2007 with the objective of inspiring the issues of implementation for management, integration, interoperation and interchange of rules in an open distributed environment, such as the Web. Rules are usually classified as three types: deductive rules, normative rules, and reactive rules. The reactive rules are further classified as ECA rules and production rules. The study of combination rule and ontology is traced back to an earlier active rule system for relational and object-oriented (OO) databases. Recently, this issue has become one of the most important research problems in the Semantic Web. Once we consider a computer executable policy as a declarative set of rules and ontologies that guides the behavior of entities within a system, we have a flexible way to implement real world policies without rewriting the computer code, as we did before. Fortunately, we have de facto rule markup languages, such as RuleML or RIF to achieve the portability and interchange of rules for different rule systems. Otherwise, executing real-life rule-based applications on the Web is almost impossible. Several commercial or open source rule engines are available for the rule-based applications. However, we still need a standard rule language and benchmark for not only to compare the rule systems but also to measure the progress in the field. Finally, a number of real-life rule-based use cases will be investigated to demonstrate the applicability of current rule systems on the Web.

Challenges Implementing Work-Integrated Learning in Human Resource Management University Courses

Science.gov (United States)

Rook, Laura

2017-01-01

The examination of work-integrated learning (WIL) programs in the undergraduate Human Resource Management (HRM) curriculum is an area under-represented in the Australian literature. This paper identifies the challenges faced in implementing WIL into the HRM undergraduate curriculum. Qualitative semi-structured interviews were conducted with 38…

Critical success factors in implementing an e-rostering system in a healthcare organisation.

Science.gov (United States)

Soomro, Zahoor A; Ahmed, Javed; Muhammad, Raza; Hayes, Dawn; Shah, Mahmood H

2017-01-01

Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts.

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

Directory of Open Access Journals (Sweden)

Florin STAMATIAN

2013-12-01

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

Implementing Competency-Based Education: Challenges, Strategies, and a Decision-Making Framework

Science.gov (United States)

Dragoo, Amie; Barrows, Richard

2016-01-01

The number of competency-based education (CBE) degree programs has increased rapidly over the past five years, yet there is little research on CBE program development. This study utilized conceptual models of higher education change and a qualitative methodology to analyze the strategies and challenges in implementing CBE business degree programs…

Challenges for Nordic VET-systems

DEFF Research Database (Denmark)

Jørgensen, Christian Helms

2015-01-01

, this challenge is not new. It has been on the agenda since the late 1960s following the crisis for apprenticeship and the growing demand for equal access to all levels of education. What is new, however, is that the challenge has intensified and the solutions developed since the 1970s don’t appear tenable today......The systems of vocational education and training (VET) in the Nordic Countries all face a similar challenge: to offer double qualifications. The Nordic VET-systems are expected to give access not only to skilled employment, but also to higher education. As an increasing share of young people....... This situation calls for new solutions to tackle the challenge of double qualifications. The question, which I will examine in this chapter, is how the Nordic VET-systems have handled this challenge in different ways and what these systems can learn from Switzerland, which is often highlighted as a model...

Implementation of ICT in Higher Education as Interacting Activity Systems

DEFF Research Database (Denmark)

Nyvang, Tom

2006-01-01

Implementation of ICT in higher education is not a trivial process. It is however a process leading to a number of challenges and problems. The paper develops a theoretical model of the implementation of ICT in higher education based on activity theory and on a case study in a Danish university...... activity and an educational activity. Based on the model and case study the paper suggest a framework of challenges that must be met for an implementation to succeed....

Implementation Challenges for Sintered Silicon Carbide Fiber Bonded Ceramic Materials for High Temperature Applications

Science.gov (United States)

Singh, M.

2011-01-01

During the last decades, a number of fiber reinforced ceramic composites have been developed and tested for various aerospace and ground based applications. However, a number of challenges still remain slowing the wide scale implementation of these materials. In addition to continuous fiber reinforced composites, other innovative materials have been developed including the fibrous monoliths and sintered fiber bonded ceramics. The sintered silicon carbide fiber bonded ceramics have been fabricated by the hot pressing and sintering of silicon carbide fibers. However, in this system reliable property database as well as various issues related to thermomechanical performance, integration, and fabrication of large and complex shape components has yet to be addressed. In this presentation, thermomechanical properties of sintered silicon carbide fiber bonded ceramics (as fabricated and joined) will be presented. In addition, critical need for manufacturing and integration technologies in successful implementation of these materials will be discussed.

A Decade of Experience in Implementing Quality Management System at Radiochemistry and Environmental Laboratory (RAS)

International Nuclear Information System (INIS)

Norfaizal Mohamed; Nita Salina Abu Bakar; Zal U'yun Wan Mahmood; Wo, Y.M.; Abdul Kadir Ishak; Nurrul Assyikeen Md Jaffary; Noor Fadzilah Yusof

2016-01-01

Quality management system has been introduced to a few laboratories in the Malaysian Nuclear Agency (Nuclear Malaysia) for the purpose to enhance the delivery of quality services to customers. Radiochemistry and Environmental Laboratory (RAS) is a service center in Nuclear Malaysia has implemented a quality management system in procedures carried out and has obtained accreditation for MS ISO/ IEC 17025 since 8 December 2005. This paper is intended to share experiences RAS in implementing a quality management system in accordance with standard MS ISO/ IEC 17025 accreditation and managed to keep it to this day. In addition, the RAS achievements including issues and challenges in implementing the quality management system in the past 10 years will also be discussed. (author)

Implementing artificial neural networks in nuclear power plants diagnostic systems: issues and challenges

International Nuclear Information System (INIS)

Boger, Z.

1998-01-01

A recent review of artificial intelligence applications in nuclear power plants (NPP) diagnostics and fault detection finds that mostly expert systems (ES) and artificial neural networks (ANN) techniques were researched and proposed, but the number of actual implementations in NPP diagnostics systems is very small. It lists the perceived obstacles to the ANN-based system acceptance and implementation. This paper analyses this list. Some of ANN limitations relate to 'quantitative' difficulties of designing and training large-scale ANNs. The availability of an efficient large-scale ANN training algorithm may alleviate most of these concerns. Other perceived drawbacks refer to the 'qualitative' aspects of ANN acceptance - how and when can we rely on the quality of the advice given by the ANN model. Several techniques are available that help to brighten the 'black box' image of the ANN. Analysis of the trained ANN can identify the significant inputs. Calculation of the Causal Indices may reveal the magnitude and sign of the influence of each input on each output. Both these techniques increase the confidence of the users when they conform to known knowledge, or point to plausible relationships. Analysis of the behavior of the neurons in the hidden layer can identify false ANN classification when presented with noisy or corrupt data. Auto-associative NN can identify faulty sensors or data. Two examples of the ANN capabilities as possible diagnostic tools are given, using NPP data, one classifying internal reactor disturbances by neutron noise spectra analysis, the other identifying the faults causes of several transients. To use these techniques the ANN developers need large amount of training data of as many transients as possible. Such data is routinely generated in NPP simulators during the periodic qualification of NPP operators. The IAEA can help by encouraging the saving and distributing the transient data to developers of ANN diagnostic system, to serve as

Key factors in the successful implementation of enterprise resource planning system

Directory of Open Access Journals (Sweden)

Farajollah Rahnavard

2014-04-01

Full Text Available Enterprise Resource Planning Systems (ERP are considered as the newest and most effective tools of enterprise resource planning and include an interconnected information, management and engineering system that meets all the needs of an organization. ERP implementation is costly and time-consuming and makes fundamental change in the process, if not implemented correctly it will cause challenges in most parts of the organization and will certainly fail. Therefore, the identification of key success factors in implementing ERP helps organizations avoid the loss of the project. This research aims to identify key success factors for ERP by examining 185 managers, professionals, experts of the Information and Communication Technology Institute associated with the Ministry of Communications and Information Technology of Iran. A questionnaire was used to collect data. Findings from exploratory factor analysis indicate that five factors: 1 user friendliness, flexible and consistency 2 establishment of project management; 3 alignment with user needs; 4 Management of organizational changes, and 5 observing the principles of successful implementation of ERP affect the institute and the corresponding suggestions are proposed consistent with these findings.

Technical experiences of implementing a wireless tracking and facial biometric verification system for a clinical environment

Science.gov (United States)

Liu, Brent; Lee, Jasper; Documet, Jorge; Guo, Bing; King, Nelson; Huang, H. K.

2006-03-01

By implementing a tracking and verification system, clinical facilities can effectively monitor workflow and heighten information security in today's growing demand towards digital imaging informatics. This paper presents the technical design and implementation experiences encountered during the development of a Location Tracking and Verification System (LTVS) for a clinical environment. LTVS integrates facial biometrics with wireless tracking so that administrators can manage and monitor patient and staff through a web-based application. Implementation challenges fall into three main areas: 1) Development and Integration, 2) Calibration and Optimization of Wi-Fi Tracking System, and 3) Clinical Implementation. An initial prototype LTVS has been implemented within USC's Healthcare Consultation Center II Outpatient Facility, which currently has a fully digital imaging department environment with integrated HIS/RIS/PACS/VR (Voice Recognition).

Implementing participatory action research in Lithuania: potential and challenges

Directory of Open Access Journals (Sweden)

Gabija Jarašiūnaitė

2015-12-01

Full Text Available Participatory action research is a quite new approach to research in Lithuania. The aim of an article was to disscuss the potential and challenges of participatory action research while implementing it in Lithuanian organizations. The qualitative approach was chosen for the study using the method of Focus groups. 20 researchers from social and biomedicine sciences from six institutions of High education in Lithuania participated in the study. The results of the study showed that participatory action reasearch is seen as an approach with many possibilities because of a wide range of used methods, constant interactions with research participants and the lenght of the research process. Researchers value the possibility to access organization at the begining, during research process and evaluate the effectiveness of the changes after the process. The research challenges are associated with the competence of a researcher including his/her sensitivity during process, ability to involve active participation of organization members in the ongoing process by creating safe and trusting environment. Some specific challenges associated with Lithuanian organizations are organizations‘ tiredness of researches and lack of faith of the benefits of researches because of some previous experiences. Keywords: Participatory Action Research, Organization, Lithuania.

Challenges in the use of the mental health information system in a resource-limited setting: lessons from Ghana.

Science.gov (United States)

Kpobi, Lily; Swartz, Leslie; Ofori-Atta, Angela L

2018-02-08

One of the most successful modes of record-keeping and data collection is the use of health management information systems, where patient information and management plans are uniformly entered into a database to streamline the information and for ease of further patient management. For mental healthcare, a Mental Health Information System (MHIS) has been found most successful since a properly established and operational MHIS is helpful for developing equitable and appropriate mental health care systems. Until 2010, the system of keeping patient records and information in the Accra Psychiatric Hospital of Ghana was old and outdated. In light of this and other factors, a complete reforming of the mental health information systems in three psychiatric hospitals in Ghana was undertaken in 2010. Four years after its implementation, we explored user experiences with the new system, and report here the challenges that were identified with use of the new MHIS. Individual semi-structured interviews were conducted with nine clinical and administrative staff of the Accra Psychiatric Hospital to examine their experiences with the new MHIS. Participants in the study were in three categories: clinical staff, administrator, and records clerk. Participants' knowledge of the system and its use, as well as the challenges they had experienced in its use were explored using an interpretative phenomenological approach. The data suggest that optimal use of the current MHIS had faced significant implementation challenges in a number of areas. Central challenges reported by users included increased workload, poor staff involvement and training, and absence of logistic support to keep the system running. Setting up a new system does not guarantee its success. As important as it is to have a mental health information system, its usefulness is largely dependent on proper implementation and maintenance. Further, the system can facilitate policy transformation only when the place of mental

Competency-based education: programme design and challenges to implementation.

Science.gov (United States)

Gruppen, Larry D; Burkhardt, John C; Fitzgerald, James T; Funnell, Martha; Haftel, Hilary M; Lypson, Monica L; Mullan, Patricia B; Santen, Sally A; Sheets, Kent J; Stalburg, Caren M; Vasquez, John A

2016-05-01

Competency-based education (CBE) has been widely cited as an educational framework for medical students and residents, and provides a framework for designing educational programmes that reflect four critical features: a focus on outcomes, an emphasis on abilities, a reduction of emphasis on time-based training, and promotion of learner centredness. Each of these features has implications and potential challenges for implementing CBE. As an experiment in CBE programme design and implementation, the University of Michigan Master of Health Professions Education (UM-MHPE) degree programme was examined for lessons to be learned when putting CBE into practice. The UM-MHPE identifies 12 educational competencies and 20 educational entrustable professional activities (EPAs) that serve as the vehicle for both learning and assessment. The programme also defines distinct roles of faculty members as assessors, mentors and subject-matter experts focused on highly individualised learning plans adapted to each learner. Early experience with implementing the UM-MHPE indicates that EPAs and competencies can provide a viable alternative to traditional courses and a vehicle for rigorous assessment. A high level of individualisation is feasible but carries with it significant costs and makes intentional community building essential. Most significantly, abandoning a time-based framework is a difficult innovation to implement in a university structure that is predicated on time-based education. © 2016 John Wiley & Sons Ltd.

Examining Technology, Structure and Identity During an Enterprise System Implementation

Energy Technology Data Exchange (ETDEWEB)

Alvarez, Rosio

2008-11-12

This paper presents a longitudinal study of an Enterprise System (ES) implementation by critically examining the discursive context in which an ES implementation unfolds. The findings show that users strongly supported the ES in the earlier stage of implementation when the technology was an imaginary phenomenon. However, in later stages, when the technology is in use, user support was not consistent. In this phase the ES produces loss of control and an inability to function as an arbiter of fairness (in allocating resources associated with the system) thereby directly challenging existing professional identities and roles. These outcomes, in turn, generate acts of resistance on the part of workers. Users reach inside the technology and reshape it by devising creative workarounds that produce a sense of reskilling to counter the deskilling produced by the loss of control and power. The analysis also shows that an ES is a complex social phenomenon that is intricately linked to and complicit in shaping organizational structure and identity. In particular this study shows how technology, structure, and identity are in a mutually constitutive relationship.

FINAL IMPLEMENTATION AND PERFORMANCE OF THE LHC COLLIMATOR CONTROL SYSTEM

CERN Document Server

Redaelli, S; Masi, A; Losito, R

2009-01-01

The 2008 collimation system of the CERN Large Hadron Collider (LHC) included 80 movable collimators for a total of 316 degrees of freedom. Before beam operation, the final controls implementation was deployed and commissioned. The control system enabled remote control and appropriate diagnostics of the relevant parameters. The collimator motion is driven with time-functions, synchronized with other accelerator systems, which allows controlling the collimator jaw positions with a micrometer accuracy during all machine phases. The machine protection functionality of the system, which also relies on function-based tolerance windows, was also fully validated. The collimator control challenges are reviewed and the final system architecture is presented. The results of the remote system commissioning and the overall performance are discussed.

Introduction of Geographical Information Systems (GIS) in Technical University Education in Ghana: Challenges and the Way Forward

Science.gov (United States)

Acquah, Prince C.; Asamoah, Jack N.; Konadu, Daniel D.

2017-01-01

Geographic Information System (GIS) continue to play very important role in improving spatial thinking skills of graduates from higher educational institutions. However, teaching and learning of GIS at the technical university level in Ghana remains very limited due to some implementation challenges. This paper reviews the implementation of GIS in…

Implementing Student Information Systems

Science.gov (United States)

Sullivan, Laurie; Porter, Rebecca

2006-01-01

Implementing an enterprise resource planning system is a complex undertaking. Careful planning, management, communication, and staffing can make the difference between a successful and unsuccessful implementation. (Contains 3 tables.)

FoamVis, A Visualization System for Foam Research: Design and Implementation

Directory of Open Access Journals (Sweden)

Dan R. Lipsa

2015-03-01

Full Text Available Liquid foams are used in areas such as mineral separation, oil recovery, food and beverage production, sanitation and fire fighting. To improve the quality of products and the efficiency of processes in these areas, foam scientists wish to understand and control foam behaviour. To this end, foam scientists have used foam simulations to model foam behaviour; however, analysing these simulations presents difficult challenges. We describe the main foam research challenges and present the design of FoamVis, the only existing visualization, exploration and analysis application created to address them. We describe FoamVis’ main features, together with relevant design and implementation notes. Our goal is to provide a global overview and individual feature implementation details that would allow a visualization scientist to extend the FoamVis system with new algorithms and adapt it to new requirements. The result is a detailed presentation of the software that is not provided in previous visualization research papers.

Issues and challenges in implementing mobile learning in malaysian schools

OpenAIRE

Mohamad, Mariam; Woollard, John

2012-01-01

This study describes the issues and challenges in implementing mobile learning via mobile phones to support English Language learning in Malaysian schools. The findings are drawn from interviews of English subject leaders, ICT subject leaders, head teachers and deputy head teachers from 4 schools in the United Kingdom. In addition, the study also describes the perspectives from the experts in education in Malaysia. They are English subject leaders, ICT subject leaders, head teachers, deputy h...

Systems Challenges for Hypersonic Vehicles

Science.gov (United States)

Hunt, James L.; Laruelle, Gerard; Wagner, Alain

1997-01-01

This paper examines the system challenges posed by fully reusable hypersonic cruise airplanes and access to space vehicles. Hydrocarbon and hydrogen fueled airplanes are considered with cruise speeds of Mach 5 and 10, respectively. The access to space matrix is examined. Airbreathing and rocket powered, single- and two-stage vehicles are considered. Reference vehicle architectures are presented. Major systems/subsystems challenges are described. Advanced, enhancing systems concepts as well as common system technologies are discussed.

Implementation of integrated management system

International Nuclear Information System (INIS)

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

2007-01-01

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

A systematic review of the challenges to implementation of the patient-centred medical home: lessons for Australia.

Science.gov (United States)

Janamian, Tina; Jackson, Claire L; Glasson, Nicola; Nicholson, Caroline

2014-08-04

To review the available literature to identify the major challenges and barriers to implementation and adoption of the patient-centred medical home (PCMH) model, topical in current Australian primary care reforms. Systematic review of peer-reviewed literature. PubMed and Embase databases were searched in December 2012 for studies published in English between January 2007 and December 2012. Studies of any type were included if they defined PCMH using the Patient-Centered Primary Care Collaborative Joint Principles, and reported data on challenges and barriers to implementation and adoption of the PCMH model. One researcher with content knowledge in the area abstracted data relating to the review objective and study design from eligible articles. A second researcher reviewed the abstracted data alongside the original article to check for accuracy and completeness. Thematic synthesis was used to in three stages: free line-by-line coding of data; organisation of "free codes" into related areas to construct "descriptive" themes and develop "analytical" themes. The main barriers identified related to: challenges with the transformation process; difficulties associated with change management; challenges in implementing and using an electronic health record that administers principles of PCMH; challenges with funding and appropriate payment models; insufficient resources and infrastructure within practices; and inadequate measures of performance. This systematic review documents the key challenges and barriers to implementing the PCMH model in United States family practice. It provides valuable evidence for Australian clinicians, policymakers, and organisations approaching adoption of PCMH elements within reform initiatives in this country.

Addressing Safeguards Challenges for the Future

Energy Technology Data Exchange (ETDEWEB)

Majali, Raed; Yim, Man-Sung [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

2015-10-15

IAEA safeguard system is considered the corner stone of the international nuclear nonproliferation regime. Effective implementation of this legal instrument enables the IAEA to draw a conclusion with a high degree of confidence on the peaceful use of nuclear material and activities in the state. This paper aims to provide an opportunity to address various challenges encountered by IAEA. Strengthening safeguards system for verification is one of the most urgent challenges facing the IAEA. The IAEA should be able to provide credible assurance not only about declared use of nuclear material and facilities but also about the absence of undeclared material and activities. Implementation of IAEA safeguards continue to play a vital role within the nuclear non-proliferation regime. IAEA must move towards more enhanced safeguards system that is driven by the full use of all the safeguards available relevant information. Safeguards system must be responsive to evolving challenges and continue innovation through efficient implementations of more effective safeguards.

Software challenges in extreme scale systems

International Nuclear Information System (INIS)

Sarkar, Vivek; Harrod, William; Snavely, Allan E

2009-01-01

Computer systems anticipated in the 2015 - 2020 timeframe are referred to as Extreme Scale because they will be built using massive multi-core processors with 100's of cores per chip. The largest capability Extreme Scale system is expected to deliver Exascale performance of the order of 10 18 operations per second. These systems pose new critical challenges for software in the areas of concurrency, energy efficiency and resiliency. In this paper, we discuss the implications of the concurrency and energy efficiency challenges on future software for Extreme Scale Systems. From an application viewpoint, the concurrency and energy challenges boil down to the ability to express and manage parallelism and locality by exploring a range of strong scaling and new-era weak scaling techniques. For expressing parallelism and locality, the key challenges are the ability to expose all of the intrinsic parallelism and locality in a programming model, while ensuring that this expression of parallelism and locality is portable across a range of systems. For managing parallelism and locality, the OS-related challenges include parallel scalability, spatial partitioning of OS and application functionality, direct hardware access for inter-processor communication, and asynchronous rather than interrupt-driven events, which are accompanied by runtime system challenges for scheduling, synchronization, memory management, communication, performance monitoring, and power management. We conclude by discussing the importance of software-hardware co-design in addressing the fundamental challenges for application enablement on Extreme Scale systems.

CONFRONTING CHALLENGES IN IMPLEMENTING E-PORTFOLIO VIA FACEBOOK IN A PHILIPPINE UNIVERSITY

Directory of Open Access Journals (Sweden)

Philippe Sipacio

2015-01-01

Full Text Available Abstract: As an alternative assessment, e-Portfolio via Facebook (evFb has been introduced at De La Salle University (DLSU specifically at Department of English and Applied Linguistics (DEAL primarily to respond to the demands of 21st century literacy. However, it was observed that despite the positive impact of evFb on students based on pilot-testing and related studies, there were still innumerable challenges that hindered its implementation. In this paper, these problems were identified, and were addressed using the lens of participatory development framework. Data were taken from interview and feedback forms of participants namely institution (represented by the department chair and project/program committee, implementers/teachers, and students, and were subjected to content analysis.  The results showed three major issues classified as: (1 strong apprehension of students to publish their writing outputs on-line; (2 resistance of teachers towards FB as an educational tool; and, (3 concerns of institution as regards academic honesty and identity theft on-line. To confront these challenges and ensure effective implementation and sustainability of evFb at DEAL, improving participatory mechanisms was suggested and discussed. Finally, some opportunities and implications for policy relevant to evFb were also presented.

Implementing the World Report on Disability in West Africa: challenges and opportunities for Ghana.

Science.gov (United States)

Tuakli-Wosornu, Yetsa A; Haig, Andrew J

2014-01-01

Disability issues have taken a prominent role on international stages in recent years. Beginning with the May 2005 World Health Assembly Resolution 58.23 and culminating in the June 2011 World Bank and World Health Organization World Report on Disability, comprehensive disability analyses from nations at various stages of development can now be accessed and used by relevant stakeholders in health, policy, and aide arenas. The implementation of this landmark report is critical for the advancement of social inclusion in diverse countries, including those with limited resources. However, activating the World Report on Disability in resource-limited countries remains a significant challenge because of threadbare data and cultural, institutional, and physical barriers to social inclusion. This review summarizes current national disability data and describes challenges and opportunities for the implementation of the World Report on Disability in Ghana. As a structural point of departure, the article uses the three broad categories of challenges outlined by the World Health Organization: attitudinal, physical, and institutional.

The national system of nuclear material control development and challenges. Vol. 3

International Nuclear Information System (INIS)

Badawy, I.

1996-01-01

This paper presents the major factors which may affect the implementation of the National System of Nuclear Material Accounting and Safeguards in Egypt. Developments of this National System-being a division of the Nuclear Regulatory Body in the country-are discussed. Also, recent requirements of the International Atomic Energy Agency within the policy of strengthening its regime of international nuclear control are reviewed. The challenges facing the National System are indicated taking in consideration the anticipated growth in the nuclear field in Egypt by the year 2000 and after. 2 figs

The national system of nuclear material control development and challenges. Vol. 3

Energy Technology Data Exchange (ETDEWEB)

Badawy, I [National Centre for Nuclear Safety and Radiation Control, Atomic Energy Authority, Cairo (Egypt)

1996-03-01

This paper presents the major factors which may affect the implementation of the National System of Nuclear Material Accounting and Safeguards in Egypt. Developments of this National System-being a division of the Nuclear Regulatory Body in the country-are discussed. Also, recent requirements of the International Atomic Energy Agency within the policy of strengthening its regime of international nuclear control are reviewed. The challenges facing the National System are indicated taking in consideration the anticipated growth in the nuclear field in Egypt by the year 2000 and after. 2 figs.

Ecological Challenges for Closed Systems

Science.gov (United States)

Nelson, Mark; Dempster, William; Allen, John P.

2012-07-01

Closed ecological systems are desirable for a number of purposes. In space life support systems, material closure allows precious life-supporting resources to be kept inside and recycled. Closure in small biospheric systems facilitates detailed measurement of global ecological processes and biogeochemical cycles. Closed testbeds facilitate research topics which require isolation from the outside (e.g. genetically modified organisms; radioisotopes) so their ecological interactions and fluxes can be studied separate from interactions with the outside environment. But to achieve and maintain closure entails solving complex ecological challenges. These challenges include being able to handle faster cycling rates and accentuated daily and seasonal fluxes of critical life elements such as carbon dioxide, oxygen, water, macro- and mico-nutrients. The problems of achieving sustainability in closed systems for life support include how to handle atmospheric dynamics including trace gases, producing a complete human diet and recycling nutrients and maintaining soil fertility, the sustaining of healthy air and water and preventing the loss of crucial elements from active circulation. In biospheric facilities the challenge is also to produce analogues to natural biomes and ecosystems, studying processes of self-organization and adaptation in systems that allow specification or determination of state variables and cycles which may be followed through all interactions from atmosphere to soils. Other challenges include the dynamics and genetics of small populations, the psychological challenges for small isolated human groups and measures and options which may be necessary to ensure long-term operation of closed ecological systems.

Challenges in the Implementation of Green Home Development in Malaysia: Perspective of Developers

Science.gov (United States)

Nordin, Rumaizah Mohd; Halim, Ahmad Hafizi Abd; Yunus, Julitta

2017-12-01

The construction industry is the main contributor to Malaysian economic growth. One of the main sectors to be highlighted by the Government is housing sector. The population in Malaysia is increasing year by year, thus the demand for houses also rises significantly. However, the fulfilment of basic needs for people normally gives the adverse impacts to the environment. Green home concept is introduced with a purpose to create an acceptable standard of living as well as to preserve nature from destruction, whilst to promote efficiency of energy, water and other natural resources. The study aims to identify current level of awareness and understanding regarding the Green Home concept, together with identifying the challenges that contribute to lack of initiatives in implementation of green home development. This study utilizes the qualitative methodology utilising interviews with housing developers operating in Klang Valley. 20 respondents were interviewed with a semi-structured interview. This study found that level of awareness and understanding on green home concept among construction players and public is low to moderate level. However, it shows improvement in terms of its implementation with all respondents agreed that cost factor is greatest challenge to its implementation. Other challenges identified from the study are low awareness and understanding among construction players and public, low demand for green home, and lack of Government enforcement and initiatives. The study is eventually intended to enhance and improve the sustainable practice in Malaysian’s construction industry.

Grand Challenges facing Storage Systems

CERN Multimedia

CERN. Geneva

2004-01-01

In this talk, we will discuss the future of storage systems. In particular, we will focus on several big challenges which we are facing in storage, such as being able to build, manage and backup really massive storage systems, being able to find information of interest, being able to do long-term archival of data, and so on. We also present ideas and research being done to address these challenges, and provide a perspective on how we expect these challenges to be resolved as we go forward.

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

Directory of Open Access Journals (Sweden)

Murray Laura K

2006-01-01

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

A Case for Implementation of Citizen Centric National Identity Management Systems

DEFF Research Database (Denmark)

Adjei, Joseph K.

of trust in transacting parties. Policy makers are therefore trying to implement identity policies to prevent identity abuses, promote the seamless flow of business transactions, and provide citizens the ability to exercise informational self-determination. Previously, the design of identity management...... and exposure, and a high level of literacy. But in developing countries infrastructural challenges, low literacy level, and physical verification of credentials hamper the effective use of identity management systems. This PhD study adapts the DeLone and McLean model of information systems success to the case...

What do school principals do to overcome the challenges of implementing a new senior secondary curriculum in Hong Kong?

Directory of Open Access Journals (Sweden)

Edith Lai

2013-11-01

Full Text Available This paper attempts to identify the challenges facing school principals as they engaged in implementing a curriculum reform in Hong Kong. Based on interview data of school principals, this paper shows three major types of implementation challenges facing school principals, namely curriculum planning, catering for learner diversity, and managing change. Drawing on the concept of ‘exploiting situated possibilities’, this paper further shows how these school principals explored and exploited possibilities in and around the school contexts to overcome the implementation challenges, as one way to strengthen the schools’ capacity for change. Implications for developing efficacious principal leadership in school capacity building are discussed.

Electronic patient information systems and care pathways: the organisational challenges of implementation and integration.

Science.gov (United States)

Dent, Mike; Tutt, Dylan

2014-09-01

Our interest here is with the 'marriage' of e-patient information systems with care pathways in order to deliver integrated care. We report on the development and implementation of four such pathways within two National Health Service primary care trusts in England: (a) frail elderly care, (b) stroke care, (c) diabetic retinopathy screening and (d) intermediate care. The pathways were selected because each represents a different type of information and data 'couplings', in terms of task interdependency with some pathways/systems reflecting more complex coordinating patterns than others. Our aim here is identify and explain how health professionals and information specialists in two organisational National Health Service primary care trusts organisationally construct and use such systems and, in particular, the implications this has for issues of professional and managerial control and autonomy. The article is informed by an institutionalist analysis. © The Author(s) 2013.

The Unanticipated Challenges Associated With Implementing an Observational Study Protocol in a Large-Scale Physical Activity and Global Positioning System Data Collection

Science.gov (United States)

Walker, David; Ellaway, Anne

2018-01-01

Background Large-scale primary data collections are complex, costly, and time-consuming. Study protocols for trial-based research are now commonplace, with a growing number of similar pieces of work being published on observational research. However, useful additions to the literature base are publications that describe the issues and challenges faced while conducting observational studies. These can provide researchers with insightful knowledge that can inform funding proposals or project development work. Objectives In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection. Methods The SPACES (Studying Physical Activity in Children’s Environments across Scotland) study was designed to collect objectively measured physical activity and GPS data from 10- to 11-year-old children across Scotland, using a postal delivery method. The 3 main phases of the project (recruitment, delivery of project materials, and data collection and processing) are described within a 2-stage framework: (1) intended design and (2) implementation of the intended design. Results Unanticipated challenges arose, which influenced the data collection process; these encompass four main impact categories: (1) cost, budget, and funding; (2) project timeline; (3) participation and engagement; and (4) data challenges. The main unforeseen issues that impacted our timeline included the informed consent process for children under the age of 18 years; the use of, and coordination with, the postal service to deliver study information and equipment; and the variability associated with when participants began data collection and the time taken to send devices and consent forms back (1-12 months). Unanticipated budgetary issues included the identification of some study materials (AC power adapter) not fitting through

The Unanticipated Challenges Associated With Implementing an Observational Study Protocol in a Large-Scale Physical Activity and Global Positioning System Data Collection.

Science.gov (United States)

McCrorie, Paul; Walker, David; Ellaway, Anne

2018-04-30

Large-scale primary data collections are complex, costly, and time-consuming. Study protocols for trial-based research are now commonplace, with a growing number of similar pieces of work being published on observational research. However, useful additions to the literature base are publications that describe the issues and challenges faced while conducting observational studies. These can provide researchers with insightful knowledge that can inform funding proposals or project development work. In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection. The SPACES (Studying Physical Activity in Children's Environments across Scotland) study was designed to collect objectively measured physical activity and GPS data from 10- to 11-year-old children across Scotland, using a postal delivery method. The 3 main phases of the project (recruitment, delivery of project materials, and data collection and processing) are described within a 2-stage framework: (1) intended design and (2) implementation of the intended design. Unanticipated challenges arose, which influenced the data collection process; these encompass four main impact categories: (1) cost, budget, and funding; (2) project timeline; (3) participation and engagement; and (4) data challenges. The main unforeseen issues that impacted our timeline included the informed consent process for children under the age of 18 years; the use of, and coordination with, the postal service to deliver study information and equipment; and the variability associated with when participants began data collection and the time taken to send devices and consent forms back (1-12 months). Unanticipated budgetary issues included the identification of some study materials (AC power adapter) not fitting through letterboxes, as well as the employment of

Implementing internet-delivered cognitive behavior therapy for common mental health disorders: A comparative case study of implementation challenges perceived by therapists and managers in five European internet services

Directory of Open Access Journals (Sweden)

Anna Paldam Folker

2018-03-01

Conclusion: The present study gives an overview of the main implementation challenges regarding the practical operation of iCBT services perceived by the therapists and managers of the iCBT services. Future studies into specific details of each challenge will be important to strengthen the evidence base of iCBT and to improve uptake and implementation of iCBT in routine care.

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

Science.gov (United States)

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

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

Big Data challenges and solutions in building the Global Earth Observation System of Systems (GEOSS)

Science.gov (United States)

Mazzetti, Paolo; Nativi, Stefano; Santoro, Mattia; Boldrini, Enrico

2014-05-01

The Group on Earth Observation (GEO) is a voluntary partnership of governments and international organizations launched in response to calls for action by the 2002 World Summit on Sustainable Development and by the G8 (Group of Eight) leading industrialized countries. These high-level meetings recognized that international collaboration is essential for exploiting the growing potential of Earth observations to support decision making in an increasingly complex and environmentally stressed world. To this aim is constructing the Global Earth Observation System of Systems (GEOSS) on the basis of a 10-Year Implementation Plan for the period 2005 to 2015 when it will become operational. As a large-scale integrated system handling large datasets as those provided by Earth Observation, GEOSS needs to face several challenges related to big data handling and big data infrastructures management. Referring to the traditional multiple Vs characteristics of Big Data (volume, variety, velocity, veracity and visualization) it is evident how most of them can be found in data handled by GEOSS. In particular, concerning Volume, Earth Observation already generates a large amount of data which can be estimated in the range of Petabytes (1015 bytes), with Exabytes (1018) already targeted. Moreover, the challenge is related not only to the data size, but also to the large amount of datasets (not necessarily having a big size) that systems need to manage. Variety is the other main challenge since datasets coming from different sensors, processed for different use-cases are published with highly heterogeneous metadata and data models, through different service interfaces. Innovative multidisciplinary applications need to access and use those datasets in a harmonized way. Moreover Earth Observation data are growing in size and variety at an exceptionally fast rate and new technologies and applications, including crowdsourcing, will even increase data volume and variety in the next future

Practical applications approach to design, development and implementation of an integrated management system

International Nuclear Information System (INIS)

Holdsworth, Rodger

2003-01-01

The introduction of quality, risk, safety, health and environmental management philosophies has significantly changed industry's view of company organization and controlling processes. Quality, risk, safety, health and environmental programs and systems, such as ISO 9000, ISO 14000, process safety, and risk management are impacting the way industry will meet the challenges of safety and environmental risks and the needs of the customer in the future. A wealth of knowledge has been extracted from practical application case studies, which would otherwise be unobtainable without years of experience related to management systems design, development, implementation and control. This paper discusses a practical applications approach to design, develop and implement an integrated management system encompassing quality (ISO 9000), process safety management (CFR 29 1910.119), risk management programs (CFR 40 part 68), environmental management (ISO 14000), and safety and health. This paper includes a discussion of management systems integration and an overview of management systems standards that apply to the petrochemical and chemical manufacturers industries. The paper also provides an overview on integrating management systems, including issues related to the following topics: - Establishing a management system team and objectives. - Assessing and knowing your organization. - Designing the management system to meet site objectives. - Developing system documentation. - Implementing effective management systems. - Measuring program performance. - Continuous improvement

Challenges in Implementing IAEA National Nuclear Safety Knowledge Platforms

International Nuclear Information System (INIS)

Samba, R.N.; Simo, A.

2016-01-01

Full text: Integrated Management Systems and human resource development of nuclear knowledge have always been a challenge for developing countries. NRPA staff when trained by IAEA return and restitute with all colleagues the themes acquired in nuclear knowledge. NRPA became a member of Forum for Nuclear Regulatory Bodies in Africa (FNRBA) in 2009. FNRBA organized with IAEA a workshop from 14th to 18th October 2013 in Nairobi, Kenya on Knowledge Safety Network. NRPA of Cameroon created the first National Nuclear Portail under FNRBA. This was linked to other national websites. During the IAEA review missions, most counterparts took opportunity from the thermatic site to share information and develop advance reference materials. The IAEA Integrated Regulatory Review Service (IRRS) team also shared materials that could not be transferred through email with national counterparts using the Global Nuclear Safety and Security Network (GNSSN) sharepoint website due to large file sizes.The regulatory documents have been uploaded on the platform and can be accessed through FNRBA and NRPA website (www.anrp.cm). UN organizations implementing projects in Cameroon are also linked to the platform. The action plans and progress reports for IAEA/AFRA projects are also available. Moreover, NRPA regulatory activities and licensing sources are available on this platform. (author

ERP system implementation costs and selection factors of an implementation approach

DEFF Research Database (Denmark)

Johansson, Björn; Sudzina, Frantisek; Newman, Mike

2011-01-01

, which influence the implementation approach in an ERP project, cause also an increase of the project cost in a European context? Our survey was conducted in Denmark, Slovakia and Slovenia and focused on this issue. Our main findings are that: 1) the number of implemented modules influences selection......Different approaches on implementation of enterprise resource planning (ERPs) systems exist. In this article, we investigate relationship between factors influencing selection of implementation approach and companies' ability to stay within budget when implementing ERPs. The question is: do factors...... of an implementation approach; 2) companies with information strategies are more likely to stay within budget regarding ERP systems implementation. However, we also found that: 3) implementation approach does not significantly influence ability to stay within budget; 4) a clear relationship between factors influencing...

Overcoming barriers to electronic medical record (EMR) implementation in the US healthcare system: A comparative study.

Science.gov (United States)

Kumar, Sameer; Aldrich, Krista

2010-12-01

An EMR system implementation would significantly reduce clinician workload and medical errors while saving the US healthcare system major expense. Yet, compared to other developed nations, the US lags behind. This article examines EMR system efforts, benefits, and barriers, as well as steps needed to move the US closer to a nationwide EMR system. The analysis includes a blueprint for implementation of EMR, industry comparisons to highlight the differences between successful and non-successful EMR ventures, references to costs and benefit information, and identification of root causes. 'Poka-yokes' (avoid (yokeru) mistakes (poka)) will be inserted to provide insight into how to systematically overcome challenges. Implementation will require upfront costs including patient privacy that must be addressed early in the development process. Government structure, incentives and mandates are required for nationwide EMR system in the US.

Design and Implementation of an Innovative Residential PV System

Science.gov (United States)

Najm, Elie Michel

chapter 6. In chapter 7, a novel integration method is proposed for the residential PV solar system. The proposal presents solutions to challenges experimented in the implementation of today's approaches. Faster installation time, easier system grounding, and integration of the power electronics in order to reduce the number of connectors' and system cost are detailed. Installers with special skills as well as special tools are not required for implementing the proposed system integration. Photos of the experimental results related to the installation of a 3kW system, which was fully completed in less than an hour and a half, are also presented.

Reduction in specimen labeling errors after implementation of a positive patient identification system in phlebotomy.

Science.gov (United States)

Morrison, Aileen P; Tanasijevic, Milenko J; Goonan, Ellen M; Lobo, Margaret M; Bates, Michael M; Lipsitz, Stuart R; Bates, David W; Melanson, Stacy E F

2010-06-01

Ensuring accurate patient identification is central to preventing medical errors, but it can be challenging. We implemented a bar code-based positive patient identification system for use in inpatient phlebotomy. A before-after design was used to evaluate the impact of the identification system on the frequency of mislabeled and unlabeled samples reported in our laboratory. Labeling errors fell from 5.45 in 10,000 before implementation to 3.2 in 10,000 afterward (P = .0013). An estimated 108 mislabeling events were prevented by the identification system in 1 year. Furthermore, a workflow step requiring manual preprinting of labels, which was accompanied by potential labeling errors in about one quarter of blood "draws," was removed as a result of the new system. After implementation, a higher percentage of patients reported having their wristband checked before phlebotomy. Bar code technology significantly reduced the rate of specimen identification errors.

Strategies to overcome clinical, regulatory, and financial challenges in the implementation of personalized medicine.

Science.gov (United States)

Tsimberidou, Apostolia M; Ringborg, Ulrik; Schilsky, Richard L

2013-01-01

This article highlights major developments over the last decade in personalized medicine in cancer. Emerging data from clinical studies demonstrate that the use of targeted agents in patients with targetable molecular aberrations improves clinical outcomes. Despite a surge of studies, however, significant gaps in knowledge remain, especially in identifying driver molecular aberrations in patients with multiple aberrations, understanding molecular networks that control carcinogenesis and metastasis, and most importantly, discovering effective targeted agents. Implementation of personalized medicine requires continued scientific and technological breakthroughs; standardization of tumor tissue acquisition and molecular testing; changes in oncology practice and regulatory standards for drug and device access and approval; modification of reimbursement policies by health care payers; and innovative ways to collect and analyze electronic patient information that are linked to prospective clinical registries and rapid learning systems. Informatics systems that integrate clinical, laboratory, radiologic, molecular, and economic data will improve clinical care and will provide infrastructure to enable clinical research. The initiative of the EurocanPlatform aims to overcome the challenges of implementing personalized medicine in Europe by sharing patients, biologic materials, and technological resources across borders. The EurocanPlatform establishes a complete translational cancer research program covering the drug development process and strengthening collaborations among academic centers, pharmaceutical companies, regulatory authorities, health technology assessment organizations, and health care systems. The CancerLinQ rapid learning system being developed by ASCO has the potential to revolutionize how all stakeholders in the cancer community assemble and use information obtained from patients treated in real-world settings to guide clinical practice, regulatory

Challenges in implementing uncomplicated malaria treatment in children: a health facility survey in rural Malawi.

Science.gov (United States)

Kabaghe, Alinune N; Phiri, Mphatso D; Phiri, Kamija S; van Vugt, Michèle

2017-10-18

Prompt and effective malaria treatment are key in reducing transmission, disease severity and mortality. With the current scale-up of artemisinin-based combination therapy (ACT) coverage, there is need to focus on challenges affecting implementation of the intervention. Routine indicators focus on utilization and coverage, neglecting implementation quality. A health system in rural Malawi was assessed for uncomplicated malaria treatment implementation in children. A cross-sectional health facility survey was conducted in six health centres around the Majete Wildlife Reserve in Chikwawa district using a health system effectiveness approach to assess uncomplicated malaria treatment implementation. Interviews with health facility personnel and exit interviews with guardians of 120 children under 5 years were conducted. Health workers appropriately prescribed an ACT and did not prescribe an ACT to 73% (95% CI 63-84%) of malaria rapid diagnostic test (RDT) positive and 98% (95% CI 96-100%) RDT negative children, respectively. However, 24% (95% CI 13-37%) of children receiving artemisinin-lumefantrine had an inappropriate dose by weight. Health facility findings included inadequate number of personnel (average: 2.1 health workers per 10,000 population), anti-malarial drug stock-outs or not supplied, and inconsistent health information records. Guardians of 59% (95% CI 51-69%) of children presented within 24 h of onset of child's symptoms. The survey presents an approach for assessing treatment effectiveness, highlighting bottlenecks which coverage indicators are incapable of detecting, and which may reduce quality and effectiveness of malaria treatment. Health service provider practices in prescribing and dosing anti-malarial drugs, due to drug stock-outs or high patient load, risk development of drug resistance, treatment failure and exposure to adverse effects.

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

Science.gov (United States)

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

2017-01-01

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

Implementation of a Low-Latency Contention-Free Geographical Routing Scheme for Mobile Cyber-Physical Systems

KAUST Repository

Bader, Ahmed

2015-07-09

Results and lessons learned from the implementation of a novel ultra low-latency geo-routing scheme are presented in this paper. The geo-routing scheme is intended for team-based mobile cyber-physical systems whereby a cluster of unmanned vehicles (robots) are deployed to accomplish a critical mission under human supervision. The contention-free nature of the developed scheme lends itself to jointly achieve lower latency and higher throughput. Implementation challenges are presented and corresponding resolutions are discussed herewith.

Moving from Good Ideas in Educational Systems Change to Sustainable Program Implementation: Coming to Terms with Some of the Realities

Science.gov (United States)

Noell, George H.; Gansle, Kristin A.

2009-01-01

Proponents of systemic changes in education commonly encounter ethical, theoretical, and pragmatic challenges in moving from possibility to implementation of their vision of change. Although ethical and theoretical issues are critically important to a successful change initiative, pragmatic issues relevant to assuring program implementation have…

Co-management of Water, Energy, and Food Systems: Where Are We and What Does it Take for Implementation?

Science.gov (United States)

Akhbari, M.

2015-12-01

Water, energy, and food are closely bound in consumption and production patterns. To increase resource efficiency and productivity in a sustainable fashion, co-management of water, energy, and food resources is becoming inevitable. These co-management schemes require implementation of nexus-based approaches, which takes the interconnections of water, energy, and food systems into account and considers that development in one area may have major effects on others. While society, economy and environment are the action areas to implement a nexus approach, finance, governance, infrastructure and technology can create solutions. Existing obstacles in the action areas and challenges associated with creating solutions increase the complexities to develop nexus-based approaches and complicate their implementation. This study, identifies existing social, economic, and environmental obstacles, financial demands and constraints, shortcomings in governance, and infrastructure problems in the United States as the main challenges that need to be overcome. Then, it will be discussed how advanced technology could be employed to facilitate implementation of nexus-based approaches, followed by providing some recommendations to enable institutions to employ new technology, overcome existing obstacles, and address challenges in order to implement nexus-based management approaches.

Materials and structures technology insertion into spacecraft systems: Successes and challenges

Science.gov (United States)

Rawal, Suraj

2018-05-01

Over the last 30 years, significant advancements have led to the use of multifunctional materials and structures technologies in spacecraft systems. This includes the integration of adaptive structures, advanced composites, nanotechnology, and additive manufacturing technologies. Development of multifunctional structures has been directly influenced by the implementation of processes and tools for adaptive structures pioneered by Prof. Paolo Santini. Multifunctional materials and structures incorporating non-structural engineering functions such as thermal, electrical, radiation shielding, power, and sensors have been investigated. The result has been an integrated structure that offers reduced mass, packaging volume, and ease of integration for spacecraft systems. Current technology development efforts are being conducted to develop innovative multifunctional materials and structures designs incorporating advanced composites, nanotechnology, and additive manufacturing. However, these efforts offer significant challenges in the qualification and acceptance into spacecraft systems. This paper presents a brief overview of the technology development and successful insertion of advanced material technologies into spacecraft structures. Finally, opportunities and challenges to develop and mature next generation advanced materials and structures are presented.

Internet security information system implement method

International Nuclear Information System (INIS)

Liu Baoxu; Mei Jie; Xu Rongsheng; An Dehai; Yu Mingjian; Chen Xiangyang; Zheng Peng

1999-01-01

On the basis of analysis of the key elements that will affect the Internet Security Information System, the author takes UNIX Operating System as an example, and provides the important stages that must be considered when implementing the Internet Security Information System. An implemental model of the Internet Security Information System is given

Challenges in small screening laboratories: implementing an on-demand laboratory information management system.

Science.gov (United States)

Lemmon, Vance P; Jia, Yuanyuan; Shi, Yan; Holbrook, S Douglas; Bixby, John L; Buchser, William

2011-11-01

The Miami Project to Cure Paralysis, part of the University of Miami Miller School of Medicine, includes a laboratory devoted to High Content Analysis (HCA) of neurons. The goal of the laboratory is to uncover signaling pathways, genes, compounds, or drugs that can be used to promote nerve growth. HCA permits the quantification of neuronal morphology, including the lengths and numbers of axons. HCA of various libraries on primary neurons requires a team-based approach, a variety of process steps and complex manipulations of cells and libraries to obtain meaningful results. HCA itself produces vast amounts of information including images, well-based data and cell-based phenotypic measures. Documenting and integrating the experimental workflows, library data and extensive experimental results is challenging. For academic laboratories generating large data sets from experiments involving thousands of perturbagens, a Laboratory Information Management System (LIMS) is the data tracking solution of choice. With both productivity and efficiency as driving rationales, the Miami Project has equipped its HCA laboratory with an On Demand or Software As A Service (SaaS) LIMS to ensure the quality of its experiments and workflows. The article discusses how the system was selected and integrated into the laboratory. The advantages of a SaaS based LIMS over a client-server based system are described. © 2011 Bentham Science Publishers

Next-Generation Climate Modeling Science Challenges for Simulation, Workflow and Analysis Systems

Science.gov (United States)

Koch, D. M.; Anantharaj, V. G.; Bader, D. C.; Krishnan, H.; Leung, L. R.; Ringler, T.; Taylor, M.; Wehner, M. F.; Williams, D. N.

2016-12-01

We will present two examples of current and future high-resolution climate-modeling research that are challenging existing simulation run-time I/O, model-data movement, storage and publishing, and analysis. In each case, we will consider lessons learned as current workflow systems are broken by these large-data science challenges, as well as strategies to repair or rebuild the systems. First we consider the science and workflow challenges to be posed by the CMIP6 multi-model HighResMIP, involving around a dozen modeling groups performing quarter-degree simulations, in 3-member ensembles for 100 years, with high-frequency (1-6 hourly) diagnostics, which is expected to generate over 4PB of data. An example of science derived from these experiments will be to study how resolution affects the ability of models to capture extreme-events such as hurricanes or atmospheric rivers. Expected methods to transfer (using parallel Globus) and analyze (using parallel "TECA" software tools) HighResMIP data for such feature-tracking by the DOE CASCADE project will be presented. A second example will be from the Accelerated Climate Modeling for Energy (ACME) project, which is currently addressing challenges involving multiple century-scale coupled high resolution (quarter-degree) climate simulations on DOE Leadership Class computers. ACME is anticipating production of over 5PB of data during the next 2 years of simulations, in order to investigate the drivers of water cycle changes, sea-level-rise, and carbon cycle evolution. The ACME workflow, from simulation to data transfer, storage, analysis and publication will be presented. Current and planned methods to accelerate the workflow, including implementing run-time diagnostics, and implementing server-side analysis to avoid moving large datasets will be presented.

Universal coverage challenges require health system approaches; the case of India.

Science.gov (United States)

Duran, Antonio; Kutzin, Joseph; Menabde, Nata

2014-02-01

This paper uses the case of India to demonstrate that Universal Health Coverage (UHC) is about not only health financing; personal and population services production issues, stewardship of the health system and generation of the necessary resources and inputs need to accompany the health financing proposals. In order to help policy makers address UHC in India and sort out implementation issues, the framework developed by the World Health Organization (WHO) in the World Health Report 2000 and its subsequent extensions are advocated. The framework includes final goals, generic intermediate objectives and four inter-dependent functions which interact as a system; it can be useful by diagnosing current shortcomings and facilitating the filling up of gaps between functions and goals. Different positions are being defended in India re the preconditions for UHC to succeed. This paper argues that more (public) money will be important, but not enough; it needs to be supplemented with broad interventions at various health system levels. The paper analyzes some of the most important issues in relation to the functions of service production, generation of inputs and the necessary stewardship. It also pays attention to reform implementation, as different from its design, and suggests critical aspects emanating from a review of recent health system reforms. Precisely because of the lack of comparative reference for India, emphasis is made on the need to accompany implementation with analysis, so that the "solutions" ("what to do?", "how to do it?") are found through policy analysis and research embedded into flexible implementation. Strengthening "evidence-to-policy" links and the intelligence dimension of stewardship/leadership as well as accountability during implementation are considered paramount. Countries facing similar challenges to those faced by India can also benefit from the above approaches. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Implementing Peer Learning in Clinical Education: A Framework to Address Challenges In the "Real World".

Science.gov (United States)

Tai, Joanna Hong Meng; Canny, Benedict J; Haines, Terry P; Molloy, Elizabeth K

2017-01-01

Phenomenon: Peer learning has many benefits and can assist students in gaining the educational skills required in future years when they become teachers themselves. Peer learning may be particularly useful in clinical learning environments, where students report feeling marginalized, overwhelmed, and unsupported. Educational interventions often fail in the workplace environment, as they are often conceived in the "ideal" rather than the complex, messy real world. This work sought to explore barriers and facilitators to implementing peer learning activities in a clinical curriculum. Previous peer learning research results and a matrix of empirically derived peer learning activities were presented to local clinical education experts to generate discussion around the realities of implementing such activities. Potential barriers and limitations of and strategies for implementing peer learning in clinical education were the focus of the individual interviews. Thematic analysis of the data identified three key considerations for real-world implementation of peer learning: culture, epistemic authority, and the primacy of patient-centered care. Strategies for peer learning implementation were also developed from themes within the data, focusing on developing a culture of safety in which peer learning could be undertaken, engaging both educators and students, and establishing expectations for the use of peer learning. Insights: This study identified considerations and strategies for the implementation of peer learning activities, which took into account both educator and student roles. Reported challenges were reflective of those identified within the literature. The resultant framework may aid others in anticipating implementation challenges. Further work is required to test the framework's application in other contexts and its effect on learner outcomes.

Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation.

Science.gov (United States)

Mills, Pamela Ruth; Weidmann, Anita Elaine; Stewart, Derek

2017-12-01

Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation

Challenges of Implementing Renewable Energy Policies at Community Scale: The Case of Strategic Energy Plans in Denmark

DEFF Research Database (Denmark)

Petersen, Jens-Phillip

2017-01-01

The implementation of national energy efficiency targets requires policies at the local scale. It is widely acknowledged that local communities play an important tole to implement these policies: as arena where renewable energy technologies can be combined with socio-economic interests of local...... stakeholders. Although a vast amount of demo projects are well-documented, insufficient attention has been given to the average performing municipalities and their challenges in linking technical energy scenarios with their socio-economic realities in practice. This paper analyses the Strategic Energy Plans...... (SEP) of 17 Danish municipalities on their development, inclusion of local communities, affected stakeholders, and on their impact on the municipalities’ working procedures. The main technical, physical, organisational and socio-economic challenges for local energy policy implementation are illustrated...

The progress and challenges of implementation of the Framework Convention on Tobacco Control (WHO FCTC) in Kyrgyz Republic

OpenAIRE

Chinara Bekbasarova

2018-01-01

Background and challenges to implementation The Kyrgyz Republic is Party of the WHO FCTC since August 23, 2006. This abstract analyzes progress and challenges during 10 years of implementation of WHO´s FCTC Intervention or response National Tobacco Control (TC) Law was adopted on August 21, 2006, entered into force on December 19, 2006 and was amended and supplemented during 10 years 2 times. TC measures were included, as one of main priorities, in the National Program on Heal...

Implementing Business Intelligence System - Case Study

Directory of Open Access Journals (Sweden)

Yasser AL-HADAD

2016-08-01

Full Text Available Understanding and analysis data is essential for making decision within a system. Any analytical tasks can be implemented directly by the transactional system but it becomes more difficult as the transactional system grows. Analytical systems and their extension appear as a solution for complex and large datasets. We think that it's time for medium companies to get the benefit from such systems as analytical systems become more variant and in hand for every possible user. In this paper, we propose an architecture of analytical system that can adapt and integrate with existent transactional system of timber export company. The proposed analytical system should have the ability of implementing the tasks required by the decision makers of the system. Also, we try to explore the ability of SQL server of implementing our proposed architecture.

Development and Implementation of Augmented Quality Programmable Digital System in NPP

International Nuclear Information System (INIS)

Mandic, D.; Linke, B.; Thomas, M. S.; Boh, F.

2008-01-01

In order to continue meeting safety and reliability requirements and in the same time controlling NPP (Nuclear Power Plant) operating costs, operators of NPPs must be able to replace and upgrade equipment in a cost effective manner. In spite of the fact, that in the last thirty years no other plant technology has passed through so spectacular development process as instrumentation and control (I and C) systems, digital I and C upgrades in NPPs were hindered because of several reasons. Upgrades of I and C systems typically involve replacement of analog devices or old digital ones with programmable digital technology. While planning and implementing design changes and upgrades in an operating NPP, quality and achievement of excellence in the final products as well as in the implemented processes becomes an unavoidable requirement that is larger challenge to be achieved, if it includes programmable digital systems (PDS). The term 'Augmented Quality' describes special quality requirements that were imposed by licensee and it is related to the subset of the Non-Safety Related (NSR) systems, structures and components (SSC) which are very important for plant reliability, operability, and availability, or like in this particular case, the NSR PDS that could have reasonable potential to cause a transient or turbine trip, which could result in a challenge to safeguard systems, functions or equipment, and because of that is identified also as ITS - Important To Safety equipment. Owing to the specifics of the PDS life cycle, they have to be treated in a different way than other plant equipment, related processes and documentation. It is well known fact that the quality of the integrated PDS can not be achieved, verified and validated solely by the post development and post installation system testing. To achieve non compromising quality and excellence as a final goal, specific quality planning requirements have to be built in all processes and products throughout the PDS life

Implementation of a Research Information Management System in a Pediatric Hospital.

Science.gov (United States)

Kissling, Alison D; Ballinger, Kimberly D

2018-01-01

Faculty publications have been collected in universities, health, and medical institutions for many years, and Cincinnati Children's is no exception. Since 1949, a yearly list of faculty publications was manually compiled using multiple data sources and disseminated by the Edward L. Pratt Research Library. Products to centralize faculty publication collection and analysis with bibliometric tools are growing in popularity. This article will review the collaborative decision to choose a Research Information Management System and the implementation process including successes, challenges, and future opportunities.

Neural System Prediction and Identification Challenge

Directory of Open Access Journals (Sweden)

Ioannis eVlachos

2013-12-01

Full Text Available Can we infer the function of a biological neural network (BNN if we know the connectivity and activity of all its constituent neurons? This question is at the core of neuroscience and, accordingly, various methods have been developed to record the activity and connectivity of as many neurons as possible. Surprisingly, there is no theoretical or computational demonstration that neuronal activity and connectivity are indeed sufficient to infer the function of a BNN. Therefore, we pose the Neural Systems Identification and Prediction Challenge (nuSPIC. We provide the connectivity and activity of all neurons and invite participants (i to infer the functions implemented (hard-wired in spiking neural networks (SNNs by stimulating and recording the activity of neurons and, (ii to implement predefined mathematical/biological functions using SNNs. The nuSPICs can be accessed via a web-interface to the NEST simulator and the user is not required to know any specific programming language. Furthermore, the nuSPICs can be used as a teaching tool. Finally, nuSPICs use the crowd-sourcing model to address scientific issues. With this computational approach we aim to identify which functions can be inferred by systematic recordings of neuronal activity and connectivity. In addition, nuSPICs will help the design and application of new experimental paradigms based on the structure of the SNN and the presumed function which is to be discovered.

Neural system prediction and identification challenge.

Science.gov (United States)

Vlachos, Ioannis; Zaytsev, Yury V; Spreizer, Sebastian; Aertsen, Ad; Kumar, Arvind

2013-01-01

Can we infer the function of a biological neural network (BNN) if we know the connectivity and activity of all its constituent neurons?This question is at the core of neuroscience and, accordingly, various methods have been developed to record the activity and connectivity of as many neurons as possible. Surprisingly, there is no theoretical or computational demonstration that neuronal activity and connectivity are indeed sufficient to infer the function of a BNN. Therefore, we pose the Neural Systems Identification and Prediction Challenge (nuSPIC). We provide the connectivity and activity of all neurons and invite participants (1) to infer the functions implemented (hard-wired) in spiking neural networks (SNNs) by stimulating and recording the activity of neurons and, (2) to implement predefined mathematical/biological functions using SNNs. The nuSPICs can be accessed via a web-interface to the NEST simulator and the user is not required to know any specific programming language. Furthermore, the nuSPICs can be used as a teaching tool. Finally, nuSPICs use the crowd-sourcing model to address scientific issues. With this computational approach we aim to identify which functions can be inferred by systematic recordings of neuronal activity and connectivity. In addition, nuSPICs will help the design and application of new experimental paradigms based on the structure of the SNN and the presumed function which is to be discovered.

An assessment of the challenges and opportunitiesof implementing ...

African Journals Online (AJOL)

user

2012-06-01

Jun 1, 2012 ... implementation of program budgeting system (PBS) in the two ministries in. Ethiopia ... use of performance information to inform decisions about budgetary .... budgeting in terms of budget credibility, expenditure control and public ... fields such as management (30.0 %), accounting (16.0%) and the balance.

Reorganization of Practicum in Initial Teacher Education: A Search for Challenges in Implementation by Ex-Ante Evaluation

Directory of Open Access Journals (Sweden)

Laila Niklasson

2015-10-01

Full Text Available The background of the study is a perceived need of increasing quality in practice during Initial Teacher Education (ITE in Sweden. In order to achieve higher quality, the government encourages reorganization towards a limited number of practice schools, competence development for supervisors and research focusing on the selected practice schools.  The aim of this study is to present and critically discuss prerequisites for implementation of the reform. The paper focuses on how a preliminary logic model and a SWOT analysis can show challenges encountered during the implementation of the reorganization. By using the logic model and the SWOT analysis an ex-ante evaluation was carried out in two steps. The results disclosed that the motivation behind reorganization, improving the quality of practicum, might meet some challenges. Indicators of higher quality being attained are not provided; the local organization is expected to construct such indicators during the process. In contrast to the challenges the results showed that the implementation was supported by earlier good relations and a common idea of developing practicum in ITE. The implication for implementation is a need to have a dialogue about indicators for quality among different stakeholders in ITE. Without such a dialogue it can be disputed whether the change in practicum was successful.

Defining the challenges for ecodesign implementation in companies: development and consolidation of a framework

DEFF Research Database (Denmark)

Dekoninck, Elies A.; Domingo, Lucie; O'Hare, Jamie Alexander

2016-01-01

This study addresses the problem of the slow take-up of ecodesign in industry by identifying and categorising the implementation challenges faced by practitioners. Case studies from nine manufacturing companies from five different countries are reported based on interviews with key ecodesign pers...

Analyzing the Challenges of IS implementation in public health institutions of a developing country

DEFF Research Database (Denmark)

Mengiste, Shegaw Anagaw

2010-01-01

, availability of adaquate and qualified manpower, and managerial commitment and support would significantly influence the implementation process. I argue that, such context-senitive challenges need to be dealt through flexible startegies that took in to account the specific context. In this paper, four...

Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

Science.gov (United States)

Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-11-16

Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

Challenges of Biopiracy: Implementing Community Based Ecotourism (CBET in the Sri Lankan context

Directory of Open Access Journals (Sweden)

H.I.G.C. Kumara

2017-03-01

Full Text Available AbstractProtecting the right of the local community/country to use their own genetic resourcesavailable in a particular area is an important element of environmental and biodiversityconservation. However, one of the biggest biodiversity conservation challenges faced bysouthern peripheral countries is biopiracy and related issues. Community based ecotourism(CBET is a well-established concept and its implementation is an important component in manyregional development strategies. This research argues that though CBET which originated as awestern concept has been successfully applied in number of projects, it generates biopiracychallenges in its implementation when CBET operates within different geo-political, economicand cultural contexts. This research examines such challenges to CBET initiatives in theSinharaja world heritage site, Sri Lanka. A qualitative-inductive research methodology hasprincipally guided this research to examine the socio-cultural and socio-economic context ofbiopiracy issues. A total of 293 participants have informed this research including 193interviews. A critical discourse analysis (CDA method is used to examine both primaryqualitative data collected through participant and direct observation, interviews and secondarydata. One of the main findings is that despite plans being developed at a community level, inwider context, challenges of biopiracy related to superimposed capitalism contest CBETideologies. Superimposed capitalism results in individualistic and competitive behaviours thatundermine collaborative and responsible community approach. Presently, smuggling out ofWallapatta plant (Gyrinops walla and gathering of Spotted bowfinger gecko (Cyrtodactylustriedra which is an endemic nocturnal reptile species have become profitable in KudawaSinharajasite and a growing number of biopirates venture into here. Local community of this sitetakes risks in forest genetic resources smuggling because it provides them with the

Experience with the Open Source based implementation for ATLAS Conditions Data Management System

CERN Document Server

Amorim, A; Oliveira, C; Pedro, L; Barros, N

2003-01-01

Conditions Data in high energy physics experiments is frequently seen as every data needed for reconstruction besides the event data itself. This includes all sorts of slowly evolving data like detector alignment, calibration and robustness, and data from detector control system. Also, every Conditions Data Object is associated with a time interval of validity and a version. Besides that, quite often is useful to tag collections of Conditions Data Objects altogether. These issues have already been investigated and a data model has been proposed and used for different implementations based in commercial DBMSs, both at CERN and for the BaBar experiment. The special case of the ATLAS complex trigger that requires online access to calibration and alignment data poses new challenges that have to be met using a flexible and customizable solution more in the line of Open Source components. Motivated by the ATLAS challenges we have developed an alternative implementation, based in an Open Source RDBMS. Several issues...

Evaluating safety management system implementation

International Nuclear Information System (INIS)

Preuss, M.

2009-01-01

Canada is committed to not only maintaining, but also improving upon our record of having one of the safest aviation systems in the world. The development, implementation and maintenance of safety management systems is a significant step towards improving safety performance. Canada is considered a world leader in this area and we are fully engaged in implementation. By integrating risk management systems and business practices, the aviation industry stands to gain better safety performance with less regulatory intervention. These are important steps towards improving safety and enhancing the public's confidence in the safety of Canada's aviation system. (author)

Challenges in implementing a Planetary Boundaries based Life-Cycle Impact Assessment methodology

DEFF Research Database (Denmark)

Ryberg, Morten; Owsianiak, Mikolaj; Richardson, Katherine

2016-01-01

of resolving the challenges and developing such methodology is discussed. The challenges are related to technical issues, i.e., modelling and including the Earth System processes and their control variables as impact categories in Life-Cycle Impact Assessment and to theoretical considerations with respect...... to the interpretation and use of Life-Cycle Assessment results in accordance with the Planetary Boundary framework. The identified challenges require additional research before a Planetary Boundaries based Life-Cycle Impact Assessment method can be developed. Research on modelling the impacts on Earth System processes......Impacts on the environment from human activities are now threatening to exceed thresholds for central Earth System processes, potentially moving the Earth System out of the Holocene state. To avoid such consequences, the concept of Planetary Boundaries was defined in 2009, and updated in 2015...

Evolving the Nation's Energy Infrastructure: A Challenging System Issue for the Twenty-First Century; Preprint

Energy Technology Data Exchange (ETDEWEB)

Garrett, B.

2007-04-01

Over the next several decades, a profound transformation of the global energy enterprise will occur driven largely by population growth and economic development. How this growing demand for energy is met poses one of the most complex and challenging issues of our time. The current national energy dialogue reflects the challenge in simultaneously considering the social, political, economic, and technical issues as the energy system is defined, technical targets are established, and programs and investments are implemented to meet those technical targets. This paper examines the general concepts and options for meeting this challenge.

Bridging the Chasm: Challenges, Opportunities, and Resources for Integrating a Dissemination and Implementation Science Curriculum into Medical Education.

Science.gov (United States)

Ginossar, Tamar; Heckman, Carolyn J; Cragun, Deborah; Quintiliani, Lisa M; Proctor, Enola K; Chambers, David A; Skolarus, Ted; Brownson, Ross C

2018-01-01

Physicians are charged with implementing evidence-based medicine, yet few are trained in the science of Dissemination and Implementation (D&I). In view of the potential of evidence-based training in D&I to help close the gap between research and practice, the goal of this review is to examine the importance of D&I training in medical education, describe challenges to implementing such training, and provide strategies and resources for building D&I capacity. We conducted (1) a systematic review to identify US-based D&I training efforts and (2) a critical review of additional literature to inform our evaluation of the challenges and opportunities of integrating D&I training in medical education. Out of 269 unique articles reviewed, 11 described US-based D&I training. Although vibrant and diverse training opportunities exist, their capacity is limited, and they are not designed to meet physicians' needs. Synthesis of relevant literature using a critical review approach identified challenges inherent to changing medical education, as well as challenges related to D&I science. Finally, selected strategies and resources are available for facilitating incorporation of D&I training into medical education and overcoming existing challenges. Integrating D&I training in the medical education curriculum, and particularly in residency and fellowship training, holds promise for bridging the chasm between scientific discoveries and improved patient care and outcomes. However, unique challenges should be addressed, including the need for greater evidence.

Managing social-ecological systems under uncertainty: implementation in the real world

Directory of Open Access Journals (Sweden)

Ana Nuno

2014-06-01

Full Text Available Management decisions for natural resources are not made in a vacuum; the environmental and ecological conditions as well as the socioeconomic and political contexts affect goals, the choice of interventions, their feasibility, and which outcomes are obtained. Although uncertainty is recognized as a feature of natural resource management, little attention has been given to the uncertainty generated by institutional settings, historical contingency, and individual people's influence. These implementation uncertainties, related to the translation of policy into practice, make it difficult to predict the outcomes of management interventions within social-ecological systems. Using the conservation of species hunted for bushmeat in the Serengeti as a case study, we investigated the challenges and potential barriers to successful implementation of natural resource management policies. We used a mixed-methods approach, combining semistructured interviews with scenario building, social network, and institutional analysis exercises. Using a management strategy evaluation (MSE conceptual framework, we obtained insights into the constraints and opportunities for fulfilling stakeholder aspirations for the social-ecological system, analyzed the multiple roles played by different institutions in the system, and described the interactions between different actor types. We found that the respondents had generally similar views about the current and future status of the Serengeti but disagreed about how to address issues of conservation concern and were more uncertain about the actual outcomes of management interventions. Improving conservation implementation (rather than research, monitoring, or status assessment was perceived as the key priority to be addressed. Institutional barriers were perceived as an important challenge given that the decision-making and implementation processes were broadly distributed across a number of institutions. Conservation social

Co-design and implementation research: challenges and solutions for ethics committees.

Science.gov (United States)

Goodyear-Smith, Felicity; Jackson, Claire; Greenhalgh, Trisha

2015-11-16

Implementation science research, especially when using participatory and co-design approaches, raises unique challenges for research ethics committees. Such challenges may be poorly addressed by approval and governance mechanisms that were developed for more traditional research approaches such as randomised controlled trials. Implementation science commonly involves the partnership of researchers and stakeholders, attempting to understand and encourage uptake of completed or piloted research. A co-creation approach involves collaboration between researchers and end users from the onset, in question framing, research design and delivery, and influencing strategy, with implementation and broader dissemination strategies part of its design from gestation. A defining feature of co-creation is its emergent and adaptive nature, making detailed pre-specification of interventions and outcome measures impossible. This methodology sits oddly with ethics committee protocols that require precise pre-definition of interventions, mode of delivery, outcome measurements, and the role of study participants. But the strict (and, some would say, inflexible) requirements of ethics committees were developed for a purpose - to protect participants from harm and help ensure the rigour and transparency of studies. We propose some guiding principles to help square this circle. First, ethics committees should acknowledge and celebrate the diversity of research approaches, both formally (through training) and informally (by promoting debate and discussion); without active support, their members may not understand or value participatory designs. Second, ground rules should be established for co-design applications (e.g. how to judge when 'consultation' or 'engagement' becomes research) and communicated to committee members and stakeholders. Third, the benefits of power-sharing should be recognised and credit given to measures likely to support this important goal, especially in research with

Models of user involvement in the mental health context: intentions and implementation challenges.

Science.gov (United States)

Storm, Marianne; Edwards, Adrian

2013-09-01

Patient-centered care, shared decision-making, patient participation and the recovery model are models of care which incorporate user involvement and patients' perspectives on their treatment and care. The aims of this paper are to examine these different care models and their association with user involvement in the mental health context and discuss some of the challenges associated with their implementation. The sources used are health policy documents and published literature and research on patient-centered care, shared decision-making, patient participation and recovery. The policy documents advocate that mental health services should be oriented towards patients' or users' needs, participation and involvement. These policies also emphasize recovery and integration of people with mental disorders in the community. However, these collaborative care models have generally been subject to limited empirical research about effectiveness. There are also challenges to implementation of the models in inpatient care. What evidence there is indicates tensions between patients' and providers' perspectives on treatment and care. There are issues related to risk and the person's capacity for user involvement, and concerns about what role patients themselves wish to play in decision-making. Lack of competence and awareness among providers are further issues. Further work on training, evaluation and implementation is needed to ensure that inpatient mental health services are adapting user oriented care models at all levels of services.

Pattern-Based Development of Enterprise Systems: from Conceptual Framework to Series of Implementations

Directory of Open Access Journals (Sweden)

Sergey V. Zykov

2013-04-01

Full Text Available Building enterprise software is a dramatic challenge due to data size, complexity and rapid growth of the both in time. The issue becomes even more dramatic when it gets to integrating heterogeneous applications. Therewith, a uniform approach is required, which combines formal models and CASE tools. The methodology is based on extracting common ERP module level patterns and applying them to series of heterogeneous implementations. The approach includes a lifecycle model, which extends conventional spiral model by formal data representation/management models and DSL-based "low-level" CASE tools supporting the formalisms. The methodology has been successfully implemented as a series of portal-based ERP systems in ITERA oil-and-gas corporation, and in a number of trading/banking enterprise applications for other enterprises. Semantic network-based airline dispatch system, and a 6D-model-driven nuclear power plant construction support system are currently in progress.

Rural electric energy services in China: Implementing the renewable energy challenge

Energy Technology Data Exchange (ETDEWEB)

Weingart, J.W.

1996-12-31

This paper discusses issues related to rural electrification in China, with emphasis on a pilot project in Mongolia to implement small scale renewable energy sources. These projects consist of photovoltaic systems, wind electric systems, photovoltaic/wind hybrid systems, and wind/gasoline generator sets. These systems are small enough to implement in rural environments, more cost effective than grid type systems, and have lower cost than standard generator sets alone because of the improved reliability. The author also discusses the use of such systems for village power sources. A number of factors are contributing to the increase in such systems. Individuals are able and willing to pay for such systems, lending institutions are willing to fund such small-scale projects, they provide reliable, high quality services which support social and economic development.

Implementation of a departmental picture archiving and communication system: a productivity and cost analysis.

Science.gov (United States)

Macyszyn, Luke; Lega, Brad; Bohman, Leif-Erik; Latefi, Ahmad; Smith, Michelle J; Malhotra, Neil R; Welch, William; Grady, Sean M

2013-09-01

Digital radiology enhances productivity and results in long-term cost savings. However, the viewing, storage, and sharing of outside imaging studies on compact discs at ambulatory offices and hospitals pose a number of unique challenges to a surgeon's efficiency and clinical workflow. To improve the efficiency and clinical workflow of an academic neurosurgical practice when evaluating patients with outside radiological studies. Open-source software and commercial hardware were used to design and implement a departmental picture archiving and communications system (PACS). The implementation of a departmental PACS system significantly improved productivity and enhanced collaboration in a variety of clinical settings. Using published data on the rate of information technology problems associated with outside studies on compact discs, this system produced a cost savings ranging from $6250 to $33600 and from $43200 to $72000 for 2 cohorts, urgent transfer and spine clinic patients, respectively, therefore justifying the costs of the system in less than a year. The implementation of a departmental PACS system using open-source software is straightforward and cost-effective and results in significant gains in surgeon productivity when evaluating patients with outside imaging studies.

IMPLEMENTATION OF ERP SYSTEMS: TECNOLOGY AND PEOPLE IN SAP R/3 IMPLEMENTATION

Directory of Open Access Journals (Sweden)

Renata Gomes de Jesus

2007-01-01

Full Text Available The objective of this study is to verify if there are influences on subjective aspects of the organizational actors involved in an ERP system implementation. With this purpose, a case study in a food company located in Vila Velha, Espírito Santo was carried out. The implementation of the SAP R/3 ERP system was initiated in 1999. The data was collected by documentary research and 19 semi-structured interviews. The theoretical discussion analyzes the implementation of the ERP systems under the perspective of the system concept, considering the technological change not only under the perspective of the technology, but also of the organizational structure and people. The conclusion proved that, in the case studied, there was a significant influence of the individuals in the result of the implementation.

Managing the Interoperability and Privacy of e-Health Systems as an Interdisciplinary Challenge

Directory of Open Access Journals (Sweden)

Alexandru Soceanu

2016-10-01

Full Text Available The growing number of patients with chronic diseases, the ageing population worldwide, the rapid increase in hospital costs and in the cost of care personnel as well as the achieving medical objectives "increase the patient quality of life and survival" face Europe with a huge challenge. One of the solutions for reaching these challenges in the future is the deployment of complex eHealth systems in support of all the healthcare aspects on the way between patient home and healthcare provider. In the last decade the European Commission (EC in cooperation with healthcare associations and standardization institutes announced large frameworks for supporting research and development of various components of the future eHealth systems. This may be considered as an immediate interdisciplinary opportunity for European researchers and developers to create jointly the spine of future healthcare systems. After a short introduction to eHealth architecture, interoperability, security and privacy the talk refers to the interdisciplinary solutions which approach these healthcare huge overall challenge. Two case studies will be addressed: a interdisciplinary partnership for conducting jointly European research concerning remote control and management of future wearable dialysis devices, and b ERASMUS supported international education programs for creating future interdisciplinary expert networks working on developing and implementing a better healthcare system.

Operational Challenges and Solutions with Implementation of an Adaptive Seamless Phase 2/3 Study

Science.gov (United States)

Spencer, Kimberly; Colvin, Kelly; Braunecker, Brad; Brackman, Marcia; Ripley, Joyce; Hines, Paul; Skrivanek, Zachary; Gaydos, Brenda; Geiger, Mary Jane

2012-01-01

A wide variety of operational issues were encountered with the planning and implementation of an adaptive, dose-finding, seamless phase 2/3 trial for a diabetes therapeutic. Compared with a conventional design, significant upfront planning was required, as well as earlier, more integrated cross-functional coordination. The existing infrastructure necessitated greater flexibility to meet the needs of the adaptive design. Rapid data acquisition, analysis, and reporting were essential to support the successful implementation of the adaptive algorithm. Drug supply for nine treatment arms had to be carefully managed across many sites worldwide. Details regarding these key operational challenges and others will be discussed along with resolutions taken to enable successful implementation of this adaptive, seamless trial. PMID:23294774

u-Healthcare system: state-of-the-art review and challenges.

Science.gov (United States)

Touati, Farid; Tabish, Rohan

2013-06-01

With the increase of an ageing population and chronic diseases, society becomes more health conscious and patients become "health consumers" looking for better health management. People's perception is shifting towards patient-centered, rather than the classical, hospital-centered health services which has been propelling the evolution of telemedicine research from the classic e-Health to m-Health and now is to ubiquitous healthcare (u-Health). It is expected that mobile & ubiquitous Telemedicine, integrated with Wireless Body Area Network (WBAN), have a great potential in fostering the provision of next-generation u-Health. Despite the recent efforts and achievements, current u-Health proposed solutions still suffer from shortcomings hampering their adoption today. This paper presents a comprehensive review of up-to-date requirements in hardware, communication, and computing for next-generation u-Health systems. It compares new technological and technical trends and discusses how they address expected u-Health requirements. A thorough survey on various worldwide recent system implementations is presented in an attempt to identify shortcomings in state-of-the art solutions. In particular, challenges in WBAN and ubiquitous computing were emphasized. The purpose of this survey is not only to help beginners with a holistic approach toward understanding u-Health systems but also present to researchers new technological trends and design challenges they have to cope with, while designing such systems.

Academics' Perceptions of the Challenges and Barriers to Implementing Research-Based Experiences for Undergraduates

Science.gov (United States)

Brew, Angela; Mantai, Lilia

2017-01-01

How can universities ensure that strategic aims to integrate research and teaching through engaging students in research-based experiences be effectively realised within institutions? This paper reports on the findings of a qualitative study exploring academics' perceptions of the challenges and barriers to implementing undergraduate research.…

[Implementing Inter-Professional Education (IPE): Challenges and Strategies].

Science.gov (United States)

Lee, Chia-Lun; Hung, Chich-Hsiu

2017-12-01

Inter-professional practice (IPP), necessary in today's healthcare environment, should be guided and practiced through inter-professional education (IPE). Within the context of an effective IPE program, collaborative medical professionals must be cognizant of the demands of patients' integrated care, organize a collaborative inter-professional team, and achieve the objectives of patient-centered care. However, the many challenges of IPE include insufficient understanding of inter-professional care, occupational culture-related boundary issues, lack of a college education, and insufficient support from academic and medical institutions. This article suggests adopting effective strategies to promote inter-professional recognition, create a harmonious medical culture, eliminate barriers to education, and enhance support for academic and medical institutions. Inter-professional collaboration between academic and clinical institutions must provide resources and substantive professional training. Effectively implementing IPE and IPP is expected to elicit trust, respect, and efficient communication from team members.

The challenges of implementing advanced access for residents in family medicine in Quebec. Do promising strategies exist?

Science.gov (United States)

Abou Malham, Sabina; Touati, Nassera; Maillet, Lara; Breton, Mylaine

2018-12-01

The advanced access (AA) model is a highly recommended innovation to improve timely access to primary healthcare. Despite that many studies have shown positive impacts for healthcare professionals, and for patients, implementing this model in clinics with a teaching mission for family medicine residents poses specific challenges. To identify these challenges within these clinics, as well as potential strategies to address them. The authors adopted a qualitative multiple case study design, collected data in 2016 using semi-structured interviews (N = 40) with healthcare professionals and clerical staff in four family medicine units in Quebec, and performed a thematic analysis. They validated results through a discussion workshop, involving many family physicians and residents practicing in different regions Results: Five challenges emerged from the data: 1) choosing, organizing residents' patient; 2) managing and balancing residents' appointment schedules; 3) balancing timely access with relational continuity; 4) understanding the AA model; 5) establishing collaborative practices with other health professionals. Several promising strategies were suggested to address these challenges, including clearly defining residents' patient panels; adopting a team-based care approach; incorporating the model into academic curriculum and clinical training; proactive and ongoing education of health professionals, residents, and patients; involving residents in the change process and in adjustment strategies. To meet the challenges of implementing AA, decision-makers should consider exposing residents to AA during academic training and clinical internships, involving them in team work on arrival, engaging them as key actors in the implementation and in intra- and inter-professional collaborative models.

Challenges of implementating a doctoral program in an international exchange in Cuba through the lens of Kanter's empowerment theory.

Science.gov (United States)

Scanlan, Judith M; Abdul Hernandéz, C

2014-08-01

The literature in international education focuses primarily on the experiences of western students in developing countries, international students in western universities, the development of an educational program in a developing country, or internationalization of curricula in western universities. There is little in the literature that addresses the challenges students and participating faculty face when implementing a graduate program in a developing country. The purpose of this paper is to describe and analyze the challenges of implementing a doctoral program in an international exchange through the lens of Kanter's theory of empowerment. Recommendations to address these challenges will be made. Copyright © 2014 Elsevier Ltd. All rights reserved.

Fall Prediction and Prevention Systems: Recent Trends, Challenges, and Future Research Directions

Directory of Open Access Journals (Sweden)

Ramesh Rajagopalan

2017-11-01

Full Text Available Fall prediction is a multifaceted problem that involves complex interactions between physiological, behavioral, and environmental factors. Existing fall detection and prediction systems mainly focus on physiological factors such as gait, vision, and cognition, and do not address the multifactorial nature of falls. In addition, these systems lack efficient user interfaces and feedback for preventing future falls. Recent advances in internet of things (IoT and mobile technologies offer ample opportunities for integrating contextual information about patient behavior and environment along with physiological health data for predicting falls. This article reviews the state-of-the-art in fall detection and prediction systems. It also describes the challenges, limitations, and future directions in the design and implementation of effective fall prediction and prevention systems.

Fall Prediction and Prevention Systems: Recent Trends, Challenges, and Future Research Directions.

Science.gov (United States)

Rajagopalan, Ramesh; Litvan, Irene; Jung, Tzyy-Ping

2017-11-01

Fall prediction is a multifaceted problem that involves complex interactions between physiological, behavioral, and environmental factors. Existing fall detection and prediction systems mainly focus on physiological factors such as gait, vision, and cognition, and do not address the multifactorial nature of falls. In addition, these systems lack efficient user interfaces and feedback for preventing future falls. Recent advances in internet of things (IoT) and mobile technologies offer ample opportunities for integrating contextual information about patient behavior and environment along with physiological health data for predicting falls. This article reviews the state-of-the-art in fall detection and prediction systems. It also describes the challenges, limitations, and future directions in the design and implementation of effective fall prediction and prevention systems.

Generating evidence for health policy in challenging settings: lessons learned from four prevention of mother-to-child transmission of HIV implementation research studies in Nigeria.

Science.gov (United States)

Sam-Agudu, Nadia A; Aliyu, Muktar H; Adeyemi, Olusegun A; Oronsaye, Frank; Oyeledun, Bolanle; Ogidi, Amaka G; Ezeanolue, Echezona E

2018-04-17

Implementation research (IR) facilitates health systems strengthening and optimal patient outcomes by generating evidence for scale-up of efficacious strategies in context. Thus, difficulties in generating IR evidence, particularly in limited-resource settings with wide disease prevention and treatment gaps, need to be anticipated and addressed. Nigeria is a priority country for the prevention of mother-to-child transmission of HIV (PMTCT). This paper analyses the experiences of four PMTCT IR studies in Nigeria, and proffers solutions to major challenges encountered during implementation. Multicentre PMTCT IR studies conducted in Nigeria during the Global Plan's assessment period (2011 to 2015) were included. Four studies were identified, namely The Baby Shower Trial, Optimizing PMTCT, MoMent and Lafiyan Jikin Mata. Major common challenges encountered were categorised as 'External' (beyond the control of study teams) and 'Internal' (amenable to rectification by study teams). External challenges included healthcare worker strikes and turnover, acts and threats of ethnic and political violence and terrorism, and multiplicity of required local ethical reviews. Internal challenges included limited research capacity among study staff, research staff turnover and travel restrictions hindering study site visits. Deliberate research capacity-building was provided to study staff through multiple opportunities before and during study implementation. Post-study employment opportunities and pathways for further research career-building are suggested as incentives for study staff retention. Engagement of study community-resident personnel minimised research staff turnover in violence-prone areas. The IR environment in Nigeria is extremely diverse and challenging, yet, with local experience and anticipatory planning, innovative solutions can be implemented to modulate internal challenges. Issues still remain with healthcare worker strikes and often unpredictable insecurity

Guidelines for Implementing Advanced Distribution Management Systems-Requirements for DMS Integration with DERMS and Microgrids

Energy Technology Data Exchange (ETDEWEB)

Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States); Chen, Chen [Argonne National Lab. (ANL), Argonne, IL (United States); Lu, Xiaonan [Argonne National Lab. (ANL), Argonne, IL (United States)

2015-08-01

This guideline focuses on the integration of DMS with DERMS and microgrids connected to the distribution grid by defining generic and fundamental design and implementation principles and strategies. It starts by addressing the current status, objectives, and core functionalities of each system, and then discusses the new challenges and the common principles of DMS design and implementation for integration with DERMS and microgrids to realize enhanced grid operation reliability and quality power delivery to consumers while also achieving the maximum energy economics from the DER and microgrid connections.

National health insurance policy in Nepal: challenges for implementation

Directory of Open Access Journals (Sweden)

Shiva Raj Mishra

2015-08-01

Full Text Available The health system in Nepal is characterized by a wide network of health facilities and community workers and volunteers. Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. But the reality is a far cry. Only 61.8% of the Nepalese households have access to health facilities within 30 min, with significant urban (85.9% and rural (59% discrepancy. Addressing barriers to health services needs urgent interventions at the population level. Recently (February 2015, the Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme (SHS after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Mechanisms should be built for monitoring unfair pricing and unaffordable copayments, and an overall benefit package be crafted to include coverage of major health services including non-communicable diseases. Regulations should include such issues as accreditation mechanisms for private providers. Health system strengthening should move along with the roll-out of SHS. Improving the efficiency of hospital, motivating the health workers, and using appropriate technology can improve the quality of health services. Also, as currently a constitution drafting is being finalized, careful planning and deliberation is necessary about what insurance structure may suit the proposed future federal structure in Nepal.

Lost in Translation? Ethical Challenges of Implementing a New Diagnostic Procedure.

Science.gov (United States)

Schmitz, Dagmar

2016-01-01

Since cell-free DNA (cfDNA) fragments of placental origin can be isolated and analyzed from the blood of pregnant women. Applications of this finding have been developed and implemented in clinical care pathways worldwide at an unprecedented pace and manner. Implementation patterns, however, exhibit considerable insufficiencies. Different "motors" of implementation processes, like the market or various regulatory institutions, can be identified at a national level. Each "motor" entails characteristic ethical challenges which are exemplified impressively by a rising number of case reports.Empirical data demonstrate that there are significant "losses" in the respective translational processes, especially when the results from clinical research are to be translated into the clinical reality of NIPT (the so called "second roadblock" (T2)). These "losses" are perceived in the fields of knowledge transfer, professional standardization and ethical debate. Recommendations of professional organizations often fail to reach general practitioners. Blindsided by the new diagnostic procedure in their clinical practice, professionals in prenatal care express their insecurities with regard to its handling. Ethical debate appears to adhere to pre-existing (and partly already proven to be insufficient) normative frameworks for prenatal testing. While all of these deficits are typical for the implementation processes of many new molecular diagnostic procedures, especially in NIPT, they show a high variability between different nations.A critical assessment of the preferred strategy of implementation against the background of already existing national ethical frameworks is indispensable, if potential adverse effects are to be diminished. The described translational losses seem to be significantly reducible by granting the translational process in roadblock T2 more time.

The Implementations and Challenges of Continuous Assessment in Public Universities of Eastern Ethiopia

Directory of Open Access Journals (Sweden)

Gemechu Abera

2017-11-01

Full Text Available The study was aimed to investigate the implementations and challenges of continuous assessment in selected Public Universities of Eastern Ethiopia. Descriptive survey research design was employed to carry out this study because it is used to describe the characteristics of a given population in a systematic and accurate fashion. Stratified random sampling technique was employed to collect pertinent information from the respondents through questionnaire and observational checklists. To make the interpretation of the findings easier, the researchers used both descriptive and inferential statistics. The first finding was that almost the implementations of continuous assessment in these selected universities were very poor. The second finding was that there was statistically a significant mean difference among these public universities in utilizing and implementing continuous assessment; the third finding was that there was statistically significant mean difference among these sampled respondents in implementing the three domains of educational objectives; the fourth interesting finding was that the implemented continuous assessment type was highly dominated by cognitive, followed by affective and then psychomotor domains respectively. Finally, it was recommended that instructors should implement continuous assessment not only for the sake of evaluating and marking students’ result but also for the sake of learning skills and practices.

Design and implementation of adaptive cruise control system for the TU/e solar powered electric car

NARCIS (Netherlands)

Papaliouras, I.

2016-01-01

The technical report presents the design and implementation of Adaptive Cruise Control. (ACC) system for the “Stella Lux” solar powered electric car, which was built by Solar Team Eindhoven and won the World Solar Challenge in Australia in 2015. Initially, an over-view of the context of the project

Development of the supply chain oriented quality assurance system for aerospace manufacturing SMEs and its implementation perspectives

Science.gov (United States)

Hussein, Abdullahi; Cheng, Kai

2016-10-01

Aerospace manufacturing SMEs are continuously facing the challenge on managing their supply chain and complying with the aerospace manufacturing quality standard requirement due to their lack of resources and the nature of business. In this paper, the ERP system based approach is presented to quality control and assurance work in light of seamless integration of in-process production data and information internally and therefore managing suppliers more effectively and efficiently. The Aerospace Manufacturing Quality Assurance Standard (BS/EN9100) is one of the most recognised and essential protocols for developing the industry-operated-and-driven quality assurance systems. The research investigates using the ERP based system as an enabler to implement BS/EN9100 quality management system at manufacturing SMEs and the associated implementation and application perspectives. An application case study on a manufacturing SME is presented by using the SAP based implementation, which helps further evaluate and validate the approach and application system development.

Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.

Science.gov (United States)

Brouwer, Miranda; Coelho, Eliana; Mosse, Carla das Dores; Brondi, Luciana; Winterton, Laura; van Leth, Frank

2014-01-01

Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to investigate Mozambican HCWs' perceptions of their occupational TB risk and the measures they report using to reduce this risk. In addition, we explored the challenges HCWs encounter while using these TBIPC measures. Focus group discussion. Analysis according content method. Four categories of HCWs: auxiliary workers, medical (doctors and clinical officers), nurses and TB program staff. HCWs are aware of their occupational TB risk and use various measures to reduce their risk of infection. HCWs find it challenging to employ measures that minimize such risks and a lack of clear guidelines contributes to these challenges. HCWs' and patient behavior further complicate the use of TBIPC measures. HCWs in Mozambique perceive a high occupational risk of TB infection. They report several challenges using measures to reduce this risk such as shortage of material, lack of clear guidelines, insufficient motivation and inadequate training. Robust training with motivational approaches, alongside supervision and support for HCWs could improve implementation of TBIPC measures. Healthcare management should address the areas for improvement that are beyond the individual HCW's control.

Technical Challenges in the Application and Licensing of Digital Instrumentation and Control Systems in Nuclear Power Plants

International Nuclear Information System (INIS)

2015-01-01

With the modernization of existing analogue instrumentation and control (I&C) systems in nuclear power plants through digital I&C technology, and the implementation of digital I&C systems in new plants, the industry is faced with significant challenges. These challenges appear in the form of difficulties in managing the necessarily incremental transition, highly integrated (and interdependent) architectures, the flexible configurability enabled by digital technology, and uncertainty and inconsistency in licensing digital I&C systems and equipment in the different Member States. This publication discusses 17 major issues that utilities, developers, suppliers and regulatory stakeholders need to consider, so that the industry can capture and benefit from shared experience, recent technological developments, and emerging best practices

Implementing Indigenous Education Policy Directives in Ontario Public Schools: Experiences, Challenges and Successful Practices

Directory of Open Access Journals (Sweden)

Emily Milne

2017-08-01

Full Text Available The Ontario Ministry of Education has declared a commitment to Indigenous student success and has advanced a policy framework that articulates inclusion of Indigenous content in schooling curriculum (Ontario Ministry of Education, 2007. What are the perceptions among educators and parents regarding the implementation of policy directives, and what is seen to encourage or limit meaningful implementation? To answer these questions, this article draws on interviews with 100 Indigenous (mainly Haudenosaunee, Anishinaabe, and Métis and non-Indigenous parents and educators from Ontario Canada. Policy directives are seen to benefit Indigenous and non-Indigenous students. Interviews also reveal challenges to implementing Indigenous curricular policy, such as unawareness and intimidation among non-Indigenous educators regarding how to teach material. Policy implications are considered.

RFIC's challenges for third-generation wireless systems

Science.gov (United States)

Boric-Lubecke, Olga; Lin, Jenshan; Gould, Penny; Kermalli, Munawar

2001-11-01

Third generation (3G) cellular wireless systems are envisioned to offer low cost, high-capacity mobile communications with data rates of up to 2 Mbit/s, with global roaming and advanced data services. Besides adding mobility to the internet, 3G systems will provide location-based services, as well as personalized information and entertainment. Low cost, high dynamic-range radios, both for base stations (BS) and for mobile stations (MS) are required to enable worldwide deployment of such networks. A receiver's reference sensitivity, intermodulation characteristics, and blocking characteristics, set by a wireless standard, define performance requirements of individual components of a receiver front end. Since base station handles multiple signals from various distances simultaneously, its radio specifications are significantly more demanding than those for mobile devices. While high level of integration has already been achieved for second generation hand-sets using low-cost silicon technologies, the cost and size reduction of base stations still remains a challenge and necessity. While silicon RFIC technology is steadily improving, it is still difficult to achieve noise figure (NF), linearity, and phase noise requirements with presently available devices. This paper will discuss base station specification for 2G (GSM) and 3G (UMTS) systems, as well as the feasibility of implementing base station radios in low-cost silicon processes.

User resistance to information system implementations

DEFF Research Database (Denmark)

Campbell, Robert H.; Grimshaw, Mark

2016-01-01

Users often resist information system implementations and it has been established that this can cause an implementation to fail. In this paper, the user attitudes that can cause resistance are examined using an established attitude change theory from social and cognitive psychology: the Elaboration......-ranging study are presented that, in addition to supporting this argument, identifies and classifies 19 new heuristics and peripheral influences (in addition to the nine already known) that commonly, and adversely, affect user attitudes and responses to new information system implementations....

A Critical Element to Successful Implementation Of Future Safeguards Systems

International Nuclear Information System (INIS)

Dickman, Deborah A.

2003-01-01

As we look to the future of nuclear materials management and safeguards systems, it is essential to place significant emphasis on creation of a strong infrastructure to support and sustain modern systems. Traditionally, safeguards infrastructure development has focused on such elements as equipment development, strengthening of the national regulatory base, creation of state-of-the-art accounting and control systems, and procedure development. Less emphasis has been placed on recognition of the 'human element' as a primary component of the necessary infrastructure and the key to successful implementation of new or existing systems. The importance of the human element can be recognized by considering the broad span of influence and control, direction, regulation and implementation of safeguards systems exhibited by a large number of professionals: diplomats, scholars, politicians, facility managers, program directors and technical specialists. These individuals provide the connectivity or 'glue' that binds together a myriad of smaller safeguards program elements and ensures a holistic approach is fostered and maintained. The education and training of our future leaders and experts must receive the highest priority. In addition, this effort must consider factors beyond development of technical capabilities. Given the rapidly evolving world climate since the end of the cold war, our safeguards leaders and experts need education and training that will provide a well-developed understanding of the broader political dimensions of current nonproliferation challenges. They need to learn how to think, rather than what to think. A sustained effort is required to highlight the importance of the human dimension of safeguards and nuclear materials management and how these systems support international nonproliferation efforts. New educational initiatives are needed to better prepare the next generation of leaders and experts. Increased regional and national cooperation in the

An overview of Quality Management System implementation in a research laboratory

Science.gov (United States)

Molinéro-Demilly, Valérie; Charki, Abdérafi; Jeoffrion, Christine; Lyonnet, Barbara; O'Brien, Steve; Martin, Luc

2018-02-01

The aim of this paper is to show the advantages of implementing a Quality Management System (QMS) in a research laboratory in order to improve the management of risks specific to research programmes and to increase the reliability of results. This paper also presents experience gained from feedback following the implementation of the Quality process in a research laboratory at INRA, the French National Institute for Agronomic Research and details the various challenges encountered and solutions proposed to help achieve smoother adoption of a QMS process. The 7Ms (Management, Measurement, Manpower, Methods, Materials, Machinery, Mother-nature) methodology based on the Ishikawa `Fishbone' diagram is used to show the effectiveness of the actions considered by a QMS, which involve both the organization and the activities of the laboratory. Practical examples illustrate the benefits and improvements observed in the laboratory.

Privacy Management and Networked PPD Systems - Challenges Solutions.

Science.gov (United States)

Ruotsalainen, Pekka; Pharow, Peter; Petersen, Francoise

2015-01-01

Modern personal portable health devices (PPDs) become increasingly part of a larger, inhomogeneous information system. Information collected by sensors are stored and processed in global clouds. Services are often free of charge, but at the same time service providers' business model is based on the disclosure of users' intimate health information. Health data processed in PPD networks is not regulated by health care specific legislation. In PPD networks, there is no guarantee that stakeholders share same ethical principles with the user. Often service providers have own security and privacy policies and they rarely offer to the user possibilities to define own, or adapt existing privacy policies. This all raises huge ethical and privacy concerns. In this paper, the authors have analyzed privacy challenges in PPD networks from users' viewpoint using system modeling method and propose the principle "Personal Health Data under Personal Control" must generally be accepted at global level. Among possible implementation of this principle, the authors propose encryption, computer understandable privacy policies, and privacy labels or trust based privacy management methods. The latter can be realized using infrastructural trust calculation and monitoring service. A first step is to require the protection of personal health information and the principle proposed being internationally mandatory. This requires both regulatory and standardization activities, and the availability of open and certified software application which all service providers can implement. One of those applications should be the independent Trust verifier.

Implementation of Bluetooth serial port based profiles in embedded systems

Science.gov (United States)

Liu, Guanglei; Qiu, Zhengding; Wang, Quanping; Gao, Qiang

2001-10-01

Bluetooth is a new short-range wireless communication technology developing rapidly in recent years. Bluetooth software architecture consists of stack and profiles. Serial Port Profile (SPP) is an underlying profile that emulates RS232 serial cable connections between two peer devices. Based on SPP, Dial-up Networking (DUN) Profile establishes PPP connection with remote dial-up server, Fax Profile realizes document facsimile function and LAN Access Profile (LAP) provides local area network access service. When it comes to their implementation in embedded systems, there are several challenges such as memory consumption, code efficiency, code reliability, and code portability onto different OS and hardware platforms to be attacked. In this paper, we propose integrated software architecture after discussing the great similarities shared among the three SPP based profiles. Then implementation of the architecture is given, in which OS-dependent and OS-independent parts are clearly separated. Profile interfaces with stack and OS are specified respectively so that the three profiles as a whole can be ported onto various software and hardware platforms easily. As a result, policy of transplanting our implementation onto different platforms is addressed at the end of the paper.

Challenges of using Hospital Information Systems by nurses: comparing academic and non-academic hospitals.

Science.gov (United States)

Ahmadian, Leila; Dorosti, Nafise; Khajouei, Reza; Gohari, Sadrieh Hajesmaeel

2017-06-01

Hospital Information Systems (HIS) are used for easy access to information, improvement of documentation and reducing errors. Nonetheless, using these systems is faced with some barriers and obstacles. This study identifies the challenges and the obstacles of using these systems in the academic and non-academic hospitals in Kerman. This is a cross-sectional study which was carried out in 2015. The statistical population in this study consisted of the nurses who had been working in the academic and non-academic hospitals in Kerman. A questionnaire consisting of two sections was used. The first section consisted of the demographic information of the participants and the second section comprised 34 questions about the challenges of HIS use. Data were analyzed by the descriptive and statistical analysis (t-test, and ANOVA) using SPSS 19 software. The most common and important challenges in the academic hospitals were about human environment factors, particularly "negative attitude of society toward using HIS". In the non-academic hospitals, the most common and important challenges were related to human factors, and among them, "no incentive to use system" was the main factor. The results of the t-test method revealed that there was a significant relationship between gender and the mean score of challenges related to the organizational environment category in the academic hospitals and between familiarity with HIS and mean score of human environment factors (pinformation systems are the factors related to the human environment and the human factors. The results of this study can bring a good perspective to the policy makers and the managers regarding obstacles of using HISs from the nurses' perspective, so that they can solve their problems and can successfully implement these systems.

Integrated Financial Management Information Systems: Guidelines for effective implementation by the public sector of South Africa

Directory of Open Access Journals (Sweden)

Christoffel J. Hendriks

2012-12-01

Objectives: The research was conducted in order to identify the challenges and risks that are involved in the implementation of the IFMIS in South Africa. After identification of the challenges and risks, solutions or guidelines were developed that may make the implementation more successful. Method: The methodology that was used is that of a literature study where theories were explored and used to solve a research problem. Based on the theoretical research, solutions and guidelines were developed to solve challenges and risks experienced. Results: The results indicated that there are a number of challenges involved with the implementation of an IFMIS. A set of best practice guidelines was developed that may make the implementation more successful. Conclusion: The sheer size and complexity of an IFMIS poses significant challenges and a number of risks to the implementation process. There are, however, critical success factors or best practices that can be used for the project to succeed. It is recommended that these best practices be used by the South African Public Service.

Challenge of Replacing Obsolete Equipment and Systems on Brownfield Sites

International Nuclear Information System (INIS)

Teasdale, St.

2009-01-01

The Nuclear Decommissioning Authority (NDA) is responsible for the decommissioning and clean-up of the UK's civil public sector nuclear sites. One of their top priorities is the retrieval of sludge and fuel from the First Generation Magnox Fuel Storage Pond (FGMSP) at Sellafield site which is one of the most complex and compact nuclear sites in the world. The FGMSP plant is currently undergoing a series of major modifications in preparation for the retrievals operations. One of the most challenging modifications undertaken in the facility has been the Control and Surveillance Project which covered replacement of the existing Environmental Monitoring System, this presented the complex challenge of replacing an existing system whilst maintaining full functionality on a live radiological safety system with a constant radiological hazard. The Control and Surveillance Project involved the design, procurement, installation, changeover and commissioning of a new Radiological Surveillance System (alpha, beta and gamma monitoring) along with Building Evacuation Systems within the FGMSP complex to replace the existing obsolete system. This Project was a key enabler to future FGMSP retrievals and decommissioning activities. The project objective was to create and maintain a safe radiological working environment for over 450 personnel working in the plant up to 2020. The Legacy Ponds at Sellafield represent one of the biggest challenges in the civil nuclear clean up portfolio in the UK. Retrieval of sludge and fuel from the First Generation Magnox Fuel Storage Pond (FGMSP), and its safe long term storage is one of the NDA's top priorities. In June 2002 Sellafield Ltd contracted with the ACKtiv Nuclear Joint Venture to progress the risk mitigation, asset restoration and the early enabling works associated with preparation for clean up. Since then significant progress has been made in preparing the facility, and it's support systems, for the clean-up operations. This has been

The computational challenges of Earth-system science.

Science.gov (United States)

O'Neill, Alan; Steenman-Clark, Lois

2002-06-15

The Earth system--comprising atmosphere, ocean, land, cryosphere and biosphere--is an immensely complex system, involving processes and interactions on a wide range of space- and time-scales. To understand and predict the evolution of the Earth system is one of the greatest challenges of modern science, with success likely to bring enormous societal benefits. High-performance computing, along with the wealth of new observational data, is revolutionizing our ability to simulate the Earth system with computer models that link the different components of the system together. There are, however, considerable scientific and technical challenges to be overcome. This paper will consider four of them: complexity, spatial resolution, inherent uncertainty and time-scales. Meeting these challenges requires a significant increase in the power of high-performance computers. The benefits of being able to make reliable predictions about the evolution of the Earth system should, on their own, amply repay this investment.

Key ecological challenges for closed systems facilities

Science.gov (United States)

Nelson, Mark; Dempster, William F.; Allen, John P.

2013-07-01

Closed ecological systems are desirable for a number of purposes. In space life support systems, material closure allows precious life-supporting resources to be kept inside and recycled. Closure in small biospheric systems facilitates detailed measurement of global ecological processes and biogeochemical cycles. Closed testbeds facilitate research topics which require isolation from the outside (e.g. genetically modified organisms; radioisotopes) so their ecological interactions and fluxes can be studied separate from interactions with the outside environment. But to achieve and maintain closure entails solving complex ecological challenges. These challenges include being able to handle faster cycling rates and accentuated daily and seasonal fluxes of critical life elements such as carbon dioxide, oxygen, water, macro- and mico-nutrients. The problems of achieving sustainability in closed systems for life support include how to handle atmospheric dynamics including trace gases, producing a complete human diet, recycling nutrients and maintaining soil fertility, the maintenance of healthy air and water and preventing the loss of critical elements from active circulation. In biospheric facilities, the challenge is also to produce analogues to natural biomes and ecosystems, studying processes of self-organization and adaptation in systems that allow specification or determination of state variables and cycles which may be followed through all interactions from atmosphere to soils. Other challenges include the dynamics and genetics of small populations, the psychological challenges for small isolated human groups and backup technologies and strategic options which may be necessary to ensure long-term operation of closed ecological systems.

Challenges and benefits of digital workflow implementation in aerospace manufacturing engineering

OpenAIRE

Rojo Abollado, Jaime; Shehab, Essam; Bamforth, P.

2017-01-01

Companies who operate in highly regulated industries have further challenges to the usual competition, continuous cost reduction and product development challenges. To address these requirements companies optimise their business processes and change their applications and information systems to support their evolving way of doing business. Workflow management technology eases the achievement of these necessities by providing methodologies, software and tools to support business process mo...

Challenges Pre-Service Teachers Face When Implementing a 5E Inquiry Model of Instruction

Science.gov (United States)

Enugu, Ramya; Hokayem, Hayat

2017-01-01

This study examined the challenges that pre-service teachers faced when implementing inquiry and their perspective on how to overcome them. The data sample was 55 pre-service teachers (PSTs) enrolled into two sections of a science methods course in a private university in North Texas. The data sources consisted of inquiry-based lesson plans, PST…

Implementing a Mobile Health System to Integrate the Treatment of Addiction Into Primary Care: A Hybrid Implementation-Effectiveness Study.

Science.gov (United States)

Quanbeck, Andrew; Gustafson, David H; Marsch, Lisa A; Chih, Ming-Yuan; Kornfield, Rachel; McTavish, Fiona; Johnson, Roberta; Brown, Randall T; Mares, Marie-Louise; Shah, Dhavan V

2018-01-30

clinicians, use of the technology was less robust than use by patients, with only a handful of clinicians using Seva in each clinic and behavioral health providers making most referrals to Seva in 2 of the 3 clinics. Implementation-At 2 sites, implementation plans were realized successfully; they were delayed in the third. Maintenance-Use of Seva dropped when grant funding stopped paying for the mobile phones and data plans. Two of the 3 clinics wanted to maintain the use of Seva, but they struggled to find funding to support this. Implementing an mHealth system can improve care among primary care patients with SUDs, and patients using the system can support one another in their recovery. Among clinicians, however, implementation requires figuring out how information from the mHealth system will be used and making mHealth data available in the electronic health (eHealth) record. In addition, paying for an mHealth system remains a challenge. ©Andrew Quanbeck, David H Gustafson, Lisa A Marsch, Ming-Yuan Chih, Rachel Kornfield, Fiona McTavish, Roberta Johnson, Randall T Brown, Marie-Louise Mares, Dhavan V Shah. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.01.2018.

Implementation digital technologies in nuclear utilities

Energy Technology Data Exchange (ETDEWEB)

Wiegand, C.; Maselli, A.J., E-mail: Tony.Maselli@Invensys.com [Invensys Operations Management, London (United Kingdom)

2012-07-01

The introduction of digital technologies into the nuclear industry has assisted in many ways and made many of the Life Extensions and Uprates a possibility. But with this introduction of digital technologies comes some potentially challenging issues which need to be addressed for ultimate project success. This presentation discusses what a nuclear utility should consider and establish when implementing digital technologies in their plant. Digital technologies have been employed in many safety critical industries such as Aerospace, Pharmaceutical, Oil and Gas, and Chemical. However, nuclear industry implementation of digital technologies has been slow and in many ways tenuous. There are even documented operating experience events in which plant trips/SCRAMs occurred during a digital system implementation. This presentation aims to prevent those issues drawing upon the lessons learned over the past 5 years. Considerations include general challenges to overcome when implementing Digital Technologies, how to justify and execute projects, evaluation of resource knowledge, and the new challenges of Cyber Security. (author)

Implementation digital technologies in nuclear utilities

International Nuclear Information System (INIS)

Wiegand, C.; Maselli, A.J.

2012-01-01

The introduction of digital technologies into the nuclear industry has assisted in many ways and made many of the Life Extensions and Uprates a possibility. But with this introduction of digital technologies comes some potentially challenging issues which need to be addressed for ultimate project success. This presentation discusses what a nuclear utility should consider and establish when implementing digital technologies in their plant. Digital technologies have been employed in many safety critical industries such as Aerospace, Pharmaceutical, Oil and Gas, and Chemical. However, nuclear industry implementation of digital technologies has been slow and in many ways tenuous. There are even documented operating experience events in which plant trips/SCRAMs occurred during a digital system implementation. This presentation aims to prevent those issues drawing upon the lessons learned over the past 5 years. Considerations include general challenges to overcome when implementing Digital Technologies, how to justify and execute projects, evaluation of resource knowledge, and the new challenges of Cyber Security. (author)

Challenges for Knowledge Management in the Context of IT Global Sourcing Models Implementation

OpenAIRE

Perechuda , Kazimierz; Sobińska , Małgorzata

2014-01-01

Part 2: Models and Functioning of Knowledge Management; International audience; The article gives a literature overview of the current challenges connected with the implementation of the newest IT sourcing models. In the dynamic environment, organizations are required to build their competitive advantage not only on their own resources, but also on resources commissioned from external providers, accessed through various forms of sourcing, including the sourcing of IT services. This paper pres...

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

Science.gov (United States)

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

2015-04-01

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

Challenges to the Implementation of a New Framework for Safeguarding Financial Stability

Directory of Open Access Journals (Sweden)

Vlahović Ana

2014-09-01

Full Text Available There is probably no single economic concept that has attracted more attention and intrigued scientific and professional circles than financial stability. For over a decade now that have been efforts to establish the starting point in explaining this condition or characteristic of the financial system since some find that the key to defining financial stability lies in stability and others argue in favour of the opposite, instability. Unfortunately, no agreement has been reached on a universal definition that would be widely accepted at the international level. Consequently, this gave rise to open discussions on systemic risk, creating a framework for preserving financial stability, and the role of central banks in this process. This article analyses the results achieved in the development of a theoretical concept of financial stability and its practical implementation. A consensus has been reached on the necessity of removing rigid barriers between macro and prudential policies and on the necessity of their coordinated actions. The primary objectives of monetary and fiscal stability have been shifted towards preserving financial stability. The isolated macroprudential principle rightfully got the epithet of an archaic approach. Coordinated micro and macroprudential policies have definitely prevailed and become reality in many countries, including Montenegro. Created institutional frameworks for safeguarding financial stability at all levels - national, Pan-European and global - represent a challenge for further comparative studies.

Implementing lean manufacturing system: ISM approach

Directory of Open Access Journals (Sweden)

Naveen Kumar

2013-09-01

Full Text Available Purpose: Lean Manufacturing System has emerged as an important area of research in Indian context. The requirement of Lean Manufacturing has increased due to defects in products (semi finished and finished and subsequent increase in cost. In this context, this study is an attempt to develop a structural model of the variables, important to implement Lean Manufacturing System in Indian automobile industry. Design/Methodology/Approach: Various variables of lean manufacturing system implementation have been identified from literature review and experts’ opinions. Contextual relationship among these identified variables has been set after carrying out brainstorming session. Further, classification of the variables has been carried out based upon the driving power and dependence. In addition to this, a structural model of variables to implement lean concept in Indian automobile industry has also been developed using Interpretive Structural Modeling (ISM technique. Questionnaire based survey has also been conducted to rank these variables. Findings: Eighteen variables have been identified from the literature and subsequent discussions with experts. Out of which, nine variables have been identified as dependent and nine variables have been identified as driver. No variable has been identified as linkage variable and autonomous variable. From the model developed, ‘Relative cost benefits’ has been identified as top level dependent variable and top management commitment as bottom level most independent variable. Research limitations/Implications: The model so developed is a hypothetical model based upon experts’ opinions. The conclusions so drawn may be further modified to apply in real situation. Practical implication: Clear understanding of interactions among these variables will help organizations to prioritize and manage these variables more effectively and efficiently to draw advantage from lean manufacturing system implementation

Multi-scale biomedical systems: measurement challenges

International Nuclear Information System (INIS)

Summers, R

2016-01-01

Multi-scale biomedical systems are those that represent interactions in materials, sensors, and systems from a holistic perspective. It is possible to view such multi-scale activity using measurement of spatial scale or time scale, though in this paper only the former is considered. The biomedical application paradigm comprises interactions that range from quantum biological phenomena at scales of 10-12 for one individual to epidemiological studies of disease spread in populations that in a pandemic lead to measurement at a scale of 10+7. It is clear that there are measurement challenges at either end of this spatial scale, but those challenges that relate to the use of new technologies that deal with big data and health service delivery at the point of care are also considered. The measurement challenges lead to the use, in many cases, of model-based measurement and the adoption of virtual engineering. It is these measurement challenges that will be uncovered in this paper. (paper)

Interprofessional education for whom? --challenges and lessons learned from its implementation in developed countries and their application to developing countries: a systematic review.

Directory of Open Access Journals (Sweden)

Bruno F Sunguya

Full Text Available BACKGROUND: Evidence is available on the potential efficacy of interprofessional education (IPE to foster interprofessional cooperation, improve professional satisfaction, and improve patient care. While the intention of the World Health Organization (WHO is to implement IPE in all countries, evidence comes from developed countries about its efficiency, challenges, and barriers to planning and implementing IPE. We therefore conducted this review to examine challenges of implementing IPE to suggest possible pathways to overcome the anticipated challenges in developing countries. METHODS: We searched for literatures on IPE in PubMed/MEDLINE, CINAHL, PsycINFO, and ERIC databases. We examined challenges or barriers and initiatives to overcome them so as to suggest methods to solve the anticipated challenges in developing countries. We could not conduct a meta-analysis because of the qualitative nature of the research question and the data; instead we conducted a meta-narrative of evidence. RESULTS: A total of 40 out of 2,146 articles were eligible for analyses in the current review. Only two articles were available from developing countries. Despite the known benefits of IPE, a total of ten challenges or barriers were common based on the retrieved evidence. They included curriculum, leadership, resources, stereotypes and attitudes, variety of students, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Out of ten, three had already been reported in developing countries: IPE curriculum, resource limitations, and stereotypes. CONCLUSION: This study found ten important challenges on implementing IPE. They are curriculum, leadership, resources, stereotypes, students' diversity, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Although only three of them are already experienced in developing countries, the remaining seven are potentially important for developing countries, too. By knowing these

Interprofessional education for whom? --challenges and lessons learned from its implementation in developed countries and their application to developing countries: a systematic review.

Science.gov (United States)

Sunguya, Bruno F; Hinthong, Woranich; Jimba, Masamine; Yasuoka, Junko

2014-01-01

Evidence is available on the potential efficacy of interprofessional education (IPE) to foster interprofessional cooperation, improve professional satisfaction, and improve patient care. While the intention of the World Health Organization (WHO) is to implement IPE in all countries, evidence comes from developed countries about its efficiency, challenges, and barriers to planning and implementing IPE. We therefore conducted this review to examine challenges of implementing IPE to suggest possible pathways to overcome the anticipated challenges in developing countries. We searched for literatures on IPE in PubMed/MEDLINE, CINAHL, PsycINFO, and ERIC databases. We examined challenges or barriers and initiatives to overcome them so as to suggest methods to solve the anticipated challenges in developing countries. We could not conduct a meta-analysis because of the qualitative nature of the research question and the data; instead we conducted a meta-narrative of evidence. A total of 40 out of 2,146 articles were eligible for analyses in the current review. Only two articles were available from developing countries. Despite the known benefits of IPE, a total of ten challenges or barriers were common based on the retrieved evidence. They included curriculum, leadership, resources, stereotypes and attitudes, variety of students, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Out of ten, three had already been reported in developing countries: IPE curriculum, resource limitations, and stereotypes. This study found ten important challenges on implementing IPE. They are curriculum, leadership, resources, stereotypes, students' diversity, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Although only three of them are already experienced in developing countries, the remaining seven are potentially important for developing countries, too. By knowing these challenges and barriers in advance, those who implement IPE programs

WE-E-213AB-01: Medical Physics Challenges for Implementation of New Technologies in External Beam Radiotherapy.

Science.gov (United States)

Boiras, C; Bourland, J; Gonzalez, L Brualla; Bulychkin, P; Ford, E; Kazantsev, P; Krylova, T; Medina, A Lopez; Prusova, M; Romanov, D; Ferrando, J Rosello; Willoughby, T; Yan, D; Yu, C; Zvereva, A

2012-06-01

's research on adaptive radiotherapy has been financially supported by: 1) NIH Research Grants, 2) Elekta Research Grants 3) Philips Research GrantConflicts of interest for Cedric X Yu: 1) Board Member of Prowess, Inc., 2) Shareholder of Xcision Medical Systems, LLC, 3) Inventor on patents licensed by Varian Medical Systems, Inc. 1. Describe fundamental aspects for four advanced radiotherapy techniques: IMRT, IGRT, SBRT, and adaptive radiotherapy. 2. Review technical and professional challenges for implementation of advanced techniques as a function of resources and capabilities available within each scientific society: AAPM, SEFM, and AMPR. 3. Discuss and plan a proposal for an international trial on IMRT/IGRT based on functional imaging. 4. Debate important implementation aspects of IMRT and IGRT according to country-specific resources. © 2012 American Association of Physicists in Medicine.

Data archiving system implementation in ITER's CODAC Core System

International Nuclear Information System (INIS)

Castro, R.; Abadie, L.; Makushok, Y.; Ruiz, M.; Sanz, D.; Vega, J.; Faig, J.; Román-Pérez, G.; Simrock, S.; Makijarvi, P.

2015-01-01

Highlights: • Implementation of ITER's data archiving solution. • Integration of the solution into CODAC Core System. • Data archiving structure. • High efficient data transmission into fast plant system controllers. • Fast control and data acquisition in Linux. - Abstract: The aim of this work is to present the implementation of data archiving in ITER's CODAC Core System software. This first approach provides a client side API and server side software allowing the creation of a simplified version of ITERDB data archiving software, and implements all required elements to complete data archiving flow from data acquisition until its persistent storage technology. The client side includes all necessary components that run on devices that acquire or produce data, distributing and streaming to configure remote archiving servers. The server side comprises an archiving service that stores into HDF5 files all received data. The archiving solution aims at storing data coming for the data acquisition system, the conventional control and also processed/simulated data.

Emergency Response Data System (ERDS) implementation

International Nuclear Information System (INIS)

Jolicoeur, J.

1991-06-01

The US Nuclear Regulatory Commission has begun implementation of the Emergency Response Data System (ERDS) to upgrade its ability to acquire data from nuclear power plants in the event of an emergency at the plant. ERDS provides a direct real-time transfer of data from licensee plant computers to the NRC Operations Center. The system has been designed to be activated by the licensee during an emergency which has been classified at an ALERT or higher level. The NRC portion of ERDS will receive the data stream, sort and file the data. The users will include the NRC Operations Center, the NRC Regional Office of the affected plant, and if requested the States which are within the ten mile EPZ of the site. The currently installed Emergency Notification System will be used to supplement ERDS data. This report provides the minimum guidance for implementation of ERDS at licensee sites. It is intended to be used for planning implementation under the current voluntary program as well as for providing the minimum standards for implementing the proposed ERDS rule. 4 refs., 3 figs

Emergency Response Data System (ERDS) implementation

International Nuclear Information System (INIS)

Jolicoeur, J.

1990-04-01

The US Nuclear Regulatory Commission has begun implementation of the Emergency Response Data System (ERDS) to upgrade its ability to acquire data from nuclear power plants in the event of an emergency at the plant. ERDS provides a direct real-time transfer of data from licensee plant computers to the NRC Operations Center. The system has been designed to be activated by the licensee during an emergency which has been classified at an ALERT or higher level. The NRC portion of ERDS will receive the data stream, sort and file the data. The users will include the NRC Operations Center, the NRC Regional Office of the affected plant, and if requested the States which are within the ten mile EPZ of the site. The currently installed Emergency Notification System will be used to supplement ERDS data. This report provides the minimum guidance for implementation of ERDS at licensee sites. It is intended to be used for planning implementation under the current voluntary program as well as for providing the minimum standards for implementing the proposed ERDS rule

Challenges When Using Jurimetrics in Brazil—A Survey of Courts

Directory of Open Access Journals (Sweden)

Bruna Armonas Colombo

2017-10-01

Full Text Available Jurimetrics is the application of quantitative methods, usually statistics, to law. An important step to implement a jurimetric analysis is to extract raw data from courts and organize that data in a way that can be processed. Most of the raw data is unstructured and written in natural language, which stands as a challenge to Computer Science experts. As it requires expertise in law, statistics, and computer science, jurimetrics is a multidisciplinary field. When trying to implement a jurimetric system in Brazil, additional challenges were identified due to the heterogeneity of the different court systems, the lack of standards, and how the open data laws in Brazil are interpreted and implemented. In this article, we present a survey of Brazilian courts in terms of readiness to implement a jurimetric system. Analyzing a sample of data, we have found, in light of Brazil’s open data regulation, privacy issues and technical issues. Finally, we propose a roadmap that encompasses both technology and public policy to meet those challenges.

Health care in China: improvement, challenges, and reform.

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Wang, Chen; Rao, Keqin; Wu, Sinan; Liu, Qian

2013-02-01

Over the past 2 decades, significant progress has been made in improving the health-care system and people's health conditions in China. Following rapid economic growth and social development, China's health-care system is facing new challenges, such as increased health-care demands and expenditure, inefficient use of health-care resources, unsatisfying implementation of disease management guidelines, and inadequate health-care insurance. Facing these challenges, the Chinese government carried out a national health-care reform in 2009. A series of policies were developed and implemented to improve the health-care insurance system, the medical care system, the public health service system, the pharmaceutical supply system, and the health-care institution management system in China. Although these measures have shown promising results, further efforts are needed to achieve the ultimate goal of providing affordable and high-quality care for both urban and rural residents in China. This article not only covers the improvement, challenges, and reform of health care in general in China, but also highlights the status of respiratory medicine-related issues.

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

Science.gov (United States)

Dilu, Eyilachew; Gebreslassie, Measho; Kebede, Mihiretu

2017-12-20

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

78 FR 59974 - Centennial Challenges 2014 Unmanned Aircraft Systems (UAS) Airspace Operations Challenge (AOC)

Science.gov (United States)

2013-09-30

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION Centennial Challenges 2014 Unmanned Aircraft Systems... wish to compete may now register. Centennial Challenges is a program of prize competitions to stimulate...: http://www.uasaoc.org For general information on the NASA Centennial Challenges Program please visit...

Mental health system governance in Nigeria: challenges, opportunities and strategies for improvement.

Science.gov (United States)

Abdulmalik, J; Kola, L; Gureje, O

2016-01-01

A health systems approach to understanding efforts for improving health care services is gaining traction globally. A component of this approach focuses on health system governance (HSG), which can make or mar the successful implementation of health care interventions. Very few studies have explored HSG in low- and middle-income countries, including Nigeria. Studies focusing on mental health system governance, are even more of a rarity. This study evaluates the mental HSG of Nigeria with a view to understanding the challenges, opportunities and strategies for strengthening it. This study was conducted as part of the project, Emerging Mental Health Systems in Low and Middle Income Countries (Emerald). A multi-method study design was utilized to evaluate the mental HSG status of Nigeria. A situational analysis of the health policy and legal environment in the country was performed. Subsequently, 30 key informant interviews were conducted at national, state and district levels to explore the country's mental HSG. The existing policy, legislative and institutional framework for HSG in Nigeria reveals a complete exclusion of mental health in key health sector documents. The revised mental health policy is however promising. Using the Siddiqi framework categories, we identified pragmatic strategies for mental health system strengthening that include a consideration of existing challenges and opportunities within the system. The identified strategies provide a template for the subsequent activities of the Emerald Programme (and other interventions), towards strengthening the mental health system of Nigeria.

Security challenges in designing I and C systems for nuclear power plant

International Nuclear Information System (INIS)

Behera, Rajendra Prasad; Jayanthi, T.; Madhusoodanan, K.; Satya Murty, S.A.V.

2016-01-01

Geographically distributed instrumentation and control (I and C) systems in any nuclear power plant (NPP) facilitate the operator with remote access to real-time data and issue supervisory command to remote control devices deployed in the field. The increased connectivity to plant communication network has exposed I and C systems to security vulnerabilities both in terms of physical and logical access. For example, denial-of service and fault induction attack can disrupt the operation of I and C systems by delaying or blocking the flow of data through plant communication network. The design process of I and C system is quite challenging since an engineer has to consider both safety and security features implemented in hardware and software components of the system. This paper analyzes attack taxonomy based on available data and presents Security Tree Analysis (STA) technique towards building safe and secures I and C systems for Nuclear Power Plant. (author)

An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator.

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Hendy, Jane; Chrysanthaki, Theopisti; Barlow, James; Knapp, Martin; Rogers, Anne; Sanders, Caroline; Bower, Peter; Bowen, Robert; Fitzpatrick, Ray; Bardsley, Martin; Newman, Stanton

2012-11-15

To investigate organisational factors influencing the implementation challenges of redesigning services for people with long term conditions in three locations in England, using remote care (telehealth and telecare). Case-studies of three sites forming the UK Department of Health's Whole Systems Demonstrator (WSD) Programme. Qualitative research techniques were used to obtain data from various sources, including semi-structured interviews, observation of meetings over the course programme and prior to its launch, and document review. Participants were managers and practitioners involved in the implementation of remote care services. The implementation of remote care was nested within a large pragmatic cluster randomised controlled trial (RCT), which formed a core element of the WSD programme. To produce robust benefits evidence, many aspect of the trial design could not be easily adapted to local circumstances. While remote care was successfully rolled-out, wider implementation lessons and levels of organisational learning across the sites were hindered by the requirements of the RCT. The implementation of a complex innovation such as remote care requires it to organically evolve, be responsive and adaptable to the local health and social care system, driven by support from front-line staff and management. This need for evolution was not always aligned with the imperative to gather robust benefits evidence. This tension needs to be resolved if government ambitions for the evidence-based scaling-up of remote care are to be realised.

Implementation of Wireless Communications Systems on FPGA-Based Platforms

Directory of Open Access Journals (Sweden)

Voros NS

2007-01-01

Full Text Available Wireless communications are a very popular application domain. The efficient implementation of their components (access points and mobile terminals/network interface cards in terms of hardware cost and design time is of great importance. This paper describes the design and implementation of the HIPERLAN/2 WLAN system on a platform including general purpose microprocessors and FPGAs. Detailed implementation results (performance, code size, and FPGA resources utilization are presented. The main goal of the design case presented is to provide insight into the design aspects of a complex system based on FPGAs. The results prove that an implementation based on microprocessors and FPGAs is adequate for the access point part of the system where the expected volumes are rather small. At the same time, such an implementation serves as a prototyping of an integrated implementation (System-on-Chip, which is necessary for the mobile terminals of a HIPERLAN/2 system. Finally, firmware upgrades were developed allowing the implementation of an outdoor wireless communication system on the same platform.

Implementing polytope projects for smart systems

CERN Document Server

Iordache, Octavian

2017-01-01

This book presents a domain of extreme industrial and scientific interest: the study of smart systems and structures. It presents polytope projects as comprehensive physical and cognitive architectures that support the investigation, fabrication and implementation of smart systems and structures. These systems feature multifunctional components that can perform sensing, control, and actuation. In light of the fact that devices, tools, methodologies and organizations based on electronics and information technology for automation, specific to the third industrial revolution, are increasingly reaching their limits, it is essential that smart systems be implemented in industry. Polytope projects facilitate the utilization of smart systems and structures as key elements of the fourth industrial revolution. The book begins by presenting polytope projects as a reference architecture for cyber-physical systems and smart systems, before addressing industrial process synthesis in Chapter 2. Flow-sheet trees, cyclic sep...

Insights into the Intrinsic and Extrinsic Challenges for Implementing Technology Education: Case Studies of Queensland Teachers

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Finger, Glenn; Houguet, Belinda

2009-01-01

This study, embedded within the "Researching School Change in Technology Education" (RSCTE) project in Queensland, Australia, aimed to gain insights into the intrinsic and extrinsic challenges experienced by teachers during the implementation of technology education within primary school settings. The official publication and launch of…

Implementation strategies of Systems Medicine in clinical research and home care for cardiovascular disease patients.

Science.gov (United States)

Montecucco, Fabrizio; Carbone, Federico; Dini, Frank Lloyd; Fiuza, Manuela; Pinto, Fausto J; Martelli, Antonietta; Palombo, Domenico; Sambuceti, Gianmario; Mach, François; De Caterina, Raffaele

2014-11-01

Insights from the "-omics" science have recently emphasized the need to implement an overall strategy in medical research. Here, the development of Systems Medicine has been indicated as a potential tool for clinical translation of basic research discoveries. Systems Medicine also gives the opportunity of improving different steps in medical practice, from diagnosis to healthcare management, including clinical research. The development of Systems Medicine is still hampered however by several challenges, the main one being the development of computational tools adequate to record, analyze and share a large amount of disparate data. In addition, available informatics tools appear not yet fully suitable for the challenge because they are not standardized, not universally available, or with ethical/legal concerns. Cardiovascular diseases (CVD) are a very promising area for translating Systems Medicine into clinical practice. By developing clinically applied technologies, the collection and analysis of data may improve CV risk stratification and prediction. Standardized models for data recording and analysis can also greatly broaden data exchange, thus promoting a uniform management of CVD patients also useful for clinical research. This advance however requires a great organizational effort by both physicians and health institutions, as well as the overcoming of ethical problems. This narrative review aims at providing an update on the state-of-art knowledge in the area of Systems Medicine as applied to CVD, focusing on current critical issues, providing a road map for its practical implementation. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Implementing energy efficiency: Challenges and opportunities for rural electric co-operatives and small municipal utilities

International Nuclear Information System (INIS)

Wilson, Elizabeth J.; Plummer, Joseph; Fischlein, Miriam; Smith, Timothy M.

2008-01-01

Challenges in implementing demand side management (DSM) programs in rural electric co-operatives and small municipal utilities are not well understood, yet these organizations sell roughly 15% of electricity in the US, many are more coal-intensive than investor-owned utilities (IOUs), and they are politically important-rural electric co-operatives cover about 75% of the US land area and municipal utilities are found in every state except Hawaii. We provide a background on rural co-operatives and municipal utilities in the context of the US electric sector and highlight the challenges and opportunities of implementing DSM programs in these institutions. Where past studies of utility DSM have mostly focused on IOUs or consisted of qualitative case studies of municipal utilities with exemplary DSM performance, this study makes a unique contribution to the DSM literature by systematically analyzing an entire co-operative and municipal utility population in Minnesota through the use of a survey. In doing so, we provide policy recommendations relevant to energy planners and policy makers to support DSM in rural electric co-operatives and municipal utilities

FPGA Implementation of the stepwise shutdown system

International Nuclear Information System (INIS)

Lotjonen, L.

2012-01-01

This report elaborates the design process of applications for field-programmable gate array (FPGA) devices. Brief introductions to EPGA technology and the design process are first given and then the design phases are walked through with the aid of a case study. FPGA is a programmable logic device that is programmed by the customer rather than the manufacturer. They are also usually re-programmable which enables updating their programming and otherwise modifying the design. There are also one-time programmable FPGAs that can be used when security issues require it. FPGA is said to be 'hardware designed like software', which means that the design process resembles software development but the end-product is considered a hardware application because the execution of the functions is entirely different from a microprocessor. This duality can give both the flexibility of software and the reliability of hardware. The FPGA design and verification and validation (V and V) methods for NPP safety systems have not yet matured because the technology is rather new in the field. Software development methods and standards can be used to some extent but the hardware aspects bring new challenges that cannot be tackled using purely software methods. International efforts are being made to development formal and consistent design and V and V methodology regulations for FPGA devices. A preventive safety function called Stepwise Shutdown System (SWS) was implemented on an Actel M1 IGLOO field-programmable gate array (FPGA) device. SWS is used to drive a process into a normal state if the process measurements deviate from the desired operating values. This can happen in case of process disturbances. The SWS implementation process from the requirements to the functional device is elaborated. The design is tested via simulation and hardware testing. The case study is to be further expanded as a part of a master's thesis. (orig.)

FPGA Implementation of the stepwise shutdown system

Energy Technology Data Exchange (ETDEWEB)

Lotjonen, L.

2012-07-01

This report elaborates the design process of applications for field-programmable gate array (FPGA) devices. Brief introductions to EPGA technology and the design process are first given and then the design phases are walked through with the aid of a case study. FPGA is a programmable logic device that is programmed by the customer rather than the manufacturer. They are also usually re-programmable which enables updating their programming and otherwise modifying the design. There are also one-time programmable FPGAs that can be used when security issues require it. FPGA is said to be 'hardware designed like software', which means that the design process resembles software development but the end-product is considered a hardware application because the execution of the functions is entirely different from a microprocessor. This duality can give both the flexibility of software and the reliability of hardware. The FPGA design and verification and validation (V and V) methods for NPP safety systems have not yet matured because the technology is rather new in the field. Software development methods and stanfards can be used to some extent but the hardware aspects bring new challenges that cannot be tacled using purely software methods. International efforts are being made to development formal and consistent design and V and V methodology regulations for FPGA devices. A preventive safety function called Stepwise Shutdown System (SWS) was implemented on an Actel M1 IGLOO field-programmable gate array (FPGA) device. SWS is used to drive a process into a normal state if the process measurements deviate from the desired operating values. This can happen in case of process disturbances. The SWS implementation processfrom the reguirements to the functional device is elaborated. The design is tested via simulation and hardware testing. The case study is to be further expanded as a part of a master's thesis. (orig.)

Anatomy of a failure: a sociotechnical evaluation of a laboratory physician order entry system implementation.

Science.gov (United States)

Peute, Linda W; Aarts, Jos; Bakker, Piet J M; Jaspers, Monique W M

2010-04-01

To investigate the human, social and organizational issues surrounding a Computerized Physician Order Entry system for Laboratory ordering (CPOE-L) implementation process and to analyze their interrelated effects on the system implementation failure in an academic medical setting. Second, to provide lessons learned and recommendations on to how to manage challenges of human, social and organizational nature surrounding CPOE-L implementations. The themes surrounding CPOE introduction were identified by a heuristic analysis of literature on CPOE implementations. The resulting set of themes was applied as a reference model for 20 semi-structured interviews conducted during the CPOE-L implementation process with 11 persons involved in the CPOE-L project and in reviewing all CPOE-L related project documentation. Data was additionally gathered by user questionnaires, by user discussion rounds and through an ethnographical study performed at the involved clinical and laboratory departments. In analyzing the interview transcripts, project documentation and data from user questionnaires and discussion rounds a grounded theory approach was applied by the evaluation team to identify problem areas or issues deserving further analysis. Outlined central problem areas concerning the CPOE-L implementation and their mutual relations were depicted in a conceptual interpretative model. Understanding of clinical workflow was identified as a key theme pressured by organizational, human and social issues ultimately influencing the entire implementation process in a negative way. Vast delays in CPOE introduction, system immaturity and under-functionality could all be directly attributed to a superficial understanding of workflow. Consequently, final CPOE integration into clinical and laboratory workflows was inhibited by both end-users as well as department managers and withdrawal of the CPOE-L system became inevitable. This case study demonstrates which human, social and organizational

The Emergence and Challenging Growth of the Bio-Ethanol Innovation System in Taiwan (1949-2015).

Science.gov (United States)

Chung, Chao-Chen; Yang, Siang-Cing

2016-02-19

This study explores the bio-ethanol innovation system in Taiwan from the perspective of a technology innovation system (TIS). Taiwan is a newly industrialized country and is not currently a main producer of bio-ethanol. This study analyzes the evolution of bio-ethanol innovation system in Taiwan and places a particular emphasis on challenges that present policies face in the context of potential long-term bio-ethanol development. Through an evaluation of the consistency of the present research, technology, development and innovation (RTDI) policies as well as the influence of these policies on the functional dynamics of bio-ethanol innovation system, mechanisms prohibiting the system from flourishing are determined. It is suggested that the production of bio-ethanol in Taiwan would be achieved if the government: (1) fixes long-term targets for both domestic bio-ethanol development and emission reduction; and (2) comprehensively designs a set of interrelated RTDI policies in accordance with the functional pattern of the bio-ethanol innovation system and consistently implements these policies. If such measures were implemented, it is considered that the bio-ethanol innovation system in Taiwan would flourish.

Implementation of an Anesthesia Information Management System (AIMS).

Science.gov (United States)

Douglas, James R; Ritter, Melody J

2011-01-01

During the administration of anesthesia, the anesthesia provider has historically created a paper record, charted manually, that included extensive patient care-related data (vital signs, other parameters, etc) and commentaries. DocuSys, a proprietary anesthesia information management system (AIMS), creates an electronic version of the anesthesia record and provides additional information. It electronically captures data from clinical monitors and other sources, including scheduling applications and laboratory computers. The AIMS facilitates chart entries such as drug doses and case narratives. Benefits of an AIMS include improved legibility of the anesthesia record and greater efficiency in documentation efforts. Use of the AIMS assists the practitioner with decision support logic, such as the timing of antibiotic administration and the inclusion of legally required documentation. Upon case completion, the AIMS data are immediately available to other information systems, such as billing and medical records. Data can be made available from a single case or, more important, from thousands of cases to analyze variables such as efficiency of services, adherence to best practices, patient outcomes, and clinical research. The AIMS was deployed at the main campus of the Ochsner Health System on March 26, 2009. In this article, we discuss the issues involved in the AIMS implementation process: the successes, surprises, and continued challenges.

Development and implementation of the Caribbean Laboratory Quality Management Systems Stepwise Improvement Process (LQMS-SIP) Towards Accreditation.

Science.gov (United States)

Alemnji, George; Edghill, Lisa; Guevara, Giselle; Wallace-Sankarsingh, Sacha; Albalak, Rachel; Cognat, Sebastien; Nkengasong, John; Gabastou, Jean-Marc

2017-01-01

Implementing quality management systems and accrediting laboratories in the Caribbean has been a challenge. We report the development of a stepwise process for quality systems improvement in the Caribbean Region. The Caribbean Laboratory Stakeholders met under a joint Pan American Health Organization/US Centers for Disease Control and Prevention initiative and developed a user-friendly framework called 'Laboratory Quality Management System - Stepwise Improvement Process (LQMS-SIP) Towards Accreditation' to support countries in strengthening laboratory services through a stepwise approach toward fulfilling the ISO 15189: 2012 requirements. This approach consists of a three-tiered framework. Tier 1 represents the minimum requirements corresponding to the mandatory criteria for obtaining a licence from the Ministry of Health of the participating country. The next two tiers are quality improvement milestones that are achieved through the implementation of specific quality management system requirements. Laboratories that meet the requirements of the three tiers will be encouraged to apply for accreditation. The Caribbean Regional Organisation for Standards and Quality hosts the LQMS-SIP Secretariat and will work with countries, including the Ministry of Health and stakeholders, including laboratory staff, to coordinate and implement LQMS-SIP activities. The Caribbean Public Health Agency will coordinate and advocate for the LQMS-SIP implementation. This article presents the Caribbean LQMS-SIP framework and describes how it will be implemented among various countries in the region to achieve quality improvement.

Challenges to the Development and Implementation of Public Policies to Achieve Animal Welfare Outcomes.

Science.gov (United States)

Rose, Margaret

2010-12-31

Although there is a long-established tradition of concern for the welfare of animals, it was not until the mid 1800's that governments sought to enact legislation to protect animals from cruelty. In the 1950's, questions concerning animal welfare re-emerged and in the ensuing years have been an on-going focus of government activities. These developments occurred against a backdrop of significant social change but there are important differences in what now underpins and informs these considerations. In the formulation and implementation of public policies, governments look for a course of action that represents and protects the interests of the community; the process may be challenging with competing interests but the final determination seeks a middle ground that best meets the needs and interests of the community as a whole. When policy development concerns our relationship with other animals, the complexity of this relationship presents particular challenges not only to the formulation of policies but also to the evaluation of outcomes. Notably, the depth of feelings and diversity of views in our community reflect the complex social, cultural and personal dimensions of this relationship. The use of animals for scientific purposes remains one of the most contentious animal welfare issues primarily because when animals are used for these purposes, accepted animal welfare benchmarks cannot always be met. Based on the Australian experience, this paper will discuss the influences in and on-going challenges to the development and implementation of public policy when animals are used for these purposes.

Challenges to the Development and Implementation of Public Policies to Achieve Animal Welfare Outcomes

Directory of Open Access Journals (Sweden)

Margaret Rose

2010-12-01

Full Text Available Although there is a long-established tradition of concern for the welfare of animals, it was not until the mid 1800’s that governments sought to enact legislation to protect animals from cruelty. In the 1950’s, questions concerning animal welfare re-emerged and in the ensuing years have been an on-going focus of government activities. These developments occurred against a backdrop of significant social change but there are important differences in what now underpins and informs these considerations. In the formulation and implementation of public policies, governments look for a course of action that represents and protects the interests of the community; the process may be challenging with competing interests but the final determination seeks a middle ground that best meets the needs and interests of the community as a whole. When policy development concerns our relationship with other animals, the complexity of this relationship presents particular challenges not only to the formulation of policies but also to the evaluation of outcomes. Notably, the depth of feelings and diversity of views in our community reflect the complex social, cultural and personal dimensions of this relationship. The use of animals for scientific purposes remains one of the most contentious animal welfare issues primarily because when animals are used for these purposes, accepted animal welfare benchmarks cannot always be met. Based on the Australian experience, this paper will discuss the influences in and on-going challenges to the development and implementation of public policy when animals are used for these purposes.

SUPPORTING TEACHERS IN IMPLEMENTING FORMATIVE ASSESSMENT PRACTICES IN EARTH SYSTEMS SCIENCE

Science.gov (United States)

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

2009-12-01

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

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

Science.gov (United States)

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

2014-05-01

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

SSV Launch Monitoring Strategies: HGDS Design Implementation Through System Maturity

Science.gov (United States)

Shoemaker, Marc D.; Crimi, Thomas

2010-01-01

With over 500,000 gallons of liquid hydrogen and liquid oxygen, it is of vital importance to monitor the space shuttle vehicle (SSV) from external tank (ET) load through launch. The Hazardous Gas Detection System (HGDS) was installed as the primary system responsible for monitoring fuel leaks within the orbiter and ET. The HGDS was designed to obtain the lowest possible detection limits with the best resolution while monitoring the SSV for any hydrogen, helium, oxygen, or argon as the main requirement. The HGDS is a redundant mass spectrometer used for real-time monitoring during Power Reactant Storage and Distribution (PRSD) load and ET load through launch or scrub. This system also performs SSV processing leak checks of the Tail Service Mast (TSM) umbilical quick disconnects (QD's), Ground Umbilical Carrier Plate (GUCP) QD's and supports auxiliary power unit (APU) system tests. From design to initial implementation and operations, the HGDS has evolved into a mature and reliable launch support system. This paper will discuss the operational challenges and lessons learned from facing design deficiencies, validation and maintenance efforts, life cycle issues, and evolving requirements

Cultural challenges to oral healthcare implementation in elders.

Science.gov (United States)

Lo, Edward C M; Tan, Hai P

2014-02-01

For successful implementation of oral healthcare services for elders, there is a need to understand and respond to their oral health beliefs, perceived needs and preferred type of care services, all of which are shaped by their cultural beliefs and values. This poses challenges to oral healthcare providers, especially when serving a diverse elderly population with people coming from different cultural backgrounds. The general principles of oral healthcare provision and their adaptation to serve culturally diverse elderly populations are discussed. The oral health beliefs and behaviours of Chinese, an ethnic group that can be found in many countries across the world, are highlighted and used as examples. Chinese elders generally attach a higher value to the physical functions than to the appearance of their dentition and prefer to use traditional self-care methods to deal with their oral health problems rather than to seek professional services. There is need to incorporate into the training of oral healthcare providers the competence to adapt their services to the beliefs and practices of culturally diverse elderly population groups in different settings. © 2014 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

International Safety Management – Safety Management Systems and the Challenges of Changing a Culture

Directory of Open Access Journals (Sweden)

Gregory Hanchrow

2017-03-01

Full Text Available Over the past generation, the ISM code has brought forth tremendous opportunities to investigate and enhance the human factor in shipping through the implementation of Safety Management Systems. One of the critical factors to this implementation has been mandatory compliance and a requirement for obtaining a Document of Compliance (DOC for vessels operating globally or at least internationally. A primary objective of these systems is to maintain them as “living” or “dynamic” systems that are always evolving. As the ISM code has evolved, there have been instances where large organizations have opted to maintain a voluntary DOC from their respective class society. This has been accomplished with a large human factor element as typically an organizational culture does not always accept change readily especially if there is not a legal requirement to do so. In other words, when considering maritime training is it possible that organizations may represent cultural challenges? The intent of this paper will be to research large maritime operations that have opted for a document of compliance voluntarily and compare them to similar organizations that have been mandated by international law to do the same. The result should be to gain insight into the human factors that must contribute to a culture change in the organization for the purposes of a legal requirement versus the human factors that contribute to a voluntary establishment of a safety management system. This analysis will include both the executive decision making that designs a system implementation and the operational sector that must execute its implementation. All success and failures of education and training can be determined by the outcome. Did the training achieve its goal? Or has the education prepared the students to embrace a new idea in conjunction with a company goal or a new regulatory scheme? In qualifying the goal of a successful ISM integration by examining both

Implementation of Industrial Narrow Band Communication System into SDR Concept

Directory of Open Access Journals (Sweden)

A. Prokes

2008-12-01

Full Text Available The rapid expansion of the digital signal processing has penetrated recently into a sphere of high performance industrial narrow band communication systems which had been for long years dominated by the traditional analog circuit design. Although it brings new potential to even increase the efficiency of the radio channel usage it also forces new challenges and compromises radio designers have to face. In this article we describe the design of the IF sampling industrial narrowband radio receiver, optimize a digital receiver structure implemented in a single FPGA circuit and study the performance of such radio receiver architecture. As an evaluation criterion the communication efficiency in form of maximum usable receiver sensitivity, co-channel rejection, adjacent channel selectivity and radio blocking measurement have been selected.

Nuclear-reactor remote-monitoring systems - concepts and implementations

International Nuclear Information System (INIS)

Rudolf, A.

1987-01-01

The paper presents general concepts and some examples of implemented nuclear-reactor remote-monitoring (RM) systems. Some functions and tasks of RM systems are demonstrated and three concepts are described in detail and assessed globally. Three examples of implemented RM systems are discussed using the Baden-Wurttemberg RM system for a description in greater detail. A brief prognosis of the future development of RM systems is made. (orig./DG) [de

The Library's role and challenges in implementing an e-learning strategy: a case study from northern Australia.

Science.gov (United States)

Ritchie, Ann

2011-03-01

  The Northern Territory Department of Health and Families' (DHF) Library supports education programs for all staff. DHF is implementing an e-learning strategy, which may be viewed as a vehicle for coordinating the education function throughout the organisation.   The objective of this study is to explore the concept of e-learning in relation to the Library's role in implementing an organisation-wide e-learning strategy.   The main findings of a literature search about the effectiveness of e-learning in health professionals' education, and the responsibility and roles of health librarians in e-learning are described. A case study approach is used to outline the current role and future opportunities and challenges for the Library.   The case study presents the organisation's strategic planning context. Four areas of operational activity which build on the Library's current educational activities are suggested: the integration of library resources 'learning objects' within a Learning Management System; developing online health information literacy training programs; establishing a physical and virtual 'e-Learning Library/Centre'; developing collaborative partnerships, taking on new responsibilities in e-learning development, and creating a new e-learning librarian role.   The study shows that the Library's role is fundamental to developing the organisation's e-learning capacity and implementing an organisation-wide e-learning strategy. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

The challenges of connecting generation to distribution systems: a utility perspective

International Nuclear Information System (INIS)

Kropp, F.

2004-01-01

'Full text:' This presentation discusses the technical, financial and regulatory barriers to connecting generation to Distribution Systems in Ontario. Case studies will be used to provide examples of the operational and technical challenges that impact the utility as well as a discussion on the site-specific advantages and disadvantages (to the utility) of the generation connections. These studies will include discussions on the problems and lessons learned with respect to the overall project implementation and the contractual agreements. The case studies will be complemented by an explanation of the financial constraints (both short term and long term) associated with the connections, and the regulatory issues that impact the financial recovery models including net and gross load billing. (author)

Implementation Guidelines for BMDO Open Systems Approach

National Research Council Canada - National Science Library

1998-01-01

This Directive: (1) Implements the policy set forth in references (a), (b) and (c); (2) Assigns responsibilities and prescribes mandatory procedures to open systems implementation with EMDO and Service Ballistic Missile Defense...

Control challenges in domestic heating systems

DEFF Research Database (Denmark)

Thybo, Honglian; Larsen, Lars F. S.; Weitzmann, Peter

2007-01-01

The objective of this paper is to analyze domestic heating applications and identify unfavorable building constructions and control challenges to be addressed by high performance heating control systems. Heating of domestic houses use a large amount of the total energy consumption in Scandinavia....... Hence the potential of reducing energy consumption by applying high performance control is vast. Indoor climate issues are becoming more in focus, which also leads to a demand for high performance heating systems. The paper presents an analysis of how the building elements of today's domestic houses...... with water based floor heating affect the control challenge. The analysis is documented with simulation results....

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

Science.gov (United States)

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

2015-01-01

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

An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator

Science.gov (United States)

2012-01-01

Background To investigate organisational factors influencing the implementation challenges of redesigning services for people with long term conditions in three locations in England, using remote care (telehealth and telecare). Methods Case-studies of three sites forming the UK Department of Health’s Whole Systems Demonstrator (WSD) Programme. Qualitative research techniques were used to obtain data from various sources, including semi-structured interviews, observation of meetings over the course programme and prior to its launch, and document review. Participants were managers and practitioners involved in the implementation of remote care services. Results The implementation of remote care was nested within a large pragmatic cluster randomised controlled trial (RCT), which formed a core element of the WSD programme. To produce robust benefits evidence, many aspect of the trial design could not be easily adapted to local circumstances. While remote care was successfully rolled-out, wider implementation lessons and levels of organisational learning across the sites were hindered by the requirements of the RCT. Conclusions The implementation of a complex innovation such as remote care requires it to organically evolve, be responsive and adaptable to the local health and social care system, driven by support from front-line staff and management. This need for evolution was not always aligned with the imperative to gather robust benefits evidence. This tension needs to be resolved if government ambitions for the evidence-based scaling-up of remote care are to be realised. PMID:23153014

Mixed methods for implementation research: application to evidence-based practice implementation and staff turnover in community-based organizations providing child welfare services.

Science.gov (United States)

Aarons, Gregory A; Fettes, Danielle L; Sommerfeld, David H; Palinkas, Lawrence A

2012-02-01

Many public sector service systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This article describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. The authors integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research.

Community Mobilization and Readiness: Planning Flaws which Challenge Effective Implementation of 'Communities that Care' (CTC) Prevention System.

Science.gov (United States)

Basic, Josipa

2015-01-01

This article reviews the experience of implementing a community approach to drug use and youth delinquency prevention based on the 'Communities that Care' (CTC) system implemented in one Croatian county consisting of 12 communities, 2002 to 2013 (Hawkins, 1999; Hawkins & Catalano, 2004). This overview explores selected critical issues which are often not considered in substance use(r) community intervention planning, implementation as well as in associated process and outcome assessments. These issues include, among others, the mobilization process of adequate representation of people; the involvement of relevant key individual and organizational stakeholders and being aware of the stakeholders' willingness to participate in the prevention process. In addition, it is important to be aware of the stakeholders' knowledge and perceptions about the 'problems' of drug use and youth delinquency in their communities as well as the characteristics of the targeted population(s). Sometimes there are community members and stakeholders who block needed change and therefore prevention process enablers and 'bridges' should be involved in moving prevention programming forward. Another barrier that is often overlooked in prevention planning is community readiness to change and a realistic assessment of available and accessible resources for initiating the planned change(s) and sustaining them. All of these issues have been found to be potentially related to intervention success. At the end of this article, I summarize perspectives from prevention scientists and practitioners and lessons learned from communities' readiness research and practice in Croatian that has international relevance.

A web accessible scientific workflow system for vadoze zone performance monitoring: design and implementation examples

Science.gov (United States)

Mattson, E.; Versteeg, R.; Ankeny, M.; Stormberg, G.

2005-12-01

Long term performance monitoring has been identified by DOE, DOD and EPA as one of the most challenging and costly elements of contaminated site remedial efforts. Such monitoring should provide timely and actionable information relevant to a multitude of stakeholder needs. This information should be obtained in a manner which is auditable, cost effective and transparent. Over the last several years INL staff has designed and implemented a web accessible scientific workflow system for environmental monitoring. This workflow environment integrates distributed, automated data acquisition from diverse sensors (geophysical, geochemical and hydrological) with server side data management and information visualization through flexible browser based data access tools. Component technologies include a rich browser-based client (using dynamic javascript and html/css) for data selection, a back-end server which uses PHP for data processing, user management, and result delivery, and third party applications which are invoked by the back-end using webservices. This system has been implemented and is operational for several sites, including the Ruby Gulch Waste Rock Repository (a capped mine waste rock dump on the Gilt Edge Mine Superfund Site), the INL Vadoze Zone Research Park and an alternative cover landfill. Implementations for other vadoze zone sites are currently in progress. These systems allow for autonomous performance monitoring through automated data analysis and report generation. This performance monitoring has allowed users to obtain insights into system dynamics, regulatory compliance and residence times of water. Our system uses modular components for data selection and graphing and WSDL compliant webservices for external functions such as statistical analyses and model invocations. Thus, implementing this system for novel sites and extending functionality (e.g. adding novel models) is relatively straightforward. As system access requires a standard webbrowser

Grand societal challenges in information systems research and education

CERN Document Server

vom Brocke, Jan; Hofmann, Sara; Tumbas, Sanja

2015-01-01

This book examines how information systems research and education can play a major role in contributing to solutions to the Societal Grand Challenges formulated in "The Millennium Project" (millenium-project.org). Individual chapters focus on specific challenges, review existing approaches and contributions towards solutions in information systems research and outline a research agenda for these challenges. The topics considered in this volume range from climate change, population growth, global ICT availability, breakthroughs in science and technology and energy demand to ethical decision-making, policymaking, gender status and transnational crime prevention. It is the first book to present ideas on how the Information Systems discipline can contribute to the solution on this wide spectrum of grand societal challenges.

Applying Systems Engineering on Energy Challenges

NARCIS (Netherlands)

Safi, J.; Muller, G.; Bonnema, Gerrit Maarten

2012-01-01

Systems engineering is a discipline with methods and techniques to address complex problems. We want to study how Systems Engineering methods can help to address today's grand challenges, such as the energy problem. The first step is problem definition which aims at articulating the problem in its

Integrating Photovoltaic Systems in Power System: Power Quality Impacts and Optimal Planning Challenges

Directory of Open Access Journals (Sweden)

Aida Fazliana Abdul Kadir

2014-01-01

Full Text Available This paper is an overview of some of the main issues in photovoltaic based distributed generation (PVDG. A discussion of the harmonic distortion produced by PVDG units is presented. The maximum permissible penetration level of PVDG in distribution system is also considered. The general procedures of optimal planning for PVDG placement and sizing are also explained in this paper. The result of this review shows that there are different challenges for integrating PVDG in the power systems. One of these challenges is integrated system reliability whereas the amount of power produced by renewable energy source is consistent. Thus, the high penetration of PVDG into grid can decrease the reliability of the power system network. On the other hand, power quality is considered one of the challenges of PVDG whereas the high penetration of PVDGs can lead to more harmonic propagation into the power system network. In addition to that, voltage fluctuation of the integrated PVDG and reverse power flow are two important challenges to this technology. Finally, protection of power system with integrated PVDG is one of the most critical challenges to this technology as the current protection schemes are designed for unidirectional not bidirectional power flow pattern.

Barriers to the success of an electronic pharmacovigilance reporting system in Kenya: an evaluation three years post implementation.

Science.gov (United States)

Agoro, Oscar O; Kibira, Sarah W; Freeman, Jenny V; Fraser, Hamish S F

2018-06-01

Electronic pharmacovigilance reporting systems are being implemented in many developing countries in an effort to improve reporting rates. This study sought to establish the factors that acted as barriers to the success of an electronic pharmacovigilance reporting system in Kenya 3 years after its implementation. Factors that could act as barriers to using electronic reporting systems were identified in a review of literature and then used to develop a survey questionnaire that was administered to pharmacists working in government hospitals in 6 counties in Kenya. The survey was completed by 103 out of the 115 targeted pharmacists (89.5%) and included free-text comments. The key factors identified as barriers were: unavailable, unreliable, or expensive Internet access; challenges associated with a hybrid system of paper and electronic reporting tools; and system usability issues. Coordination challenges at the national pharmacovigilance center and changes in the structure of health management in the country also had an impact on the success of the electronic reporting system. Different personal, organizational, infrastructural, and reporting system factors affect the success of electronic reporting systems in different ways, depending on the context. Context-specific formative evaluations are useful in establishing the performance of electronic reporting systems to identify problems and ensure that they achieve the desired objectives. While several factors hindered the optimal use of the electronic pharmacovigilance reporting system in Kenya, all were considered modifiable. Effort should be directed toward tackling the identified issues in order to facilitate use and improve pharmacovigilance reporting rates.

Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities.

Science.gov (United States)

DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

2017-07-01

Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee-for-service payment system and the provision of other women's health services. We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007-2014. In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. The WHP's experience using a fee-for-service model for cervical cancer screening demonstrates that in Cameroon VIA-DC is acceptable, feasible, and scalable and can be nearly self-sustaining. Integrating other women's health services enabled women to address additional health care needs. The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse-led, fee-for-service cervical cancer screening program using visual inspection with acetic acid-enhanced by digital cervicography in

The Emergence and Challenging Growth of the Bio-Ethanol Innovation System in Taiwan (1949–2015)

Science.gov (United States)

Chung, Chao-Chen; Yang, Siang-Cing

2016-01-01

This study explores the bio-ethanol innovation system in Taiwan from the perspective of a technology innovation system (TIS). Taiwan is a newly industrialized country and is not currently a main producer of bio-ethanol. This study analyzes the evolution of bio-ethanol innovation system in Taiwan and places a particular emphasis on challenges that present policies face in the context of potential long-term bio-ethanol development. Through an evaluation of the consistency of the present research, technology, development and innovation (RTDI) policies as well as the influence of these policies on the functional dynamics of bio-ethanol innovation system, mechanisms prohibiting the system from flourishing are determined. It is suggested that the production of bio-ethanol in Taiwan would be achieved if the government: (1) fixes long-term targets for both domestic bio-ethanol development and emission reduction; and (2) comprehensively designs a set of interrelated RTDI policies in accordance with the functional pattern of the bio-ethanol innovation system and consistently implements these policies. If such measures were implemented, it is considered that the bio-ethanol innovation system in Taiwan would flourish. PMID:26907306

The Emergence and Challenging Growth of the Bio-Ethanol Innovation System in Taiwan (1949–2015

Directory of Open Access Journals (Sweden)

Chao-Chen Chung

2016-02-01

Full Text Available This study explores the bio-ethanol innovation system in Taiwan from the perspective of a technology innovation system (TIS. Taiwan is a newly industrialized country and is not currently a main producer of bio-ethanol. This study analyzes the evolution of bio-ethanol innovation system in Taiwan and places a particular emphasis on challenges that present policies face in the context of potential long-term bio-ethanol development. Through an evaluation of the consistency of the present research, technology, development and innovation (RTDI policies as well as the influence of these policies on the functional dynamics of bio-ethanol innovation system, mechanisms prohibiting the system from flourishing are determined. It is suggested that the production of bio-ethanol in Taiwan would be achieved if the government: (1 fixes long-term targets for both domestic bio-ethanol development and emission reduction; and (2 comprehensively designs a set of interrelated RTDI policies in accordance with the functional pattern of the bio-ethanol innovation system and consistently implements these policies. If such measures were implemented, it is considered that the bio-ethanol innovation system in Taiwan would flourish.

Implementation of enterprise resource planning systems: a user perspective

Science.gov (United States)

Reitsma, E.; Hilletofth, P.; Mukhtar, U.

2018-04-01

The purpose of this study is to evaluate critical success factors (CSFs) for the implementation of an enterprise resource planning (ERP) system from a user perspective. Users play a vital role when implementing an ERP system, but their perspective has been neglected in the literature. A better understanding of their perspective promises to contribute to the design of more effective ERP systems, its implementation, and management. In order to identify the user perspective, a survey was conducted within three Pakistani companies that recently have implemented a new ERP system. The questionnaire was developed based on thirteen CSFs deduced from literature. Based on each CSF’s level of importance, they are ranked in order of importance and divided into three groups: most important, important and not important. Findings reveal that users believe that management should prioritize the following four CSFs when implementing an ERP system: education and training, strategic decision-making, communication, and business process alignment.

Experiences, opportunities and challenges of implementing task shifting in underserved remote settings: the case of Kongwa district, central Tanzania

Directory of Open Access Journals (Sweden)

Munga Michael A

2012-11-01

Full Text Available Abstract Background Tanzania is experiencing acute shortages of Health Workers (HWs, a situation which has forced health managers, especially in the underserved districts, to hastily cope with health workers’ shortages by adopting task shifting. This has however been due to limited options for dealing with the crisis of health personnel. There are on-going discussions in the country on whether to scale up task shifting as one of the strategies for addressing health personnel crisis. However, these discussions are not backed up by rigorous scientific evidence. The aim of this paper is two-fold. Firstly, to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. Methods We employed in-depth interviews with informants at the district level and supplemented the information with additional interviews with informants at the national level. Interviews focussed on the informants’ practical experiences of implementing task shifting in their respective health facilities (district level and their opinions regarding opportunities and challenges which might be associated with implementation of task shifting practices. At the national level, the main focus was on policy issues related to management of health personnel in the context of implementation of task shifting, in addition to seeking their opinions and perceptions regarding opportunities and challenges of implementing task shifting if formally adopted. Results Task shifting has been in practice for many years in Tanzania and has been perceived as an inevitable coping mechanism due to limited options for addressing health personnel shortages in the country. Majority of informants had the concern that quality of services is likely to be affected if appropriate policy

System for implement draft reduction

DEFF Research Database (Denmark)

2008-01-01

Abstract of WO 2008095503  (A1) There is disclosed a system and method of reducing draft forces when working soil with agricultural soil working implements (206, 211) creating draft forces, the soil working implements (208, 206, 211) beingoperable connectable to a frame (204, 304, 404, 504, 604......, the second part of the width comprising an other part of said width (212) than the first part (222), so as e.g. to reduce draft forces compared to working both first and second parts at the same time....

THE QATAR HEALTH SYSTEM: CHALLENGES AND OPPORTUNITIES

Directory of Open Access Journals (Sweden)

Shaher ALSHAMARI

2017-06-01

Full Text Available Qatar’s healthcare system is comparatively new and has experienced noteworthy developments over its brief history. In this paper, our aim is to look at the unique challenges this small nation has faced in building that system. This paper will describe the accomplishments of Qatar’s medical authorities and the challenges they faced. It will also compare public and private healthcare providers. Today, the government of Qatar has financed all the health care for this rapidly-developing, multicultural nation, but it is now planning to introduce medical insurance. This report of its experience will benefit other nations wanting to develop their own healthcare systems.

Past and future challenges in developing remote systems technology

International Nuclear Information System (INIS)

Ferguson, K.R.

1978-01-01

During the early development of remote systems for processing and examining fuel and materials from nuclear reactors, the facility designer and operator worked closely together to meet the challenges of this new field. Numerous challenges still face the nuclear remote systems engineer, e.g., the development of systems that reduce the exposure of workers, the need for advances in basic technology, and the development of cost-effective facilities. The solution to these and other challenges can be accelerated by an expanded program of information exchange, an aggressive development program, and improved project management procedures

Dealing with organizational change when implementing EHR systems

DEFF Research Database (Denmark)

Høstgaard, Anne Marie; Nøhr, Christian

2004-01-01

The article is based upon a case study carried out at Skejby Hospital in Denmark. The research shows that the employees have some expectations when implementing an EHR system, thus hospital management provided the organization with important information before the implementation of a new EHR system....

Development and implementation of integrated management system

International Nuclear Information System (INIS)

Tomov, E.; Nenkova, B.

2013-01-01

Risk Engineering Ltd is a private Bulgarian company in the field of scientific technical consultancy and engineering services, established in 1990. The aim of this report is to present the experience of Risk Engineering Ltd. in the development, implementation and operation of an integrated management system. The process of implementation of the system was completed at the end of 2011. In January 2012, the Risk Engineering Integrated Management System was certified by Lloyd's Register for compliance with standards ISO 9001:2008, ISO 140001:2004 and BS OHSAS 18001:2007

PUBLIC PROCUREMENT IN GHANA: THE IMPLEMENTATION CHALLENGES TO THE PUBLIC PROCUREMENT LAW 2003 (ACT 663

Directory of Open Access Journals (Sweden)

Ameyaw, Collins

2012-08-01

Full Text Available The purpose of this study was to identify various implementation bottlenecks to the Ghana Public Procurement Law 2003 (Act 663. The study adopted multiple research approaches, including; review of relevant literature, interviews and questionnaire survey of 49 District Assemblies and Metropolitan and Municipal Assemblies in the Ashanti and Brong Ahafo Regions of Ghana. The study identified low capacity of procurement professionals, low interaction between procurement entities and Public Procurement Authority (PPA, deliberate controlling of competition, non-compliance with provisions of the law, splitting of contracts into smaller lots, lack of funds and non-cooperativeness of suppliers, as the major challenges militating against the implementation of the Public Procurement Law.

The National Shipbuilding Research Program. 1997 Ship Production Symposium. Implementation of Integrated CAD/CAM Systems in Small and Medium Sized Shipyards: A Case Study

National Research Council Canada - National Science Library

Mercier, Larry; Byington, Tracy; Senkwic, Walt; Barry, Christopher

1997-01-01

.... Implementing CAD/CAM is primarily a management, rather than technical, challenge. Performance-Based Management Techniques were used to develop the new system as an integrated whole, controlled and documented under ISO 9001...

The IGSN Experience: Successes and Challenges of Implementing Persistent Identifiers for Samples

Science.gov (United States)

Lehnert, Kerstin; Arko, Robert

2016-04-01

Physical samples collected and studied in the Earth sciences represent both a research resource and a research product in the Earth Sciences. As such they need to be properly managed, curated, documented, and cited to ensure re-usability and utility for future science, reproducibility of the data generated by their study, and credit for funding agencies and researchers who invested substantial resources and intellectual effort into their collection and curation. Use of persistent and unique identifiers and deposition of metadata in a persistent registry are therefore as important for physical samples as they are for digital data. The International Geo Sample Number (IGSN) is a persistent, globally unique identifier. Its adoption by individual investigators, repository curators, publishers, and data managers is rapidly growing world-wide. This presentation will provide an analysis of the development and implementation path of the IGSN and relevant insights and experiences gained along its way. Development of the IGSN started in 2004 as part of a US NSF-funded project to establish a registry for sample metadata, the System for Earth Sample Registration (SESAR). The initial system provided a centralized solution for users to submit information about their samples and obtain IGSNs and bar codes. Challenges encountered during this initial phase related to defining the scope of the registry, granularity of registered objects, responsibilities of relevant actors, and workflows, and designing the registry's metadata schema, its user interfaces, and the identifier itself, including its syntax. The most challenging task though was to make the IGSN an integral part of personal and institutional sample management, digital management of sample-based data, and data publication on a global scale. Besides convincing individual researchers, curators, editors and publishers, as well as data managers in US and non-US academia, state and federal agencies, the PIs of the SESAR project

Health recommender systems: concepts, requirements, technical basics and challenges.

Science.gov (United States)

Wiesner, Martin; Pfeifer, Daniel

2014-03-03

During the last decades huge amounts of data have been collected in clinical databases representing patients' health states (e.g., as laboratory results, treatment plans, medical reports). Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS) are meant to centralize an individual's health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS). In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed.

Health Recommender Systems: Concepts, Requirements, Technical Basics and Challenges

Directory of Open Access Journals (Sweden)

Martin Wiesner

2014-03-01

Full Text Available During the last decades huge amounts of data have been collected in clinical databases representing patients’ health states (e.g., as laboratory results, treatment plans, medical reports. Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS are meant to centralize an individual’s health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS. In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed.

Factors Affecting Successful Implementation of Hospital Information Systems.

Science.gov (United States)

Farzandipur, Mehrdad; Jeddi, Fatemeh Rangraz; Azimi, Esmaeil

2016-02-01

Today, the use of information systems in health environments, like any other fields, is necessary and organizational managers are convinced to use these systems. However, managers' satisfaction is not the only factor in successfully implementing these systems and failed information technology projects (IT) are reported despite the consent of the directors. Therefore, this study aims to determine the factors affecting the successful implementation of a hospital information system. The study was carried out as a descriptive method in 20 clinical hospitals that the hospital information system (HIS) was conducted in them. The clinical and paraclinical users of mentioned hospitals are the study group. 400 people were chosen as samples in scientific method and the data was collected using a questionnaire consisted of three main human, managerial and organizational, and technological factors, by questionnaire and interview. Then the data was scored in Likert scale (score of 1 to 5) and were analyzed using the SPSS software. About 75 percent of the population were female, with average work experience of 10 years and the mean age was 30 years. The human factors affecting the success of hospital information system implementation achieved the mean score of 3.5, both organizational and managerial factors 2.9 and technological factors the mean of 3. Human factors including computer skills, perceiving usefulness and perceiving the ease of a hospital information system use are more effective on the acceptance and successful implementation of hospital information systems; then the technological factors play a greater role. It is recommended that for the successful implementation of hospital information systems, most of these factors to be considered.

ERP implementation in hospitals: a case study.

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Agarwal, Divya; Garg, Poonam

2012-01-01

In a competitive healthcare sector, hospitals have to focus on their processes in order to deliver high-quality care while at the same time reducing costs. Many hospitals have decided to adopt one or another Enterprise Resource Planning (ERP) system to improve their businesses, but implementing an ERP system can be a demanding endeavour. The systems are so difficult to implement that some are successful; many have failed, causing multimillion dollar losses. The challenge of ERP solutions lie in implementation because they are complex, time consuming and expensive too. This paper describes the various process workflows and phases of ERP implementation at Fortis Hospital Cunningham Road, Bangalore, India. This knowledge will provide valuable insights for the researchers and practitioners to understand the different process workflows and to make informed decisions when implementing ERP in any hospital.

Mixed Methods for Implementation Research: Application to Evidence-Based Practice Implementation and Staff Turnover in Community Based Organizations Providing Child Welfare Services

Science.gov (United States)

Aarons, Gregory A.; Fettes, Danielle L.; Sommerfeld, David H.; Palinkas, Lawrence

2013-01-01

Many public sector services systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well-suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This paper describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. We integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research. PMID:22146861

School Psychologists' Stages of Concern with RTI Implementation

Science.gov (United States)

Bogue, Heidi; Marrs, Heath; Little, Suzanne

2017-01-01

Responsiveness to intervention has been an important change in models of service delivery within school systems in the recent past. However, there are a significant number of challenges to implementing the paradigm shift that these changes entail (Reschly 2008). Therefore, implementation of RTI varies among states, districts, and schools and some…

3D-TV System with Depth-Image-Based Rendering Architectures, Techniques and Challenges

CERN Document Server

Zhao, Yin; Yu, Lu; Tanimoto, Masayuki

2013-01-01

Riding on the success of 3D cinema blockbusters and advances in stereoscopic display technology, 3D video applications have gathered momentum in recent years. 3D-TV System with Depth-Image-Based Rendering: Architectures, Techniques and Challenges surveys depth-image-based 3D-TV systems, which are expected to be put into applications in the near future. Depth-image-based rendering (DIBR) significantly enhances the 3D visual experience compared to stereoscopic systems currently in use. DIBR techniques make it possible to generate additional viewpoints using 3D warping techniques to adjust the perceived depth of stereoscopic videos and provide for auto-stereoscopic displays that do not require glasses for viewing the 3D image.   The material includes a technical review and literature survey of components and complete systems, solutions for technical issues, and implementation of prototypes. The book is organized into four sections: System Overview, Content Generation, Data Compression and Transmission, and 3D V...

The dynamic nature of HRM implementation : a structuration perspective

NARCIS (Netherlands)

van Mierlo, Jorrit; Bondarouk, Tanya; Sanders, Karin

2018-01-01

Over the past decades, scholars have dedicated substantial attention to the process of HRM implementation. Most progress has been made with debates on HRM system strength, roles of organisational actors in HRM implementation, and intended, actual and perceived HRM. In this paper, we challenge the

Manufacturing Challenges Implementing Material Changes for the Super Light Weight External Tank: A Welding Process Perspective

Science.gov (United States)

Lawless, K.; Jones, C.

2001-01-01

A viewgraph presentation gives an overview of the manufacturing challenges in implementing welding material changes for the super lightweight external tank. Details are given on the external tank configuration, the weld purging equipment used, planning the selection of weld filler wire alloy, the initial weld microstructure, the wide panel tensile testing, and the dome cap welding.

EPICS system: RSX implementation issues

International Nuclear Information System (INIS)

Lahey, T.E.; Bartlett, J.F.; Bobbitt, J.S.; Kramper, B.J.; MacKinnon, B.A.; West, R.E.

1984-02-01

This paper presents implementation details of the Experimental Physics Interactive Control System (EPICS). EPICS is used to control accelerated particle beams for high-energy physics experiments at the Fermi National Accelerator Laboratory. The topics discussed are: interprocessor communication, support of beamline terminals and devices, resource management, mapping, various problems, some solutions to the problems, performance measurement, and modifications and extensions to RSX-11M. This paper is the third of three related papers on the EPICS system. The other two cover (1) the system overview and (2) the system structure and user interface

Integrated System Health Management (ISHM): Systematic Capability Implementation

Science.gov (United States)

Figueroa, Fernando; Holland, Randy; Schmalzwel, John; Duncavage, Dan

2006-01-01

This paper provides a credible approach for implementation of ISHM capability in any system. The requirements and processes to implement ISHM capability are unique in that a credible capability is initially implemented at a low level, and it evolves to achieve higher levels by incremental augmentation. In contrast, typical capabilities, such as thrust of an engine, are implemented once at full Functional Capability Level (FCL), which is not designed to change during the life of the product. The approach will describe core ingredients (e.g. technologies, architectures, etc.) and when and how ISHM capabilities may be implemented. A specific architecture/taxonomy/ontology will be described, as well as a prototype software environment that supports development of ISHM capability. This paper will address implementation of system-wide ISHM as a core capability, and ISHM for specific subsystems as expansions and evolution, but always focusing on achieving an integrated capability.

Implementing PAT with Standards

Science.gov (United States)

Chandramohan, Laakshmana Sabari; Doolla, Suryanarayana; Khaparde, S. A.

2016-02-01

Perform Achieve Trade (PAT) is a market-based incentive mechanism to promote energy efficiency. The purpose of this work is to address the challenges inherent to inconsistent representation of business processes, and interoperability issues in PAT like cap-and-trade mechanisms especially when scaled. Studies by various agencies have highlighted that as the mechanism evolves including more industrial sectors and industries in its ambit, implementation will become more challenging. This paper analyses the major needs of PAT (namely tracking, monitoring, auditing & verifying energy-saving reports, and providing technical support & guidance to stakeholders); and how the aforesaid reasons affect them. Though current technologies can handle these challenges to an extent, standardization activities for implementation have been scanty for PAT and this work attempts to evolve them. The inconsistent modification of business processes, rules, and procedures across stakeholders, and interoperability among heterogeneous systems are addressed. This paper proposes the adoption of specifically two standards into PAT, namely Business Process Model and Notation for maintaining consistency in business process modelling, and Common Information Model (IEC 61970, 61968, 62325 combined) for information exchange. Detailed architecture and organization of these adoptions are reported. The work can be used by PAT implementing agencies, stakeholders, and standardization bodies.

Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification, Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

Energy Technology Data Exchange (ETDEWEB)

R. Fink, D. Hill, J. O' Hara

2004-11-30

Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces.

Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification. Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

International Nuclear Information System (INIS)

Fink, R.; Hill, D.; O'Hara, J.

2004-01-01

Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces

Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries.

Directory of Open Access Journals (Sweden)

Charlotte Hanlon

Full Text Available Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda participating in the PRogramme for Improving Mental health carE (PRIME. The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care.A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts.The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care.The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential

Cancer vaccines: the challenge of developing an ideal tumor killing system.

Science.gov (United States)

Mocellin, Simone

2005-09-01

Despite the evidence that the immune system plays a significant role in controlling tumor growth in natural conditions and in response to therapeutic vaccination, cancer cells can survive their attack as the disease progresses and no vaccination regimen should be currently proposed to patients outside experimental clinical trials. Clinical results show that the immune system can be actively polarized against malignant cells by means of a variety of vaccination strategies, and that in some cases this is associated with tumor regression. This implies that under some unique circumstances, the naturally "dormant" immune effectors can actually be put at work and used as endogenous weapons against malignant cells. Consequently, the main challenge of tumor immunologists appears to lie on the ability of reproducing those conditions in a larger set of patients. The complexity of the immune network and the still enigmatic host-tumor interactions make these tasks at the same time challenging and fascinating. Recent tumor immunology findings are giving new impetus to the development of more effective vaccination strategies and might revolutionize the way of designing the next generation of cancer vaccines. In the near future, the implementation of these insights in the clinical setting and the completion/conduction of comparative randomized phase III trials will allow oncologists to define the actual role of cancer vaccines in the fight against malignancy.

A small step in VLC systems - a big step in Li-Fi implementation

Science.gov (United States)

Rîurean, S. M.; Nagy, A. A.; Leba, M.; Ionica, A. C.

2018-01-01

Light is part of our sustainable environmental life so, using it would be the handiest and cheapest way for wireless communication. Since ever, light has been used to send messages in different ways and now, due to the high technological improvements, bits through light, at high speed on multiple paths, allow humans to communicate. Using the lighting system both for illumination and communication represents lately one of the worldwide main research issues with several implementations with real benefits. This paper presents a viable VLC system, that proves its sustainability for sending by light information not only few millimetres but meters away. This system has multiple potential applications in different areas where other communication systems are bottlenecked, too expensive, unavailable or even forbidden. Since a Li-Fi fully developed system requires bidirectional, multiple access communication, there are still some challenges towards a functional Li-Fi wireless network. Although important steps have been made, Li-Fi is still under experimental stage.

Challenges faced by professional nurses when implementing the Expanded Programme on Immunisation at rural clinics in Capricorn District, Limpopo

Directory of Open Access Journals (Sweden)

Tebogo M. Mothiba

2016-05-01

Full Text Available Background: Immunisation is the cornerstone of primary healthcare. Apart from the provision of safe water, immunisation remains the most cost-effective public health intervention currently available. Immunisation prevents infectious conditions that are debilitating, fatal and have the potential to cause huge public health burdens, both financially and socially, in South Africa. Aim: To determine the challenges faced by professional nurses when implementing the Expanded Programme on Immunisation (EPI at rural clinics in Capricorn District, Limpopo Province, South Africa. Setting: The study was conducted in selected primary healthcare clinics of Capricorn District, Limpopo Province. Methods: A qualitative explorative descriptive contextual research design was used to gather data related to the challenges faced by professional nurses when implementing EPI at rural clinics in Capricorn District. Results: The findings revealed that professional nurses had knowledge of the programme, but that they experienced several challenges during implementation of EPI that included staff shortages and problems related to maintenance of the vaccines’ potency. Conclusions: The Department of Health as well as the nursing administration should monitor policies and guidelines, and especially maintenance of a cold chain for vaccines, to ensure that they are practised throughout Limpopo Province. The problem of staff shortages also needs to be addressed so that the EPI can achieve its targeted objectives. Keywords: Professional nurse, knowledge, EPI-SA, immunisation

Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective.

Science.gov (United States)

Sidek, Yusof Haji; Martins, Jorge Tiago

2017-11-01

Electronic health records (EHR) make health care more efficient. They improve the quality of care by making patients' medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics. This article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context. We used Grounded Theory to analyse data collected in the context of Brunei's national EHR - the Healthcare Information and Management System (Bru-HIMS). Data analysis followed the stages of open, axial and selective coding. Six perceived critical success factors emerged: usability of the system, emergent behaviours, requirements analysis, training, change management, and project organisation. The study identified a mismatch between end-users and product owner/vendor perspectives. Workflow changes were significant challenges to clinicians' confident use, particularly as the system offered limited modularity and configurability. Recommendations are made for all the parties involved in healthcare information systems implementation to manage the change process by agreeing system goals and functionalities through wider consensual debate, and participated supporting strategies realised through common commitment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Evaluation System and Implementation Countermeasure of Automobile Green Maintenance

Science.gov (United States)

Zhang, Fei; Xie, Xinxin; Yan, Chaoyong

2018-01-01

Green maintenance research is in the beginning of our country, the work is being explored. Based on the existing research results at home and abroad, this paper learns and draws lessons from the experiences and lessons of foreign advanced countries and domestic advanced enterprises. In the face of the challenges brought by economic development and energy saving and emission reduction, this paper discusses the green maintenance theory and security system, And the research status of green maintenance content and system at home and abroad, through the deletion and selection of green maintenance index, through the AHP method to determine the green evaluation criteria, and the introduction of C equivalent evaluation system, the use of fuzzy synthesis Evaluation method to build a green maintenance evaluation model, and the actual validation, put forward the implementation of green maintenance feasibility programs and related security recommendations, vehicle maintenance enterprises to carry out green maintenance, improve business efficiency and reduce environmental management costs to provide theoretical basis. And to achieve effective reduction of environmental pollution, reduce maintenance costs of the target, a reasonable promotion of maintenance and environmental protection and sustainable development. Promote green maintenance from research to practice, from the laboratory to the maintenance of enterprises, from the pilot to the overall development and transformation.

Jerneh gas project challenges and implementation performance

International Nuclear Information System (INIS)

Perreau, M.E.

1993-01-01

The Jerneh gas project is part of Peninsular Malaysia's Gas Utilization Project, a mammoth undertaking to provide gas from the offshore fields off Malaysia's East Coast, to power stations and other industrial users throughout Peninsular Malaysia and Singapore. Prior to 1992, the only customers of the offshore Peninsular Malaysia gas were a local power station, and a steel mill in Terengganu, linked to the Phase 1 pipeline system. The Bekok platform is Esso Production Malaysia Inc. (EPMI)'s gas collection platform for existing associated gas fields. The Duyong and Sotong platforms are gas production/compression platforms operated by PETRONAS. In late 1991, the onshore pipeline system was extended by PETRONAS to cover the west and south coasts of Peninsular Malaysia and Singapore depicted in the map as the Phase 2 system. With the completion of the Jerneh platform and offshore trunklines, Jerneh became the primary source of supply to an increased number of customers in the wider Phase 2 gas network. Jerneh is estimated to have three TCF of non-associated gas. Phase 1 customers were utilizing about 120 MSCFD and the demand is expected to initially step-up to 400 MSCFD in 1992 and progressively increase thereafter. This paper provides an overview of the US$400 M Jerneh project for which detailed design commenced in 1989 and was commissioned in 1992. The paper describes the technical challenges, project execution, safety record and actions to achieve the fast track schedule for this project

Intelligent control with implementation on the wind energy conversion system

International Nuclear Information System (INIS)

Basma, Mohamad Khalil

1997-05-01

In this thesis our main job is to compare intelligent control and conventional control algorithms, by applying each scheme to the same control problem. Based on simulation, we analyze and compare the results of applying fuzzy logic and neural networks controllers on a popular control problem: variable speed wind energy conversion system. The reason behind our choice is the challenging nature of the problem where the plant should be controlled to maximize the power generated, while respecting its hardware constraints under varying operating conditions and disturbances. We have shown the effectiveness of fuzzy logic exciter controller for the adopted wind energy generator when compared to a conventional PI exciter. It showed better performance in the whole operating range. However, in the high wind speeds region, both controllers were unable to deliver the rpm requirements. We proposed the use of neural network intelligent techniques to supply us the optimal pitch. Our aim was to develop a simple and reliable controller that can deliver this optimal output, while remaining adaptive to system uncertainties and disturbances. The proposed fuzzy controller with a neural pitch controller showed best dynamic and robust performance as compared to the adaptive pitch controller together with the PI exciter. This study has shown that artificial neural networks and fuzzy logic control algorithms can be implemented for real time control implementations. the neuro-fuzzy control approach is robust and its performance is superior to that of traditional control methods. (author)

Surveying the critical success factors of BPM-systems implementation.

NARCIS (Netherlands)

Ravesteyn, P.; Batenburg, R.

2010-01-01

Purpose – The purpose of this paper is to explore if there is a common ground for the definition of business process management (BPM) and BPM-systems, as well as the critical success factors (CSFs) for BPM-system implementation. A BPM-system implementation framework is validated that classifies the

Data archiving system implementation in ITER's CODAC Core System

Energy Technology Data Exchange (ETDEWEB)

Castro, R., E-mail: rodrigo.castro@visite.es [CIEMAT Fusion Program, Avda. Complutense 40, Madrid (Spain); Abadie, L. [ITER Organization, Route de Vinon-sur-Verdon, 13115 St. Paul-lez-Durance (France); Makushok, Y. [Sgenia, C/Chile, 4 Edificio II, Las Rozas, Madrid (Spain); Ruiz, M.; Sanz, D. [Instrumentation and Applied Acoustic Research Group, Technical University of Madrid, Madrid (Spain); Vega, J. [CIEMAT Fusion Program, Avda. Complutense 40, Madrid (Spain); Faig, J. [INDRA Sistemas, S.A. Unid. de Sistemas de Control, Dirección de Tecnología Energética, Madrid (Spain); Román-Pérez, G. [Sgenia, C/Chile, 4 Edificio II, Las Rozas, Madrid (Spain); Simrock, S.; Makijarvi, P. [ITER Organization, Route de Vinon-sur-Verdon, 13115 St. Paul-lez-Durance (France)

2015-10-15

Highlights: • Implementation of ITER's data archiving solution. • Integration of the solution into CODAC Core System. • Data archiving structure. • High efficient data transmission into fast plant system controllers. • Fast control and data acquisition in Linux. - Abstract: The aim of this work is to present the implementation of data archiving in ITER's CODAC Core System software. This first approach provides a client side API and server side software allowing the creation of a simplified version of ITERDB data archiving software, and implements all required elements to complete data archiving flow from data acquisition until its persistent storage technology. The client side includes all necessary components that run on devices that acquire or produce data, distributing and streaming to configure remote archiving servers. The server side comprises an archiving service that stores into HDF5 files all received data. The archiving solution aims at storing data coming for the data acquisition system, the conventional control and also processed/simulated data.

Electrical implementation of a complete synchronization dynamic system

International Nuclear Information System (INIS)

Goncalves, C; Neto, L G

2011-01-01

This work presents an electrical implementation of complete synchronization systems, proposing a master/slave synchronization of two identical particle-in-a-box electronic circuits, exhibiting a rich chaotic behaviour. This behaviour was measured, and also emulated, and the results were compared. Just a few works in literature describe experimental measurements of chaotic systems. The master/slave electronic circuits employed have a very simple electronic implementation and results show a complete synchronization of the system.

Challenges Inherent in the Design and Implementation of After-School Intervention Programs for Middle Grade Underachieving Readers

Science.gov (United States)

Velten, Justin; Mokhtari, Kouider

2016-01-01

In this brief report, we share three challenges we encountered when designing and implementing an after school intervention program for an ethnically diverse group of middle grade underachieving readers. We also offer practical solutions to help guide middle school teams in anticipating and addressing potential problems when putting in place…

A Systems Thinking Approach to Engineering Challenges of Military Systems-of-Systems

Science.gov (United States)

2016-09-01

as part of organizational thinking , processes and practice; and 2) an adequate SoSE practice supporting environment created and used to enable SoS...UNCLASSIFIED UNCLLASIFIED A Systems Thinking Approach to Engineering Challenges of Military Systems-of-Systems Pin Chen and Mark...their products and outcomes. This report introduces a systems thinking -based approach, SoS thinking , which offers a language and a thoughtful process

Building a house on shifting sand: methodological considerations when evaluating the implementation and adoption of national electronic health record systems

Directory of Open Access Journals (Sweden)

Takian Amirhossein

2012-04-01

Full Text Available Abstract Background A commitment to Electronic Health Record (EHR systems now constitutes a core part of many governments’ healthcare reform strategies. The resulting politically-initiated large-scale or national EHR endeavors are challenging because of their ambitious agendas of change, the scale of resources needed to make them work, the (relatively short timescales set, and the large number of stakeholders involved, all of whom pursue somewhat different interests. These initiatives need to be evaluated to establish if they improve care and represent value for money. Methods Critical reflections on these complexities in the light of experience of undertaking the first national, longitudinal, and sociotechnical evaluation of the implementation and adoption of England’s National Health Service’s Care Records Service (NHS CRS. Results/discussion We advance two key arguments. First, national programs for EHR implementations are likely to take place in the shifting sands of evolving sociopolitical and sociotechnical and contexts, which are likely to shape them in significant ways. This poses challenges to conventional evaluation approaches which draw on a model of baseline operations → intervention → changed operations (outcome. Second, evaluation of such programs must account for this changing context by adapting to it. This requires careful and creative choice of ontological, epistemological and methodological assumptions. Summary New and significant challenges are faced in evaluating national EHR implementation endeavors. Based on experiences from this national evaluation of the implementation and adoption of the NHS CRS in England, we argue for an approach to these evaluations which moves away from seeing EHR systems as Information and Communication Technologies (ICT projects requiring an essentially outcome-centred assessment towards a more interpretive approach that reflects the situated and evolving nature of EHR seen within

Building a house on shifting sand: methodological considerations when evaluating the implementation and adoption of national electronic health record systems.

Science.gov (United States)

Takian, Amirhossein; Petrakaki, Dimitra; Cornford, Tony; Sheikh, Aziz; Barber, Nicholas

2012-04-30

A commitment to Electronic Health Record (EHR) systems now constitutes a core part of many governments' healthcare reform strategies. The resulting politically-initiated large-scale or national EHR endeavors are challenging because of their ambitious agendas of change, the scale of resources needed to make them work, the (relatively) short timescales set, and the large number of stakeholders involved, all of whom pursue somewhat different interests. These initiatives need to be evaluated to establish if they improve care and represent value for money. Critical reflections on these complexities in the light of experience of undertaking the first national, longitudinal, and sociotechnical evaluation of the implementation and adoption of England's National Health Service's Care Records Service (NHS CRS). We advance two key arguments. First, national programs for EHR implementations are likely to take place in the shifting sands of evolving sociopolitical and sociotechnical and contexts, which are likely to shape them in significant ways. This poses challenges to conventional evaluation approaches which draw on a model of baseline operations → intervention → changed operations (outcome). Second, evaluation of such programs must account for this changing context by adapting to it. This requires careful and creative choice of ontological, epistemological and methodological assumptions. New and significant challenges are faced in evaluating national EHR implementation endeavors. Based on experiences from this national evaluation of the implementation and adoption of the NHS CRS in England, we argue for an approach to these evaluations which moves away from seeing EHR systems as Information and Communication Technologies (ICT) projects requiring an essentially outcome-centred assessment towards a more interpretive approach that reflects the situated and evolving nature of EHR seen within multiple specific settings and reflecting a constantly changing milieu of policies

mHealth Clinic Appointment PC Tablet: Implementation, Challenges and Solutions

Science.gov (United States)

Smith, Carol E.; Spaulding, Ryan; Piamjariyakul, Ubolrat; Werkowitch, Marilyn; Yadrich, Donna Macan; Hooper, Dedrick; Moore, Tyson; Gilroy, Richard

2015-01-01

Background Patients requiring daily intravenous (IV) home parenteral nutrition (HPN) would benefit from in-home professional observation to improve self-care, to assess, detect and prevent serious complications. Aims The study aims are to assess the viability and utility of conducting mobile healthcare (mHealth) videoconference assessments with patients managing lifelong daily 12-hour IV nutrition infusions in their homes. The challenges and solutions to implementing mobile personal computer (PC) tablet based clinic appointments are described. Methods A wireless Apple iPad Mini™ mobile touch-screen tablet computer with 5 mega-pixel camera was loaned to patients. Each tablet had Polycom RealPresence software and a fourth generation (4G) mobile telecommunications data plan. These supported audio-visual mobile videoconferencing encrypted connections between health professionals in their offices and HPN patients and their family members in their homes. Patients’ and professionals’ evaluations of their mHealth clinic experiences are collected. Results Patients (mean age = 41.9, SD = 2.8 years) had been prescribed 12-hour home parenteral nutrition (HPN) infusions daily due short bowel disorders. Patients had been on HPN from 1 to 10 years (M=4, SD=3.6). Evaluation of clinic appointments revealed that 100% of the patients (n=45) and the professionals (n=6) indicated that they can clearly hear and easily see one another. The mHealth audio-visual interactions were highly rated by patients and family members. Professionals highly rated their ability to obtain a medical history and visual inspection of patients. Several challenges were identified and recommendations for resolutions are described. Discussion All patients and professionals highly rated the iPad mHealth clinic appointments for convenience and ease of communicating between homes and offices. An important challenge for all mHealth visits is the clinical professional’s ability to make clinically accurate

Next-Generation Environment-Aware Cellular Networks: Modern Green Techniques and Implementation Challenges

KAUST Repository

Ghazzai, Hakim

2016-09-16

Over the last decade, mobile communications have been witnessing a noteworthy increase of data traffic demand that is causing an enormous energy consumption in cellular networks. The reduction of their fossil fuel consumption in addition to the huge energy bills paid by mobile operators is considered as the most important challenges for the next-generation cellular networks. Although most of the proposed studies were focusing on individual physical layer power optimizations, there is a growing necessity to meet the green objective of fifth-generation cellular networks while respecting the user\\'s quality of service. This paper investigates four important techniques that could be exploited separately or together in order to enable wireless operators achieve significant economic benefits and environmental savings: 1) the base station sleeping strategy; 2) the optimized energy procurement from the smart grid; 3) the base station energy sharing; and 4) the green networking collaboration between competitive mobile operators. The presented simulation results measure the gain that could be obtained using these techniques compared with that of traditional scenarios. Finally, this paper discusses the issues and challenges related to the implementations of these techniques in real environments. © 2016 IEEE.

Using Theories of Change to inform implementation of health systems research and innovation: experiences of Future Health Systems consortium partners in Bangladesh, India and Uganda.

Science.gov (United States)

Paina, Ligia; Wilkinson, Annie; Tetui, Moses; Ekirapa-Kiracho, Elizabeth; Barman, Debjani; Ahmed, Tanvir; Mahmood, Shehrin Shaila; Bloom, Gerry; Knezovich, Jeff; George, Asha; Bennett, Sara

2017-12-28

The Theory of Change (ToC) is a management and evaluation tool supporting critical thinking in the design, implementation and evaluation of development programmes. We document the experience of Future Health Systems (FHS) Consortium research teams in Bangladesh, India and Uganda with using ToC. We seek to understand how and why ToCs were applied and to clarify how they facilitate the implementation of iterative intervention designs and stakeholder engagement in health systems research and strengthening. This paper combines literature on ToC, with a summary of reflections by FHS research members on the motivation, development, revision and use of the ToC, as well as on the benefits and challenges of the process. We describe three FHS teams' experiences along four potential uses of ToCs, namely planning, communication, learning and accountability. The three teams developed ToCs for planning and evaluation purposes as required for their initial plans for FHS in 2011 and revised them half-way through the project, based on assumptions informed by and adjusted through the teams' experiences during the previous 2 years of implementation. All teams found that the revised ToCs and their accompanying narratives recognised greater feedback among intervention components and among key stakeholders. The ToC development and revision fostered channels for both internal and external communication, among research team members and with key stakeholders, respectively. The process of revising the ToCs challenged the teams' initial assumptions based on new evidence and experience. In contrast, the ToCs were only minimally used for accountability purposes. The ToC development and revision process helped FHS research teams, and occasionally key local stakeholders, to reflect on and make their assumptions and mental models about their respective interventions explicit. Other projects using the ToC should allow time for revising and reflecting upon the ToCs, to recognise and document the

Trust dynamics in a large system implementation

DEFF Research Database (Denmark)

Schlichter, Bjarne Rerup; Rose, Jeremy

2013-01-01

outcomes, but largely ignored the dynamics of trust relations. Giddens, as part of his study of modernity, theorises trust dynamics in relation to abstract social systems, though without focusing on information systems. We use Giddens’ concepts to investigate evolving trust relationships in a longitudinal......A large information systems implementation (such as Enterprise Resource Planning systems) relies on the trust of its stakeholders to succeed. Such projects impact diverse groups of stakeholders, each with their legitimate interests and expectations. Levels of stakeholder trust can be expected...... case analysis of a large Integrated Hospital System implementation for the Faroe Islands. Trust relationships suffered a serious breakdown, but the project was able to recover and meet its goals. We develop six theoretical propositions theorising the relationship between trust and project outcomes...

Implementing novel models of posttreatment care for cancer survivors: Enablers, challenges and recommendations.

Science.gov (United States)

Jefford, Michael; Kinnane, Nicole; Howell, Paula; Nolte, Linda; Galetakis, Spiridoula; Bruce Mann, Gregory; Naccarella, Lucio; Lai-Kwon, Julia; Simons, Katherine; Avery, Sharon; Thompson, Kate; Ashley, David; Haskett, Martin; Davies, Elise; Whitfield, Kathryn

2015-12-01

The American Society of Clinical Oncology and US Institute of Medicine emphasize the need to trial novel models of posttreatment care, and disseminate findings. In 2011, the Victorian State Government (Australia) established the Victorian Cancer Survivorship Program (VCSP), funding six 2-year demonstration projects, targeting end of initial cancer treatment. Projects considered various models, enrolling people of differing cancer types, age and residential areas. We sought to determine common enablers of success, as well as challenges/barriers. Throughout the duration of the projects, a formal "community of practice" met regularly to share experiences. Projects provided regular formal progress reports. An analysis framework was developed to synthesize key themes and identify critical enablers and challenges. Two external reviewers examined final project reports. Discussion with project teams clarified content. Survivors reported interventions to be acceptable, appropriate and effective. Strong clinical leadership was identified as a critical success factor. Workforce education was recognized as important. Partnerships with consumers, primary care and community organizations; risk stratified pathways with rapid re-access to specialist care; and early preparation for survivorship, self-management and shared care models supported positive project outcomes. Tailoring care to individual needs and predicted risks was supported. Challenges included: lack of valid assessment and prediction tools; limited evidence to support novel care models; workforce redesign; and effective engagement with community-based care and issues around survivorship terminology. The VCSP project outcomes have added to growing evidence around posttreatment care. Future projects should consider the identified enablers and challenges when designing and implementing survivorship care. © 2015 Wiley Publishing Asia Pty Ltd.

Reconfigurable Manufacturing System Design and Implementation

DEFF Research Database (Denmark)

Hadar, Ronen; Bilberg, Arne

2013-01-01

is meant primarily to show the physical feasibility of the system and provide a first-look into a real production application of the RMS ideas. The purpose of this paper is to present the design of the manufacturer’s RMS proof of concept, its implementation, and evaluation results.......Reconfigurable Manufacturing Systems (RMS) have been an increasing area of interest in the research arena. However, it seems that current literature is lacking application and implementation cases where RMS are simulated, tested, and evaluated as a feasible manufacturing concept. A Manufacturer...... of Consumer Goods identified the potential of the RMS concept and decided to investigate the concept in a real production installation. The result of this development is a proof of concept of a changeable and reconfigurable assembly and decoration system based on the principles of RMS. This proof of concept...

Strengthening the regulatory system through the implementation and use of a quality management system

Directory of Open Access Journals (Sweden)

Reinhold Eisner

2017-04-01

Full Text Available ABSTRACT Quality management systems (QMS, based on ISO 9001 requirements, are applicable to government service organizations such as Health Canada’s Biologics and Genetic Therapies Directorate (BGTD. This communication presents the process that the BGTD followed since the early 2000s to implement a quality management system and describes how the regulatory system was improved as a result of this project. BGTD undertook the implementation of a quality management system based on ISO 9001 and containing aspects of ISO 17025 with the goal of strengthening the regulatory system through improvements in the people, processes, and services of the organization. We discuss the strategy used by BGTD to implement the QMS and the benefits that were realized from the various stages of implementation. The eight quality principals upon which the QMS standards of the ISO 9000 series are based were used by senior management as a framework to guide QMS implementation.

Human factors challenges for advanced process control

International Nuclear Information System (INIS)

Stubler, W.F.; O'Hara, J..M.

1996-01-01

New human-system interface technologies provide opportunities for improving operator and plant performance. However, if these technologies are not properly implemented, they may introduce new challenges to performance and safety. This paper reports the results from a survey of human factors considerations that arise in the implementation of advanced human-system interface technologies in process control and other complex systems. General trends were identified for several areas based on a review of technical literature and a combination of interviews and site visits with process control organizations. Human factors considerations are discussed for two of these areas, automation and controls

Health systems in the Republic of Congo: challenges and opportunities for implementing tuberculosis and HIV collaborative service, research, and training activities

Directory of Open Access Journals (Sweden)

Laure Stella Ghoma Linguissi

2017-03-01

Full Text Available The Republic of Congo is on the World Health Organization (WHO list of ‘high burden’ countries for tuberculosis (TB and HIV. TB is the leading cause of death among HIV-infected patients in the Republic of Congo. In this viewpoint, the available data on TB and HIV in the Republic of Congo are reviewed, and the gaps and bottlenecks that the National TB Control Program (NTCP faces are discussed. Furthermore, priority requirements for developing and implementing TB and HIV collaborative service activities are identified. HIV and TB control programs operate as distinct entities with separate case management plans. The implementation of collaborative TB/HIV activities to evaluate and monitor the management of TB/HIV co-infected individuals remains inefficient in most regions, and these activities are sometimes non-existent. This reveals major challenges that require definition in order to improve the delivery of healthcare. The NTCP lacks adequate resources for optimal implementation of control measures of TB and HIV compliance and outcomes. The importance of aligning and integrating TB and HIV treatment services (including follow-up and adherence support services through coordinated and collaborative efforts between individual TB and HIV programs is discussed. Aligning and integrating TB and HIV treatment services through coordinated and collaborative efforts between individual TB and HIV programs is required. However, the WHO recommendations are generic, and health services in the Republic of Congo need to tailor their TB and HIV programs according to the availability of resources and operational feasibility. This will also open opportunities for synergizing collaborative TB/HIV research and training activities, which should be prioritized by the donors supporting the TB/HIV programs.

Military Readiness: Progress and Challenges in Implementing the Navy’s Optimized Fleet Response Plan

Science.gov (United States)

2016-05-02

command and control under the OFRP contributes to wide swings in port workload , which in turn can have a negative effect on the private - sector industrial...for 53 percent of all private - sector aircraft carrier maintenance contracts and 70 percent of cruiser and destroyer contracts from fiscal years...their impact on the Navy; (2) the Navy’s goals and progress in implementing the OFRP; and (3) challenges faced by public and private shipyards

Development of ATC Tower Systems: Electronic Flight Strip System at LKPR and the Implementation of TAXI Milestone to SUM

Directory of Open Access Journals (Sweden)

Pavel Černý

2016-10-01

Full Text Available This article describes the Electronic Flight Strip System used at Václav Havel Airport Prague and presents the results of an analysis of the clearance input from ATCOs. The outcomes indicate that various clearances are frequently issued together in a common time frame, usually depending on the traffic flow structure. The focus then moves towards the implementation of the TAXI milestone into the Start-Up Manager. The used statistic methods indicate that the amount of TTOT recalculations after AOBT decreases, but not significantly. However, the accuracy of TTOT after TAXI clearance is considerably better. The mean and most common deviation of ATOT from TTOT after the implementation of TAXI milestone is -1 minute. The results are challenged and confirmed by a further analysis of the TTOT-ATOT difference regarding individual stand/RWY pairs. The results may be used to adjust the assumed taxi times.

Wireless multimedia communication systems design, analysis, and implementation

CERN Document Server

Rao, KR; Bakmaz, Bojan M

2014-01-01

Rapid progress in software, hardware, mobile networks, and the potential of interactive media poses many questions for researchers, manufacturers, and operators of wireless multimedia communication systems. Wireless Multimedia Communication Systems: Design, Analysis, and Implementation strives to answer those questions by not only covering the underlying concepts involved in the design, analysis, and implementation of wireless multimedia communication systems, but also by tackling advanced topics such as mobility management, security components, and smart grids.Offering an accessible treatment

Challenges to the Implementation of PLAP in Primary Schools: Perceptions of ZOU Bachelor of Educational Management Students

Science.gov (United States)

Mercy, Kurebwa; Mabhanda, Wilson

2015-01-01

The study explored the challenges that impact on the implementation of PLAP in the Primary schools. The research was conducted with teachers who study towards the BEd Management degree with Zimbabwe Open University (ZOU) in the Midlands Region. The study used a qualitative research approach and collected data through open ended questionnaires and…

Preliminary Insights into the Implementation of Standardised IT in Franchise Systems

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Angele Cavaye

1999-05-01

Full Text Available The franchise context provides a rich background for studying the implementation of standardised, interlinked IT systems. Benefits of IT implementation in franchises appear obvious, but the small business context and potential tension between the two main stakeholders (franchisor and franchisees tend to create difficulties in the implementation process. Case study methods were used to investigate IT implementation in franchise systems. Franchisee-related factors that clearly impact on implementation include perceived need for the IT system, cost of the system and the level of IT literacy among franchisees. Franchisor-related factors like coercion of franchisees and education of franchisees strongly facilitate implementation.