Exploring the process of implementing a smoking cessation intervention in pregnancy training program for midwives

The question of how to implement evidence effectively reveals a deficiency in our knowledge and understanding of the compound factors involved in such a process (Kitson, Rycroft-Malone et al. 2008). Although there is some awareness of the complexities of the process, there has been little exploration of the effectiveness of implementing evidence-based programs in health care. Despite public awareness of the dangers of smoking in pregnancy, and widespread public health measures to prevent smoking-related disease, women still continue to smoke in pregnancy (Ananth, Savitz et al. 1997; Laws and Hilder 2008). Evaluation of public health measures concludes that smoking cessation interventions during pregnancy increase quit rates among pregnant women (Melvin, Dolan-Mullen et al. 2000; Albrecht, Maloni et al. 2004; Lumley, Oliver et al. 2007). Notwithstanding the potential for improvement in health outcomes for pregnant women and their unborn babies, smoking interventions are often conducted poorly or not at all. Although midwives understand why women smoke in pregnancy and parenthood and are aware of the risks of smoking to both the pregnancy and the unborn child, they require specific knowledge and skills in the provision of support and advice on smoking for pregnant women (Bull and Whitehead 2006) . Organisational-change research demonstrates the complexity of the process of planned change in professionalised institutions such as health care (Greenhalgh, Robert et al. 2005). Some innovations and interventions are never accepted, and others are poorly supported (Greenhalgh, Robert et al. 2004). Comprehension of the change process around health promotion is crucial to the implementation of new health promotion interventions within health care (Riley, Taylor et al. 2003). This study utilised a case study approach to explore the process of implementing a smoking cessation training program for midwives in Queensland metropolitan and regional clinical areas, who attended a ‘Train-the-Trainer program’. The study draws on the organisational change work of Greenhalgh et al (2004) as the theoretical framework through which situational and structural factors are explored and examined as they inform the implementation of smoking cessation programs. The research data constituted staged interviews with midwives who instituted training programs for midwives, as well as organisational and policy documentation. Analysis of the data identified some areas that were not fully addressed in the theoretical model; these formed the basis of the Discussion and Implications for Future Research.

Peer state assessment of TxDOT maintenance program and practices : workshop and road rally findings

In an effort to evaluate and improve their practices to ensure the future excellence of the Texas highway system, the Texas Department of Transportation (TxDOT) sought a forum in which experts from other state departments of transportation could share their expertise. Thus, the Peer State Review of TxDOT Maintenance Practices project was organized and conducted for TxDOT by the Center for Transportation Research (CTR) at The University of Texas at Austin. The goal of the project was to conduct a workshop at CTR and in the Austin District that would educate the visiting peers on TxDOT’s maintenance practices and invite their feedback. CTR and TxDOT arranged the participation of the following directors of maintenance: Steve Takigawa, CA; Roy Rissky, KS; Eric Pitts, GA; Jim Carney, MO; Jennifer Brandenburg, NC; and David Bierschbach, WA. One of the means used to capture the peer reviewers’ opinions was a carefully designed booklet of 15 questions. The peers provided TxDOT with written responses to these questions, and the oral comments made during the workshop were also captured. This information was then compiled and summarized in the following report. An examination of the peers’ comments suggests that TxDOT should use a more holistic, statewide approach to funding and planning rather than funding and planning for each district separately. Additionally, the peers stressed the importance of allocating funds based on the actual conditions of the roadways instead of on inventory. The visiting directors of maintenance also recommended continuing and proliferating programs that enhance communication, such as peer review workshops.

Infrastructure asset : developing maintenance management capability

Purpose Maintenance management is a core process in infrastructure asset management. Infrastructure organisations must constantly strive to ensure the effectiveness of this process in order to obtain the greatest lifetime value from their infrastructure assets. This paper aims to investigate how infrastructure organisations can enhance the effectiveness of their maintenance management process. Approach This study utilised multiple case studies as the research approach. The case organisations were asked to identify the challenges faced in the maintenance process and the approaches they have adopted to overcome these challenges. Analysis of these findings, together with deductive reasoning, leads to the development of the proposed capability needed for effective maintenance management process. Findings The case studies reveal that maintenance management process is a core process in ensuring that infrastructure assets are optimally and functionally available to support business operations. However, the main challenge is the lack of skilled and experienced personnel to understand and anticipate maintenance requirement. A second challenge is the reduced window of time available to carry out inspection and maintenance works. To overcome these challenges, the case organisations have invested in technologies. However, technologies available to facilitate this process are complex and constantly changing. Consequently, there is a need for infrastructure organizations to develop their technological absorptive capability, i.e. the ability to embrace and capitalize on new technologies to enhance their maintenance management process. Originality/Value This paper is original in that it provides empirical evidence to identify technological absorptive capability as core to improving the maintenance management process. The findings are valuable because it sheds light on where infrastructure organisation, regardless of whether they are privately or publicly owned, should channel their scarce resources. The development of the core capability will ensure that the maintenance process can contribute value to their organisation.

A capability model to improve infrastructure asset performance

Infrastructure organizations are operating in an increasingly challenging business environment as a result of globalization, privatization and deregulation. In an external business environment that is constantly changing, extant literature on strategic management advocates the need to focus on factors internal to the organization such as resources and capabilities to sustain their performance. Specifically, they need to develop dynamic capabilities in order to survive and prosper under conditions of change. The aim of this paper is to explore the dynamic capabilities needed in the management of transport infrastructure assets using a multiple case study research strategy. This paper produced a number of findings. First, the empirical evidence showed that the core infrastructure asset management processes are capacity management, options evaluation, procurement & delivery, maintenance management, and asset information management. Second, the study identified five dynamic capabilities namely stakeholder connectivity, cross-functional, relational, technology absorptive and integrated information capability as central to executing the strategic infrastructure asset management processes well. These findings culminate in the development of a capability model to improve the performance of infrastructure assets in an increasingly dynamic business environment.

Process mining manifesto

Process mining techniques are able to extract knowledge from event logs commonly available in today’s information systems. These techniques provide new means to discover, monitor, and improve processes in a variety of application domains. There are two main drivers for the growing interest in process mining. On the one hand, more and more events are being recorded, thus, providing detailed information about the history of processes. On the other hand, there is a need to improve and support business processes in competitive and rapidly changing environments. This manifesto is created by the IEEE Task Force on Process Mining and aims to promote the topic of process mining. Moreover, by defining a set of guiding principles and listing important challenges, this manifesto hopes to serve as a guide for software developers, scientists, consultants, business managers, and end-users. The goal is to increase the maturity of process mining as a new tool to improve the (re)design, control, and support of operational business processes.

The risk of airborne influenza transmission in passenger cars

Travel in passenger cars is a ubiquitous aspect of the daily activities of many people. During the 2009 influenza A (H1N1) pandemic a case of probable transmission during car travel was reported in Australia, to which spread via the airborne route may have contributed. However, there are no data to indicate the likely risks of such events, and how they may vary and be mitigated. To address this knowledge gap, we estimated the risk of airborne influenza transmission in two cars (1989 model and 2005 model) by employing ventilation measurements and a variation of the Wells-Riley model. Results suggested that infection risk can be reduced by not recirculating air; however, estimated risk ranged from 59 to 99.9% for a 90 min trip when air was recirculated in the newer vehicle. These results have implications for interrupting in-car transmission of other illnesses spread by the airborne route.

Assessment of operability and maintainability success factors in provision of extended constructability principles

The concept of constructability integrates individual construction functions and experiences through suitable and timely inputs into early stages of project planning and design. It aims to ease construction processes for a more effective and efficient achievement of overall project objectives. Similarly, the concepts of operability and maintainability integrate the functions and experiences of Operation and Maintenance (O&M) into project planning and design. Various studies suggested that these concepts have been implemented in isolation of each other and thus preventing optimum result in delivering infrastructure projects. This paper explores the integration of these three concepts in order to maximize the benefits of their implementation. It reviews the literature to identify the main O&M concerns, and assesses their association with constructability principles. This provides a structure to develop an extended constructability model that includes O&M concerns. It is anticipated that an extended constructability model that include O&M considerations can lead to a more efficient and effective delivery of infrastructure projects.

Outdoor experiential training as a medium for the development of today’s leaders

Outdoor experiential training is often used for the enhancement of generalised workplace skills including those considered relevant for effective leadership. Traditionally, facilitation processes and strategies employed in outdoor experiential training have often relied on theories delivered as part of an outdoor leadership training program. This was premised on the assumption that skills and capabilities developed in such programs transfer to the mainstream business market. In this paper we present data from an International study on the characteristics of outdoor education professionals that adds further insights into the role that outdoor experiential training plays in the development of generic leadership characteristics. Outdoor leaders were found to characterise transformational leadership qualities and considered that the development of these qualities were directly linked to their outdoor experiential training.

Conformance checking of service behavior

A service-oriented system is composed of independent software units, namely services, that interact with one another exclusively through message exchanges. The proper functioning of such system depends on whether or not each individual service behaves as the other services expect it to behave. Since services may be developed and operated independently, it is unrealistic to assume that this is always the case. This article addresses the problem of checking and quantifying how much the actual behavior of a service, as recorded in message logs, conforms to the expected behavior as specified in a process model.We consider the case where the expected behavior is defined using the BPEL industry standard (Business Process Execution Language for Web Services). BPEL process definitions are translated into Petri nets and Petri net-based conformance checking techniques are applied to derive two complementary indicators of conformance: fitness and appropriateness. The approach has been implemented in a toolset for business process analysis and mining, namely ProM, and has been tested in an environment comprising multiple Oracle BPEL servers.

Acoustic emission for diesel engine monitoring: A review and preliminary

Vibration analysis has been a prime tool in condition monitoring of rotating machines, however, its application to internal combustion engines remains a challenge because engine vibration signatures are highly non-stationary that are not suitable for popular spectrum-based analysis. Signal-to-noise ratio is a main concern in engine signature analysis due to severe background noise being generated by consecutive mechanical events, such as combustion, valve opening and closing, especially in multi-cylinder engines. Acoustic Emission (AE) has been found to give excellent signal-to-noise ratio allowing discrimination of fine detail of normal or abnormal events during a given cycle. AE has been used to detect faults, such as exhaust valve leakage, fuel injection behaviour, and aspects of the combustion process. This paper presents a review of AE application to diesel engine monitoring and preliminary investigation of AE signature measured on an 18-cylinder diesel engine. AE is compared with vibration acceleration for varying operating conditions: load and speed. Frequency characteristics of AE from those events are analysed in time-frequency domain via short time Fourier trasform. The result shows a great potential of AE analysis for detection of various defects in diesel engines.

Integrated approach for HP-LNG pump diagnosis and prognostics based on health state probability estimation

This paper presents an innovative prognostics model based on health state probability estimation embedded in the closed loop diagnostic and prognostic system. To employ an appropriate classifier for health state probability estimation in the proposed prognostic model, the comparative intelligent diagnostic tests were conducted using five different classifiers applied to the progressive fault levels of three faults in HP-LNG pump. Two sets of impeller-rubbing data were employed for the prediction of pump remnant life based on estimation of discrete health state probability using an outstanding capability of SVM and a feature selection technique. The results obtained were very encouraging and showed that the proposed prognosis system has the potential to be used as an estimation tool for machine remnant life prediction in real life industrial applications.

Hodgkin lymphoma and immunodeficiency in persons with HIV/AIDS

In persons with HIV/AIDS (PWHAs), Hodgkin lymphoma (HL) risk is increased. However, HL incidence in PWHAs has unexpectedly increased since highly active antiretroviral therapy (HAART) was introduced. We linked nationwide HIV/AIDS and cancer registry data from 1980 through 2002. Immunity was assessed by CD4 T-lymphocyte counts at AIDS onset. Annual HL incidence rates were calculated for 4 through 27 months after AIDS onset. During 477 368 person years (py's) of follow-up in 317 428 persons with AIDS (PWAs), 173 HL cases occurred (36.2 per 105 py's). Incidence was significantly higher in 1996 to 2002 than earlier. Incidence in PWAs with 150 to 199 CD4 cells/μL was 53.7 per 105 py's, whereas in PWAs with fewer than 50 CD4 cells/μL, it was 20.7 per 105 py's (Ptrend = .002). For each HL subtype, incidence decreased with declining CD4 counts, but nodular sclerosing decreased more precipitously than mixed cellularity, thereby increasing the proportion of mixed cellularity HL seen in PWAs. We conclude that HL incidence is lower with severe immunosuppression than with moderate immunosuppression, and HAART-related improvements in CD4 counts likely explain the increasing HL incidence in PWHAS observed since 1996. With more severe immunosuppression, nodular sclerosing HL becomes infrequent, explaining the higher proportion of mixed cellularity HL found in PWAs. Pathogenesis implications are discussed.

A novel method for the synthesis of monodisperse gold-coated silica nanoparticles

Monodisperse silica nanoparticles were synthesised by the well-known Stober protocol, then dispersed in acetonitrile (ACN) and subsequently added to a bisacetonitrile gold(I) coordination complex ([Au(MeCN)2]?) in ACN. The silica hydroxyl groups were deprotonated in the presence of ACN, generating a formal negative charge on the siloxy groups. This allowed the [Au(MeCN)2]? complex to undergo ligand exchange with the silica nanoparticles and form a surface coordination complex with reduction to metallic gold (Au0) proceeding by an inner sphere mechanism. The residual [Au(MeCN)2]? complex was allowed to react with water, disproportionating into Au0 and Au(III), respectively, with the Au0 adding to the reduced gold already bound on the silica surface. The so-formed metallic gold seed surface was found to be suitable for the conventional reduction of Au(III) to Au0 by ascorbic acid (ASC). This process generated a thin and uniform gold coating on the silica nanoparticles. The silica NPs batches synthesised were in a size range from 45 to 460 nm. Of these silica NP batches, the size range from 400 to 480 nm were used for the gold-coating experiments.