14 resultados para implementation science
em Aston University Research Archive
Resumo:
Objective - To evaluate behavioural components and strategies associated with increased uptake and effectiveness of screening for coronary heart disease and diabetes with an implementation science focus. Design - Realist review. Data sources - PubMed, Web of Knowledge, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register and reference chaining. Searches limited to English language studies published since 1990. Eligibility criteria - Eligible studies evaluated interventions designed to increase the uptake of cardiovascular disease (CVD) and diabetes screening and examined behavioural and/or strategic designs. Studies were excluded if they evaluated changes in risk factors or cost-effectiveness only. Results - In 12 eligible studies, several different intervention designs and evidence-based strategies were evaluated. Salient themes were effects of feedback on behaviour change or benefits of health dialogues over simple feedback. Studies provide mixed evidence about the benefits of these intervention constituents, which are suggested to be situation and design specific, broadly supporting their use, but highlighting concerns about the fidelity of intervention delivery, raising implementation science issues. Three studies examined the effects of informed choice or loss versus gain frame invitations, finding no effect on screening uptake but highlighting opportunistic screening as being more successful for recruiting higher CVD and diabetes risk patients than an invitation letter, with no differences in outcomes once recruited. Two studies examined differences between attenders and non-attenders, finding higher risk factors among non-attenders and higher diagnosed CVD and diabetes among those who later dropped out of longitudinal studies. Conclusions - If the risk and prevalence of these diseases are to be reduced, interventions must take into account what we know about effective health behaviour change mechanisms, monitor delivery by trained professionals and examine the possibility of tailoring programmes according to contexts such as risk level to reach those most in need. Further research is needed to determine the best strategies for lifelong approaches to screening.
Resumo:
Background - This review provides a worked example of ‘best fit’ framework synthesis using the Theoretical Domains Framework (TDF) of health psychology theories as an a priori framework in the synthesis of qualitative evidence. Framework synthesis works best with ‘policy urgent’ questions. Objective - The review question selected was: what are patients’ experiences of prevention programmes for cardiovascular disease (CVD) and diabetes? The significance of these conditions is clear: CVD claims more deaths worldwide than any other; diabetes is a risk factor for CVD and leading cause of death. Method - A systematic review and framework synthesis were conducted. This novel method for synthesizing qualitative evidence aims to make health psychology theory accessible to implementation science and advance the application of qualitative research findings in evidence-based healthcare. Results - Findings from 14 original studies were coded deductively into the TDF and subsequently an inductive thematic analysis was conducted. Synthesized findings produced six themes relating to: knowledge, beliefs, cues to (in)action, social influences, role and identity, and context. A conceptual model was generated illustrating combinations of factors that produce cues to (in)action. This model demonstrated interrelationships between individual (beliefs and knowledge) and societal (social influences, role and identity, context) factors. Conclusion - Several intervention points were highlighted where factors could be manipulated to produce favourable cues to action. However, a lack of transparency of behavioural components of published interventions needs to be corrected and further evaluations of acceptability in relation to patient experience are required. Further work is needed to test the comprehensiveness of the TDF as an a priori framework for ‘policy urgent’ questions using ‘best fit’ framework synthesis.
Resumo:
Ageing populations with greater wellness and athletic expectations require quality sports and active living experiences in order to increase and sustain participation levels. Responding to the diverse needs and circumstances of Masterslveterans players is a complex and multi-faceted process. While sports science contributions have been very effective at enhancing active living in a variety of youth and adult sports events, very little has been documented regarding their efficacy in events for Masterslveteran players. This paper draws upon action research to examine the growth and development of a unique Masters World Cup 6-0-side Soccer Tournament, involving representative teams from twelve nations. lntegrated sports science concepts and strategies were employed to develop quality soccer experiences. Longitudinal data suggest that fostering a community of practice is critical to the success of Masters soccer programs. In addition to critical leadership contributions, an eclectic range of age-appropriate and responsive soccer experiences are essential to ensure that Masters events meet the diverse needs and circumstances of the players.
Resumo:
The development of increasingly powerful computers, which has enabled the use of windowing software, has also opened the way for the computer study, via simulation, of very complex physical systems. In this study, the main issues related to the implementation of interactive simulations of complex systems are identified and discussed. Most existing simulators are closed in the sense that there is no access to the source code and, even if it were available, adaptation to interaction with other systems would require extensive code re-writing. This work aims to increase the flexibility of such software by developing a set of object-oriented simulation classes, which can be extended, by subclassing, at any level, i.e., at the problem domain, presentation or interaction levels. A strategy, which involves the use of an object-oriented framework, concurrent execution of several simulation modules, use of a networked windowing system and the re-use of existing software written in procedural languages, is proposed. A prototype tool which combines these techniques has been implemented and is presented. It allows the on-line definition of the configuration of the physical system and generates the appropriate graphical user interface. Simulation routines have been developed for the chemical recovery cycle of a paper pulp mill. The application, by creation of new classes, of the prototype to the interactive simulation of this physical system is described. Besides providing visual feedback, the resulting graphical user interface greatly simplifies the interaction with this set of simulation modules. This study shows that considerable benefits can be obtained by application of computer science concepts to the engineering domain, by helping domain experts to tailor interactive tools to suit their needs.
Resumo:
This thesis reports the results of research into the connections between transaction attributes and buyer-supplier relationships (BSR) in advanced manufacturing technology (AMT) acquisitions and implementation. It also examines the impact of the different patterns of BSR on performance. Specifically, it addresses the issues of how the three transaction attributes; namely level of complexity, level of asset specificity, and level of uncertainty, can affect the relationships between the technology buyer and suppler in AMT acquisition and implementation, and then to see the impact of different patterns of BSR on the two aspect of performance; namely technology and implementation performance. In understanding the pohenomena, the study mainly draws on and integrates the literature of transaction cost economics theory,buyer-supplier relationships and advanced manufacturing technology as a basis of theoretical framework and hypotheses development.data were gathered through a questionnaire survey with 147 responses and seven semi-structured interviews of manufacturing firms in Malaysia. Quantitative data were analysed mainly using the AMOS (Analysis of Moment Structure) package for structural equation modeling and SPSS (Statistical Package for Social Science) for analysis of variance (ANOVA). Data from interview sessions were used to develop a case study with the intention of providing a richer and deeper understanding on the subject under investigation and to offer triangulation in the research process. he results of the questionnaire survey indicate that the higher the level of technological specificity and uncertainty, the more firms are likely to engage in a closer relationship with technology suppliers.However, the complexity of the technology being implemented is associated with BSR only because it is associated with the level of uncertainty that has direct impact upon BSR.The analysis also provides strong support for the premise that developing strong BSR could lead to an improved performance. However, with high levels of transaction attribute, implementation performance suffers more when firms have weak relationships with technology suppliers than with moderate and low levels of transaction attributes. The implications of the study are offered for both the academic and practitioner audience. The thesis closes with reports on its limitations and suggestions for further research that would address some of these limitations.
Resumo:
We report the implementation of vector bending sensors using long-period gratings (LPGs) UV-inscribed in flat-clad, four-core and D-shaped fibres. Our experiments reveal a strong fibre-orientation dependence of the spectral response when such LPGs are subjected to dynamic bending, which provided an opportunity to realize curvature measurement with direction recognition.
Resumo:
High-sensitivity optical chemsensors have been implemented by exploiting fibre Bragg grating structures UV-inscribed in D-shape, single-mode and multimode fibres and post-sensitized by hydrofluoric acid (HF) etching treatment. We have demonstrated that the Bragg grating structures which are intrinsically insensitive to chemicals can be sensitized by effective etching. All etched devices possess refractive index sensing capability that offers an encoding function to chemical concentrations. Most etched devices have been used to measure the concentrations of sugar solutions, showing a potential capability of detecting concentration changes as small as 0.1–0.5%.
Resumo:
The status of Science and Technology in KUWAIT has been analysed in order to assess the extent of the application of Science and Technology needed for the Country's development. The design and implementation of a Science and Technology Policy has been examined to identify the appropriate technology necessary to improve KUWAIT's socio-economic-industrial structures. Following a general and critical review of the role of Science and Technology in the developing countries, the author has reviewed the past and contemporary employment of Science and Technology for development.of various sectors and the existence, if any, of any form (explicit, implicit, or both) of a Science and Technology Policy in KUWAIT. The thesis is structured to evaluate almost all of the sectors in KUWAIT which utilise Science and/or Technology, the effectiveness of such practices, their policymaking process, the channels by which policies were transformed into sources of influence through Governmental action and the impact that various policy instruments at the disposal of the the Government had on the development of S & T capabilities. The author has studied the implications of the absence of a Science and Technology Policy in Kuwait by examining some specific case studies, eg, the absence of a Technology Assessment Process and the negative impacts resulting from this; the ad-hoc allocation of the research and development budget instead of its being based on a percentage of GNP; the limitations imposed on the development of indigenous contracting companies and consultancy and engineering design offices; the impacts of the absence of Technology Transfer Centre, and so forth. As a consequence of the implications of the above studies, together with the negative results from the absence of an explicit Science and Technology Policy, eg, research and development activities do not relate to the national development plans, the author suggests that a Science and Technology Policy-Making Body should be established to formulate, develop, monitor and correlate the Science and Technology Activities in KUWAIT.
Resumo:
Concurrent engineering and design for manufacture and assembly strategies have become pervasive in use in a wide array of industrial settings. These strategies have generally focused on product and process design issues based on capability concerns. The strategies have been historically justified using cost savings calculations focusing on easily quantifiable costs such as raw material savings or manufacturing or assembly operations no longer required. It is argued herein that neither the focus of the strategies nor the means of justification are adequate. Product and process design strategies should include both capability and capacity concerns and justification procedures should include the financial effects that the product and process changes would have on the entire company. The authors of this paper take this more holistic view of the problem and examine an innovative new design strategy using a comprehensive enterprise simulation tool. The results indicate that both the design strategy and the simulator show promise for further industrial use. © 2001 Elsevier Science B.V. All rights reserved.
Resumo:
The work in this chapter is concerned with product-centric servitization. This is where a portfolio of services are formed and integrated to support product availability and use. Such servitization can be a valuable source of revenue for a manufacturer, yet little attention has been given to the configuration of the wider operations strategy that needs to be in place to deliver integrated products and services successfully. Therefore, the purpose of this chapter is to put forward a generic set of characteristics for such operations. Our intention is that these characteristics will be valuable to practitioners contemplating sophisticated forms of servitization, as they suggest the likely and significant changes that will be needed to the operations strategy of a conventional manufacturing organisation.
Resumo:
We report the implementation of vector bending sensors using long-period gratings (LPGs) UV-inscribed in flat-clad, four-core and D-shaped fibres. Our experiments reveal a strong fibre-orientation dependence of the spectral response when such LPGs are subjected to dynamic bending, which provided an opportunity to realize curvature measurement with direction recognition.
Resumo:
High-sensitivity optical chemsensors have been implemented by exploiting fibre Bragg grating structures UV-inscribed in D-shape, single-mode and multimode fibres and post-sensitized by hydrofluoric acid (HF) etching treatment. We have demonstrated that the Bragg grating structures which are intrinsically insensitive to chemicals can be sensitized by effective etching. All etched devices possess refractive index sensing capability that offers an encoding function to chemical concentrations. Most etched devices have been used to measure the concentrations of sugar solutions, showing a potential capability of detecting concentration changes as small as 0.1–0.5%.
Resumo:
Poster With the use of the coarse-step method for simulating the phenomenon of PMD the fibre-twist as not included into the equations. This was an obstacle in representing low-PMD spun fibres numerially.
Resumo:
Introduction: There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis: Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and dissemination: The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.