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Effective Implementation (effective + implementation)
Selected AbstractsQuality assurance program for spent radioactive sealed sources in EgyptQUALITY ASSURANCE JOURNAL, Issue 2 2009Yasser T. Mohamed Abstract Effective implementation of the Hot Laboratories Center Quality Assurance Program (QAP) is dependent on the efforts at all levels of all participants. Management is responsible for defining quality, developing appropriate plans to attain quality, and supporting the workers in the pursuit of quality. QA organizations of the program participants are responsible for verifying the achievement of quality in the implementation of the Hot Laboratories Center QA program. A written QAP shall be developed, implemented, and maintained. The QAP describes the organizational structure, functional responsibilities, levels of authority, and interfaces for those managing, performing, and assessing the work. The QAP shall describe the management processes, including planning, scheduling, and resource considerations. The organization, responsibilities/authorities of all participants, internal and external interfaces, and lines of communication should be established during the conceptual phase. Quality Assurance (QA) as an essential management tool is being strongly applied in the area of predisposal of Spent Radioactive Sealed Sources (SRSS). Quality Control is now considered as part of the planning and systematic actions of QA. To ensure compliance with the requirements, and to assure the envisaged behavior of the SRSS package and disposal system, a QAP for all stages of SRSS management, including SRSS conditioning, transportation, storage, and disposal are required. Copyright © 2009 John Wiley & Sons, Ltd. [source] Prevention of occupational skin disease: a workplace intervention study in geriatric nursesBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2009M. Dulon Summary Background, Health care workers have an increased risk of occupational dermatosis. Objectives To determine whether a skin care programme reduces skin disease on the hands of geriatric nurses and increases protective behaviour and the provision of skin care products at the workplace. The intervention was based on a 2-h skin care training session and an occupational advisory service. Methods, The study design was a randomized intervention study with a control group. Three hundred and eighty-eight geriatric nurses were included in the intervention group exposed to a skin care programme (IG; n = 146) and in the control group (CG; n = 242). Both groups completed questionnaires on exposure and underwent clinical examinations of their hands at the beginning and after a 12-month period. Preventive measures initiated by the employer at the workplace were documented at baseline and at 3 months after the intervention. Results, At baseline, no difference between the IG and the CG was found with respect to skin changes or work-related behaviour. At follow-up, the frequency of skin disease was significantly reduced in the IG, from 26% at baseline to 17% at follow-up, whereas the frequency remained almost unchanged in the CG. Effects on behaviour in the IG included significant increases in the use of moisturizers and hand disinfection instead of hand washing. The provision of cotton gloves and barrier cream products increased at intervention workplaces. Conclusions, Effective implementation of an occupational skin care programme for geriatric nurses should include both the training of the nurses and an occupational advisory service for management. [source] Designing new institutions for implementing integrated disaster risk management: key elements and future directionsDISASTERS, Issue 4 2007Chennat Gopalakrishnan The goal of integrated disaster risk management is to promote an overall improvement in the quality of safety and security in a region, city or community at disaster risk. This paper presents the case for a thorough overhaul of the institutional component of integrated disaster risk management. A review of disaster management institutions in the United States indicates significant weaknesses in their ability to contribute effectively to the implementation of integrated disaster risk management. Our analysis and findings identify eight key elements for the design of dynamic new disaster management institutions. Six specific approaches are suggested for incorporating the identified key elements in building new institutions that would have significant potential for enhancing the effective implementation of integrated disaster risk management. We have developed a possible blueprint for effective design and construction of efficient, sustainable and functional disaster management institutions. [source] Toward Adaptive Community Forest Management: Integrating Local Forest Knowledge with Scientific Forestry,ECONOMIC GEOGRAPHY, Issue 1 2002Daniel James Klooster Abstract: This case study of indigenous communities in highland Michoacán, Mexico, examines data on forest change, woodcutting practices, social history, and a recent forest inventory and management plan prepared by a professional forester. It assesses the social and environmental fit of both local knowledge and scientific forestry and considers their abilities to contribute to sustainable forest management. Both bodies of knowledge are limited in their ability to inform the social practice of environmental management. The local forest knowledge system is particularly hampered by a limited ability to monitor the forest's response to woodcutting, while scientific forestry lacks the institutional flexibility to ensure the just and effective implementation of restrictions and prescriptions. This article recommends cross-learning between scientific resource managers and woodcutters, participatory environmental monitoring to assess the results of different cutting techniques, and explicit management experiments to facilitate institutional learning at the community level. This kind of adaptive management approach permits the flexible integration of local knowledge, scientific forestry, and appropriate institutional parameters to modulate human needs and goals with the discordant harmonies of inhabited and heavily used forests in a constant state of flux under processes of succession, disturbance, and spatial variation. Several barriers to this kind of institutional innovation exist, but outside intervention has the potential to change the dynamics of institutional evolution. [source] The Water Framework Directive and agricultural nitrate pollution: will great expectations in Brussels be dashed in Lower Saxony?ENVIRONMENTAL POLICY AND GOVERNANCE, Issue 4 2007Britta Kastens Abstract This paper discusses the opportunities and constraints regarding the effective implementation of the European Water Framework Directive (WFD) in the area of diffuse nitrate pollution. Owing to the subsidiarity principle and a new procedural mode of governance, the WFD only sets distinct environmental targets, leaving most decisions on how to operationalize and institutionalize the reduction of diffuse nitrate pollution to the member states. This is a particular challenge for Germany, where lower scale regions have become the main implementers of European water policy. Successful implementation of the WFD, i.e. the actual improvement of water quality, depends on a series of key contextual and contingent factors, operating at a regional scale. In a Northwest German region with intensive agriculture and severe nitrate pollution, we analyse the historical and economic context and actor network of the region as well as the influence of environmental groups on public participation, the potential of biogas technology and new financial options. Besides the specific influence of these factors on the implementation process, we explore the uncertainties and difficulties surrounding European legislation and its operationalization in Germany and on a regional scale. Copyright © 2007 John Wiley & Sons, Ltd and ERP Environment. [source] The Bologna Process: From a European Law PerspectiveEUROPEAN LAW JOURNAL, Issue 2 2010Sacha Garben The Bologna Process, an intergovernmental process of voluntary policy convergence towards a common higher education structure, poses several concerns from a European law perspective. The Bologna Process takes place outside the institutional framework of the EU, while there would have been legal competence to enact the content of the Bologna Declaration as a Community measure. Hence it could be argued that Member States have straddled the borders of loyal cooperation by avoiding the institutional framework of the EC with its built-in checks and balances. They have obstructed the Community in the attainment of its tasks, which stands in tense relation to Article 10 EC. Moreover, there exist several other objections against the Bologna Process, particularly in terms of democracy, transparency and efficiency. The Bologna Process resembles a deal done in a smoke-filled room, and its voluntary character combined with a lack of coordination prevents its effective implementation. [source] The inclusion challenge with reduced-load professionals: The role of the managerHUMAN RESOURCE MANAGEMENT, Issue 3 2008Pamela Lirio Increased interest in reduced-load (part-time) work among professionals who want to have a life beyond work has led to new challenges for managers who must sustain productivity while also supporting employees. However, to date, little attention has been focused on exactly how managers facilitate effective implementation of these alternative work arrangements. This study presents findings from an interview study of 83 cases of reduced-load professionals in 43 organizations in the United States and Canada. Analysis of the interviews with both professionals and their managers surfaced recurrent themes that led to identification of five clusters of behaviors and five clusters of dispositions that capture the nature of managerial support in implementing reduced-load work. The ten categories of behaviors and dispositions expand on existing notions of supervisory support and provide new insight into the role of managers in fostering inclusiveness. Additional quantitative analyses found significant relationships between the success of the reduced-load arrangements and specific managerial behaviors and dispositions. © 2008 Wiley Periodicals, Inc. [source] The role of monitored natural recovery in sediment remediationINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 1 2006Victor S Magar Abstract The long-term goal of monitored natural recovery (MNR) is to achieve ecological recovery of biological endpoints in order to protect human and ecological health. Insofar as ecological recovery is affected by surface-sediment-contaminant concentrations, the primary recovery processes for MNR are natural sediment burial and contaminant transformation and weathering to less toxic forms. This paper discusses the overall approach for effective implementation of MNR for contaminated sediment sites. Several lines of evidence that may be used to demonstrate natural recovery processes are summarized, including documentation of source control; evidence of contaminant burial; measurement of surface sediment mixing depths and the active sediment benthic layer; measurement of sediment stability; contaminant transformation and weathering; modeling sediment transport, contaminant transport, and ecological recovery; measuring ecological recovery and long-term risk reduction; knowledge of future plans for use and development of the site; and watershed and institutional controls. In general, some form of natural recovery is expected and should be included as part of a remedy at virtually all contaminated sediment sites. Further, MNR investigations and an understanding of natural recovery processes provide cost-effective information and support the evaluation of more aggressive remedies such as capping, dredging, and the use of novel amendments. The risk of dredging or capping may be greater than the risk of leaving sediments in place at sites where capping or dredging offer little long-term environmental gain but pose significant short-term risks for workers, local communities, and the environment. [source] Success factors for the effective implementation of renewable energy options for rural electrification in India,Potentials of the CLEAN DEVELOPMENT MECHANISMINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 12 2008Gudrun Elisabeth Benecke Abstract Developing countries as well as international development assistance have for a long time aspired to combat energy poverty in rural areas of developing countries. However, until now a major part of national and international public and private attempts to provide affordable and stable energy supply have failed due to various economic, political, social and institutional obstacles. This situation is reflected in case of India where in comparison with other South Asian states the status of rural electrification and of energy supply are in a dismal state despite the promotion of renewable energy and rural electrification as early as from the 1960s. Embedded in the global context of the international climate change regime, the Clean Development Mechanism (CDM) of the Kyoto Protocol has now emerged as a new option to facilitate investment in climate change mitigating projects. In this respect, promoting the deployment of renewable energy through this project-based mechanism opens new avenues for rural electrification. The main objective of this paper is, hence, to examine the context conditions and factors determining the effective application of renewable energy options for rural electrification in a developing country context, namely India. Understanding contextual requirements for renewable energy investment has proved imminently important in order to appreciate the potentials provided by new market-based mechanisms such as the CDM for rural poverty alleviation. Comparative political science case study research methods are applied to the analysis of CDM biomass projects in the context of the four Indian states of Tamil Nadu, Maharashtra, Punjab and Andhra Pradesh. This allows for the conclusion that socio-political and historic framework conditions matter for the implementation of new renewable energy options. Copyright © 2008 John Wiley & Sons, Ltd. [source] Optimizing in-kind drug donations for Tanzania,a case studyINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 4 2008Gaby Gehler Mariacher Abstract A questionnaire survey (QS) among stakeholders in Tanzania had shown that in-kind drug donations (DDs) are important to boost the drug supply system. Major problems were their insufficient quantity for sustainable treatment and the discrepancy between the needs of the recipients and the donors' supply. Objectives in this study were to discuss these findings and to learn from key informants (KIs) how to improve the DD process. Data were collected through KI interviews in 2001/2002. A 30% gap in drug supply has to be bridged by DDs. KIs confirmed the importance of the World Health Organisation and Tanzanian DD guidelines as a tool for good donation practice and emphasized the role of the government in their implementation. They requested that donors meet the recipient country's regulatory requirements. In contrast to QS respondents, KIs did not view DD quality as a minor problem, and proposed that DD quality should be adapted to the national quality assurance procedures. DD processes could be improved through (a) effective implementation of DD guidelines as an aid for decision-making and for quality assurance, (b) availability of data to improve communication between donors and recipients, (c) transparency between recipients and donors and (d) clearly defined accountability. Copyright © 2007 John Wiley & Sons, Ltd. [source] Prescription practices of public and private health care providers in Attock District of PakistanINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2002S. Siddiqi Abstract The irrational use of drugs is a major problem of present day medical practice and its consequences include the development of resistance to antibiotics, ineffective treatment, adverse effects and an economic burden on the patient and society. A study from Attock District of Pakistan assessed this problem in the formal allopathic health sector and compared prescribing practices of health care providers in the public and private sector. WHO recommended drug use indicators were used to study prescription practices. Prescriptions were collected from 60 public and 48 private health facilities. The mean (±,SE) number of drugs per prescription was 4.1,±,0.06 for private and 2.7,±,0.04 for public providers (,p,<,0.0001). General practitioners (GPs) who represent the private sector prescribed at least one antibiotic in 62% of prescriptions compared with 54% for public sector providers. Over 48% of GP prescriptions had at least one injectable drug compared with 22.0% by public providers (,p,<,0.0001). Thirteen percent of GP prescriptions had two or more injections. More than 11% of GP prescriptions had an intravenous infusion compared with 1% for public providers (,p,<,0.001). GPs prescribed three or more oral drugs in 70% of prescriptions compared with 44% for public providers (,p,<,0.0001). Prescription practices were analysed for four health problems, acute respiratory infection (ARI), childhood diarrhoea (CD), fever in children and fever in adults. For these disorders, both groups prescribed antibiotics generously, however, GPs prescribed them more frequently in ARI, CD and fever in children (,p,<,0.01). GPs prescribed steroids more frequently, however, it was significantly higher in ARI cases (,p,<,0.001). For all the four health problems studied, GPs prescribed injections more frequently than public providers (,p,<,0.001). In CD cases GPs prescribed oral rehydration salt (ORS) less frequently (33.3%) than public providers (57.7%). GPs prescribed intravenous infusion in 12.3% cases of fever in adults compared with none by public providers (,p,<,0.001). A combination of non-regulatory and regulatory interventions, directed at providers as well as consumers, would need to be implemented to improve prescription practices of health care providers. Regulation alone would be ineffective unless it is supported by a well-established institutional mechanism which ensures effective implementation. The Federal Ministry of Health and the Provincial Departments of Health have to play a critical role in this respect, while the role of the Pakistan Medical Association in self-regulation of prescription practices can not be overemphasized. Improper prescription practices will not improve without consumer targeted interventions that educate and empower communities regarding the hazards of inappropriate drug use. Copyright © 2002 John Wiley & Sons, Ltd. [source] Critical success factors for cross-functional teamwork in new product developmentINTERNATIONAL JOURNAL OF MANAGEMENT REVIEWS, Issue 3 2000Sarah Holland There is consensus that the effective implementation of cross-functional teams is critical to new product success. However, such teams face particular challenges because of well-documented barriers between functions. Furthermore, there is little evidence-based guidance for practitioners on how to achieve effective cross-functional teamwork. In order to address this gap, the literature on cross-functional teamwork was analysed to identify critical success factors. Using a heuristic team effectiveness model, these were categorized into six groups: task design, group composition, organizational context, internal processes, external processes and group psychosocial traits. Recent theory on group effectiveness has increasingly recognized the significance of a supportive organizational context, and this is particularly pertinent for cross-functional teams. Key success factors include strategic alignment between functions, a climate supportive of teamwork and team-based accountability. The findings are integrated into a diagnostic model which is intended to be of practical benefit to people designing, leading and facilitating cross-functional new product development teams. [source] Conversations in conservation: revealing and dealing with language differences in environmental conflictsJOURNAL OF APPLIED ECOLOGY, Issue 4 2008Thomas J. Webb Summary 1Applied ecology aims to translate research into policy recommendations. However, conflicts frequently develop if these recommendations propose a contentious course of action. A first step towards addressing such conflicts is to attempt to understand the values underpinning stakeholder viewpoints. 2We develop a computer-aided Content Analysis to analyse the language surrounding environmental conflicts for insights into stakeholder values. Using the conflict arising over proposals to cull hedgehogs Erinaceus europaeus on several Scottish islands, we show how different stakeholder groups frame the problem in different ways. 3Stakeholder groups supporting different courses of action (culling vs. translocating hedgehogs) use different arguments, the former emphasizing conservation and biodiversity, the latter focusing on animal welfare. Our method results in a graphical representation of this failure to agree on a common way to frame the issue. 4Including texts obtained from media sources illustrates how the media can exacerbate environmental conflicts through the issues they emphasize and the vocabulary they use. 5Synthesis and applications. Our method provides a simple means to quantify levels of stakeholder disagreement concerning potentially contentious environmental issues. Our results provide a starting point for the development of a quantitative, graphical tool for managers, where repeated analysis will aid in monitoring and managing conflicts. In addition, we provide a clear example of the role of societal attitudes influencing the effective implementation of ecological advice, which should encourage ecologists to become more aware of the social environment into which policy recommendations are to be launched and to ensure that their advice does not ignore important stakeholder values. [source] Review: evaluating information systems in nursingJOURNAL OF CLINICAL NURSING, Issue 5 2008Cristina Oroviogoicoechea MSc Aims., To review existing nursing research on inpatient hospitals' information technology (IT) systems in order to explore new approaches for evaluation research on nursing informatics to guide further design and implementation of effective IT systems. Background., There has been an increase in the use of IT and information systems in nursing in recent years. However, there has been little evaluation of these systems and little guidance on how they might be evaluated. Methods., A literature review was conducted between 1995 and 2005 inclusive using CINAHL and Medline and the search terms ,nursing information systems', ,clinical information systems', ,hospital information systems', ,documentation', ,nursing records', ,charting'. Results., Research in nursing information systems was analysed and some deficiencies and contradictory results were identified which impede a comprehensive understanding of effective implementation. There is a need for IT systems to be understood from a wider perspective that includes aspects related to the context where they are implemented. Conclusions., Social and organizational aspects need to be considered in evaluation studies and realistic evaluation can provide a framework for the evaluation of information systems in nursing. Relevance to clinical practice., The rapid introduction of IT systems for clinical practice urges evaluation of already implemented systems examining how and in what circumstances they work to guide effective further development and implementation of IT systems to enhance clinical practice. Evaluation involves more factors than just involving technologies such as changing attitudes, cultures and healthcare practices. Realistic evaluation could provide configurations of context-mechanism-outcomes that explain the underlying relationships to understand why and how a programme or intervention works. [source] Caterers' experiences and perceptions of implementing the 2006 school meal standardsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2008C.J. Weir Background:, School meal standards were introduced in 2006 (Department for Education and Skills) and caterers are expected to comply with these standards. No research has been conducted looking at the caterer's experiences and perceptions of implementing these standards. This area has 32 school meal provider organisations for 103 schools. Half the schools are with one provider and the others are, mostly, single-handed in-house operations, often managed by a local community member. The aim of the current study was to explore caterers' understanding of the school meal standards, the barriers to implementation, and proposed solutions, to inform local practice. Methods:, A combined quantitative and qualitative design was used. A questionnaire was used to assess understanding and implementation of the standards and distributed to all the catering provider organisations (n = 32), with a good response rate of 78% (n = 25). For each question about achievement of the ten food-based standards the responses were scored 0,4 where: 0 = ,Do not intend to achieve this standard'; to 4 = ,Fully achieved'. This gave a total standards achievement score for each catering provider organisation, where the minimum score that could be achieved was zero which indicated the minimum level of achievement and the maximum score which could be achieved was forty which indicated all ten standards fully achieved. Four focus group were undertaken involving 40 people who considered themselves to be in a management role within a catering provider organisation. Semi structured interviews were undertaken with 11 people (until saturation), using purposive sampling, to explore barriers and solutions to implementation of the standards in detail. Descriptive and appropriate inferential statistics (Fisher's Exact tests and independent samples t- tests) were performedon the datausingStatistical Package for Social Sciences (SPSS). The process undertaken for the qualitative analysis was thematic analysis, and used analytic hierarchy (Richie & Lewis, 2003). Approval for this study was obtained from Leeds Metropolitan University ethics committee. Results:, The qualitative discussions led to caterers' identifying two main themes. These were: support from various groups, and the roles and responsibilities caterers believed these groups had and should be performing in order to achieve successful implementation of the standards ,Think it's good someone's shaken up school meals but who is doing the actually work , it's us isn't it'.(Semi structured interview respondent medium primary provider) ,I've found it really difficult as I'm on my own at the school, totally on my own without anyone to help'. (Focus group participant primary school group). The groups that caterers identified as those who had roles and responsibilities and who should be providing support were the ,whole school'; catering provider organisations; parents; the local authority; and, the broader environment/whole population. Caterers felt the standards had ,gone too far too soon' and did not allow choice. Caterers felt finances were a barrier, and that training was required across all sectors to achieve success. The standards implementation achievement score were statistically higher for caterers who had received formal training compared with those with only food and hygiene (P = 0.001); and, between caterers who provided to a secondary school as opposed to a primary school only (P = 0.034). There was a statistically significant relationship between providers and qualifications with those providing to secondary schools more likely to have had formal qualifications (P = 0.015). Discussion:, Caterers felt all those involved in schools and school meals needed to undertake their roles and responsibilities, to provide support, and, to implement the ethos of a whole school approach. The caterers in this study identified many barriers and practical obstacles either experienced or perceived to implementing the new school meals standards. Conclusions:, The results will be used to inform the Local Authority and Primary Care Trust to ensure the effective implementation of the school meal standards. There may be opportunity to transfer these results to other school caterers, and to develop support and training to assist implementation. [source] Stakeholders Influence and Internal Championing of Product Stewardship in the Italian Food Packaging IndustryJOURNAL OF INDUSTRIAL ECOLOGY, Issue 1 2000Marcello Braglia Summary Environmental management is becoming a top issue on managers' agendas in several industries. The adoption and implementation of a sound "green" strategy involves following product stewardship practices. Product stewardship is the idea that manufacturers, rather than consumers, governments, or waste companies, ought to take responsibility for the recycling and disposal of their products at the end of their life cycle. This article is aimed at investigating the relationships between the adoption of product stewardship practices and the involvement of different actors in the decision-making process. By means of discriminant analysis, 120 firms have been classified into two different environmental profiles. Results indicate that firms that are more committed to product stewardship differ from less-committed firms in the influence exerted by different stakeholders and in the supportive role played by the management at different hierarchical and functional levels. In general, it appears that top management involvement in the decision-making process is a critical condition for the successful championship of product stewardship. In addition, the effective implementation of product stewardship along the product life-cycle stages is correlated to a strong commitment on the part of chief technical officers and development engineers rather than of manufacturing or marketing managers. [source] Health care managers' perspectives on new nursing and midwifery roles: perceived impact on patient care and cost effectivenessJOURNAL OF NURSING MANAGEMENT, Issue 5 2009Adv Dip Ed RNT, BSc(Hons), DPhil, DipN(Lond), FRCSI, HUGH McKENNA CBE Aims, The aim of this study was to explore new nursing and midwifery roles and associated levels of practice from the health care providers' perspective. This paper will present findings relating to the perceived cost effectiveness of these roles and their impact on patient care. Background, Profound changes in the way the health care systems are organized, managed and financed have resulted in the proliferation of new nursing and midwifery roles. However, the evidence base for these workforce developments is limited, especially with regard to health care providers' perspectives on cost effectiveness and patient outcomes. Method, Qualitative interviews were carried out with all Directors of Nursing in the 18 Health and Social Services (HSS) Trusts and the Chief Nurses and Directors of Primary Care in the four HSS Boards in Northern Ireland. Results, Key findings were as follows: there was widespread support for the development of these roles, they are perceived to have a positive impact on patient care; however, the need for support was recognized to ensure the continuation of such roles. Securing funding was problematic and this was influential on the kind of new roles that were developed. Implications for Nursing Management, Issues relating to effective implementation and the need for further research into the efficacy and effectives of such initiatives is required. [source] Responsive Regulation and Taxation: IntroductionLAW & POLICY, Issue 1 2007VALERIE BRAITHWAITE The implementation of responsive regulation in taxation means influencing the community's commitment to pay tax through respectful treatment, through attending to resistance and reforming faulty processes, through fairly directed and fully explained disapproval of non-compliant behavior, through preparedness to administer sanctions, and capacity to follow through to escalate regulatory intervention in the face of continuing non-compliance. Responsive regulation and regulatory formalism are pitted against each other in this issue on responsive regulation and taxation. Normative and explanatory arguments in favor of responsive regulation are explored by data collected in taxation contexts; and institutional obstacles are identified that limit effective implementation. [source] Mother-to-Child Transmission of HIV in China and the USA: A Comparative AnalysisASIAN SOCIAL WORK AND POLICY REVIEW, Issue 3 2010Susanna Arcella This paper analyzes and compares the existing policies and programs for the prevention of mother-to-child transmission of HIV existing in China and in the USA. The implementation of these is still imperfect and there needs to be improvements in the education (the spreading of information) and in the general health care system of China. Particular attention will be drawn to the existing barriers to the effective implementation of prevention of mother-to-child-transmission. The recommendations aim to solve similar barriers in both countries and some specifically dealing with problems in China. Since HIV infection in children is caused almost entirely by prenatal transmission, it is important that the governments, in partnership with civic society organizations, make all the necessary efforts to save the lives of their newborn citizens. [source] Operational teledermatology in Broken Hill, rural AustraliaAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 3 2005Adrian See SUMMARY From January 2001 to January 2002, Broken Hill, New South Wales, served as a trial site for teledermatology as one method of access to dermatologists. Fourteen participating general practitioners referred 46 patients making up 48 teledermatology cases. The mean diagnostic agreement between general practitioners and dermatologists was 35% and 50% for primary and differential diagnoses, respectively. Teledermatology patients formed 12% of the collectively referred dermatology patients (outpatients and teledermatology). In this project, high patient and general practitioner acceptability and positive medical outcomes confirm the value of rural teledermatology. However, this project also revealed unexpected barriers and pitfalls in the effective operation of rural teledermatology. Lack of education of participants, inertia among potential users and patient inconvenience are issues that may adversely affect the effective implementation of rural teledermatology. [source] How Should Governments Make Risky Policy Decisions?AUSTRALIAN JOURNAL OF PUBLIC ADMINISTRATION, Issue 3 2009J. Brian Hardaker Public policy-making does not follow the long-established and well-recognised principles of rational decision analysis under risk. Public views of risk are often inconsistent and seemingly irrational, and a gulf exists between risk perceptions and attitudes of the public and those of ,experts'. On the other hand, experts often claim unjustifiably high levels of confidence in their predictions of policy choice outcomes, creating a lack of public faith in their recommendations. While risky policy choices deserve more systematic decision analysis, many challenges remain to effective implementation of such analyses. Among the suggestions for improvement that we offer is the need for more effective interaction between policy-makers, decision analysts and the public. [source] GOAL ATTAINMENT SCALING: AN EFFECTIVE OUTCOME MEASURE FOR RURAL AND REMOTE HEALTH SERVICESAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 5 2002Ruth Cox ABSTRACT: The aim of this paper is to demonstrate the utility of Goal Attainment Scaling (GAS) as an effective, multidisciplinary measure of client outcomes for rural and remote health services. Goal Attainment Scaling was adopted by the Spinal Outreach Team (SPOT) as a client-focussed evaluation tool, as it is sensitive to the individual nature of clients' presenting issues and the multidisciplinary focus of the team. It enables individualised goals to be set on a five-point scale. Goal Attainment Scaling was introduced to the SPOT service after a pilot trial established guidelines for its effective implementation. An ongoing review process ensures that goal scaling remains realistic and relevant. Service outcomes can be effectively summarised using a frequency distribution of GAS scores. One of the important benefits of GAS is its facilitation of collaborative goal setting between clinician and client. Goal Attainment Scaling is recommended to rural and remote multidisciplinary health services because of its ability to summarise outcomes from heterogeneous service activities. [source] Transformative Knowledge Transfer Through Empowering and Paying Community ResearchersBIOTROPICA, Issue 5 2009Stephen T. Garnett ABSTRACT Environmental research is often conducted independently of the community in which the environment is situated, with transfer of results into policy and on-ground action occurring independently of the community's interests or aspirations. Increasingly the need for greater community involvement in the research process has been recognized. For community members, however, such engagement usually involves trade-offs. While it is often assumed that community members should participate voluntarily because they will gain from the research, any benefits from knowledge, understanding and a capacity to influence the research have to be offset against time and potential loss of unremunerated intellectual property. We argue, using case studies from tropical Australia and Africa, that a more effective means of engagement and knowledge transfer is training and remuneration of community members as coresearchers. This engagement is much more than payment for labor,it is investment in local intellectual property and requires researcher humility, power-sharing and recognition that access to research funding provides no moral or intellectual authority. Further, we argue that, for effective adoption of research results, community members need to be part of negotiated agreements on the initial nature of the research to ensure it answers questions of genuine local relevance and that local researchers have the capacity to place locally conducted research into a wider context. We argue that immediate rewards for involvement not only secure engagement but, where appropriate, are likely to lead to effective implementation of research results, enhanced local capacity and greater equity in intellectual power-sharing. [source] The Challenge to Social WorkCHILD AND ADOLESCENT MENTAL HEALTH, Issue 1 2001Anne Hollows The Framework for the Assessment of Children in Need and their Families signifies a major achievement in the development of a coherent approach to promoting the welfare of children while safeguarding them from harm. In this article, the aspirations of the Framework are considered, with particular focus on the challenges posed by the Framework, not only to the practice of social workers but also to the status of the social work profession. The area of professional judgement making is discussed, along with the threats to the effective implementation of the Framework. The author concludes that the Framework could bring about not only a better deal for children and families service users, but a new era of professional respect for social workers. [source] | |||||||||||||||||||||||||||||||||||||