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Protocol implementation in anesthesia: beta-blockade in non-cardiac surgery patients

CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE 2007年第2期54卷 114-123页

作者： Baxter, Alan D. Kanji, Salmaan Ottawa Gen Hosp Dept Anesthesia & Crit Care Ottawa ON K1H 8L6 Canada Ottawa Gen Hosp Dept Pharm Ottawa ON K1H 8L6 Canada Ottawa Gen Hosp Dept Crit Care Ottawa ON K1H 8L6 Canada Ottawa Hlth Res Inst Ottawa ON Canada

Purpose: An audit of intensive care unit (ICU) patients with perioperative myocardial ischemia and/or infarction (PMI/I) suggested under-use of prophylactic beta-adrenergic blocking drugs (ABDs). A multidisciplinary team developed an institutional protocol to identify at-risk patients, to standardize and facilitate prophylactic beta-adrenergic blockade, and to improve management of such patients. We report a retrospective assessment of the efficiency of program implementation. Methods: Eligible preanesthesia assessment unit patients received metoprolol for one to four weeks prior to surgery, intraoperatively, and postoperatively. Patients with PMI/I requiring ICU admission were tracked from January 2002 to December 2004. The protocol was implemented in May 2003. The efficiency of program implementation was evaluated during two months of normal operating room activity (September 2003 and February 2004). Results: The use of ABDs increased during the audit. Preoperative use increased from 31% in September 2003 to 39% of eligible patients in February 2004, with a stable surgical population. The incidence of patients with PMI/I admitted to ICU decreased from 2.6/1,000 surgical cases pre-implementation to 1.6/1,000 surgical cases post-implementation (P = 0.025). For the whole hospital, implementation was associated with a decrease in PMI/I incidence from 5.9 to 2.0/1,000 surgical cases (P < 0.001). Conclusion: Heightened awareness and standardization of perioperative beta-blockade coincided with an increase in metoprolol use in at-risk patients and reduction in PMI/I. There was an increase in at-risk patients receiving prophylactic ABDs, a reduction in PMI/I diagnoses throughout the hospital, and reduced ICU patient admissions with PMI/I.

关键词： Intensive Care Units Surgical aspects Risk program implementation Knowledge acquisition using a method of assessment 加强医疗病房危险 program implementation Metoprolol Patients Surgery At-risk

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The tortoise and the hare enigma in e-transformation in Japanese and Korean higher education

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BRITISH JOURNAL OF EDUCATIONAL TECHNOLOGY 2008年第4期39卷 610-630页

作者： Latchem, Colin Jung, Insung Aoki, Kumiko Ozkul, Ali Ekrem Curtin Univ Teaching & Learning Grp Perth WA Australia Int Christian Univ Tokyo Japan Natl Inst Multimedia Educ Chiba Japan Anadolu Univ Eskisehir Turkey

Japan and Korea have highly developed information and communications technology infrastructures and have recently reformed their higher education systems and encouraged e-transformation. However, Japanese universities have not embraced e-learning as wholeheartedly as their Korean counterparts. The paper concludes that this is due to governmental and institutional failure to develop a cogent vision and strategic plan for e-learning, to recognise the need for fundamental shifts in organisational cultures and structures and pedagogy and to provide training, funding, recognition and reward for such development. It attributes this to differences in the cultural perspectives, values and customs of the two countries' policy makers, managers and faculty members. The findings are seen to hold important lessons for other countries embarking on e-transformation.

关键词： Strategic Planning Higher Education Foreign Countries Faculty Development Educational Change Technology Integration Educational Technology Organizational Culture College Environment Educational Policy College Faculty College Administration Resistance to Change Adoption (Ideas) Cultural Differences program implementation program EffectivenessJapan South KoreaJapan Korea

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On the development and assessment of a computer-based learning and assessment environment for the transition from lower to upper secondary chemistry education

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CHEMISTRY EDUCATION RESEARCH AND PRACTICE 2013年第3期14卷 345-353页

作者： Krause, Moritz Kienast, Stephan Witteck, Torsten Eilks, Ingo Univ Bremen D-28359 Bremen Germany Ursulinengymnasium Werl Werl Germany Westfalen Kolleg Bielefeld Bielefeld Germany

This paper describes the development and assessment of a learning environment to support the transition of students from lower to upper secondary chemistry education in Germany. The learning environment centers on reviewing and expanding learners' prior chemistry knowledge in heterogeneous learning groups upon entering upper secondary education. The different learning materials are integrated in a computer-based learning environment, which offers a set of different learning stages which sequentially build upon each other. Another central element of the learning environment is an integrated test platform, which provides assessment and instant feedback to the students after completing each of the learning stages. This paper reports on the development of the learning environment by a group of teachers following the model of Participatory Action Research. Four schools and 81 students were involved in the implementation of the learning environment. Data sources used to reflect the learning environment were classroom observations, analysis of teacher feedback during monthly discussions, and a student survey. The study describes potential uses and reflects the benefits of using computer-based assessment within this learning environment from the viewpoint of the teachers and the students.

关键词： Computer Assisted Instruction Educational Environment Transitional programs Chemistry Articulation (Education) Action Research Participatory Research program implementation Feedback (Response) Student Surveys Computer Assisted Testing Secondary School Curriculum Curriculum Development Curriculum Design Computer System Design Foreign Countries Observation Qualitative ResearchGermany

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The role of the principal's leadership style in the implementation of ICT policy

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BRITISH JOURNAL OF EDUCATIONAL TECHNOLOGY 2011年第2期42卷 311-326页

作者： Hadjithoma-Garstka, Christina Univ Bristol Bristol BS8 1TH Avon England HEA Benchmarking Exercise Bristol Bristol Avon England London Knowledge Lab IoE London England

This paper presents findings of a study in information communication technology (ICT) implementation, on the principal's leadership style in relation to other factors that influence implementation. The principal's leadership style is perceived-on the basis of the characteristics of the context where the study was conducted-as a personal quality, rather than a change/transformational leadership behaviour or related to the principals' positional authority. The study employed firstly a large-scale survey based on which case studies of four schools were selected for further research. The findings have implications for practice, more specifically, for principals' training and for the support provided to schools for embedding ICT. The paper draws on an institutionalist implementation approach to describe the principals' role in theorising the concept of ICT in education.

关键词： Transformational Leadership Leadership Principals Administrator Role Leadership Styles Information Technology program implementation Surveys

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DERIVATION OF EFFICIENT PARALLEL programS - AN EXAMPLE FROM GENETIC SEQUENCE-ANALYSIS

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INTERNATIONAL JOURNAL OF PARALLEL programMING 1989年第6期18卷 447-484页

作者： SINGH, AK OVERBEEK, R UNIV CALIF SANTA BARBARA DEPT COMP SCISANTA BARBARACA 93106 ARGONNE NATL LAB ARGONNEIL 60439

implementation issues such as synchronization, implementation of abstract data types, and scheduling of processes are usually not addressed in the formal derivation of parallel programs. We seek to redress the situation by considering these issues in the context of developing an efficient implementation of an actual parallel program. The computational problem that we proceed by developingan algorithm in Unity and investigating the issues that arise in producing an efficient C implementation of the resulting algorithm. Along the way, we develop some theorems about program refinements, and illustrate the usefulness of the theorems in the context of refining the original Unity program.

关键词： program implementation program correctness stepwise refinement

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"In the middle of difficulty lies opportunity" - using a case study to identify Critical Success Factors contributing to the initiation of international collaborative projects

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EDUCATION FOR INFORMATION 2005年第1-2期23卷 9-42页

作者： Johnson, Ian M. Robert Gordon Univ Aberdeen Business Sch Aberdeen Scotland

This paper identifies factors that contribute to the successful initiation of international collaborative projects intended to support the development of education for librarianship and information sciences. It discusses the widespread failure to analyse the Critical Success Factors in international collaborative projects and proposes a case study methodology to identify these factors through an analysis of the decision by the European Commission's ALFA programme to support REVISTAS, a study of the feasibility of digitising all Spanish and Portuguese journals in librarianship and information sciences, particularly those published in Latin America. To contextualise the proposal, it discusses the development of the 'Information Society' in Latin America, and the key role attributed to libraries and librarians. It then examines problems in the development of education and practice in librarianship and information sciences in the region, and in journal publishing for the profession, the availability of indexing and abstracting services, and the utility of document delivery services. It presents an outline of the author's initial research into the underlying challenges, and outlines the development of the international partnership that will deliver the planned outcomes of the REVISTAS project. Finally, it analyses the issues that have contributed to the establishment of this cooperative effort, and the limitations of this study.

关键词： Library Education Foreign Countries Information Science Library Role Partnerships in Education International programs International Cooperation Electronic Publishing program implementation Periodicals Publishing Industry Indexing Documentation Delivery Systems Success Factor AnalysisLatin America

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Engaging Pregnant and Parenting Teens: Early Challenges and Lessons Learned From the Evaluation of Adolescent Pregnancy Prevention Approaches

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JOURNAL OF ADOLESCENT HEALTH 2014年第3期54卷 S84-S91页

作者： Asheer, Subuhi Berger, Amanda Meckstroth, Alicia Kisker, Ellen Keating, Betsy Math Policy Res Princeton NJ 08543 USA Child Trends Princeton NJ USA Twin Peaks Partners LLC Princeton NJ USA

This article draws on data from the ongoing federal Evaluation of Adolescent Pregnancy Prevention Approaches to discuss the early implementation experiences of two new and innovative programs intended to delay rapid repeat pregnancy among teen mothers: (1) AIM 4 Teen Moms, in Los Angeles County, California;and (2) Teen Options to Prevent Pregnancy (T.O.P.P.), in Columbus, Ohio. program staff report common challenges in working with teen mothers, particularly concerning recruitment and retention, staff capacity and training, barriers to participation, and participants' overarching service needs. Lessons learned in addressing these challenges provide useful guidance to program developers, providers, policy makers, and stakeholders working with similar populations. (C) 2014 Society for Adolescent Health and Medicine. All rights reserved.

关键词： Repeat births Parenting teens program implementation Teen pregnancy prevention program evaluation

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A facility birth can be the time to start family planning: Postpartum intrauterine device experiences from six countries

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INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS 2015年第Sup2期130卷 S54-S61页

作者： Pfitzer, Anne Mackenzie, Devon Blanchard, Holly Hyjazi, Yolande Kumar, Somesh Kassa, Serawit Lisanework Marinduque, Bernabe Mateo, Marie Grace Mukarugwiro, Beata Ngabo, Fidele Zaeem, Shabana Zafar, Zonobia Smith, Jeffrey Michael Jhpiego Maternal & Child Hlth Integrated Program Washington DC 20036 USA Jhpiego Conakry Guinea Jhpiego New Delhi India Jhpiego Addis Ababa Ethiopia Jhpiego Manila Philippines Jhpiego Kigali Rwanda Minist Hlth Kigali Rwanda Jhpiego Islamabad Pakistan Jhpiego Baltimore MD USA

Initiation of family planning at the time of birth is opportune, since few women in low-resource settings who give birth in a facility return for further care. Postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care in six low- and middle-income countries, applying an insertion technique developed in Paraguay. Facilities with high delivery volume were selected to integrate PPFP/PPIUD services into routine care. Effective PPFP/PPIUD integration requires training and mentoring those providers assisting women at the time of birth. Ongoing monitoring generated data for advocacy. The percentages of PPIUD acceptors ranged from 2.3% of women counseled in Pakistan to 5.8% in the Philippines. Rates of complications among women returning for follow-up were low. Expulsion rates were 3.7% in Pakistan, 3.6% in Ethiopia, and 1.7% in Guinea and the Philippines. Infection rates did not exceed 1.3%, and three countries recorded no cases. Offering PPFP/PPIUD at birth improves access to contraception. (C) 2015 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics. This is an open access article under the CC BY-NC-ND license.

关键词： Intrauterine device Postpartum family planning Postpartum care Prenatal care program implementation

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Predicting readiness to adopt evidence-based programs for divorcing families: Champions, attitudes, and access to funding

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AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2007年第4期77卷 573-581页

作者： Cookston, Jeffrey T. Sandler, Irwin N. Braver, Sanford L. Genalo, M. Toni San Francisco State Univ San Francisco CA 94132 USA Arizona State Univ Dept Psychol Prevent Res Program Tempe AZ 85287 USA

This paper attempts to identify the factors that explain service provider readiness to fund and implement evidence-based programs for children from divorcing families. Representatives from 128 family courts in United States counties were surveyed about the programs currently being offered for families of divorce and plans for changes in the services provided. Path analyses provided evidence that readiness to adopt effective programming was predicted by (a) the presence of champions who could potentially advocate for adoption, (b) county size, and (c) community attitudes favorable to services for families of divorce. The counties' ability to access funding to support programming did not predict ultimate readiness to adopt extended programming. Implications for research on the dissemination of prevention programs for children of divorce are discussed.

关键词： organizational readiness divorcing parent education program implementation dissemination family court

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A practical model of development for China's National Quality Course Plan

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BRITISH JOURNAL OF EDUCATIONAL TECHNOLOGY 2012年第6期43卷 920-932页

作者： Long, Wang Haklev, Stian Chinese Peoples Publ Secur Univ Natl Qual Course Plan Beijing Peoples R China Beijing Citys Natl Qual Courses Evaluat Project Beijing Peoples R China

The Chinese National Quality Course Plan is a large-scale project by the Ministry of Education, which has led to the production of more than 12 000 courses from some 700 universities since 2003. This paper describes in detail the purpose of the project and how it is organized at all levels, including how individual courses get selected at university level, provincial level and national level. The paper discusses the similarities and differences between the Chinese project and Open Educational Resources projects around the world, including Massachusetts Institute of Technology (MIT) OpenCourseWare. The Chinese project is unique, not only because of its highly centralized organization and funding but also because its purpose is not just to produce open resources but to use the production of open resources to drive curriculum reform and quality improvement in Chinese higher education.

关键词： Foreign Countries Curriculum Development Educational Change Educational Resources Comparative Education Educational Policy Educational Improvement College Curriculum program implementation Models program Descriptions Government Role Instructional Development Educational Quality Courseware Online Courses Web Based Instruction Open Source Technology Instructional Design College Instruction CentralizationChina MassachusettsMassachusetts China

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