Core Implementation Research Articles

Cloud-Enabled Innovation in Retail: Transforming Inventory Management and Demand Forecasting

This comprehensive article explores the transformative impact of cloud computing technologies on the retail industry, examining core platform solutions, implementation strategies, and future trends. The article investigates how cloud integration has revolutionized inventory management, demand forecasting, and operational efficiency across the retail sector. Through detailed case studies of major retailers, the research demonstrates the substantial benefits of cloud adoption in areas such as real-time data processing, predictive analytics, and supply chain optimization. The article encompasses technical considerations, best practices, and emerging technologies, providing insights into successful implementation strategies and operational guidelines. The article further evaluates the integration opportunities and standardization initiatives shaping the future of retail cloud computing, highlighting the critical role of artificial intelligence, blockchain, IoT, and advanced analytics in driving industry innovation.

Examining Changes in Implementation of Priority Healthy Eating and Physical Activity Practices, and Related Barriers, Over Time in Australian Early Childhood Education and Care Services: A Repeated Cross-Sectional Study.

Background: Promoting healthy eating and physical activity in early childhood education and care (ECEC) is recommended within guidelines and supported by health promotion programs; however, implementation is suboptimal. Evidence suggests implementation within the sector varies over time; however, this has not been empirically examined in relation to implementation barriers. This study aims to: (1) describe changes in the prevalence of, and barriers to, implementation of priority healthy eating and physical activity practices; and (2) explore the associations between such barriers and implementation. Methods: This was a repeated cross-sectional study over an 8-month period. A cross-section of 150-180 Australian ECEC services were prospectively randomly sampled for each month (April-November 2023), with 1127 ECEC services sampled in total and 20% of services sampled twice. Services reported via survey their implementation of two priority practices: (1) healthy menu standards and (2) educating and engaging parents in child physical activity. They also reported on implementation status, implementation stage, and five core implementation barriers. Results: Overall, 716 services completed 809 surveys. There were no significant differences in the prevalence of implementation or general trends in barriers to implementation of the two priority practices across that time. Services reporting less barriers were significantly more likely to be implementing the priority practices, and services in more advanced implementation stages were significantly less likely to report barriers. Conclusions: To enhance the implementation of priority practices in ECEC services, key barriers to implementation need to be understood and targeted to progress services through to advanced implementation stages.

Dual-Network Layered Network: A Method to Improve Reliability, Security, and Network Efficiency in Distributed Heterogeneous Network Transmission

This article delves into the routing architecture and reliable transmission service framework of dual-network layered networks, with a focus on analyzing their core design ideas and implementation strategies. In the context of increasing network complexity today, traditional single-network architectures are unable to meet diverse application needs. Therefore, dual-network layered networks, as an innovative solution, are gradually receiving attention from both academia and industry. This article first analyzes the key technical elements in the dual-network layered network architecture, including the optimization of routing algorithms, distributed consensus, reliability assurance mechanisms for packet transmission, and dynamic allocation strategies for network resources. Through in-depth research on these technologies, this article elaborates on the important role of dual-network layered networks in building efficient and stable transmission environments, providing important theoretical foundations and technical support for the construction and optimization of future network systems.

The Practice of Employee Assistance Program in Small and Medium-Sized Enterprises in The Internet Era Based on Harmonious Society

With the arrival of the internet era, information technology and digital transformation have profoundly changed the operations of small and medium-sized enterprises (SMEs). This study explores the practice of Employee Assistance Programs (EAP) in SMEs, analyzing how EAP, from the perspective of a harmonious society, promotes employee mental health and career development, while enhancing organizational cohesion and competitiveness. The core components and implementation steps of EAP, including psychological health support, career development guidance, and stress management, are discussed. Due to resource limitations, SMEs often adopt flexible EAP models, such as online counseling and workplace training. However, the implementation of EAP faces challenges such as limited resources, privacy protection, and a lack of professional expertise. To optimize EAP, companies need to strengthen management support, use outsourcing services, and establish privacy protection mechanisms. In the future, SMEs can explore more innovative and feasible EAP models, such as AI-based intelligent support, adaptation to remote work environments, creation of culturally adaptable models, and establishment of data-driven effectiveness assessment methods. These approaches will help SMEs address the challenges of the internet era, enhance employee satisfaction, and promote sustainable development.

Charge-coupled device readout by digital-correlated double sampling

Charge-coupled devices (CCDs) play crucial roles in astronomy owing to their widespread use in the optical band, offering high sensibility, low noise, high dynamic range, and high spatial resolution. Recent advancements in CCDs have focused on improving the sub-electron noise levels for particle detection and enhancing readout speeds through simulation studies. The main objective of this study is to replace the analog processing of CCD signals using the digital-correlated double sampling (DCDS) technique. DCDS allows post-acquisition noise correction through intermittent sampling of an internal reference voltage to provide compact and flexible performance. In this study, DCDS was evaluated using two digital processing systems, namely, a 2.5 mega-samples per second (MSPS) 24-bit analog-to-digital converter (ADC) board and a 250 MSPS 16-bit ADC field-programmable-gate-array( FPGA)-based buffer memory board. The readout noise value at 74 kpix/s (7.1 e) was a significant improvement over that obtained with analog processing (9.7 e). The DCDS implementation demonstrates optimal signal-to-noise ratio for a wide range of readout speeds. Parameters such as the sample positions per pixel, number of samples, and number of pixels were identified to be essential in achieving an accurate gain value. Finally, hardware implementation of the DCDS IP core algorithm on a Xilinx Zynq-7000 AP system-on-a-chip (SoC) showed a significant improvement in power dissipation (7.1 W) compared to the analog Monsoon correlated double sample (CDS) circuit (13.6 W). The DCDS IP core implementation also showed a background noise reduction of up to 34% compared to DCDS offline readout processing using a Python algorithm.

Exploring the role of primary care pharmacists in NHS Lanarkshire following the implementation of the pharmacotherapy hub: a service evaluation

Abstract Introduction The General Medical Service (GMS) contract was produced in Scotland in an attempt to tackle General Practitioner (GP) workforce issues. The pharmacotherapy work stream is part of this and provides a framework for pharmacy teams, dividing services into level 1 (core), level 2 (advanced) and level 3 (specialist).1 A statement by the Royal Pharmaceutical Society (RPS) and the British Medical Association (BMA) discussed the introduction of pharmacotherapy hubs to complete level 1 work for multiple practices, centralising the medicines reconciliation process. Theoretically, this would release pharmacists to carry out clinical and more advanced/specialist services.2 There are currently 8 pharmacotherapy hubs within NHS Lanarkshire (NHSL), incorporating level 2 and 3 services into job plans for General Practice Clinical Pharmacists (GPCPs). No work has been undertaken to explore changes in practice since the implementation of these hubs. The qualitative study explored drivers and motivators for pharmacists in practice, shaping future pharmacotherapy services in NHSL and Scotland. Aim To explore the views and attitudes of primary care pharmacists towards their practice role in NHSL following the implementation of the pharmacotherapy hub. Methods Ethical approval was granted from the School of Pharmacy and Life Sciences Ethics Committee (Robert Gordon University). Pharmacists working within the 8 hub localities were invited to participate via email correspondence if they had over 6 months experience in practice pre-hub implementation and then 6 months post-hub implementation. Participants attended a one-to-one interview to share their views towards their practice role since the hub was implemented. Interviews were recorded, transcribed verbatim and thematically analysed. Results Twelve pharmacists across six localities participated. The five key themes identified were job role, managing time, professional development, professional belonging and patient care. The implementation of the hub was an enabler for pharmacists to partake in advanced pharmacotherapy tasks. Pharmacists negatively perceived level 1 core pharmacotherapy tasks in comparison to level 3 clinical patient-facing time. Participants linked the hubs impact on practice with role development, an increase in autonomy, confidence and job satisfaction. Discussion/Conclusion The hub has enabled in-practice pharmacists to move to a more sustainable balance between core and advanced/specialist tasks. Collaboration is required between pharmacy teams and practices to understand the pharmacist role in pharmacotherapy. Further recommendations include continuing the roll-out of pharmacotherapy hubs, standardisation of pharmacist clinical time balanced with core tasks and implementation of protected learning time for pharmacy teams. The study was open to response bias but this was addressed by using semi-structure interview guides in the one-to-one interviews. Researcher bias was minimised by two researchers analysing the data and practicing reflexivity. The study was open to recall bias due to participant’s retrospective thinking. In NHSL prioritising the hub roll-out and collaboration with stakeholders are essential. This will ensure the balance between efficient pharmacotherapy services and maintaining attractive roles, contributing to a sustainable workforce.

Teaching health disparities on the road: An experiential educational intervention for doctor of nursing practice students

AimThis analysis was conducted to understand the nuanced and underlying benefits and challenges of an experiential educational intervention for DNP students learning how neighborhoods and health disparities may be related. BackgroundPoor social and environmental conditions in many low-income urban neighborhoods are linked to deleterious health outcomes. Many of the structural and political influences are unknown to health providers, which can inhibit their understanding of the social effects on health. One aspect of a new DNP social determinants of health curriculum is a guided community bus tour in economically disadvantaged neighborhoods to enhance understanding of health disparities. DesignA concurrent mixed methods design, including comparison surveys and thematic analysis, was used to analyze student responses to the experiential educational intervention. MethodA community-based bus tour implemented in socially disadvantaged neighborhoods in an urban environment was the study focus. New DNP students (n=91) in a midwestern university introductory course agreed to provide feedback following an experiential learning activity. The analysis of responses to the educational intervention was completed using a systematic thematic analysis alongside descriptive statistics and paired t-tests in a convergent mixed methods analytical approach to answer the research aim. ResultsStudents expressed confidence in naming and addressing health disparities after the bus tour activity. Analysis showed: (a) A visual tour can impact new learning, (b) Policy can explain inequity and is new to students, (c) Students do not well articulate racial disparities and (d) Understanding racial history requires attention and conversation. ConclusionA community bus tour met our expectations for teaching DNP students concepts related to health disparities as it illustrated real-life situations in actual neighborhoods. However, there were unusual student responses that prompted us to reflect on the activity and consider improvements. More emphasis needs to be placed on cultural wealth and on discussion planning for such experiences. Our results lay the groundwork for curriculum development. Setting goals and targets in line with the 2022 CDC’s Core Health Equity Science and Implementation Strategy is essential.

A community-academic partnership to develop an implementation support package for overdose prevention in permanent supportive housing

IntroductionThe overdose crisis in the U.S. disproportionately impacts people experiencing homelessness. Permanent supportive housing (PSH) – permanent, affordable housing with voluntary support services – is an effective, evidence-based intervention to address homelessness. However, overdose risk remains high even after entering PSH for individual and structural reasons. In this study, we aimed to refine a set of evidence-based overdose prevention practices (EBPs) and an associated implementation support package for PSH settings using focus groups with PSH tenants, frontline staff, and leaders. MethodsOur community-academic team identified an initial set of overdose EBPs applicable for PSH through research, public health guidance, and a needs assessment. We adapted these practices based on feedback from focus groups with PSH leaders, staff, and tenants. Focus groups followed semi-structured interview guides developed using the EPIS (Exploration, Preparation, Implementation, Sustainment) framework constructs of inner context, outer context, and bridging factors related to overdose prevention and response. ResultsWe conducted 16 focus groups with 40 unique participants (14 PSH tenants, 15 PSH staff, 11 PSH leaders); focus groups were held in two iterative rounds and individuals could participate in one or both rounds. Participants were diverse in gender, race, and ethnicity. Focus group participants were enthusiastic about the proposed EBPs and implementation strategies, while contributing unique insights and concrete suggestions to improve upon them. The implementation support package contains an iteratively refined PSH Overdose Prevention (POP) Toolkit with 20 EBPs surrounding overdose prevention and response, harm reduction, and support for substance use treatment and additional core implementation strategies including practice facilitation, tenant-staff champion teams, and learning collaboratives. ConclusionsThis manuscript describes how robust community-academic partnerships and input from people with lived experience as tenants and staff in PSH informed adaptation of evidence-based overdose prevention approaches and implementation strategies to improve their fit for PSH settings. This effort can inform similar efforts nationally in other settings serving highly marginalized populations. We are currently conducting a randomized trial of the refined overdose prevention implementation support package in PSH.

Implementing a perioperative medicine for older people undergoing surgery (POPS) service: A guide for clinical leaders.

This study aimed to translate previous implementation science research describing the implementation of perioperative medicine for older people undergoing surgery (POPS) services into a format that is comprehensible and relevant to clinical leaders contemplating implementing a POPS service. We conducted a multistage expert end-user review process to design a POPS implementation guide. Our expert research team created a draft POPS service implementation guide using previous implementation science research that described the core elements and implementation of a POPS service. Next, we invited multidisciplinary (allied health, anaesthetics, geriatric medicine, nursing and surgery) clinical leaders in perioperative medicine (n = 12) from five contextually different health services to review the guide. These clinical leaders then participated in two rounds of review and refinement of the implementation guide. The first draft of the POPS service implementation guide was reviewed by clinical leaders (n = 4) with participants querying implementation science-based language and concepts, the format of the guide and its practical use. We revised the guide accordingly, and the next draft was reviewed by the second group of clinical leaders (n = 8). Feedback from the second group review was supportive of the guide's comprehensibility and relevance, and only minor changes were made to the final version of the POPS service implementation guide. We used an implementation science-based approach to create a POPS service implementation guide that is comprehensible and relevant to clinical leaders in perioperative care. The next steps are to use the guide and assess its utility to support implementation of a POPS service.

Improving goal-concordant care via a uniquely collaborative and multi-site PFAC model.

265 Background: Studies reveal a mismatch between the goals of care (GOC) of cancer patients and actual care received. The 10 members of the Alliance of Dedicated Cancer Centers (ADCC) convened the Improving Goal Concordant Care (IGCC) initiative to address system gaps. IGCC was led by palliative care and oncology experts, with guidance from patient and family advisors. Uniquely, the advisors were identified from patient family advisory councils (PFAC) at each center, forming a collaborative Advisory Group (AG) with the lived experience of each center and the knowledge of advocating for the patient/family voice locally. Methods: PFAC members were recruited from each site to serve on the AG. The 19 member AG met quarterly, with minutes shared with the IGCC oversight group, the Implementation Workgroup (IWG). In September 2023, all AG members were surveyed about perceptions of PFAC engagement and local impact of IGCC. In May 2024, 20 IWG members were surveyed about implementation successes and barriers, including items related to PFAC engagement. Results: AG evaluation and recommendations altered IGCC planned core implementation and evaluation actions meaningfully; for example in 1) selection of structured fields in electronic health record (EHR) and universally accessible GOC documentation and in 2) centering patients in the GOC measure set, including incorporating “Heard & Understood” survey into IGCC evaluation. Other AG guidance around direct patient engagement readiness for GOC conversations and implementing patient GOC surveys was left to individual sites to consider with variable adoption. AG Survey: 63% response rate. 80% noted that the GOC program was discussed with their local PFAC and 92% experienced changed routine patient care after GOC implementation. IWG Survey: 100% response rate. 68% agreed that their center sought guidance from their PFAC during GOC implementation and that leadership presented to their PFAC about their GOC implementation. 26% indicated reporting data to their PFAC; of those that did, 80% agreed that this positively impacted their GOC implementation. Conclusions: While PFACs are occasionally included in quality interventions, this model centered the patient/family voice by supporting a PFAC stakeholder feedback loop working collaboratively and locally to support implementation and evaluation of IGCC objectives. While not all AG recommendations were formally integrated into IGCC, all were considered and many adopted at individual centers. Despite ongoing IGCC-level involvement, center-specific engagement of PFACs varied. Future efforts can track this during process evaluation as local PFAC engagement was highly valued. Consensus building for national best practice implementation and evaluation by recruiting local experts including PFAC members into national collaborative efforts is a successful model for local change.

Process evaluation of a New psychosocial goal-setting and manualised support intervention for Independence in Dementia (NIDUS-Family).

We report a mixed-methods process evaluation embedded within a randomised controlled trial. We aimed to test and refine a theory of change model hypothesising key causal assumptions to understand how the New Interventions for Independence in Dementia Study (NIDUS)-Family (a manualised, multimodal psychosocial intervention), was effective relative to usual care, on the primary outcome of Goal Attainment Scaling (GAS) over 1year. In 2021-2022, intervention-arm dyads completed an acceptability questionnaire developed to test causal assumptions. We conducted qualitative interviews with dyads and intervention facilitators, purposively selected for diverse follow-up GAS scores. We collected observational data from intervention session recordings. We thematically analysed data, then integrated qualitative and quantitative data. 174/204 (85.3%) dyads allocated to NIDUS-Family, fully completed it, 18 partially completed, while 12 received no intervention. We interviewed 27/192 (14%) of dyads receiving any sessions, and 9/10 facilitators; and observed 12 sessions. 47/192 (24.5%) of carers completed the acceptability questionnaire. We identified four themes: (A) 'Someone to talk to helps dyads feel supported'; (B) 'NIDUS-Family helps carers change their perspective'; (C) 'Personalisation helps people living with dementia maintain their identity' and (D) 'Small steps help dyads move forward'. Key causal pathway mechanisms were: a respectful, trusting and impartial relationship with the facilitator: supporting the development of meaningful goals and support to find manageable solutions. Core implementation factors were delivery of the modules from a consistent facilitator across regular sessions. Core contextual factors influencing these mechanisms were dyadic participation and understanding of abilities.

Design and Implementation of SoC-based Image Codec IP Cores

Design and Implementation of SoC-based Image Codec IP Cores

"We Wanna Be Nurses Because We Want the Human Connection": Acceptability and Usability of a Person-Centered Narrative Intervention in an Acute Care Setting.

The use of narrative interventions in health care is an effective way to communicate connection between patients and clinicians. The electronic health record (EHR) is a primary mode of communicating patient information across clinical teams. Thus, incorporating a person-centered cocreated narrative with patients into the EHR is an opportunity to share a person's cultural values, beliefs, and preferences; provide connection; and foster positive patient-clinician interactions. This study of a person-centered narrative intervention was a randomized controlled trial to test intervention effects on the person's (patient) perceptions of the quality of communication with their nurses and their psychosocial and existential well-being. This article describes the clinical team's experiences and reach of the cocreated person-centered narrative integration into the patient's EHR. The data collected included (1) exit interviews (n = 14), (2) a usability survey (n = 8), and (3) data collected from the EHR for clinicians (n = 600) who accessed the uploaded narratives. Overall, the System Usability Scale and nurse participant's experiences provided confirmation that the person-centered narrative intervention was usable. There were also interprofessional groups of clinicians in the health care system who accessed the narratives. Future research should continue to identify core components and implementation strategies of EHR-integrated person-centered narratives in complex health care settings.

Implementing absolute cardiovascular disease risk assessment into pathology collection services.

Pathology services represent an ideal setting to integrate absolute cardiovascular disease (CVD) risk estimation when patients attend for routine cholesterol testing. This study aimed to explore the process of implementing CVD risk estimation into point-of-care service delivery by pathology staff to inform future implementation and sustainability. A new service for CVD risk estimation via a self-directed screening station was implemented into 14 pathology service sites across Tasmania, Australia. Before implementation, observations at pathology services (n = 26) and semi-structured interviews were undertaken with 26 pathology staff (88% female, 77% aged 41-60 years) to identify factors that could impact implementation of the service. The process of implementation was then evaluated using participant observations and clinical trial recruitment data. Transcripts and field notes were analysed thematically according to the Medical Research Council Framework and used to develop a programme logic model to understand how the service could be adapted to be successfully integrated into routine workflow at pathology services. Eight key themes were identified during the pre-implementation phase as important factors that could impact upon integration of CVD risk estimation into pathology services. Themes related to factors within the organisation, including available resources, logistics and workflow, as well as having sufficient time to complete the intervention. Additional factors related to the individual motivations of staff, collaborative leadership and patient characteristics. Success of implementation varied among sites, requiring the trialling of different strategies to support uptake of the service and patient recruitment. Implementing CVD risk estimation into point-of-care pathology services required an understanding of the core implementation components specific to each context, and for implementation strategies to be targeted to the individual and organisational contexts. The generated programme logic model may be useful in guiding future implementation endeavours within these services and aiding the selection of apt implementation strategies. ClinicalTrials.gov Identifier: NCT04896021, registered 19/05/2021, https://clinicaltrials.gov/study/NCT04896021.

Arctos: Community-driven innovations for managing natural and cultural history collections.

More than tools for managing physical and digital objects, museum collection management systems (CMS) serve as platforms for structuring, integrating, and making accessible the rich data embodied by natural history collections. Here we describe Arctos, a scalable community solution for managing and publishing global biological, geological, and cultural collections data for research and education. Specific goals are to: (1) Describe the core features and implementation of Arctos for a broad audience with respect to the biodiversity informatics principles that enable high quality research; (2) Highlight the unique aspects of Arctos; (3) Illustrate Arctos as a model for supporting and enhancing the Digital Extended Specimen concept; and (4) Emphasize the role of the Arctos community for improving data discovery and enabling cross-disciplinary, integrative studies within a sustainable governance model. In addition to detailing Arctos as both a community of museum professionals and a collection database platform, we discuss how Arctos achieves its richly annotated data by creating a web of knowledge with deep connections between catalog records and derived or associated data. We also highlight the value of Arctos as an educational resource. Finally, we present the financial model of fiscal sponsorship by a nonprofit organization, implemented in 2022, to ensure the long-term success and sustainability of Arctos.

Optimizing the physical activity intervention for older adults with mild cognitive impairment: a factorial randomized trial.

Physical activity (PA) intervention is one of the most effective interventions to promote cognitive function of older adults with mild cognitive impairment (MCI). However, the level of PA remains low. Based on the two core interventions (X-CircuiT and health education), this study aimed to examine the effect of three implementation strategies (viz., role modeling, goal-setting, and reminding) on the PA level among older adults with MCI using the multiphase optimization strategy (MOST). Participants were randomized into one of eight conditions in a factorial design involving three factors with two levels: (i) role modeling (on vs. off); (ii) goal-setting (on vs. off); and (iii) reminding (on vs. off). The primary outcome was PA level at 12 weeks. The secondary outcomes were cognitive function, self-efficacy, and cost-effectiveness at 12 weeks. The intention-to-treat (ITT) analysis was performed as the main analysis and the per-protocol (PP) analysis as the sensitivity analysis. A total of 107 participants were included and randomly assigned into three groups, each receiving different implementation strategies. The results of the multivariate regression analysis showed that the three implementation strategies, namely, reminding (B = 0.31, p < 0.01), role modeling (B = 0.21, p < 0.01), and goal-setting (B = 0.19, p < 0.01), could significantly improve PA level. Specifically, it was found that role modeling (B = 0.68, p = 0.03) could significantly improve cognitive function. There were no significant interactions among the three implementation strategies. Role modeling was the most cost-effective strategy, costing 93.41 RMB for one unit of PA. Role modeling was likely to be the best implementation strategy. The value-based and cost-effective PA intervention package could include the core intervention (X-CircuiT and health education) and implementation strategy (role modeling). https://www.chictr.org.cn, The study was retrospectively registered on 30 June 2022 (ChiCTR2200061693).

Core components of pharmacist-led medication reviews and their relationship to outcomes: a systematic review

Abstract Introduction Medication reviews are a recognised intervention undertaken by healthcare professionals to support patients prescribed multiple medicines or with complex medication regimens. Pharmacist-led medication reviews are now an established intervention in policy and practice. There are different types of medication review, each implemented differently. Huiskes et al. demonstrated that medication reviews undertaken by any professional in any setting had minimal effects on clinical outcomes and that evidence is lacking about their effect on economic outcomes.[1] The implementation of medication reviews in practice was recognised as a factor which may impact outcomes, but this has not been explored further. Aim To develop an initial programme theory that links the core components of pharmacist-led medication reviews to outcomes in different contexts. Methods A systematic review was conducted to identify randomised controlled trials of medication reviews in adults (18+). The review updated that by Huiskes et al. and used the same search strategy in the MEDLINE, EMBASE and Web of Science databases.[1] The search terms used were related to ‘medication review’, ‘pharmacist’ and ‘randomised controlled trial’. Medication review was defined as “a consultation between a pharmacist and a patient to review the patient’s total medicines use with a view to improve patient health outcomes and minimise medicines related problems”. Studies reporting any outcomes were included. Papers not published in English or not available as full texts were excluded. The Cochrane Risk of Bias 2.0 tool was used to assess the studies. Data were extracted using a previously piloted bespoke data collection form. Descriptions of the medication reviews’ core components, implementation and outcomes were narratively synthesised to draw out common themes. The GRADE framework informed the overall assessment of the quality of the evidence from the studies.[2] Results Records screened n=10947, total reports of studies included n=68. Of the 50 individual studies that were identified, 66% were assessed as having a high risk of bias. Narrative synthesis of the data extracted relating to the description and implementation of the medication reviews, and where and how this may have affected outcomes, is presented in our programme theory as core components. Collaborative working may help reduce medicines-related problems and number of medicines prescribed. Patient involvement in goal setting and action planning may improve patients’ ability to take medicines as prescribed and help them achieve their treatment goals. Additional support and follow-up may lead to improved blood pressure, diabetes control, quality of life and a reduction of medicines-related problems. Conclusion This is an extensive systematic review that has explored pharmacist-led medication reviews in all settings and resulted in the production of a draft programme theory. It is best practice for stakeholders to be involved in the development of a programme theory. Providers of medication reviews can evaluate their processes and consider if and how these core components are implemented in their service provision. This initial programme theory will be refined and discussed in future research.

Telemedicine in HIV health care during the COVID-19 pandemic: An implementation research study in Buenos Aires, Argentina.

From October 2020 to October 2022, we conducted an implementation study to offer telemedicine (TM) across four HIV units of general public hospitals in Buenos Aires. The intervention used TM to provide a continuum of care to patients with HIV. We used the RE-AIM framework to evaluate the strategy. The study started during a COVID-19 outbreak with strict lockdown policies and continued until return to normal practices. Implementation facilitation served as the core implementation strategy. We reached 4118 patients (58% of eligible individuals), and the main perceived benefits were the ability to avoid exposure to infectious diseases and reduced travel time and cost. After a median of 515 days of follow-up, 95.7% of participants with HIV were receiving antiretroviral therapy, and 87.8% were virally suppressed, with a median CD4+ count of 648 cells/μL. In total, 36.6% reported clinical events, and 20.4% presented with COVID-19 infection. The proportion of physicians adopting TM was 69.37%. After enrolment, 2406 of 5640 (43%) follow-up visits were conducted via TM. By the end of the study, 26.29% of appointments offered in the four centres were through TM, whereas 73.71% were in-person appointments. It was feasible to implement TM in the four centres in the public health sector in Buenos Aires, Argentina. It was acceptable for both patients and healthcare workers, and effectively reached a large proportion of the population served in these clinics. Both healthcare workers and patients consider it a model of care that will continue to be offered in the future.

The Application of Participatory Design in Weifang Kites, China

This paper discusses the key application of participatory design in Weifang kite culture. Kite, as a treasure of Chinese traditional culture, carries rich historical and cultural connotations. Weifang kite is famous both at home and abroad for its exquisite craftsmanship and unique design. However, under the impact of modern society, the traditional kite culture is facing the dual challenges of inheritance and innovation. Participatory design, with its emphasis on user participation and joint creation, provides a new perspective and method for the inheritance of kite culture. Through the systematic analysis of the core concept and implementation methods of participatory design, this paper creatively puts forward a set of targeted participatory design strategies based on the uniqueness of Weifang kite culture and the realistic needs of inheritance. These strategies aim to stimulate the enthusiasm of the community people to participate, gather collective wisdom, and jointly promote the innovation and development of kite culture. This paper mainly focuses on the theoretical discussion and the construction of the strategy system, aiming to provide new ideas and directions for the inheritance of Weifang kite culture, rather than being limited to specific cases or empirical analysis.

Enabling Efficient On-Edge Spiking Neural Network Acceleration with Highly Flexible FPGA Architectures

Spiking neural networks (SNNs) promise to perform tasks currently performed by classical artificial neural networks (ANNs) faster, in smaller footprints, and using less energy. Neuromorphic processors are set out to revolutionize computing at a large scale, but the move to edge-computing applications calls for finely-tuned custom implementations to keep pushing towards more efficient systems. To that end, we examined the architectural design space for executing spiking neuron models on FPGA platforms, focusing on achieving ultra-low area and power consumption. This work presents an efficient clock-driven spiking neuron architecture used for the implementation of both fully-connected cores and 2D convolutional cores, which rely on deep pipelines for synaptic processing and distributed memory for weight and neuron states. With them, we developed an accelerator for an SNN version of the LeNet-5 network trained on the MNIST dataset. At around 5.5 slices/neuron and only 348 mW, it is able to use 33% less area and four times less power per neuron as current state-of-the-art implementations while keeping low simulation step times.