Implementation Program Research Articles

Analisis Tingkat Kepuasan Masyarakat Terhadap Program Pengembangan Pendidikan dan Kreativitas Anak (Pendikresa) di Kota Samarinda

Children’s education and creativity development program is carried out by the schools around the company areas embodies the company commitment related to the world of education in Samarinda. The aim of this research is to upgrade the service providers in improving the quality of services in Pendikresa Program. The sampling method used is Survey method. The data analysis methods used in this survey were descriptive analysis, customer satisfaction index and importance performance analysis. The results of the analysis illustrated that the survey on Community Satisfaction, underdone by Public Service Delivery Unit shows a figure of 71.20. It can be seen that this number fulfills the category of the value range 60% < IKM ≤ 80% which illustrates that the IKM value is in the "Good" criteria. The IPA analysis shows what included in the priority quadrant of improvement program, these include indicators such as : the openness of information regarding to program of the implementation procedures; the ease of program procedures; the accuracy of the implementation program schedule; the effectiveness of program implementation; the technical competency of program implementers; the managerial competency of program managers; the discipline and responsibility of program managers; the clarity of complaints handling procedures; and the clarity of complaint handling time; and) the facilitation procurement of supporting facilities or infrastructure program.

Analisis Implementasi Kebijakan Program Bantuan Pemberdayaan Masyarakat Keluarga Miskin (PPMKM) dalam Meningkatkan Kesejahteraan Masyarakat Keluarga Miskin di Kabupaten Donggala

This study aims to analyze: 1) the implementation of the Poor Family Community Empowerment Program in Donggala Regency; and 2) factors that affect the Implementation of the Poor Family Community Empowerment Assistance Program in Donggala Regency. This study uses a qualitative type of research. The population in this study is 10,748 people from poor families in Biromaru, Marawola and Tanantovea Districts who received PPMKM assistance according to 2005 data. The determination of the sample in this study uses purposive sampling where 94 people are used as samples in this study. The data analysis used is a qualitative analysis using a frequency table. The results of the study show that program communication, program implementation resources, program implementation disposition and program implementation bureaucratic structure are very decisive for the implementation of the Poor Family Community Empowerment Assistance Program in improving the welfare of poor families. Meanwhile, the dominant factor influencing the Poor Family Community Empowerment program is the role of the local government as a policy maker so that in general in this study it is stated that the implementation of policies has a significant effect on the implementation of PPMKM in improving the welfare of poor families in Donggala Regency.

“Killing two birds with one stone” – a qualitative study on women’s perspectives on the dual prevention pill in Johannesburg, South Africa

Background HIV incidence remains high in South Africa, with ~ 60% of all new HIV infections among adolescent girls and women (Country factsheets HIV and AIDS Estimates, 2022). Oral pre-exposure prophylaxis (PrEP), approved for HIV prevention in South Africa since 2015, is hampered by low uptake and adherence, particularly among adolescent girls and young women (AGYW). Combining oral PrEP with oral contraceptives could increase PrEP uptake, persistence and address unmet needs for contraception. We investigated the acceptability of a dual prevention pill (DPP), combining oral PrEP and a combined oral contraceptive (COC) for HIV and pregnancy prevention among women in Johannesburg, South Africa.MethodsBetween March-July 2021, we conducted 12 focus group discussions (FGDs) with adolescent girls and women (n = 74) aged 16–40 stratified by ages (16–17, 18–24, 25–40), half of whom were COC users. We explored adolescent girls and women’s opinions about the DPP concept, existing HIV and pregnancy prevention options, and input on perceived facilitators and barriers to DPP use. FGDs were conducted in English or isiZulu, using a standardized interview guide. FGDs were audio-recorded, transcribed to English and analyzed using ethnographic content analysis.ResultsThe majority viewed the DPP favorably as a multipurpose option preventing unplanned pregnancy and HIV. Most saw it as a convenient “two-in-one” solution, requiring one clinic visit for both PrEP and COCs. AGYW were viewed as the most likely to benefit from the DPP due to the likelihood of multiple partners and unplanned sex, possibly preventing school dropout from unplanned pregnancy or HIV acquisition. The DPP was perceived to be more reliable than condoms, especially when condom negotiation is limited. Benefits were also seen by participants in rape cases, protecting against pregnancy and HIV. DPP use barriers included side effect concerns, unsupportive partners and judgmental healthcare providers.Conclusions/significanceThe DPP was perceived as acceptable for HIV and pregnancy prevention to AGYW in Johannesburg and its dual indications helpful in supporting improved PrEP uptake and persistence. DPP implementation programs need to consider solutions to potential barriers, like education on DPP benefits, coupled with reliable side effect support and healthcare provider sensitization as part of routine sexual health services to encourage uptake and adherence.

“It changed me for the better”: Feasibility, acceptability, and safety of an online program for sexual and gender minority youth to prevent alcohol use and teen dating violence

ObjectiveThe purpose of the current study was to describe and present implementation outcome data from an open pilot trial of the Promoting Resilient Youth with Strong Hearts and Mind (PRYSHM) Program, an online, live-facilitated, nine-session group program for dating sexual and gender minority youth (SGMY) ages 15 to 18. The program, co-facilitated by two LGBTQIA2S+ adults, focuses on reducing proximal forms of minority stress and building LGBTQIA2S+ community in addition to providing evidence-based teen dating violence (TDV) and alcohol use (AU) prevention components. MethodParticipants (recruited via social media) included 18 SGMY (ages 15 to 17) from across the U.S. who completed a baseline survey and immediate post-test, as well as post-session surveys following each of the nine sessions. Sessions were recorded to monitor fidelity and facilitation skills. ResultsThe intervention was highly acceptable, and the program was perceived to be relevant and impactful, as evidenced by SGMY agreeing or strongly agreeing to items assessing these domains. Further, fidelity was 82.4% (average) across sessions, and the average attendance was 6.50 out of 9 sessions. SGMY also provided open-ended feedback used to revise the PRYSHM program for future implementation and evaluation research. ConclusionThese data provide preliminary support for PRYSHM as a feasible, acceptable, and safe prevention program and suggest that further evaluation of the program using larger samples and rigorous outcome evaluation methods is warranted.

Development of a Multifaceted Program for Pharmacogenetics Adoption at an Academic Medical Center: Practical Considerations and Lessons Learned.

In 2019, Indiana University launched the Precision Health Initiative to enhance the institutional adoption of precision medicine, including pharmacogenetics (PGx) implementation, at university-affiliated practice sites across Indiana. The overarching goal of this PGx implementation program was to facilitate the sustainable adoption of genotype-guided prescribing into routine clinical care. To accomplish this goal, we pursued the following specific objectives: (i) to integrate PGx testing into existing healthcare system processes; (ii) to implement drug-gene pairs with high-level evidence and educate providers and pharmacists on established clinical management recommendations; (iii) to engage key stakeholders, including patients to optimize the return of results for PGx testing; (iv) to reduce health disparities through the targeted inclusion of underrepresented populations; (v) and to track third-party reimbursement. This tutorial details our multifaceted PGx implementation program, including descriptions of our interventions, the critical challenges faced, and the major program successes. By describing our experience, we aim to assist other clinical teams in achieving sustainable PGx implementation in their health systems.

Youth Organization Empowerment through Creative Entrepreneurship Business in the Village

One of the youth groups that has a strategic role in village development is Youth Organization. This service aims to analyze youth empowerment through creative entrepreneurship in the village (district). This service method uses the Participatory Rural Appraisal (PRA) or participatory approach, including training, mentoring, and collaboration with relevant stakeholders. Implementation starts from coordination, activity socialization, activity implementation phase, program sustainability, and report preparation, to monitoring and evaluation. The results of this service are Creative Business Training, which has been carried out in a blinded manner, producing outputs in the form of the growth of a creative entrepreneurial spirit, new products typical of the people of the Dekai District of Papua, handbooks, training modules, progress reports, final reports, of course, this is expected to have a principle of usefulness.

Development of a Monk-Led Elderly Mental Health Counseling Program in Thai Buddhist Communities

The increasing mental health challenges among elders demand specialized interventions, especially within Thai communities where resources are limited and stigma persists. While monks offer spiritual support, there is a gap in addressing complex mental health needs. This research aims to develop a monk-led elderly mental health counseling program in Thai Buddhist communities. From January 2023 to March 2024, this study underwent four phases. Initially, qualitative interviews with thirty-six monk and elder participants elucidated requirements. The program development integrated findings from the requirement study, the Solution-Focused Brief Therapy process, and Buddhist mindfulness principles to create a prototype. The quality assessment involved expert content validation, feasibility examination by stakeholders, and a small-scale pilot testing with five monks. Finally, the feasibility of the program was assessed with thirty-two monks. The study reveals three key components of the monk-led elderly counseling program focused on mental health: the counseling process known as MPS-MAV-PI (an Introduction to Mindfulness, Identifying Problems, Assessing the Severity, Mindfully Observing Thoughts and Emotions, Acceptance, Visualizing Success, Planning Strategies for Problem-solving, and Implementation and Subsequent Monitoring), the C-TIME strategy (Collaboration, Training Manual, Implementation, the Monitoring, and Evaluation), and the program manual. Moreover, feasibility assessments among monks show the high feasibility of the program for implementation. The monk-led counseling program holds promise in addressing these challenges, with high feasibility indicating potential effectiveness and scalability. Future research will prioritize evaluating its cost-effectiveness and overall effectiveness.

Cross-Site Evaluation of Alcohol Screening and Brief Intervention Implementation Programs in Healthcare Systems Serving Individuals of Reproductive Age.

With US Centers for Disease Control and Prevention funding, from 2018 to 2022, 4 large healthcare systems (n = 53 health centers across 7 states) serving people of reproductive age trained staff and provided implementation support for alcohol screening and brief intervention (SBI). This cross-site evaluation explores each healthcare system's implementation approach to implement SBI, reduce excessive alcohol use, and prevent prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders. The SBIRT (Screening, Brief Intervention, and Referral to Treatment) Program Matrix framed the multilevel strategies to implement alcohol SBI programs from 2018 to 2022. Qualitative and quantitative data sources examined outcomes, guided by one logic model, through systems-level process data and provider-level performance metrics. Data analyses utilized frequencies and means for quantitative data and themes for qualitative data according to an established framework. Successful approaches within systems included using electronic health records, flexible implementation and workflow protocols, customized training and technical assistance programs, quality assurance feedback loops, and stakeholder buy-in. Centralized management structures were efficient in standardizing implementation across health centers. Decentralized management structures used tailored approaches, enhancing provider/staff SBI acceptance. Across systems, 1259 staff (eg, clinicians, medical assistants) were trained to provide alcohol SBI services and reported pre-post training increases in self-efficacy in performing brief intervention; skills in PAE counseling; and confidence in screening. Fifty-three (48 providing data) health centers implemented alcohol SBI, screening 106 826 patients over the study period with most of the 10 087 patients who screened positive for excessive alcohol use receiving a BI. Maximizing the use of technology, employing flexibility in program delivery, and institutionalizing processes and protocols improved workflow, efficiency, and program reach. Ongoing partnership and stakeholder communication identify areas for ongoing improvement, engagement, and best practices for sustainability around substance use screening, which are essential with increases in substance use since the pandemic.

Prospective development and validation of a universal classification for paediatric videolaryngoscopic tracheal intubation: the PeDiAC score.

The VIDIAC score, a prospectively developed universal classification for videolaryngoscopy, has shown excellent diagnostic performance in adults. However, there is no reliable classification system for videolaryngoscopic tracheal intubation in children. We aimed to develop and validate a multivariable logistic regression model and easy-to-use score to classify difficult videolaryngoscopic tracheal intubation in children and to compare it with the Cormack and Lehane classification. A secondary aim was to externally validate the VIDIAC score in children. We conducted a prospective observational study within a structured universal videolaryngoscopy implementation programme. We used C-MAC™ videolaryngoscopes in all children undergoing tracheal intubation for elective surgical procedures. We validated the VIDIAC score externally and assessed its performance. We then identified eligible co-variables for inclusion in the PeDiAC score, developed a multivariable logistic regression model and compared its performance against the Cormack and Lehane classification. We studied 809 children undergoing 904 episodes of tracheal intubation. The VIDIAC score outperformed the Cormack and Lehane classification when classifying the difficulty of videolaryngoscopic tracheal intubation, with an area under the receiver operating characteristic curve of 0.80 (95%CI 0.73-0.87) vs. 0.69 (95%CI 0.62-0.76), respectively, p = 0.018. Eight eligible tracheal intubation-related factors, that were selected by 100-times repeated 10-fold cross-validated least absolute shrinkage selector operator regression, were used to develop the PeDiAC model. The PeDiAC model and score showed excellent diagnostic performance and model calibration. The PeDiAC score achieved significantly better diagnostic performance than the Cormack and Lehane classification, with an area under the receiver operating characteristic curve of 0.97 (95%CI 0.96-0.99) vs. 0.69 (95%CI 0.62-0.76), respectively, p < 0.001. We developed and validated a specifically tailored classification for paediatric videolaryngoscopic tracheal intubation with excellent diagnostic performance and calibration that outperformed the Cormack and Lehane classification.

Factors influencing older adult community fall prevention exercise implementation: a scoping review.

Exercise that challenges balance is the most effective fall prevention intervention in community-dwelling older adults. Identifying factors influencing implementation of community fall prevention exercise programs is a critical step in developing strategies to support program delivery. To identify implementation facilitators, barriers, and details reported in peer-reviewed publications on community fall prevention exercise for older adults. Scoping review. We searched multiple databases up to July 2023 for English-language publications that reported facilitators and/or barriers to implementing an evidence-based fall prevention exercise program in adults aged 50+ years living independently. At least two reviewers independently identified publications and extracted article, implementation, and exercise program characteristics and coded barriers and facilitators using the Consolidated Framework for Implementation Research (CFIR). We included 22 publications between 2001 and July 2023 that reported factors influencing implementation of 10 exercise programs. 293 factors were reported: 183 facilitators, 91 barriers, 6 described as both a facilitator and barrier, and 13 unspecified factors. Factors represented 33 CFIR constructs across all five CFIR domains: implementation inner setting (n = 95 factors); innovation (exercise program) characteristics (n = 84); individuals involved (n = 54); implementation process (n = 40) and outer setting (n = 20). Eight publications reported implementation strategies used; 6 reported using a conceptual framework; and 13 reported implementation outcomes. The high number of factors reflects the complexity of fall prevention exercise implementation. The low reporting of implementation strategies, frameworks and outcomes highlight the ongoing need for work to implement and sustain community fall prevention exercise programs.

Utilizing the Summer Treatment Program Model to Promote School Readiness in Young Children Living in Urban Poverty: An Initial Effectiveness Open Trial

ABSTRACT Access to, and engagement in, quality mental health care for young children with externalizing behavior problems (EBPs) who are living in urban poverty is limited. Innovative efforts to engage families in early intervention are needed to ensure school success. The goals of the current study were to transport the Summer Treatment Program for Prekindergartners (STP-PreK, an adaptation of the Children’s Summer Treatment Program and evaluate the implementation and initial program promise for children living in urban poverty via an open trial. Participants were 115 preschool children (68.7% male; 84.3% Black) with EBPs and their caregivers. Nearly all the participating families were living with low to extremely low incomes. Participants received a 7-week STP-PreK, including a daily school readiness program and weekly behavioral parenting training. Implementation outcomes were measured via attendance records, satisfaction ratings, and fidelity measures. Program promise was measured via caregiver ratings and child assessments, collected pre-, post-, and at 6 months following the intervention. On average, results demonstrate strong feasibility and acceptability with high child attendance (90.56%) and caregiver satisfaction with services. Intervention effects across domains of child functioning reveal medium-to-large effects on academics (d’s = 0.46–1.95), overall impairment (d = 0.79), behavioral functioning (d’s = 0.38 – 0.84), and executive functioning (d = 0.58). Effects were largely maintained at 6-month follow-up (d’s = 0.13–1.86). Overall, the results support the promise of the STP-PreK model in enhancing school readiness outcomes for young children at-risk. Directions for continued adaptation and future research are discussed.

The strategic architecture of “BPDPKS” – Oil Palm Plantation Fund Management Agency

Abstract The Oil Palm Plantation Fund Management Agency, Badan Pengelola Dana Perkebunan Kelapa Sawit, is a government institution that manages funds for oil palm plantations using export levies from crude palm oil (CPO) products and their derivatives. However, there is a dichotomy between supporting conglomerates and smallholders. To address this issue, an analysis is required to determine the agency’s position as a strategic organization capable of implementing sustainable oil palm development programs. The strategic architecture outlines the future and business outlook of the agency. Hence, this study uses IPA analysis to analyze the current planning needs and what is required in the agency’s strategic architecture. The core competencies were identified using VRIO frameworks and external analysis using PESTEL. Result from that analysis as a parameter to create a strategic architecture for 2024-2028. The strategic architecture has been developed based on internal and external evaluation matrices, employing strengths, weaknesses, opportunities, and threats (SWOT) analysis. Additionally, this research was followed by preparing an action plan as a guideline for implementation programs.

Investigation on low-iodine diet implementation by medical staff before radioactive iodine treatment for differentiated thyroid carcinoma.

To explore the implementation of low-iodine diets by medical staff caring for patients with differentiated thyroid carcinoma prior to 131I therapy across 58 hospitals, and offer valuable insights for the development of guidelines on low-iodine diets. Convenience sampling was utilized to conduct a survey among 163 medical staff members working in nuclear medicine departments across 58 tertiary hospitals using a self-designed questionnaire. Concerning the duration of the low-iodine diet prior to treatment, the medical staff's recommendations were as follows: 58.28% suggested 2-4weeks, 31.29% recommended more than 4weeks, 9.2% opted for 7-13days, and 1.23% favored less than 1week. Regarding the timing of resuming a normal diet, the respondents' recommendations ranged from immediately after treatment (1.84%) to 3months post-treatment (8.58%), with intermediate recommendations of 2h (8.58%), 24-48h (14.11%), post-discharge (12.26%), and 1month (42.94%). Furthermore, the surveyed medical staff unanimously recommended abstaining from seafood, with 90.8% also advising against the consumption of iodized salt, 91.41% recommending avoidance of iodine-containing medications, and 71.17% advising caution with moderately high-iodine foods. Notably, 75.46% of the medical staff evaluated patient compliance with the low-iodine diet. When patients failed to adhere to the diet preparation, 33.74% of healthcare workers chose to proceed with treatment. In terms of guidance sources, 96.93% of respondents relied on relevant guidelines, 66.26% referred to the literature, and 49.69% drew upon their clinical experience. During hospitalization, 58.28% of the medical staff continued to guide patients on the low-iodine diet, while only 8.59% provided such guidance after discharge. Notably, only 20.25% of the staff considered consulting the nutrition department. This study underscored substantial variations in the duration and selection criteria for low-iodine diets, which were linked to a scarcity of standardized evaluations. Consequently, there is an urgent need for further research to establish detailed, practical, accessible, comprehensive, and dependable implementation programs for low-iodine diets.

Experiences of antenatal care practices to reduce stillbirth: surveys of women and healthcare professionals pre-post implementation of the Safer Baby Bundle

BackgroundThe Safer Baby Bundle (SBB) aimed to reduce stillbirth rates in Australia through improving pregnancy care across five elements; smoking cessation, fetal growth restriction (FGR), decreased fetal movements (DFM), side sleeping in late pregnancy and decision making around timing of birth. We assessed experiences of women and healthcare professionals (HCPs) with antenatal care practices around the five elements.MethodsA pre-post study design using online surveys was employed to assess change in HCPs awareness, knowledge, and frequency of performing recommended practices (22 in total) and women’s experiences of care received related to reducing their chance of stillbirth. Women who had received antenatal care and HCPs (midwives and doctors) at services participating in the SBB implementation program in two Australian states were invited to participate. Surveys were distributed over January to July 2020 (pre) and August to December 2022 (post). Comparison of pre-post responses was undertaken using Fisher’s exact, Pearson’s chi-squared or Wilcoxon rank-sum tests.Results1,225 women (pre-1096/post-129) and 1,415 HCPs (pre-1148/post-267, ≥ 83% midwives) completed the surveys. The frequency of HCPs performing best practice ‘all the time’ significantly improved post-SBB implementation across all elements including providing advice to women on side sleeping (20.4–79.4%, p < 0.001) and benefits of smoking cessation (54.5–74.5%, p < 0.001), provision of DFM brochure (43.2–85.1%, p < 0.001), risk assessments for FGR (59.2–84.1%, p < 0.001) and stillbirth (44.5–73.2%, p < 0.001). Practices around smoking cessation in general showed less improvement e.g. using the ‘Ask, Advise and Help’ brief advice model at each visit (15.6–20.3%, p = 0.088). Post-implementation more women recalled conversations about stillbirth and risk reduction (32.2–50.4%, p < 0.001) and most HCPs reported including these conversations in their routine care (35.1–83.0%, p < 0.001). Most HCPs agreed that the SBB had become part of their routine practice (85.0%).ConclusionsImplementation of the SBB was associated with improvements in practice across all targeted elements of care in stillbirth prevention including conversations with women around stillbirth risk reduction. Further consideration is needed around strategies to increase uptake of practices that were more resistant to change such as smoking cessation support.Trial registrationThe Safer Baby Bundle Study was retrospectively registered on the Australian New Zealand Clinical Trials Registry database, ACTRN12619001777189, date assigned 16/12/2019.

Collective teacher efficacy and its relationship to attitudes to inclusion of students with special educational needs in Sweden

ABSTRACT This study aimed to investigate the perceived collective teacher efficacy, teacher attitudes to inclusion of students with special educational needs, and the relationship between the constructs in a sample of Swedish teachers. The participants were 930 teachers involved in the Inclusive Behavioural Support in Schools implementation programme. The teachers answered the two questionnaires: The Teacher Attitudes to Inclusion Scale Swedish version (TAIS-Sw) and the Collective Teacher Efficacy Scale (CTES). The questionnaires were analysed and adapted to fit the sample adequately. This exploration identified a three-factor model for TAIS-Sw that is suitable for the data. The three latent variables related to classroom management, perception of the positive effects of inclusion for all students, and objections towards segregated special education. For CTES, a two-factor model showed a good fit for the data. The latent variables were related to aspects of teachers’ competence, including belief in competency and skills to teach all students. The questionnaires identified positive expressions of collective teacher efficacy but more hesitant attitudes to inclusion. Structural equation modelling was used to investigate the relationship between the constructs of collective teacher efficacy and attitudes to inclusion, revealing a small positive relationship. Further investigations could help identify factors supporting successful inclusive practices.

Impact of Socialization and Technical Guidance Program on Implementation of Independent Curriculum Independently

An analysis of the impact of the socialization and technical guidance program for Implementation of Independent Curriculum Independently was conducted to encourage the operationalization of educational units, particularly teachers, to access, learn, complete, and adapt teaching materials available on Platform Merdeka Mengajar (PMM) This involves using and utilizing the results of minimum competency assessments in class to design meaningful learning. The methods employed in this community service are socialization programs/in-service training and technical guidance/in-service training for Implementation of Independent Curriculum Independently. In-service training is an activity aimed at increasing the quality of educational personnel in performing their duties as professional teachers, particularly in utilizing Information and Communication Technology (ICT) for learning, such as adapting PMM to use and utilize the results of minimum competency assessments in class to design meaningful learning. The findings of this community service program include a participant satisfaction survey, where forums for teachers such as teacher working groups have successfully emphasized teaching focused on students' learning achievements (teaching at the right level). Teachers have been able to conduct formative assessments at the beginning of the learning process to assess students' learning achievements. In conclusion, Implementation of Independent Curriculum Independently is reflected in formulating learning outcomes, becoming learning objectives, and ways to achieve these learning objectives. This is demonstrated during the community service workshop, where teachers have successfully adapted to PMM by using and utilizing the results of minimum competency assessments in class to design meaningful learning.

Mobility Assessment Instruments

ObjectivesReview commonly used mobility assessment instruments and discuss their use in multidisciplinary research and clinical practice. MethodsData sources include peer-reviewed articles sourced in electronic databases (PubMed, CINAHL), government websites, national, and international best practice guidelines to describe frequently used mobility assessment instruments. ResultsNumerous clinician-, observer-, patient-reported, and performance outcome instruments and evidence-based implementation program resources exist, though these vary in their intended purpose and setting. Wearable and ambient sensors provide new opportunities to collect passive, objective physical activity data and observe changes in mobility across settings. ConclusionsSelection among multiple assessment tools requires consideration of the available evidence for use in the desired population, the outcomes of interest, whether use is feasible for the setting, and the strength of validity and reliability data for the tool. Implications for Nursing PracticeNurses, especially in the inpatient setting, are typically in most frequent contact with patients and are well-positioned to assess mobility and ensure that safe, progressive mobility care plans are in place. Development of an organization-wide mobility culture requires a systematic, multidisciplinary approach and long-term commitment.

Universal Basic Education Implementation Issues in Nigeria: Options of Innovation for Improvement in the Administration of Basic Education System

The paper explored Universal Basic Education, UBE implementation issues in its systemic administration and management of basic schools in Nigeria. On a more specific note, it discusses: the roles of Universal Basic Education at federal and State government levels; beneficiaries of UBE; existing implementation issues of UBE; and other Basic Issues termed unique UBE implementation Programme. All these put together may work against innovative ideas that existed with the UBE programme as stipulated in the Basic Education Act of 2004. The paper concluded and recommended the following among others, the actual statistics of out-of-school children should be obtained and balanced provision of education resources to rehabilitate them should be done by the commission, and UBE teacher’s capacity building boost should be revisited to train many of them to acquire knowledge regarding UBE operations in addition to their existing academic qualifications.

Newborn screening for acid sphingomyelinase deficiency in Illinois: A single center's experience.

Acid sphingomyelinase deficiency (ASMD) is a rare lysosomal storage disorder (LSD) caused by reduced activity of the acid sphingomyelinase (ASM) enzyme, which leads to progressive storage of sphingomyelin and related lipids in the body. ASMD is caused by biallelic variants in the SMPD1 gene, which encodes for the ASM enzyme. Current estimates of disease incidence range from 0.4 to 0.6 in 100 000 livebirths, although this is likely an underestimation of the true frequency of the disorder. While there is no cure for ASMD, comprehensive care guidelines and enzyme replacement therapy are available, making an early diagnosis crucial. Newborn screening (NBS) for ASMD is possible through measurement of ASM activity in dried blood spots and offers the opportunity for early diagnosis. In 2015, Illinois (IL) became the first to initiate statewide implementation of NBS for ASMD. This study describes the outcomes of screen-positive patients referred to Ann & Robert H. Lurie Children's Hospital (Lurie). Ten infants were referred for diagnostic evaluation at Lurie, and all 10 infants were classified as confirmed ASMD or at risk for ASMD through a combination of molecular and biochemical testing. Disease incidence was calculated using data from this statewide implementation program and was ~0.79 in 100 000 livebirths. This study demonstrates successful implementation of NBS for ASMD in IL, with high screen specificity and a notable absence of false positive screens.

Universal paediatric videolaryngoscopy and glottic view grading: a prospective observational study.

Although videolaryngoscopy has been proposed as a default technique for tracheal intubation in children, published evidence on universal videolaryngoscopy implementation programmes is scarce. We aimed to determine if universal, first-choice videolaryngoscopy reduces the incidence of restricted glottic views and to determine the diagnostic performance of the Cormack and Lehane classification to discriminate between easy and difficult videolaryngoscopic tracheal intubations in children. We conducted a prospective observational study within a structured universal videolaryngoscopy implementation programme. We used C-MAC™ (Karl Storz, Tuttlingen, Germany) videolaryngoscopes in all anaesthetised children undergoing elective tracheal intubation for surgical procedures. The direct and videolaryngoscopic glottic views were classified using a six-stage grading system. There were 904 tracheal intubations in 809 children over a 16-month period. First attempt and overall success occurred in 607 (67%) and 903 (> 99%) tracheal intubations, respectively. Difficult videolaryngoscopic tracheal intubation occurred in 47 (5%) and airway-related adverse events in 42 (5%) tracheal intubations. Direct glottic view during laryngoscopy was restricted in 117 (13%) and the videolaryngoscopic view in 32 (4%) tracheal intubations (p < 0.001). Videolaryngoscopy improved the glottic view in 57/69 (83%) tracheal intubations where the vocal cords were only just visible, and in 44/48 (92%) where the vocal cords were not visible by direct view. The Cormack and Lehane classification discriminated poorly between easy and difficult videolaryngoscopic tracheal intubations with a mean area under the receiver operating characteristic curve of 0.68 (95%CI 0.59-0.78) for the videolaryngoscopic view compared with 0.80 (95%CI 0.73-0.87) for the direct glottic view during laryngoscopy (p = 0.005). Universal, first-choice videolaryngoscopy reduced substantiallythe incidence of restricted glottic views. The Cormack and Lehane classification was not a useful tool for grading videolaryngoscopic tracheal intubation in children.