Practical Implementation Research Articles

An integrated, multidisciplinary management team intervention to improve patient-centeredness, HIV, and maternal-child outcomes in Lesotho: formative research on participatory implementation strategies

BackgroundReducing perinatal HIV transmission and optimizing maternal and child health (MCH) outcomes in high HIV prevalence settings is an urgent, but complex, priority. Extant interventions over-emphasize individual-level provider and patient behaviors, and neglect critical health systems-level changes. The ‘Integrated Management Team to Improve Maternal-Child Outcomes (IMPROVE)’ study implemented a three-part, patient-centered, health-systems-level intervention to improve MCH and HIV outcomes in Lesotho. Ensuring intervention fit within the health systems context is important, but often overlooked. This manuscript describes implementation research conducted to tailor and adapt intervention implementation to optimize appropriateness, acceptability, and feasibility. It identifies resulting implementation variation across study sites and lessons learned.MethodsThe research team reviewed intervention implementation documentation and conducted structured reflections to: 1) assess implementation strategy adaptations, 2) identify facility-specific strategies employed to improve the MCH patient experience, and 3) synthesize lessons.ResultsFacility-based, integrated, multi-disciplinary management teams (MDT) were feasible and acceptable to establish through engagement with facility leadership and facilitation of a participatory training curriculum that established shared values between cadres supporting MCH, and identified facility-specific service delivery gaps and potential solutions. Ongoing MDT meetings provided coordination between facility and community-based MCH service providers to implement early ANC follow-up. Facility-specific improvement strategies included fee, staffing, and patient documentation-based changes. Piloting Positive Health, Dignity, and Prevention-focused counseling approaches resulted in tailored job aids pre-implementation. Leadership involvement was critical for improved coordination while staff turnover and competing donor priorities challenged MDT efforts.ConclusionsIMPROVE created facility-specific adaptation opportunities through participatory intervention implementation practices. The MDTs, benefitting from leadership support, built relationships between HCW cadres, led facility-specific quality improvements, and, importantly, offered HCWs sought-after positive feedback by recognizing HCW efforts. The coordination, monitoring and cross-cadre communication functions of the MDTs supported implementation of other interventions, and may serve as a valuable platform for improving patient-centered care practices in similar settings and for other health services. Trial registration number: NCT04598958, 05 October 2020, retrospectively registered.Trial registrationClinicalTrials.gov, NCT04598958. Registered 05 October 2020—Retrospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT04598958

Technology Integration in Teaching and Learning: Exploring Prospective Teachers' Perceptions, Practices and Challenges

The current study explores the inclusion of Information and Communication Technology (ICT) in schools in teaching and learning practices in Pakistan. Twelve prospective teachers from public schools of a district in Punjab were chosen using purposive sampling. Semi-structured interviews were used to collect data and thematically analyzed through NVivo 15. The findings revealed five major themes: teachers' perceptions towards ICT, current implementation practices, challenges and implementation barriers, professional development, and support needs, and future perspectives and recommendations. The result of the positive attitude of teachers towards technology was explored as the potential to engage students, but some of the significant barriers were limited infrastructure, inadequate technical support, and insufficient professional development. The study revealed critical gaps between teacher's desire to adopt technology and its effective institutional capacity to implement. Recommendations suggest systemic professional development, improved infrastructure, and institutional support for effectively integrating ICT into Pakistani schools. These findings enhance the understanding of the complexities of technology integration within developing educational contexts and provide insights for policy development and resource allocation.

Comparative analysis of meso-level strategies: region, industry, corporation

Objective: to identify the features of strategies of various entities at mesoeconomical level: territorial systems (regions), industries and large corporations (ecosystems) based on a comparative analysis of their structure, key elements and attributes. Methods: a structural approach to strategic documents at the macro-, meso- and microlevels, comparative analysis and synthesis, review of theoretical research and practice of strategy formation and implementation. Results: the article defines the features of strategy formation at the regional, industry and corporate levels. The author states that the key difference between regional and sectoral strategies is a long planning horizon, while corporate strategies are more often subject to adjustment. The article shows that the strategies of mesoeconomical level entities have a number ofsystemic problems related to their formation and implementation. It was found that due to the variability and turbulence of environmental conditions, the entities at meso-level are forced to constantly adjust their strategies, while corporate strategies, unlike regional and sectoral ones, are not limited by the top-level strategy. The author reveals the shortcomings of interaction and coordination (institutional vacuum) of strategies of macro-, meso- and micro-level entities in terms of coherence and coordination of actions in long-term planning. Scientific novelty: it consists in applying a structural approach to the analysis of strategies of meso-level entities, comparing them and identifying common features and differences in approaches to their formation and implementation. Practical significance: it consists in the developing applied methods for the formation and implementation of strategies and improving the effectiveness of strategic planning at the mesoeconomical level.

COMPARISON OF HAND-REARED PRONGHORN (ANTILOCAPRA AMERICANA) MILK REPLACER COMPOSITIONS AND GROWTH RATES.

Hand-rearing protocols for nondomestic ungulates used for research, zoological parks, and reintroduction to the wild are evaluated on the basis of implementation practicality, gastrointestinal disturbances, survival to weaning, and growth rates compared with those of dam-raised individuals. Although species-specific protocols utilizing milk replacers formulated for nondomestic ungulates have been reported, no such protocols have been published for pronghorn (Antilocapra americana). Five pronghorn fawns were fed Day One 30/40 Black Tail Deer plus Lactobacillus acidophilus probiotics four times per day with Day One Ultra Boost (all products from Fox Valley Animal Nutrition, Inc, Huntley, IL 60142, USA) added at one feeding per day and weighed twice per week for up to the first 16 wk of life. All fawns survived beyond weaning and four out of five fawns experienced a combined total of seven bouts of diarrhea. Based on a linear mixed-effects model, the growth rate of pronghorn fawns was 178 g/d (SE, 14.8; 95% CI, 149-207). The observed growth rate was greater than or similar to that of individuals fed evaporated milk five times per day, a dam-raised singlet, and a singular set of dam-raised twins. Despite small sample sizes, this protocol shows promise as a method for hand-rearing pronghorn at growth rates comparable to those of dam-raised fawns.

Optimizing cover crop practices as a sustainable solution for global agroecosystem services

The practice of cover crops has gained popularity as a strategy to improve agricultural sustainability, but its full potential is often limited by environmental trade-offs. Using meta-analytic and data-driven quantifications of 2302 observations, we optimized cover crop practices and evaluated their benefits for global agroecosystems. Cover crops have historically boosted crop yields, soil carbon storage, and stability, but also stimulated greenhouse gas emissions. However, combining them with long-term implementation (five years or more) and climate-smart practices (such as no-tillage) can enhance these services synergistically. A biculture of legume and non-legume cover crops, terminated 25 days before planting the next crop and followed by residue mulching, is the optimal portfolio. Such optimized practices are projected to increase agroecosystem multiservices by 1.25%, equivalent to annual gains of 97.7 million metric tons in crop production, 21.7 billion metric tons in carbon dioxide sequestration, and 2.41 billion metric tons in soil erosion reduction. By 2100, the continued implementation of optimized practices could mitigate climate-related yield losses and contribute to climate neutrality and soil stabilization, especially in harsh and underdeveloped areas. These findings underscore the promising potential of optimized cover crop practices to achieve the synergy in food security and environmental protection.

Energy Transition Study of the Scheme for Replacing Steam Power Plants with Nuclear Power Plants Regarding Safety Aspects, Supporting Infrastructure, and Regulation Availability

Coal has been an essential contributor to the modern economy, but it is also a cause of global climate warming and environmental problems. Therefore, many countries have undertaken initiatives to achieve net zero emissions and reduce greenhouse gas emissions in recent years, including Indonesia, with a genuine commitment stipulated in Law Number 59 of 2024 as part of the energy transition. A literature study has been conducted on the energy transition scheme of replacing coal power plants (CPP) with nuclear power plants (NPP) and its influence on safety aspects, supporting infrastructure, and regulatory availability. The paper aims to analyze the options covered in replacing the CPP boiler with an NPP and its effect on safety aspects, supporting infrastructure, and regulatory availability. A literature study compared implementation practices in Poland, the People's Republic of China, and the United States. The results of the analysis show that the replacement of CPP to NPP is applicable due to the similarity of systems and components between the two plants. The important elements in replacing CPP with NPP are site, reactor technology, supporting infrastructure, human resources, and regulations. Keywords: coal power plants (CPP), nuclear power plants (NPP), energy transition, regulation

The Practice of Managed Visibility: Insights into China’s Frontline Diplomacy from Two European Capitals

Summary The People’s Republic of China has the world’s largest diplomatic network with a total of 274 missions. Yet little is known about how Chinese diplomats engage in bilateral diplomatic communities. The often-alleged reserve of Chinese diplomats towards their diplomatic peers is particularly curious. This article adds two case studies to our understanding of China’s frontline diplomacy. Based on semi-structured interviews and observation, the article explores in-person interactions between Chinese and foreign diplomats in two European capitals. It finds remarkably different degrees of social engagement in Ankara and Oslo. I therefore propose the term ‘managed visibility’ as a carefully implemented practice driven by contextual bilateral factors. My findings suggest that (i) the diplomatic repertoire of Chinese diplomats is larger and more adaptive than generally assumed; (ii) the practices of Chinese diplomats profoundly influence foreign diplomats’ perceptions of China; and (iii) sociable interactions among diplomats are becoming increasingly securitized.

Innovative strategies and implementation science approaches for health delivery among migrants in humanitarian settings: A scoping review.

Over 100 million displaced people rely on health services in humanitarian contexts, defined as unstable or transitory settings created in response to complex emergencies. While services are often described, there is a dearth of evidence on best practices for successful implementation to guide efforts to optimize health delivery. Implementation science is a promising but underutilized tool to address this gap. This scoping review evaluates implementation science in health services for forced migrants in humanitarian settings. We conducted a scoping review according to JBI methodologies. A search of eight databases yielded 7,795 articles, after removal of duplicates, that were screened using PRISMA-ScR guidelines. Data extraction assessed study descriptors, implementation objects, barriers, facilitators, implementation strategies, and use of implementation frameworks in service delivery. Data from 116 studies represented 37 countries and 11 topic areas. Methods were mainly cross-sectional with low-medium evidence rigor. Mental health programs (25%) and vaccination services (16%) were the most common objects of implementation. Thirty-eight unique barriers were identified including resource limitations (30%), health worker shortages (24%), and security risks (24%). Among 29 facilitators, the most common were health worker availability (25%), pre-existing partnerships (25%), and positive perceptions towards the intervention (20%). More than 90% of studies collectively identified 35 implementation strategies, the most common being capacity building (44%), stakeholder engagement (35%), information dissemination (38%), and feedback mechanisms (25%). Only 10 studies used formal implementation models, with RE-AIM (n = 3) and Intervention mapping (n = 2) being most frequent. In this scoping review, we found similar barriers, facilitators, and implementation strategies across diverse humanitarian migrant settings and services. However, the use of rigorous methods and formal implementation models was rare. Frameworks included RE-AIM, CFIR, and Precede-Proceed. Increased use of implementation science frameworks and methods will help humanitarians more rigorously and systematically evaluate and develop best practices for implementation of health services for migrants in humanitarian settings.

Constructing the “moralization shock”: The role of contingency in the translation of anticorruption policy in France

AbstractThis article applies the concept of transaction to the process of policy transfer, through the case of conflict of interest regulation in France, using archives, documentary sources, and interviews with stakeholders. It contributes to the literature on policy translation by clarifying the role of contingency, which remains underspecified. It shows that timing matters in two ways: it affects actors' ability to open a policy window, and it ultimately affects problem definition and future implementation instruments and practices. It explores the construction of the situation as a scandal, making it necessary to adapt transferred ideas to the political context, where a “shock of moralization” was seen as necessary. It also offers an opportunity to enrich the scholarship on policy transaction with an application to transnational policymaking, where problem definitions and policy solutions are imported from elsewhere and where foreign or transnational actors contribute to the co‐construction of actors and issues.

Planning, Strategies Implementation and Evaluation Practices among CSL Teachers in China

Teaching Chinese as a Second Language (TCSL) has witnessed a growing significance in the global educational landscape due to the increasing demand for proficiency in Mandarin. The study assessed the TCSL professional development programs by identifying strengths and areas for improvement in TCSL teachers’ planning, strategies implementation and evaluation practices. Using descriptive research design, 399 TCSL teachers in China answered an adopted modified questionnaire. Results reveal that on planning among TCSL teachers, their course objectives were clear, specific, and can be easily conveyed to the students. Additionally, on strategies implementation, TCSL teachers were able to regularly reflect on their teaching and were able to choose appropriate teaching strategies based on the language proficiency and learning needs of their students. Lastly, they were able to use various evaluation methods in order to adjust their teaching strategies and methods in a timely manner. Overall, the study indicates that better planning leads to better strategies implementation and evaluation. Similarly, better strategies implementation also leads to better evaluation.

Driving sustainability in Indonesia: the importance of corporate citizenship in realizing sustainable development goals

Purpose of the article – Corporate Citizenship (CC) and Sustainable Development Goals (SDGs) are two interrelated and essential concepts to achieve sustainable development by 2030. This topic is particularly interesting and relevant today, where companies are expected to pursue profits and contribute to social and environmental well-being. This study aims to describe the implementation practices of corporate citizenship in supporting the achievement of the Sustainability Development Goals of companies in Indonesia. Research methodology – The research method used is a literature review of journals/articles relevant to the topic. Findings – This study emphasizes the significance of adopting corporate citizenship to aid in accomplishing Indonesia's Sustainable Development Goals. Corporate citizenship significantly impacts employees, business performance, and sustainability. Practical implications – The study recommends incorporating CC principles into business strategies and working with stakeholders to speed up the achievement of the SDGs, bolstered by government policies that endorse CC practices. Companies in Indonesia need to participate in CC to achieve the SDGs and create a more sustainable future. Originality/Value – Exemplary CC implementation has been proven to help various SDGs goals, such as poverty alleviation, improving the quality of education, health, welfare, and action on climate change. The company views the CC program as a strategic investment that positively affects society and the environment while offering benefits like enhanced business performance and improved reputation.

Political Leadership, Institutional Memory and the Implementation of Health in All Policies: An Explanatory Case Study of the Health 2015 Public Health Programme in Finland

Our study sought to examine how and why political leadership and institutional memory affected the implementation of Health 2015, a public health programme prepared following the principles of the Health in All Policies (HiAP) strategy, between 2001 and 2015 in Finland. We analysed the data using a realist explanatory case study method. We found that the HiAP strategy did not have a strong leader who was able to generate interest in HiAP among other policymakers. This contrasted with the Finnish success story in previous decades when several interested elected politicians and high-ranking civil servants promoted the implementation of healthy public policies. Our results also pointed to institutional amnesia. During the implementation of Health 2015, a transition to project-based implementation, the retirement of many long-term policymakers and a change from the financial steering of local authorities to steering by information took place. The subsequent institutional amnesia was followed by discontinuity of previous institutionalised HiAP implementation structures and practices, such as intersectoral working groups.

Creating Caring Campuses: A Faculty‐Led Approach

ABSTRACTCaring Campus–Faculty is a program that supports faculty as they develop and implement “behavioral commitments” designed to help students feel a sense of belonging and to support them in their educational journey. Developed by the Institute for Evidence‐Based Change, Caring Campus was evaluated by the Community College Research Center (CCRC) from 2019 to 2023. In this article, we describe Caring Campus as practiced by faculty, as well as findings from the research on implementation practices and outcomes. We also share the experiences of Delta College, which has been implementing its own version of Caring Campus for a number of years. Caring Campus allows faculty to take leadership in student success efforts by changing instructional practices in ways that can improve student experiences and outcomes. Further, as they implement Caring Campus strategies, faculty encourage changes in the culture of the college in ways that support students as well as their own engagement with their work and each other.

Practice and thinking of multi-dimensional teaching of "Principle of Biotechnology" under the "Double First-Class" initiative

The Principle of Biotechnology is a compulsory course for undergraduates majoring in bioengineering at Zhejiang University of Technology. In response to the "Double First-Class" initiative and in order to improve the teaching effect of this course and the quality of talent training, we reformed the teaching of Principle of Biotechnology, the core course in bioengineering. Specifically, we reorganized the teaching contents, improved the process management of teaching and learning, and implemented multi-dimensional teaching practice. These measures improved teaching quality and promoted the achievement of training goals, which was of great significance for developing "First-Class" disciplines.

PROCESS-ORIENTED APPROACH TO MANAGEMENT AND ITS APPLICATION IN MANAGEMENT ACCOUNTING AND ANALYSIS

High level of competition, growth of costs and cost of limited resources in modern conditions of active growth of technologies necessitate the study of the most effective practices of implementation and development of process-oriented approach to management of organizations as a source of increasing the efficiency of functioning and economic security of the company. This allows to analyze in detail production and technological operations and determine key points of influence on them. This article discusses the principles, classification, features of construction and increasing the efficiency of business processes of the organization taking into account the use of tools for analysis, optimization and reengineering of business processes and also disclosed the main directions for the implementation of a process-oriented approach to management in management accounting.

School entry examinations in the former German Democratic Republic (GDR) from 1949 to 1989 - An overview of formal and content-related implementation

Summarising the formal and substantive enrolment practice of school entry examinations (SEU) in the German Democratic Republic (GDR). Through a systematic literature review using a conventional as well as internet-based sources, specialised literature on specific topics and original documents were made available following selected search terms to capture essential characteristics of SEU in the GDR and to present them in a general context. In the GDR, regular school enrolment took place at the age of 6, although SEU implementation practice during the 1950s and 1960s was fundamentally inconsistent in terms of form and content. On the basis of mandatory annual screening examinations for children, the medical screening examination at pre-school age of 5-6 years was formally valid as a SEU. On a case-by-case basis, the responsible paediatricians carried out supplementary, but non-standardised developmental tests. From the 1970s onwards, the increasing density of kindergarten in the GDR led to their specialist staff getting more involved in the assessment of pre-school children's competences relevant to schooling. In addition, screening at the age of 4-5 years also became more relevant for developmental diagnostic purposes. While various examination procedures were initially used, a standardised inventory of instruments for assessing learning ability, intellectual development and language development gradually emerged during the 1970s. These two staggered SEUs between the age of 4 and 6 years enabled preschool children to be supported if necessary, so that children with developmental delays could be given adequate developmental and educational opportunities. This concept also enabled an intensifying, partly informal cooperation between the specialist staff in the kindergartens, paediatricians, parents and school headmasters. Overall, the SEU in the GDR was based on a professionally and a well thought-out concept from the 1970s onwards. At this time, the standardised, staggered and multidisciplinary approach was methodologically superior to school enrolment practice in West Germany.

Gap-Trailing: Scaffolding and Exploring Situated Knowledge.

User knowledge and lived experiences are pivotal in bridging the gaps between the environment and individuals causing disability. Examples of best practices help us refine and develop the theoretical groundings of UD in academia and the practical implementation in design practices. Yet best practices are also needed in our methodological approaches across research and practice concerning how to work with and in the intersection of people and environments. The approach of the researcher is pivotal when facing individuals with diverse physical or cognitive abilities, but also when exploring the role of the environment. Architectural anthropology is one way of combining tools and mindsets that could be useful when studying more complex or nuanced processes, e.g., aging or impairment. In this paper, we focus on the knowledge of people who are experiencing incipient vision loss and the mutual and dynamic interrelation of (dis)abilities between the individual and their (home) environment. In the project entitled "The Role of Lighting When Vision Changes" we explore the phenomenon of vision loss, and in this paper, we provide a critical-reflective perspective on how fieldworks can contribute to this exploration. During the winter season of 2023-24, walk-along interviews were conducted in the homes of 37 participants 55+, including 10 normally sighted and 27 visually impaired (still using their residual vision). Based on transcriptions and fieldnotes, as well as reflective notes from subsequent joint discussions among the researchers, this paper discusses the role of architectural anthropology in the project and how it can scaffold new socio-material explorations as well as critical reflections.

Towards sustainable AI: a comprehensive framework for Green AI

The rapid advancement of artificial intelligence (AI) has brought significant benefits across various domains, yet it has also led to increased energy consumption and environmental impact. This paper positions Green AI as a crucial direction for future research and development. It proposes a comprehensive framework for understanding, implementing, and advancing sustainable AI practices. We provide an overview of Green AI, highlighting its significance and current state regarding AI’s energy consumption and environmental impact. The paper explores sustainable AI techniques, such as model optimization methods, and the development of efficient algorithms. Additionally, we review energy-efficient hardware alternatives like tensor processing units (TPUs) and field-programmable gate arrays (FPGAs), and discuss strategies for designing and operating energy-efficient data centers. Case studies in natural language processing (NLP) and Computer Vision illustrate successful implementations of Green AI practices. Through these efforts, we aim to balance the performance and resource efficiency of AI technologies, aligning them with global sustainability goals.

Factors associated with the implementation of dialectical behavior therapy by Spanish speaking mental health professionals who treat suicide risk

BackgroundThe lack of training for professionals on how to manage suicide risk is an important barrier to effective intervention. Dialectical Behavior Therapy Intensive Training™ (DBT-IT) includes specific training for suicide and has shown promising results to enhance implementation of DBT. To our knowledge, no published studies have evaluated the effect of DBT-IT on therapists’ attitudes towards treating suicide risk and among Spanish-speaking mental health professionals. The main aim of this study was to evaluate the effect of DBT-IT on therapists’ attitudes regarding treating suicide risk and its relationship with the implementation of DBT before and after receiving DBT-IT.MethodsA total of 242 mental health workers (76.4% women, mean age 35.38, SD = 9.17; 77.7% from Latin America; 22.3% from Spain) who had received a DBT-IT participated in the study. Self-efficacy (Efficacy in Assessing and Managing Suicide Risk Scale) and concerns (Concerns about Treating Suicidal Clients Scale) in treating suicide, perceived burnout (Copenhagen Burnout Inventory), confidence in applying DBT (Behavioral Anticipation and Confidence Questionnaire), barriers to implementation (Barriers to Implementation Inventory), implementation of DBT and reach were measured via online survey at parts 1 (pre-training) and 2 (post-training, after 9 months of implementation) of the DBT-IT.ResultsDifferences between pre-training and post-training (n = 61) indicated statistically significant improvements in self-efficacy, concerns about the lack of training and competence in treating suicide, and confidence in applying DBT. Statistically significant increases in the rates of DBT treatment modes implementation (except for individual therapy) and mindfulness practice, as well as the number of team members and consultation team hours, were also found. Findings also indicated statistically significant positive correlations between burnout and concerns about treating suicidal clients, as well as with structural and administrative implementation barriers, and between self-efficacy in managing suicide, confidence in applying DBT and implementation of DBT treatment modes. Participants with more implementation barriers reported lower rates of consultation team meetings and phone coaching implementation.ConclusionsDBT-IT could be an adequate training model to increase self-efficacy and confidence in treating suicide risk as well as to facilitate implementation of DBT treatment modes by Spanish-speaking mental health professionals.Clinical trial numberNot applicable.

The Advantages of Adopting the ISO/IEC 17025: 2017 Lab Management System in Calibration and Testing Laboratories

International Organization for Standardization (ISO) and International Electrotechnical Commission (IEC) standards for testing and calibration laboratories are known as ISO/IEC17025:2017, which is the standard for laboratory certification. The testing laboratory's accreditation, the methods of execution, and the tangible advantages of working with such an organization. This study examined the advantages of ISO/IEC17025:2017 implementation in Chengalpat region's calibration and testing laboratories using a descriptive research design. The advantages of putting ISO/IEC 17025:2017 into practice are the main variable in the current study. The investigator utilized a method called purposive sampling. This research is based on a survey with 180 responses. After the data was gathered, analysis was done using SPSS 20. It has been found that to implement best practices and believe in the benefits, Top Management must fully understand the advantages of enacting the ISO/IEC 17025: 2017 Lab Management System, task and lab managers must fully understand the Lab Management System ISO/IEC 17025: 2017 implementation, the management tools for the Calibration and Testing Labs, the infrastructure that is being developed for the Labs, teams must collaborate, and accountability is linked to the Labs.