Implementasi Kebijakan Penyelenggaraan Lalu Lintas Dan Angkutan Jalan (Studi Kasus Penyediaan Perlengkapan Jalan Umum yang Berstatus Sebagai Jalan Kota di Kecamatan Pekanbaru Kota)

This research is based on the purpose of Regional Regulation No.10 of 2017 which is to realize road traffic and transportation in Pekanbaru Kota can be safe, comfortable and efficient which has not been reached. the purpose of this research is to determine the implementation and what factors hinder implementation the policy the provision of road equipment in Pekanbaru Kota Distric. This research uses Grindle theory, namely the content variables of this policy include: group interests, types of benefits, changes to be achieved, location of decision making, program implementation, resources used. The policy environment includes: Power, interests, and strategy of policy actors; Characteristics of the institutions; Group compliance level. This study used descriptive qualitative method. The results of this study indicate that the implementation or application of the road equipment provision policy in Pekanbaru Kota District is seen from the process or workflow is good, but there are several obstacles, namely: road facilities that are less maintenance so that the benefits of this policy have not been maximally realized. The factors that hindered this policy were limited budget, bad behavior of public elements and poor maintenance of road equipment. Keywords : Implementation of Policy, Traffic, Road Equipment.

Co-designing a Community Pharmacy Pharmacogenomics Testing Service In The UK

Introduction: Pharmacogenomics (PGx) testing services have been delivered through community pharmacies across the globe, though not yet in the UK. This paper is reporting a focus group study, the first stage of a participatory co-design process to increase the chance of a successful implementation of a PGx service through community pharmacy in the UK.Aim: To identify the barriers and enablers to implementing a community pharmacy based PGx service in the UK.Method: Three focus groups were conducted with community pharmacists (n= 10), prescribers (n= 8) and patients (n=8) in England. The focus groups were recorded, transcribed and thematically analysed using the Braun and Clarke six step reflexive thematic analysis approach.Results: The analysis identified five themes about PGx testing in community pharmacies: (1) In- principle receptiveness, (2) Appreciation of the benefits, (3) Lack of implementation resources (4) Ambiguity about implications for implementation and (5) Interprofessional relationship challenges.Conclusion: The identified enablers for implementation of a PGx service were at a macro health system strategic level; the concerns were more at a granular operational procedural level. Overall receptiveness was noted by all three participant groups, and both prescriber and pharmacist groups appreciated the potential benefits for patients and the healthcare system. Prior to implementation in the UK, there is a need to disambiguate health professional’s concerns of the guidance, resources, and knowledge required to set up and deliver the service and to resolve patient concerns about the nature of genomics.

Evaluation of the Veterans Affairs Pharmacogenomic Testing for Veterans (PHASER) clinical program at initial test sites

Aim: The first Plan-Do-Study-Act cycle for the Veterans Affairs Pharmacogenomic Testing for Veterans pharmacogenomic clinical testing program is described. Materials & methods: Surveys evaluating implementation resources and processes were distributed to implementation teams, providers, laboratory and health informatics staff. Survey responses were mapped to the Consolidated Framework for Implementation Research constructs to identify implementation barriers. The Expert Recommendation for Implementing Change strategies were used to address implementation barriers. Results: Survey response rate was 23–73% across personnel groups at six Veterans Affairs sites. Nine Consolidated Framework for Implementation Research constructs were most salient implementation barriers. Program revisions addressed these barriers using the Expert Recommendation for Implementing Change strategies related to three domains. Conclusion: Beyond providing free pharmacogenomic testing, additional implementation barriers need to be addressed for improved program uptake.

Gaps in Nutrition Policy Implementation in Childcare Centres in The Edmonton Metropolitan Region: A Cross-Sectional Survey

Purpose: To describe (i) nutrition policies in childcare centres, (ii) the resources and processes used to enable policy implementation, and (iii) the association between policy implementation and childcare centres’ or administrators’ characteristics. Methods: Between October 2018 and June 2019 a web-based survey that addressed nutrition policy, policy implementation, and sociodemographic characteristics was sent to eligible childcare programs (centre-based and provided meals) in the Edmonton (Alberta) metropolitan region. The survey was pretested and pilot tested. Statistical tests examined the relationship between policy implementation with centres’ and administrators’ characteristics. Results: Of 312 childcare centres that received the survey invitation, 43 completed it. The majority of centres had a nutrition policy in place (94%). On average, centres had about 9 of the 17 implementation resources and processes assessed. Most often administrators reported actively encouraging the implementation of the nutrition policy (n = 35; 87%) and least often writing evaluation reports of the implementation of the nutrition policy (n = 9; 22%). Administrator’s education level was associated with implementation total score (p = 0.009; Kruskal-Wallis). Conclusion: Most childcare centres had a nutrition policy in place, but many lacked resources and processes to enable policy implementation. Additional support is required to improve nutrition policy development and implementation.

Actively Involving Students With Learning Disabilities in Progress Monitoring Practices

Academic progress monitoring is essential when implementing individualized education programs for students with learning disabilities and more generally in a multi-tiered system of supports framework. Although students are progress-monitored frequently in schools today, they often are not actively involved in this practice. Research has shown that actively involving students in progress monitoring through performance feedback and goal setting can lead to improved academic and motivational outcomes. This column describes a progress-monitoring performance feedback and goal-setting routine that supplements typical academic progress monitoring practices. The ways in which the routine aligns with evidence-based practices to improve student outcomes in reading, writing, mathematics, and academic motivation are discussed. Step-by-step guidance, examples, and resources are provided to support practitioner implementation. Resources for evaluating outcomes are described.

Stakeholder Perspectives on Barriers and Facilitators on the Implementation of the 1000 Days Plus Nutrition Policy Activities in Ghana

Optimizing nutrition in the preconception and 1000 days periods have long-term benefits such as higher economic productivity, reduced risk of related non-communicable diseases and increased health and well-being. Despite Ghana’s recent progress in reducing malnutrition, the situation is far from optimal. This qualitative study analyzed the maternal and child health nutrition policy framework in Ghana to identify the current barriers and facilitators to the implementation of nutrition policies and programs relating to the first 1000 days plus. Data analyzed included in-depth interviews and focus group discussions conducted in Ghana between March and April 2019. Participants were composed of experts from government agencies, civil society organizations, community-based organizations and international partners at national and subnational levels. Seven critical areas were identified: planning policy implementation, resources, leadership and stakeholders’ engagement, implementation guidance and ongoing communication, organizational culture, accountability and governance and coverage. The study showed that, to eradicate malnutrition in Ghana, priorities of individual stakeholders have to be merged and aligned into a single 1000 days plus nutrition policy framework. Furthermore, this study may support stakeholders in implementing successfully the 1000 days plus nutrition policy activities in Ghana.

Designing provider-focused implementation trials with purpose and intent: introducing the PRECIS-2-PS tool

Background First articulated by Schwartz and Lellouch (1967), randomized controlled trials (RCTs) can be conceptualized along a continuum from more explanatory to more pragmatic. The purpose and intent of the former is to test interventions under ideal contexts, and the purpose and intent of the latter is to test interventions in real-world contexts. The PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) is a validated tool that helps researchers make decisions about the elements of the trial to match the overall purpose and intent of the trial along the continuum. The PRECIS-2 tool has guided the design of hundreds of RCTs. However, a few aspects of the tool would benefit from greater clarity, including its application to provider-focused implementation trials rather than patient-focused intervention trials. Main text We describe the newly developed PRECIS-2-Provider Strategies (PRECIS-2-PS) tool, an extension of the PRECIS-2 tool, which has been adapted for trials testing provider-focused strategies. We elaborate on nine domains that can make a provider-focused trial more explanatory or more pragmatic, including eligibility, recruitment, setting, implementation resources, flexibility of provider strategies, flexibility of intervention, data collection, primary outcome, and primary analysis. We detail the complementary roles that researchers and stakeholders play in the trial design phase, with implications for generalizability of trial results to the contexts in which they are intended to be applied. Conclusions The PRECIS-2-PS tool is designed to help research and practice teams plan for provider-focused trials that reflect the overall intent and purpose of the trial. The tool has potential to help advance the science of provider-focused strategies across a range of trials, with the ultimate goal of facilitating the adoption, integration, and sustainability of provider-focused strategies outside the context of trials.

Are Online Resources for Evidence-Based Practices Useful

Because many websites claim to provide information about evidence-based practices (EBPs), consumers must know the information and practices are based upon quality research. Practitioners may intend to locate trustworthy online sources providing EBPs, but if those sources are not easy to navigate and lack implementation resources (i.e., are accessible), then practitioners may be more likely to access less trustworthy sources for instructional strategies and materials. Therefore, the purpose of this study was to evaluate websites, identified as trust or trust with caution, to determine whether they demonstrate a level of usefulness for practitioners. Thirty websites, classified as trust and trust with caution, were reviewed for usefulness and results indicated 14 (46.7%) websites were found to be useful, nine (30%) websites were categorized as somewhat useful, and seven (23.3%) websites were determined to be not useful. Suggestions for future research and implications for practice are provided.

The connectivity dilemma in freshwater management: exploring the role of street level bureaucrats in water governance

Connectivity is key in freshwater management, e.g. to ensure viable populations of fish, but restoring it may cause the spread of invasive species. Goal conflicts of this kind are common in freshwater management, and the burden of addressing them rests on the shoulders of street-level bureaucrats, i.e. public officials at the end of the policy chain. This study uses a theoretical framework to explore their management choices employing previous research on natural resource management. The findings, based on qualitative semi-structured interviews with street-level bureaucrats from all water districts in Sweden, show that the three factors explored – their understanding of formal policy, their implementation resources, and their policy beliefs – matter when anthropogenic connectivity barriers are considered in ongoing management. Additionally, the factors are interrelated in a way that can obstruct the implementation of policy goals. While connectivity issues rank high and are considered a great problem all over the country, invasive species are regarded as a relatively small problem. If this should change in the future, the level of preparedness is low, primarily due to restricted implementation resources, but also due to the absence of guidance and formal responsibilities.