Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review

Purpose Although Cardiac Rehabilitation (CR) implementation models recommend delivery of any CR treatment component, Sub-Saharan Africa (SSA) constitutes only 17% of globally available CR programs. The aims of this review were to assess the benefits of employing any CR treatment modality in SSA, and evaluate if this approach should be encouraged in this resource-constrained region.MethodologyRecords were identified electronically via CINAHL, MEDLINE, Cochrane library, African journal online, PubMed, Web of science and google scholar, and grey literature was hand-searched. Articles reporting effectiveness of any CR treatment modality were included if participants had any cardiovascular disease and if the study was conducted in SSA. Quality assessment for each enrolled study was done using Downs and Black (1998) checklist and data was extracted using a modified standard tool.ResultsSearches identified 1666 records, 24 full text articles were examined and 10 were included for the review; 60%, 30% and 10% of the enrolled studies were done in South Africa, Nigeria and Benin respectively. The studies implemented exercise, psychosocial and education treatment modalities of CR, and the approach of delivery was either comprehensive or modified. Comprehensive CR and delivery of combined aerobic and resistance exercises improved physical (13%, p=0.001), social (40%, p=0.001) and mental aspects of quality of life and reduced anxiety (-12%, p<0.05) and depression (-6%, p<0.001) respectively. Comprehensive CR and aerobic training both reduced systolic blood pressure (range of mean reduction [RMR] -6 to -14mmHg), diastolic blood pressure (RMR -4 to -6mmHg) and resting heart rate (RMR -7 to -17bpm). Overall, all types of exercises showed a 1-5ml.kg-1.min-1 increase in peak oxygen consumption.ConclusionThe findings support delivery of exercise treatment modality and comprehensive delivery of CR in SSA. However, efficacy of independent implementation of education and psychosocial therapeutic components of CR remains unclear; hence the need for further investigations

Using waterfall, iterative and spiral models in ERP-system implementation projects under uncertainty

The article considers the use of cascade and multi-pass implementation models of corporate information systems in case of business and technological uncertainty. A review of waterfall, iterative and spiral ERP-systems implementation models is given. The business and technological uncertainties inherent in software systems implementation projects are introduced. The basic principles of development complex applications in ERP-systems are analyzed, including the rules of evolution and functionality. One compares business uncertainty for refined requirements in the waterfall and Agile-based implementation models, which operate with a change request and allocation requirements to a new round of development respectively. There is no or minimal technological uncertainty in ERP-systems implementation projects, however high business uncertainty exists, which can not be decreased by any basic implementation approaches. The application area of the waterfall and multi-pass implementation models is clarified for ERP projects from scratch, rollout and evolution under business uncertainty.

CRIMINALS AGGRESSION: PSYCHOLOGICAL REASONS

The article deals with the problem of aggressiveness, its origins and implementation models. The emotional sector of the individual with aggressive behaviour is analysed. This sector includes emotions defined by K. Izard as a triad of hostility: «anger – disgust – contempt». Particular attention is paid to the problem of paranoid aggressors. A description of this type of personality and its patterns of behaviour is given by P.B. Gannushkin. The conclusion is that paranoid individuals' main characteristic is the existence of the so-called super-valuable ideas in which they find themselves. These ideas define patterns of behavior of such persons, with the main idea of their supervalue, their constant complacency and excessive ego. A special attention is paid on a group of paranoiac persons so-called fanatics, whose world view consists of a small number of borrowed ideas to which they are faithful until their death and they have no need to comprehend them, it makes them a tool for the most aggressive behavior. In addition to the internal aggression causes, the authors also give the external ones, such as the priming effect: whatever negative event is covered by the media, there is a person or a group of persons who want to repeat the crime scenario they see. The views of such authors as E. Fromm, D. Dollard, L. Berkowitz, A. Bandura, R. Sapolsky, U.M. Antonyan and others are analysed.

Ensuring quality control of educational activities of higher educational institutions

The study aims to establish a general concept and stages of modeling the implementation of quality control of the educational process; to determine the assessment of employees of the institution of higher education presented an innovative model of quality control using automated learning and control systems (ALCS). The main method was the experiment, the study also used questionnaire and observation methods. The data was analyzed through content and thematic analysis. The main hypothesis is that the implementation models of quality control of education should be comprehensive, meet the mission and strategy of the educational institution and require continuous improvement. The result is the establishment of the main conceptual framework for the formation of an innovative model of quality control, should focus on quality education, use a wide range of advanced technologies, effective communication, improve learning strategies. A further perspective is to investigate the effectiveness of models of quality control of the educational process.

Implementation Models for Development in Low- and Middle-income Countries: Systematic Review of Peer-Reviewed Literature

Background. This study operationally defines a relatively small, but growing field of study on practical implementation models for health behavior change in the context of international development. The paper examines the continuum of behavioral theories and their application in the context of development programs and research in low- and middle-income countries (LMICs). We describe implementation models, point out that they have strengths in terms of feasibility and evaluability, and examine how they have been used to design theory-based interventions.The main research question (RQ1) is the following: What is the extent and nature of evidence published in this field? Two additional hypotheses are: (H1) There are examples, such as the Fogg Behavioral Model and others, that have established evidence for practical implementation models; and (H2) There are some practical implementation models that represent best practices and may be recommended as a basis for resources and intervention design in the context of international development. The study describes the state of evidence for feasible implementation models for development.Methods. The authors conducted a systematic search of the published, peer-reviewed literature following the widely accepted PRISMA methods for systematic reviews. We aimed to identify all relevant manuscripts published in the English language in health, social science, and business literature that apply implementation models, located in an LMIC, with a behavior change objective. We located 1,078 articles through database searching and 106 through other means. Ultimately, we identified 25 relevant articles for inclusion.Results. In answer to RQ1, we found that the peer-reviewed literature on implementation models for development has been growing in recent years, with 80% of reviewed papers published since 2015. There was a wide range of different models revealed by this review but none demonstrated clear-cut evidence of being most effective. However, the models found in this review share common characteristics of focusing on the three central tenets of Opportunity, Ability, and Motivation (OAM).Conclusions. This review found that implementation models for development are a promising and growing approach to behavior change in LMICs. Intervention models research should be expanded and applied in new domains, such as vaccination.

The Implementation of Sustainable Development and Protection of Cultural Heritage at Different Levels of Spatial and Urban Planning: A Case Study of the Republic of Serbia

The starting point in this paper is the position that spatial and urban planning has a key role in sustainable development and the protection of cultural heritage. The planning method used in areas of cultural heritage differs depending on the type and level of the spatial plan. It is possible to identify aspects of protection and sustainable development in plans, with the protection of cultural heritage dominating in practice. Research was carried out on a case study of three spatial plans at different levels, which both in terms of their methodology and content make up the planning system for the protection and sustainable development of cultural heritage in Serbia. The comparative analysis of the plans includes three aspects: protection, the sustainable development of cultural heritage, and the integration of cultural heritage into the planning and protection of landscapes. The implementation models of the spatial plans were considered. The main conclusion of the paper is that the concept of protecting cultural heritage has not evolved into a system of comprehensive and adequate planning for its sustainable development, nor is it sufficiently integrated with the planning and protection of landscapes. The paper provides guidelines for improving both the methodology of spatial planning and the concept of the sustainable development and protection of cultural heritage in spatial plans.

Pharmacogenomic testing to support prescribing in primary care: a structured review of implementation models

The application of pharmacogenomics could meaningfully contribute toward medicines optimization within primary care. This review identified 13 studies describing eight implementation models utilizing a multi-gene pharmacogenomic panel within a primary care or community setting. These were small feasibility studies (n <200). They demonstrated importance and feasibility of pre-test counseling, the role of the pharmacist, data integration into the electronic medical record and point-of-care clinical decision support systems (CDSS). Findings were considered alongside existing primary care prescribing practices and implementation frameworks to demonstrate how issues may be addressed by existing nationalized healthcare and primary care infrastructure. Development of point-of-care CDSS should be prioritized; establishing clinical leadership, education programs, defining practitioner roles and responsibilities and addressing commissioning issues will also be crucial.

Considerations for Monitoring School Health and Nutrition Programs

School health and nutrition (SHN) interventions are among the most ubiquitous public health investments and comprise a key mechanism for reaching populations that are otherwise difficult to reach through the health system. Despite the critical role of monitoring these multisectoral programs to enable data-informed adaptive programming, information to guide program implementers is scant. This manuscript provides an overview of how monitoring indicators can be selected across a SHN program's logical framework, with specific examples across five SHN implementation models. Adaptation of SHN programs in times of school closures, such as those currently being experienced globally due to the emergence of COVID-19, is also addressed. Key aspects of SHN program monitoring are explored, including: (1) why monitor; (2) what to measure; (3) how to measure; and (4) who measures. In situations of school closures, strategies to shift both program activities and corresponding monitoring mechanisms are critical to understanding the rapidly evolving situation and subsequently guiding policy actions to protect vulnerable populations.

Bridging the research to practice gap: a systematic scoping review of implementation of interventions for cancer-related fatigue management

Background Cancer-related fatigue (CRF) is one of the most common and distressing symptoms in people with cancer. Although efficacy of interventions for CRF have been extensively investigated, less has been done to ensure successful translation into routine clinical practice. The aim of this systematic scoping review was to synthesise knowledge surrounding the implementation of CRF interventions, summarise the processes and outcomes of implementation strategies used, and identify opportunities for further research. Methods PubMed, Cochrane CENTRAL, EMBASE and CINAHL databases were searched (up to December 2020). The Cochrane Effective Practice and Organisation of Care (EPOC) Group taxonomy and the RE-AIM Framework were used to guide the evaluation of implementation strategies and outcomes, respectively. Results Six studies were included. Three used an implementation framework (PARIHS, KTA, Cullens & Adams’ Implementation Guide) to guide implementation. Overall, the implementation strategies used across all studies were reported to have directly resulted in immediate changes at the clinician level (e.g., increased clinician behaviours, self-efficacy, attitudes, knowledge of CRF management). No clear relationship was found between the use of implementation models and the number or type of implementation strategies used. For outcomes, Effectiveness and Implementation were the most highly reported RE-AIM measures followed by Reach then Maintenance. Adoption was the least reported. Conclusions Despite the high prevalence of CRF and evidence-based interventions for managing CRF, there is limited evidence informing the sustainable implementation of these interventions. This systematic scoping review emphasises the lack of quality CRF implementation studies presently available in the literature leading to a disconnect between effective CRF interventions, routine clinical care, and cancer survivors at present. This review highlights the need for robust study designs guided by established frameworks to methodically design and evaluate the implementation of CRF management interventions in the future.