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Howieson, Bryan. "The Phoenix Rises: The Australian Accounting Standards Board and IFRS Adoption." Journal of International Accounting Research 16, no. 2 (June 1, 2017): 127–54. http://dx.doi.org/10.2308/jiar-51825.
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ABSTRACT The Australian experience of International Financial Reporting Standards (IFRS) is used to explore the impact of IFRS adoption on the sphere of authority (SOA) of a national accounting standard-setter (NASS). Data for the study were gathered from interviews with AASB technical staff and retired IASB members. The study demonstrates how changes in the social order between the IASB and NASSs impact domestic and international standards and how power is exercised and shared in the IASB/NASSs relationship. I find that a standard-setter's technical agenda is influenced by its strategic agenda. I show the significant influence of the standard-setting entity's chairperson on the development and implementation of the strategic agenda. In addition, individual technical staff members help drive this agenda. Knowledge of the behavior of standard-setting organizations can be considerably deepened by studying the characteristics and motivations of the individuals within those organizations. The findings are useful to NASSs by, for example, demonstrating the importance of employing individuals with both strong technical and political skills. If NASSs wish to have influence at the global level, then they must be proactive in driving change through networks and alliances with other NASSs.
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Nixon, Howard L. "Sport Sociology, NASSS, and Undergraduate Education in the United States: A Social Network Perspective for Developing the Field." Sociology of Sport Journal 27, no. 1 (March 2010): 76–88. http://dx.doi.org/10.1123/ssj.27.1.76.
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There has been no research about the prevalence of undergraduate sport sociology courses or about the links between NASSS and the institutions and faculty offering these courses. This article begins to fill this research gap. It uses a social network perspective to show how NASSS is connected to the “idea space” of undergraduate sport sociology courses in the U.S. and to the “social space” of institutions and instructors offering these courses. The data concern the prevalence, distribution, and content of undergraduate sport sociology courses in the U.S. and their connection to NASSS. A “call to action” for NASSS is proposed, especially in terms of how NASSS could expand its social network and its influence over the curricular idea space of sport sociology by reaching out to instructors of sport sociology courses. Suggestions for related future research are also proposed.
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Greenhalgh, Trisha, Harvey Maylor, Sara Shaw, Joseph Wherton, Chrysanthi Papoutsi, Victoria Betton, Natalie Nelissen, et al. "The NASSS-CAT Tools for Understanding, Guiding, Monitoring, and Researching Technology Implementation Projects in Health and Social Care: Protocol for an Evaluation Study in Real-World Settings." JMIR Research Protocols 9, no. 5 (May 13, 2020): e16861. http://dx.doi.org/10.2196/16861.
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Background Projects to implement health care and social care innovations involving technologies are typically ambitious and complex. Many projects fail. Greenhalgh et al’s nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework was developed to analyze the varied outcomes of such projects. Objective We sought to extend the NASSS framework to produce practical tools for understanding, guiding, monitoring, and researching technology projects in health care or social care settings. Methods Building on NASSS and a complexity assessment tool (CAT), the NASSS-CAT tools were developed (in various formats) in seven co-design workshops involving 50 stakeholders (industry executives, technical designers, policymakers, managers, clinicians, and patients). Using action research, they were and are being tested prospectively on a sample of case studies selected for variety in conditions, technologies, settings, scope and scale, policy context, and project goals. Results The co-design process resulted in four tools, available as free downloads. NASSS-CAT SHORT is a taster to introduce the instrument and gauge interest. NASSS-CAT LONG is intended to support reflection, due diligence, and preliminary planning. It maps complexity through stakeholder discussion across six domains, using free-text open questions (designed to generate a rich narrative and surface uncertainties and interdependencies) and a closed-question checklist; this version includes an action planning section. NASSS-CAT PROJECT is a 35-item instrument for monitoring how subjective complexity in a technology implementation project changes over time. NASSS-CAT INTERVIEW is a set of prompts for conducting semistructured research or evaluation interviews. Preliminary data from empirical case studies suggest that the NASSS-CAT tools can potentially identify, but cannot always help reconcile, contradictions and conflicts that block projects’ progress. Conclusions The NASSS-CAT tools are a useful addition to existing implementation tools and frameworks. Further support of the implementation projects is ongoing. We are currently producing digital versions of the tools, and plan (subject to further funding) to establish an online community of practice for people interested in using and improving the tools, and hold workshops for building cross-project collaborations. International Registered Report Identifier (IRRID) DERR1-10.2196/16861
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Greendorfer, Susan L. "NASSS Then and Now." Sociology of Sport Journal 4, no. 3 (September 1987): 298–303. http://dx.doi.org/10.1123/ssj.4.3.298.
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This paper presents a brief overview of the growth and development of the North American Society for Sociology of Sport, beginning with its formation at the Second CIC Symposium on Sociology of Sport at Minneapolis in 1978. Although the organization’s maturation and success may not be highly correlated with the development of the subdiscipline itself, consistent interest in sport sociology topics and the absence of a forum for exchange are viewed as important factors that led to its formation. Historically, the organization has consisted of diverse perspectives which have been viewed as an organizational strength. Recently, however, a form of subtle intolerance seems to be promoting a separate identification for various scholarly perspectives. A cautionary warning is issued against the possible rise of elitism that could evolve from the creation of false cleavages.
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Gremyr, Andreas, Boel Andersson Gäre, Trisha Greenhalgh, Ulf Malm, Johan Thor, and Ann-Christine Andersson. "Using Complexity Assessment to Inform the Development and Deployment of a Digital Dashboard for Schizophrenia Care: Case Study." Journal of Medical Internet Research 22, no. 4 (April 23, 2020): e15521. http://dx.doi.org/10.2196/15521.
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Background Health care is becoming more complex. For an increasing number of individuals, interacting with health care means addressing more than just one illness or disorder, engaging in more than one treatment, and interacting with more than one care provider. Individuals with severe mental illnesses such as schizophrenia are disproportionately affected by this complexity. Characteristic symptoms can make it harder to establish and maintain relationships. Treatment failure is common even where there is access to effective treatments, increasing suicide risk. Knowledge of complex adaptive systems has been increasingly recognized as useful in understanding and developing health care. A complex adaptive system is a collection of interconnected agents with the freedom to act based on their own internalized rules, affecting each other. In a complex health care system, relevant feedback is crucial in enabling continuous learning and improvement on all levels. New technology has potential, but the failure rate of technology projects in health care is high, arguably due to complexity. The Nonadoption, Abandonment, and challenges to Scale-up, Spread, and Sustainability (NASSS) framework and complexity assessment tool (NASSS-CAT) have been developed specifically to help identify and manage complexity in technology-related development projects in health care. Objective This study aimed to use a pilot version of the NASSS-CAT instrument to inform the development and deployment of a point-of-care dashboard supporting schizophrenia care in west Sweden. Specifically, we report on the complexity profile of the project, stakeholders’ experiences with using NASSS-CAT, and practical implications. Methods We used complexity assessment to structure data collection and feedback sessions with stakeholders, thereby informing an emergent approach to the development and deployment of the point-of-care dashboard. We also performed a thematic analysis, drawing on observations and documents related to stakeholders' use of the NASSS-CAT to describe their views on its usefulness. Results Application of the NASSS framework revealed different types of complexity across multiple domains, including the condition, technology, value proposition, organizational tasks and pathways, and wider system. Stakeholders perceived the NASSS-CAT tool as useful in gaining perspective and new insights, covering areas that might otherwise have been neglected. Practical implications derived from feedback sessions with managers and developers are described. Conclusions This case study shows how stakeholders can identify and plan to address complexities during the introduction of a technological solution. Our findings suggest that NASSS-CAT can bring participants a greater understanding of complexities in digitalization projects in general.
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Longacre, Margaret L., Cynthia Keleher, Marcin Chwistek, Michelle Odelberg, Mark Siemon, Molly Collins, and Carolyn Y. Fang. "Developing an Integrated Caregiver Patient-Portal System." Healthcare 9, no. 2 (February 10, 2021): 193. http://dx.doi.org/10.3390/healthcare9020193.
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We have developed an integrated caregiver patient-portal system (i.e., patient–caregiver portal) that (1) allows a patient to identify their primary caregiver and their communication preferences with that caregiver in the healthcare setting; (2) connects the caregiver to a unique portal page to indicate their needs; and (3) informs the healthcare team of patient and caregiver responses to aid in integrating the caregiver. The purpose of this manuscript is to report on the formative phases (Phases I and II) of system development. Phase I involved a pre-assessment to anticipate complexity or barriers in the system design and future implementation. We used the non-adaption, abandonment, scale-up, spread, and sustainability (NASSS) framework and rubric to conduct this pre-assessment. Phase II involved exploring reactions (i.e., concerns or benefits) to the system among a small sample of stakeholders (i.e., 5 palliative oncology patients and their caregivers, N = 10). The purpose of these two phases was to identify system changes prior to conducting usability testing among patient/caregiver dyads in palliative oncology (phase III). Completion of the NASSS rubric highlighted potential implementation barriers, such as the non-uniformity of caregiving, disparities in portal use, and a lack of cost–benefit (value) findings in the literature. The dyads’ feedback reinforced several NASSS ratings, including the benefits of connecting caregivers and allowing for caregiver voice as well as the concerns of limited use of patient-portals by the patients (but not the caregivers) and the need for user assistance during stressful health events. One change that resulted from this analysis was ensuring that we provided research participants (users) with detailed guidance and support on how to log in and use a patient–caregiver portal. In future iterations, we will also consider allowing more than one caregiver to be included and incorporating additional strategies to enable caregivers to interact in the system as part of the care team (e.g., via email).
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Melnick, Merrill J., and Donald F. Sabo. "Analysis of Free Communications Presented at the First Seven NASSS Annual Meetings: Some Patterns and Trends." Sociology of Sport Journal 4, no. 3 (September 1987): 289–97. http://dx.doi.org/10.1123/ssj.4.3.289.
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An analysis of the 434 free communications by the 575 presenters at the first seven annual meetings of NASSS (1980–1986) reveals several important patterns and trends with respect to (a) number of free communications, (b) number of presenters, (c) presenter’s sex, (d) presenter’s institutional affiliation, and (e) dual and multiple authorships. A classification of the free communications by subject matter reveals which research topics are of current interest to sport sociologists. Implications of these data for understanding the current stage of development of the subfield are discussed in relation to Mullins’ four-stage developmental model for scientific specialties.
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Montez de Oca, Jeffrey. "Marketing Politics and Resistance: Mobilizing Black Pain in National Football League Publicity." Sociology of Sport Journal 38, no. 2 (June 1, 2021): 101–10. http://dx.doi.org/10.1123/ssj.2021-0005.
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The 2020 North American Society for the Sociology of Sport (NASSS) Presidential Address analyzed aspects of the National Football League’s (NFL) current socially conscious marketing to make sense of corporatized racial justice politics following a summer of mass political mobilization triggered by the police killing of George Floyd. The analysis shows that the mass, multiracial racial justice activism forced corporatized sport leagues such as the NFL to respond to popular political pressure. The NFL followed the lead of the National Basketball Association and instead of resisting popular sentiments, it has incorporated social justice language into its marketing. Guided by Indigenous decolonial scholarship and radical Black scholars, I argue that the NFL’s incorporation of social justice language is a politics of recognition and colonial governmentality that insulates it from racial justice politics and helps to stabilize challenges to racial capitalism.
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Grady, Alice, Courtney Barnes, Luke Wolfenden, Christophe Lecathelinais, and Sze Lin Yoong. "Barriers and Enablers to Adoption of Digital Health Interventions to Support the Implementation of Dietary Guidelines in Early Childhood Education and Care: Cross-Sectional Study." Journal of Medical Internet Research 22, no. 11 (November 20, 2020): e22036. http://dx.doi.org/10.2196/22036.
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Background Few Australian childcare centers provide foods consistent with sector dietary guidelines. Digital health technologies are a promising medium to improve the implementation of evidence-based guidelines in the setting. Despite being widely accessible, the population-level impact of such technologies has been limited due to the lack of adoption by end users. Objective This study aimed to assess in a national sample of Australian childcare centers (1) intentions to adopt digital health interventions to support the implementation of dietary guidelines, (2) reported barriers and enablers to the adoption of digital health interventions in the setting, and (3) barriers and enablers associated with high intentions to adopt digital health interventions. Methods A cross-sectional telephone or online survey was undertaken with 407 childcare centers randomly sampled from a publicly available national register in 2018. Center intentions to adopt new digital health interventions to support dietary guideline implementation in the sector were assessed, in addition to perceived individual, organizational, and contextual factors that may influence adoption based on seven subdomains within the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) of health and care technologies framework. A multiple-variable linear model was used to identify factors associated with high intentions to adopt digital health interventions. Results Findings indicate that 58.9% (229/389) of childcare centers have high intentions to adopt a digital health intervention to support guideline implementation. The changes needed in team interactions subdomain scored lowest, which is indicative of a potential barrier (mean 3.52, SD 1.30), with organization’s capacity to innovate scoring highest, which is indicative of a potential enabler (mean 5.25, SD 1.00). The two NASSS subdomains of ease of the adoption decision (P<.001) and identifying work and individuals involved in implementation (P=.001) were significantly associated with high intentions to adopt digital health interventions. Conclusions A substantial proportion of Australian childcare centers have high intentions to adopt new digital health interventions to support dietary guideline implementation. Given evidence of the effectiveness of digital health interventions, these findings suggest that such an intervention may make an important contribution to improving public health nutrition in early childhood.
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Lee, Eng Sing, Poay Sian Sabrina Lee, Evelyn Ai Ling Chew, Gayathri Muthulingam, Hui Li Koh, Shu Yun Tan, and Yew Yoong Ding. "Video Consultations for Older Adults With Multimorbidity During the COVID-19 Pandemic: Protocol for an Exploratory Qualitative Study." JMIR Research Protocols 9, no. 10 (October 26, 2020): e22679. http://dx.doi.org/10.2196/22679.
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Background Multimorbidity, the coexistence of multiple chronic conditions in an individual, is a growing public health challenge. Amidst the COVID-19 pandemic, physical distancing remains an indispensable measure to limit the spread of the virus. This pertains especially to those belonging to high-risk groups, namely older adults with multimorbidity. In-person visits are discouraged for this cohort; hence, there is a need for an alternative form of consultation such as video consultations to continue the provision of care. Objective The potential of video consultations has been explored in several studies. However, the emergence of COVID-19 presents us with an unprecedented opportunity to explore the use of this technological innovation in a time when physical distancing is imperative. This study will evaluate the sustainability of video consultations on a micro-, meso-, and macro-level by assessing the views of patients, physicians, and organizational and national policymakers, respectively. Methods The NASSS (nonadoption, abandonment, scale-up, spread, and sustainability) framework was designed as a guide for the development of health care technologies. In this study, the implementation of and experiences related to video consultations will be studied using the NASSS framework. Individual in-depth interviews or focus group discussions will be conducted with participants using the Zoom platform. Data will be analyzed by at least two investigators trained in qualitative methodology, organized thematically, and coded in two phases—an initial phase and a focused selective phase. All disagreements will be resolved by consulting the larger research team until consensus is reached. Results This study was approved for funding from the Geriatric Education and Research Institute. Ethics approval was obtained from the National Healthcare Group Domain Specific Review Board (reference #2020/00760). Study recruitment commenced in July 2020. The results of the data analysis are expected to be available by the end of the year. Conclusions This study aims to evaluate the adoption and sustainability of video consultations for older adults with multimorbidity during the pandemic as well as post COVID-19. The study will yield knowledge that will challenge the current paradigm on how care is being delivered for community-dwelling older adults with multimorbidity. Findings will be shared with administrators in the health care sector in order to enhance the safety and quality of these video consultations to improve patient care for this group of population. International Registered Report Identifier (IRRID) DERR1-10.2196/22679
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Valera, Luca. "From Spontaneous Experience to the Cosmos: Arne Næss’ Phenomenology." Problemos 93 (October 22, 2018): 142–53. http://dx.doi.org/10.15388/problemos.2018.93.11758.
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[full article, abstract in English; only abstract in Lithuanian]
The aim of this paper is to focus on Arne Nass’s phenomenological method and some of its anthropological and cosmological implications. Nass’s Ecology, Community and Lifestyle, in fact, can be fruitfully read as an example of phenomenological inquiry, in which the notion of “spontaneous experience” plays a fundamental role. This method leads Nass to develop a “relational ontology,” in which the “ecological self” is seen as a “relational junction within the total field.” In addition, I show how Tymieniecka’s philosophical thought can offer us the proper eco-phenomenological perspective to better understand Nass’s Ecosophy T.
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Adams, Mary Louise, Michelle T. Helstein, Kyoung-yim Kim, Mary G. McDonald, Judy Davidson, Katherine M. Jamieson, Samantha King, and Geneviéve Rail. "Feminist Cultural Studies: Uncertainties and Possibilities." Sociology of Sport Journal 33, no. 1 (March 2016): 75–91. http://dx.doi.org/10.1123/ssj.2014-0060.
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This collection of commentaries emerged from ongoing conversations among the contributors about our varied understandings of and desires for the sport studies field. One of our initial concerns was with the absence/presence of feminist thought within sport studies. Despite a rich history of feminist scholarship in sport studies, we have questioned the extent to which feminism is currently being engaged or acknowledged as having shaped the field. Our concerns crystallized during the spirited feminist responses to a fiery roundtable debate on Physical Cultural Studies (PCS) at the annual conference of the North American Society for the Sociology of Sport (NASSS) in New Orleans in November 2012. At that session, one audience member after another spoke to what they saw as the unacknowledged appropriation by PCS proponents of longstanding feminist—and feminist cultural studies—approaches to scholarship and writing. These critiques focused not just on the intellectual moves that PCS scholars claim to be making but on how they are made, with several audience members and some panelists expressing their concerns about the territorializing effects of some strains of PCS discourse.
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James, Hannah M., Chrysanthi Papoutsi, Joseph Wherton, Trisha Greenhalgh, and Sara E. Shaw. "Spread, Scale-up, and Sustainability of Video Consulting in Health Care: Systematic Review and Synthesis Guided by the NASSS Framework." Journal of Medical Internet Research 23, no. 1 (January 26, 2021): e23775. http://dx.doi.org/10.2196/23775.
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Background COVID-19 has thrust video consulting into the limelight, as health care practitioners worldwide shift to delivering care remotely. Evidence suggests that video consulting is acceptable, safe, and effective in selected conditions and settings. However, research to date has mostly focused on initial adoption, with limited consideration of how video consulting can be mainstreamed and sustained. Objective This study sought to do the following: (1) review and synthesize reported opportunities, challenges, and lessons learned in the scale-up, spread, and sustainability of video consultations, and (2) identify transferable insights that can inform policy and practice. Methods We identified papers through systematic searches in PubMed, CINAHL, and Web of Science. Included articles reported on synchronous, video-based consultations that had spread to more than one setting beyond an initial pilot or feasibility stage, and were published since 2010. We used the Nonadoption, Abandonment, and challenges to the Scale-up, Spread, and Sustainability (NASSS) framework to synthesize findings relating to 7 domains: an understanding of the health condition(s) for which video consultations were being used, the material properties of the technological platform and relevant peripherals, the value proposition for patients and developers, the role of the adopter system, organizational factors, wider macro-level considerations, and emergence over time. Results We identified 13 papers describing 10 different video consultation services in 6 regions, covering the following: (1) video-to-home services, connecting providers directly to the patient; (2) hub-and-spoke models, connecting a provider at a central hub to a patient at a rural center; and (3) large-scale top-down evaluations scaled up or spread across a national health administration. Services covered rehabilitation, geriatrics, cancer surgery, diabetes, and mental health, as well as general specialist care and primary care. Potential enablers of spread and scale-up included embedded leadership and the presence of a telehealth champion, appropriate reimbursement mechanisms, user-friendly technology, pre-existing staff relationships, and adaptation (of technology and services) over time. Challenges tended to be related to service development, such as the absence of a long-term strategic plan, resistance to change, cost and reimbursement issues, and the technical experience of staff. There was limited articulation of the challenges to scale-up and spread of video consultations. This was combined with a lack of theorization, with papers tending to view spread and scale-up as the sum of multiple technical implementations, rather than theorizing the distinct processes required to achieve widespread adoption. Conclusions There remains a significant lack of evidence that can support the spread and scale-up of video consulting. Given the recent pace of change due to COVID-19, a more definitive evidence base is urgently needed to support global efforts and match enthusiasm for extending use.
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Clarkson, Paul, Ivaylo Vassilev, Anne Rogers, Charlotte Brooks, Nicky Wilson, Jem Lawson, and Jo Adams. "Integrating a Web-Based Self-Management Tool (Managing Joint Pain on the Web and Through Resources) for People With Osteoarthritis-Related Joint Pain With a Web-Based Social Network Support Tool (Generating Engagement in Network Involvement): Design, Development, and Early Evaluation." JMIR Formative Research 4, no. 11 (November 26, 2020): e18565. http://dx.doi.org/10.2196/18565.
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Background Joint pain caused by osteoarthritis (OA) is highly prevalent and can be extremely debilitating. Programs to support self-management of joint pain can be effective; however, most programs are designed to build self-efficacy and rarely engage social networks. Digital interventions are considered acceptable by people with joint pain. However, many existing resources are not accessible for or developed alongside people with lower health literacy, which disproportionately affects people with OA. Objective This study aims to design and develop an accessible digital self-management tool for people with joint pain and integrate this with an existing social network activation tool (Generating Engagement in Network Involvement [GENIE]) and to explore the feasibility of these linked tools for supporting the management of joint pain. Methods The study was conducted in 2 phases: a design and development stage and a small-scale evaluation. The first phase followed the person-based approach to establish guiding principles for the development of a new site (Managing joint Pain On the Web and through Resources [EMPOWER]) and its integration with GENIE. People with joint pain were recruited from libraries, a community café, and an exercise scheme to take part in 3 focus groups. EMPOWER was tested and refined using think-aloud interviews (n=6). In the second phase, participants were recruited through the web via libraries to participate in a small-scale evaluation using the LifeGuide platform to record use over a 1-month period. Participants (n=6) were asked to complete evaluation questionnaires on their experiences. The NASSS (nonadoption, abandonment, scale-up, spread, and sustainability) framework was used to explore the feasibility of the sites. Results The focus groups established guiding principles for the development of the tool. These included ensuring accessibility and relevance for people with OA-related joint pain and recognizing that joint pain is the reason for seeking support, trust, social facilitation, and goal setting. Think-aloud interviews identified issues with user experience and site navigation and the need for professional input for referral and goal setting, confusion, and tensions over the role of GENIE and site connectivity. Participants expected the sites to be specific to their pain-related needs. EMPOWER was accessed 18 times; 6 users registered with the site during the evaluation study. Participants mostly explored information pages on being active and being a healthy weight. Only one participant undertook goal setting and 4 participants visited the GENIE website. Conclusions Using the NASSS framework, we identified the complexity associated with integrating EMPOWER and GENIE. The value proposition domain highlighted the technical and conceptual complexity associated with integrating approaches. Although identified as theoretically achievable, the integration of differing propositions may have caused cognitive and practical burdens for users. Nevertheless, we believe that both approaches have a distinct role in the self-management of joint pain.
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Donnelly, Peter. "Report on the 8th Annual Conference of the North American Society for the Sociology of Sport (NASSS), Edmonton, Alberta, Canada, 4-7 November, 1987." International Review for the Sociology of Sport 23, no. 2 (June 1988): 172–76. http://dx.doi.org/10.1177/101269028802300208.
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Renyi, Madeleine, Ulrike Lindwedel-Reime, Lisa Blattert, Frank Teuteberg, and Christophe Kunze. "Collaboration applications for mixed home care — A systematic review of evaluations and outcomes." International Journal of Technology Assessment in Health Care 36, no. 4 (July 20, 2020): 395–403. http://dx.doi.org/10.1017/s0266462320000458.
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ObjectivesMixed home care, in which informal and professional actors work closely together, contributes significantly to ensuring home care up to old age. In this context, collaboration applications can considerably enhance the interactions among caregivers. However, although much research is conducted on need and requirement analyses of such applications, little is known about their introduction and use in care models. The purpose of this contribution is to identify studies that evaluate collaboration applications for mixed home care and compare their outcomes.MethodsTo identify literature on mixed home care collaboration applications (mHCA) and their evaluation, a systematic literature review was conducted in five bibliographic databases covering the years 2008 through 2019. The results were supplemented by a search in the meta-database Google Scholar. The evaluation approaches of the studies were analyzed and results compared by using the NASSS framework. Finally, a context concretized model was derived which summarizes interrelations.ResultsTwelve qualitative studies evaluating eleven applications could be identified. They report on increased competency in self-management, psychological relatedness, involvement, and understanding. However, most studies conclude that large scale platform tests are still needed to prove significant changes in care processes, communication, or organization.ConclusionAmong other things, their implementation is rather difficult due to the specifics of the target group. To enable a more targeted and successful implementation, it might be helpful to classify care networks beforehand and assess their communication behavior and needs. To prove the added value of mHCAs standardized assessment tools should be used.
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Benson, Tim. "Digital innovation evaluation: user perceptions of innovation readiness, digital confidence, innovation adoption, user experience and behaviour change." BMJ Health & Care Informatics 26, no. 1 (April 2019): e000018. http://dx.doi.org/10.1136/bmjhci-2019-000018.
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BackgroundInnovation spread is a key policy objective for health systems world-wide, but adoption success varies enormously. We have developed a set of short generic user-reported measures to help understand how and why healthcare innovations spread. This work builds on the literature and on practical experience in developing and using patient-reported outcome measures.MeasuresThe Innovation Readiness Score measures user perceptions of how much they are open to and up-to-date with new ideas, and whether their organisations are receptive to and capable of innovation. It is based on Rogers’ classification of innovativeness (innovator, early adopter, early majority, etc).The Digital Confidence Score rates users’ digital literacy and confidence to use digital products, with dimensions of familiarity, social pressure, support and digital self-efficacy.The Innovation Adoption Score rates the adoption process in terms of coherence and reflective thought before, during and after implementation. It is based on Normalisation Process Theory.The User Satisfaction measure assesses a digital product in terms of usefulness, ease of use, support and satisfaction.The Behaviour Change measure covers user perceptions of their capability, opportunity and motivation to change behaviour, based on the COM-B model.These measures have been mapped onto Greenhalgh’s NASSS Framework (non-adoption, abandonment and challenges to scale-up, spread and sustainability of health and care technologies).ConclusionThese tools measure different aspects of digital health innovations and may help predict the success of innovation dissemination, diffusion and spread programmes.
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Strohm, Lea, Charisma Hehakaya, Erik R. Ranschaert, Wouter P. C. Boon, and Ellen H. M. Moors. "Implementation of artificial intelligence (AI) applications in radiology: hindering and facilitating factors." European Radiology 30, no. 10 (May 26, 2020): 5525–32. http://dx.doi.org/10.1007/s00330-020-06946-y.
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Abstract Objective The objective was to identify barriers and facilitators to the implementation of artificial intelligence (AI) applications in clinical radiology in The Netherlands. Materials and methods Using an embedded multiple case study, an exploratory, qualitative research design was followed. Data collection consisted of 24 semi-structured interviews from seven Dutch hospitals. The analysis of barriers and facilitators was guided by the recently published Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework for new medical technologies in healthcare organizations. Results Among the most important facilitating factors for implementation were the following: (i) pressure for cost containment in the Dutch healthcare system, (ii) high expectations of AI’s potential added value, (iii) presence of hospital-wide innovation strategies, and (iv) presence of a “local champion.” Among the most prominent hindering factors were the following: (i) inconsistent technical performance of AI applications, (ii) unstructured implementation processes, (iii) uncertain added value for clinical practice of AI applications, and (iv) large variance in acceptance and trust of direct (the radiologists) and indirect (the referring clinicians) adopters. Conclusion In order for AI applications to contribute to the improvement of the quality and efficiency of clinical radiology, implementation processes need to be carried out in a structured manner, thereby providing evidence on the clinical added value of AI applications. Key Points • Successful implementation of AI in radiology requires collaboration between radiologists and referring clinicians. • Implementation of AI in radiology is facilitated by the presence of a local champion. • Evidence on the clinical added value of AI in radiology is needed for successful implementation.
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Barbotin, Maurice. "La pêche à la nasse à Marie-Galante et la fabrication des nasses en bambou." Bulletin de la Société d'Histoire de la Guadeloupe, no. 95-96-97-98 (1993): 3. http://dx.doi.org/10.7202/1043726ar.
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Luque-Almagro, Victor M., Isabel Manso, Matthew J. Sullivan, Gary Rowley, Stuart J. Ferguson, Conrado Moreno-Vivián, David J. Richardson, Andrew J. Gates, and M. Dolores Roldán. "Transcriptional and translational adaptation to aerobic nitrate anabolism in the denitrifier Paracoccus denitrificans." Biochemical Journal 474, no. 11 (May 10, 2017): 1769–87. http://dx.doi.org/10.1042/bcj20170115.
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Transcriptional adaptation to nitrate-dependent anabolism by Paracoccus denitrificans PD1222 was studied. A total of 74 genes were induced in cells grown with nitrate as N-source compared with ammonium, including nasTSABGHC and ntrBC genes. The nasT and nasS genes were cotranscribed, although nasT was more strongly induced by nitrate than nasS. The nasABGHC genes constituted a transcriptional unit, which is preceded by a non-coding region containing hairpin structures involved in transcription termination. The nasTS and nasABGHC transcripts were detected at similar levels with nitrate or glutamate as N-source, but nasABGHC transcript was undetectable in ammonium-grown cells. The nitrite reductase NasG subunit was detected by two-dimensional polyacrylamide gel electrophoresis in cytoplasmic fractions from nitrate-grown cells, but it was not observed when either ammonium or glutamate was used as the N-source. The nasT mutant lacked both nasABGHC transcript and nicotinamide adenine dinucleotide (NADH)-dependent nitrate reductase activity. On the contrary, the nasS mutant showed similar levels of the nasABGHC transcript to the wild-type strain and displayed NasG protein and NADH–nitrate reductase activity with all N-sources tested, except with ammonium. Ammonium repression of nasABGHC was dependent on the Ntr system. The ntrBC and ntrYX genes were expressed at low levels regardless of the nitrogen source supporting growth. Mutational analysis of the ntrBCYX genes indicated that while ntrBC genes are required for nitrate assimilation, ntrYX genes can only partially restore growth on nitrate in the absence of ntrBC genes. The existence of a regulation mechanism for nitrate assimilation in P. denitrificans, by which nitrate induction operates at both transcriptional and translational levels, is proposed.
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Hollick, Rosemary J., Alison J. Black, David M. Reid, and Lorna McKee. "Shaping innovation and coordination of healthcare delivery across boundaries and borders." Journal of Health Organization and Management 33, no. 7/8 (November 7, 2019): 849–68. http://dx.doi.org/10.1108/jhom-10-2018-0315.
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Purpose Using a complexity-informed approach, we aim to understand why introduction of a mobile service delivery model for osteoporosis across diverse organisational and country contexts in the UK National Health Service (NHS) met with variable success. Design/methodology/approach Six comparative case studies; three prospectively in Scotland using an action research-informed approach; and three retrospectively in England with variable degrees of success. The Non-adoption, Abandonment, Scale-up, Spread and Sustainability framework explored interactions between multi-level contextual factors and their influence on efforts to introduce and sustain services. Findings Cross-boundary service development was a continuous process of adaptation and evolution in rapidly shifting healthcare context. Whilst the outer healthcare policy context differed significantly across cases, inner contextual features predominated in shaping the success or otherwise of service innovations. Technical and logistical issues, organisational resources, patient and staff actions combined in unpredictable ways to shape the lifecycle of service change. Patient and staff thoughts about place and access to services actively shaped service development. The use of tacit “soft intelligence” and a sense of “chronic unease” emerged as important in successfully navigating around awkward people and places. Practical implications “Chronic unease” and “soft intelligence” can be used to help individuals and organisations “tame” complexity, identify hidden threats and opportunities to achieving change in a particular context, and anticipate how these may change over time. Understanding how patients think and feel about where, when and how care is delivered provides unique insights into previously unseen aspects of context, and can usefully inform development and sustainability of patient-centred healthcare services. Originality/value This study has uniquely traced the fortunes of a single service innovation across diverse organisational and country contexts. Novel application of the NASSS framework enabled comparative analysis across real-time service change and historical failures. This study also adds to theories of context and complexity by surfacing the neglected role of patients in shaping healthcare context.
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Vanhaeren, M., and F. d'Errico. "Nassa gibbossula." Encyclopédie berbère, no. 33 (October 4, 2012): 5256. http://dx.doi.org/10.4000/encyclopedieberbere.2677.
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Terliesner, Stefan. "Nasses Gold." VDI nachrichten 75, no. 27-28 (2021): 25. http://dx.doi.org/10.51202/0042-1758-2021-27-28-25-1.
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Lutz-Westphal, Brigitte. "Nasse Mitte." Mitteilungen der Deutschen Mathematiker-Vereinigung 26, no. 1 (March 1, 2018): 48. http://dx.doi.org/10.1515/dmvm-2018-0015.
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Neumann, Sabine. "Nasse Vielseitigkeit." VDI nachrichten 74, no. 12 (2020): 40. http://dx.doi.org/10.51202/0042-1758-2020-12-40-2.
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Fərhadzadə, Eldar, and Elnur Əliyev. "SUYUN NEFT LAYINA VURULMASI ÜÇÜN NASOS STANSİYALARININ ENERJİ SƏMƏRƏLİLİYİNİN ARTIRILMASI BARƏDƏ." PAHTEI-Procedings of Azerbaijan High Technical Educational Institutions 05, no. 01 (February 20, 2021): 14–20. http://dx.doi.org/10.36962/0501202114.
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Məqalədə qeyri-məhsuldar elektrik enerjisi itkilərinin azaldılması hesabına suyun neft layina vurulmasi üçün nasos stansiyalarının enerji səmərəliliyinin yüksəldilməsi məsələlərinə baxılmışdır. Bu məqsədlə, həmin nasos stansiyalarında elektrik enerjisi işlədicilərinin strukturu araşdırılmış, qeyri-məhsuldar elektrik enerjisi itkilərinin daha çox olduğu elementlər müəyyən olunmuş, həmçinin nasos stansiyalarının iş rejimlərinin mövcud idarəetmə üsulları və onların təkmilləşdirilməsi yolları təhlil edilmişdir. Araşdırmalar göstərir ki, laya su vurulması üçün elektrik enerjisi istehlakı müasir neft yatağının enerji istehlakının 60%-ni təşkil edir. Eyni zamanda, neft hasilatında baş verən qeyri-məhsuldar elektrik enerjisi itkilərinin 55-60%-i lay təzyiqinin saxlanılması sisteminin payına düşür. Elektrik itkilərinin əksər hissəsi laya su vurulması üçün nəzərdə tutulmuş nasos aqreqatlarında baş verir ki, bu da onların elektrik intiqalının idarəetmə səviyyəsinin aşağı olması və uyğun olaraq, nasos qrupunun parametrlərinin hidravlik şəbəkənin parametrlərinə və neft yataqlarının işlənmə texnologiyasının dəyişən şərаitinə uyğunsuzluğu ilə izah olunur. Belə ki, istifadə olunan tənzimlənmə üsullarının əksəriyyəti yalnız tələb olunan suvurma həcmlərinin təmin edilməsinə yönəldiyindən, burada məsələnin energetik tərəfi nəzərə alınmır. Bu isə sistemdə elektrik enerjisi itkilərinin artmasına səbəb olmaqla yanaşı, nasos aqreqatlarının iş rejimlərinə nəzarət imkanlarını genişləndirməyə də imkan vermir. Bundan əlavə, nasos aqreqatlarının elektrik mühərriklərinin optimal gücünün müəyyən olunması da nasos stansiyalarının energetik və texnoloji səmərəliliyinin artırılmasına yönəlmiş tədbirlərin vacib hissəsidir. Lay təzyiqinin saxlanılması sistemində yüksək elektrik enerjisi itkisi probleminin qənaətbəxş həlli üçün nasos aqreqatlarının iş rejimlərinə nəzarət etmək üçün mövcud və yeni yanaşmaların təhlili aparılmışdır. Müəyyən olunmuşdur ki, nasos aqreqatlarının məhsuldarlığının valın fırlanma tezliyinin dəyişdirilməsilə tənzimlənməsi üsulundan istifadə etməklə, həm nasos stansiyasının texnoloji imkanlarının genişləndirilməsinə, həm də qeyri-məhsuldar elektrik enerjisi itkilərinin minimuma endirilməsinə nail olmaq mümkündür. Tezlik tənzimləyicili elektrik intiqallarından istifadə olunması paralel işləyən nasos aqreqatları arasında yükün optimal paylanmasına imkan verir ki, bu da hidravlik və energetik xarakteristikaları fərqli olan nasosların birgə işi zamanı xüsusilə vacibdir. Beləliklə, mövcud nasos stansiyalarının modernləşdirilməsi və ya yenilərinin layihələndirilməsi zamanı, tezlik tənzimləyicili intiqallarda asinxron mühərriklərin rasional qidalanma sxemini müəyyən etməklə sistemin işləkliyini və etibarlılığını təmin etmək mümkündür. Açar sözlər: enerji səmərəliliyi, nasos stansiyası, lay təzyiqi, elektrik enerjisi, məhsuldarlıq, elektrik mühərriki.
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Meinert, Edward, Madison Milne-Ives, Svitlana Surodina, and Ching Lam. "Agile Requirements Engineering and Software Planning for a Digital Health Platform to Engage the Effects of Isolation Caused by Social Distancing: Case Study." JMIR Public Health and Surveillance 6, no. 2 (May 6, 2020): e19297. http://dx.doi.org/10.2196/19297.
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Background Social distancing and shielding measures have been put in place to reduce social interaction and slow the transmission of the coronavirus disease (COVID-19). For older people, self-isolation presents particular challenges for mental health and social relationships. As time progresses, continued social distancing could have a compounding impact on these concerns. Objective This project aims to provide a tool for older people and their families and peers to improve their well-being and health during and after regulated social distancing. First, we will evaluate the tool’s feasibility, acceptability, and usability to encourage positive nutrition, enhance physical activity, and enable virtual interaction while social distancing. Second, we will be implementing the app to provide an online community to assist families and peer groups in maintaining contact with older people using goal setting. Anonymized data from the app will be aggregated with other real-world data sources to develop a machine learning algorithm to improve the identification of patients with COVID-19 and track for real time use by health systems. Methods Development of this project is occurring at the time of publication, and therefore, a case study design was selected to provide a systematic means of capturing software engineering in progress. The app development framework for software design was based on agile methods. The evaluation of the app’s feasibility, acceptability and usability shall be conducted using Public Health England's guidance on evaluating digital health products, Bandura’s model of health promotion, the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework and the Nonadoption, Abandonment and Challenges to the Scale-up, Spread and Suitability (NASSS) framework. Results Making use of a pre-existing software framework for health behavior change, a proof of concept was developed, and a multistage app development and deployment for the solution was created. Grant submissions to fund the project and study execution have been sought at the time of publication, and prediscovery iteration of the solution has begun. Ethical approval for a feasibility study design is being sought. Conclusions This case study lays the foundations for future app development to combat mental and societal issues arising from social distancing measures. The app will be tested and evaluated in future studies to allow continuous improvement of the app. This novel contribution will provide an evidence-based exemplar for future app development in the space of social isolation and loneliness.
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Vetlesen, Arne Johan. "Ethics and Value in Naess’ Ecophilosophy." Worldviews 21, no. 3 (2017): 251–61. http://dx.doi.org/10.1163/15685357-02103004.
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It appears that Naess thought his ecophilosophy could do without ethics. What made him think so? Since Naess was largely implicit about his metaethical views, I turn to Warwick Fox’ elaborate presentation of Naess’ ecophilosophy to find an answer. Doing so allows me to investigate what is insufficiently accounted for in Naess’ ecophilosophy, namely its ontological presuppositions. To be philosophically sound, Naess’ criticisms of ethics need to question the taboo against the so-called naturalistic fallacy, a commonplace in ethical theories since Hume. I argue that a realist notion of value—understood as a property of nature, operative in nature—provides ecophilosophy with a sorely needed ontological foundation.
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Sullivan, William J. "Welcome to NASSJ." North American Spine Society Journal (NASSJ) 1 (May 2020): 100001. http://dx.doi.org/10.1016/j.xnsj.2020.100001.
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Grauer, Jonathan N. "NASSJ is underway." North American Spine Society Journal (NASSJ) 1 (May 2020): 100002. http://dx.doi.org/10.1016/j.xnsj.2020.100002.
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Nass, Meryl. "NASS RESPONDS." American Journal of Public Health 92, no. 11 (November 2002): 1708–9. http://dx.doi.org/10.2105/ajph.92.11.1708.
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&NA;. "NASS Movement." Back Letter 6, no. 2 (December 1991): 8. http://dx.doi.org/10.1097/00130561-199112000-00010.
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&NA;. "NASS 1997." Back Letter 12, no. 12 (December 1997): 133. http://dx.doi.org/10.1097/00130561-199712000-00002.
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&NA;. "NASS Prelude." Back Letter 13, no. 11 (November 1998): 121. http://dx.doi.org/10.1097/00130561-199811000-00002.
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Sen, Akhil K., Sandip Roy, and Vinay A. Juvekar. "On the Importance of Purification of Sodium Polystyrene Sulfonate." ISRN Analytical Chemistry 2012 (March 7, 2012): 1–5. http://dx.doi.org/10.5402/2012/514509.
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Ion exchange is commonly employed for purification of sodium polystyrene sulfonate (NaPSS), a molecule widely used as a model polyelectrolyte. However, the present work demonstrates that the ion exchange process itself may introduce some extraneous species into NaPSS samples by two possible mechanisms: (i) chemical transformation of polystyrene sulfonic acid (HPSS), a relatively unstable intermediate formed during ion exchange and (ii) release of small amount of “condensed” acid from cationic resins during the elution of NaPSS molecules. Based on these observations, it is proposed that simple dialysis is adopted as a standard protocol for the purification of primary NaPSS sample.
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Shulman, Yanina, and Philip G. Tibbo. "Neuroactive Steroids in Schizophrenia." Canadian Journal of Psychiatry 50, no. 11 (October 2005): 695–702. http://dx.doi.org/10.1177/070674370505001109.
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Schizophrenia is a psychiatric disorder with a complicated pathophysiology, involving many biochemical abnormalities in the brain. Because neuroactive steroids (NASs) modulate neurotransmitter systems that are implicated in the pathology of schizophrenia, recent research has focused on examining the role that NASs play in the illness. Although research in this area is relatively new, it appears that NASs may potentially be implicated in the pathophysiology of the illness. This paper reviews the current understanding of NASs, the research literature on NASs in schizophrenia and in animal models of the illness (including the effects of antipsychotic medication on NASs) and on the potential antipsychotic role of NASs themselves and, finally, discusses future directions for this area of schizophrenia research.
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Kim, Yoon-Seob, Yun Ok Kang, and Seong-Ho Choi. "Radiolytic Synthesis of Vinyl Polymer-Clay Nanocomposite Membranes for Direct Methanol Fuel Cell." Journal of Nanomaterials 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/562865.
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The three-type vinyl polymer-clay nanocomposite membranes with sulfonate (–SO3Na) are prepared by the solvent casting method after radiation-induced copolymerization for application of the direct methanol fuel cell (DMFC) membrane. The three-type vinyl polymers in polymer-clay nanocomposite membranes are included in poly(styrene-co-sodium styrene sulfonate), poly(St-co-NaSS), poly(2-hydroxyethyl methacrylate-co-NaSS), poly(HEMA-co-NaSS), and poly(acrylic acid-co-NaSS), and poly(AAc-co-NaSS). The proton conductivity (S/cm), water uptake (%), and ion-exchange capacity (meq/g) of the poly(St-co-NaSS)-clay nanocomposite membrane are 0.0779, 32.4, 3.63, respectively. The MeOH permeability of the poly(St-co-NaSS)-clay nanocomposite membrane is exhibited as7.7×10−9 mmol·cm−2·s−1. DMFC performance for poly(St-co-NaSS)-clay nanocomposite membrane is also measured in cell voltage and power density verses current density. As results, the poly(St-co-NaSS)-clay nanocomposite membrane can be used as a DMFC membrane on behalf of the commercial Nafion membrane.
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Brown, Poppy, Felicity Waite, Sinéad Lambe, Laina Rosebrock, and Daniel Freeman. "Virtual Reality Cognitive Therapy in Inpatient Psychiatric Wards: Protocol for a Qualitative Investigation of Staff and Patient Views Across Multiple National Health Service Sites." JMIR Research Protocols 9, no. 8 (August 20, 2020): e20300. http://dx.doi.org/10.2196/20300.
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Background Patients in psychiatric wards typically have very limited access to individual psychological therapy. Inpatients often have significant time available, and an important transition back to everyday life to prepare for—but historically, there have been few trained therapists available on wards for the delivery of evidence-based therapy. Automated virtual reality (VR) therapy may be one route to increase the provision of powerful psychological treatments in psychiatric hospitals. The gameChange automated VR cognitive therapy is targeted at helping patients overcome anxious avoidance and re-engage in everyday situations (such as walking down the street, taking a bus, or going to a shop). This treatment target may fit well for many patients preparing for discharge. However, little is known about how VR therapy may be viewed in this setting. Objective The objectives of the study are to explore psychiatric hospital staff and patients’ initial expectations of VR therapy, to gather patient and staff views of an automated VR cognitive therapy (gameChange) after briefly experiencing it, and to identify potential differences across National Health Service (NHS) mental health trusts for implementation. Guided by an implementation framework, the knowledge gained from this study will be used to assess the feasibility of VR treatment adoption into psychiatric hospitals. Methods Focus groups will be conducted with NHS staff and patients in acute psychiatric wards at 5 NHS mental health trusts across England. Staff and patients will be interviewed in separate groups. Individual interviews will also be conducted when preferred by a participant. Within each of the 5 trusts, 1 to 2 wards will be visited. A total of 8-15 staff and patients per ward will be recruited, with a minimum total of 50 staff and patients recruited across all sites. Focus group questions have been derived from the nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) framework. Focus groups will discuss expectations of VR therapy before participants are given the opportunity to briefly try the gameChange VR therapy. Questions will then focus on opinions about the therapy and investigate feasibility of adoption, with particular consideration given to site specific issues. A thematic analysis will be conducted. Results As of May 15, 2020, 1 patient focus group has been conducted. Conclusions The study will provide unique insight from patients and staff into the potential for implementing automated VR therapy in psychiatric wards. Perspectives will be captured both on the use of immersive technology hardware and therapy-specific issues in such settings. International Registered Report Identifier (IRRID) DERR1-10.2196/20300
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KOZŁOWSKA, ANNA. "A new generic name, Semigothograptus, for Gothograptus? meganassa Rickards & Palmer, 2002, from the Silurian post-lundgreni Biozone recovery phase, and comparative morphology of retiolitids from the lowermost upper Homerian (upper Wenlock)." Zootaxa 4208, no. 6 (December 21, 2016): 534. http://dx.doi.org/10.11646/zootaxa.4208.6.2.
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Gothograptus? meganassa Rickards & Palmer, 2002 is assigned to a new genus Semigothograptus. New, well preserved material from the dubius/nassa Biozone (upper Homerian, Silurian) of the Bartoszyce IG-1 drill core Poland is described. This provides a new phylogenetic perspective on the evolution of post-lundgreni Event retiolitines. Semigothograptus meganassa is considered to be a descendant of Gothograptus nassa, although one of the most significant differences between these forms is the position of the nema, and narrow finite tubarium ending in an appendix in G. nassa. S. meganassa possesses looping meshes of the ancora umbrella recognised in Gothograptus, Papiliograptus, and Baculograptus and shares the common characters of all stratigraphical younger retiolitines. It is recognised that the S. meganassa is known from four terrains: Avalonia, Baltica, Bohemia, and Saxo-Thuringia. Analysis of the genicular hoods of nassa type, characteristic of Gothograptus nassa, Gothograptus kozlowskii, Semigothograptus meganassa, and Neogothograptus eximinassa, demonstrates their unique, solid bandage construction.
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Balch, Stephen H. "Presentation: NAS’s greatest generation." Academic Questions 15, no. 3 (September 2002): 75–76. http://dx.doi.org/10.1007/s12129-002-1011-5.
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Hannay, Alastair. "Arne Naess (1912–2009)." Inquiry 52, no. 3 (May 21, 2009): 306–7. http://dx.doi.org/10.1080/00201740902917176.
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Handwerk, Gary, and Debbie Lee. "NASSR 2001: Romantic Subjects." European Romantic Review 13, no. 2 (January 2002): 133–37. http://dx.doi.org/10.1080/10509580212758.
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Martin, Wayne, and Kristian Bjørkdahl. "Arne Dekke Eide Naess." Inquiry 54, no. 1 (January 26, 2011): 1. http://dx.doi.org/10.1080/0020174x.2011.542942.
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Lazos, Evangelos S. "Freshwater Nase(Chondrostoma nasus)." Journal of Aquatic Food Product Technology 6, no. 2 (March 11, 1997): 45–63. http://dx.doi.org/10.1300/j030v06n02_05.
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Kraus, Dagmar. "Nasse Stellen trocken legen." CME 13, no. 6 (June 2016): 32. http://dx.doi.org/10.1007/s11298-016-5778-z.
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Abimbola, Seye, Bindu Patel, David Peiris, Anushka Patel, Mark Harris, Tim Usherwood, and Trisha Greenhalgh. "The NASSS framework for ex post theorisation of technology-supported change in healthcare: worked example of the TORPEDO programme." BMC Medicine 17, no. 1 (December 2019). http://dx.doi.org/10.1186/s12916-019-1463-x.
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Abstract Background Evaluation of health technology programmes should be theoretically informed, interdisciplinary, and generate in-depth explanations. The NASSS (non-adoption, abandonment, scale-up, spread, sustainability) framework was developed to study unfolding technology programmes in real time—and in particular to identify and manage their emergent uncertainties and interdependencies. In this paper, we offer a worked example of how NASSS can also inform ex post (i.e. retrospective) evaluation. Methods We studied the TORPEDO (Treatment of Cardiovascular Risk in Primary Care using Electronic Decision Support) research programme, a multi-faceted computerised quality improvement intervention for cardiovascular disease prevention in Australian general practice. The technology (HealthTracker) had shown promise in a cluster randomised controlled trial (RCT), but its uptake and sustainability in a real-world implementation phase was patchy. To explain this variation, we used NASSS to undertake secondary analysis of the multi-modal TORPEDO dataset (results and process evaluation of the RCT, survey responses, in-depth professional interviews, videotaped consultations) as well as a sample of new, in-depth narrative interviews with TORPEDO researchers. Results Ex post analysis revealed multiple areas of complexity whose influence and interdependencies helped explain the wide variation in uptake and sustained use of the HealthTracker technology: the nature of cardiovascular risk in different populations, the material properties and functionality of the technology, how value (financial and non-financial) was distributed across stakeholders in the system, clinicians’ experiences and concerns, organisational preconditions and challenges, extra-organisational influences (e.g. policy incentives), and how interactions between all these influences unfolded over time. Conclusion The NASSS framework can be applied retrospectively to generate a rich, contextualised narrative of technology-supported change efforts and the numerous interacting influences that help explain its successes, failures, and unexpected events. A NASSS-informed ex post analysis can supplement earlier, contemporaneous evaluations to uncover factors that were not apparent or predictable at the time but dynamic and emergent.
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Dyb, Kari, Gro Rosvold Berntsen, and Lisbeth Kvam. "Adopt, adapt, or abandon technology-supported person-centred care initiatives: healthcare providers’ beliefs matter." BMC Health Services Research 21, no. 1 (March 17, 2021). http://dx.doi.org/10.1186/s12913-021-06262-1.
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Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.
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Weidner, Kristen, Joneen Lowman, Anne Fleischer, Kyle Kosik, Peyton Goodbread, Benjamin Chen, and Ramakanth Kavuluru. "Twitter, Telepractice, and the COVID-19 Pandemic: A Social Media Content Analysis." American Journal of Speech-Language Pathology, September 9, 2021, 1–11. http://dx.doi.org/10.1044/2021_ajslp-21-00034.
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Purpose Telepractice was extensively utilized during the COVID-19 pandemic. Little is known about issues experienced during the wide-scale rollout of a service delivery model that was novel to many. Social media research is a way to unobtrusively analyze public communication, including during a health crisis. We investigated the characteristics of tweets about telepractice through the lens of an established health technology implementation framework. Results can help guide efforts to support and sustain telehealth beyond the pandemic context. Method We retrieved a historical Twitter data set containing tweets about telepractice from the early months of the pandemic. Tweets were analyzed using a concurrent mixed-methods content analysis design informed by the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework. Results Approximately 2,200 Twitter posts were retrieved, and 820 original tweets were analyzed qualitatively. Volume of tweets about telepractice increased in the early months of the pandemic. The largest group of Twitter users tweeting about telepractice was a group of clinical professionals. Tweet content reflected many, but not all, domains of the NASSS framework. Conclusions Twitter posting about telepractice increased during the pandemic. Although many tweets represented topics expected in technology implementation, some represented phenomena were potentially unique to speech-language pathology. Certain technology implementation topics, notably sustainability, were not found in the data. Implications for future telepractice implementation and further research are discussed.
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Rudin, Robert S., Sofia Perez, Jorge A. Rodriguez, Jessica Sousa, Savanna Plombon, Adriana Arcia, Dinah Foer, David W. Bates, and Anuj K. Dalal. "User-centered design of a scalable, electronic health record-integrated remote symptom monitoring intervention for patients with asthma and providers in primary care." Journal of the American Medical Informatics Association, August 18, 2021. http://dx.doi.org/10.1093/jamia/ocab157.
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Abstract Objective To determine user and electronic health records (EHR) integration requirements for a scalable remote symptom monitoring intervention for asthma patients and their providers. Methods Guided by the Non-Adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework, we conducted a user-centered design process involving English- and Spanish-speaking patients and providers affiliated with an academic medical center. We conducted a secondary analysis of interview transcripts from our prior study, new design sessions with patients and primary care providers (PCPs), and a survey of PCPs. We determined EHR integration requirements as part of the asthma app design and development process. Results Analysis of 26 transcripts (21 patients, 5 providers) from the prior study, 21 new design sessions (15 patients, 6 providers), and survey responses from 55 PCPs (71% of 78) identified requirements. Patient-facing requirements included: 1- or 5-item symptom questionnaires each week, depending on asthma control; option to request a callback; ability to enter notes, triggers, and peak flows; and tips pushed via the app prior to a clinic visit. PCP-facing requirements included a clinician-facing dashboard accessible from the EHR and an EHR inbox message preceding the visit. PCP preferences diverged regarding graphical presentations of patient-reported outcomes (PROs). Nurse-facing requirements included callback requests sent as an EHR inbox message. Requirements were consistent for English- and Spanish-speaking patients. EHR integration required use of custom application programming interfaces (APIs). Conclusion Using the NASSS framework to guide our user-centered design process, we identified patient and provider requirements for scaling an EHR-integrated remote symptom monitoring intervention in primary care. These requirements met the needs of patients and providers. Additional standards for PRO displays and EHR inbox APIs are needed to facilitate spread.
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Cartledge, S., J. Rawstorn, M. Tran, P. Ryan, E. Howden, and A. Jackson. "Throwing cardiac rehabilitation into the 21st Century: a focus group study exploring the impact of COVID-19 on cardiac rehabilitation delivery in Victoria, Australia." European Journal of Cardiovascular Nursing 20, Supplement_1 (July 1, 2021). http://dx.doi.org/10.1093/eurjcn/zvab060.069.
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Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiac rehabilitation (CR) education and exercise are predominantly delivered in group face-to-face settings. This delivery model was challenged during the COVID-19 pandemic due to government enforced lockdowns which restricted the delivery of these models of care. The Australian state of Victoria experienced the longest and most severe local restrictions and was in lockdown for approximately 26 weeks of 2020. Purpose We aimed to explore the experience, barriers and enablers of delivering CR during a pandemic, and identify strategies for future COVID-safe programs among cardiac rehabilitation clinicians. Methods Victorian members of the Australian Cardiovascular Health and Rehabilitation Association (ACRA) were invited to attend an exploratory qualitative online focus group in November 2020. An inductive thematic analysis was undertaken before deductively applying the Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework to identify barriers and enablers for technology adoption in CR. Results 30 members participated in a 106 minute focus group. 17 members who provided demographics represented multiple disciplines (nursing n = 13, exercise physiology n = 3, physiotherapy n = 1) and geographical settings (metropolitan n = 10, regional n = 4, rural n = 3). Four main themes were identified: Consequences of sudden service delivery change; Technology use – challenges and benefits; Capacity (program and staff); and The way forward. The deductive NASSS analysis demonstrated the main challenges of continuing remotely delivered CR lie with all adopters (staff, patients, carers) and with organisations. Future CR strategies included the importance of resuming face-to-face programs but important barriers including finding capacity, particularly staffing, to run concurrent telehealth programs remain to be addressed. Conclusion The COVID-19 pandemic forced and expedited significant changes to CR delivery models. While clinicians agreed that delivery of CR via telehealth will continue, it is now timely to review remote models of care and plan how they will integrate alongside traditional face-to-face programs.