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Implementation appraisals were conducted on a total of 103 studies (references can be obtained from the original reviews). New Balance 997 Made in US Color Spectrum Mens Made in USA Shoes M997CS2 RwyGuP
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Twenty-one studies were identified in the task restructuring review, 18 studies in the employee participation review, 40 studies in the compressed working week review and 26 studies in the shift work review. 17 Mezlan Mens Viso Zip Boot PVYIEq
Two studies appeared in two reviews. In Cynthia Rowley Sandal UFpw2mWcaV
, the numerical implementation scores are summarised for all studies and, in Salvatore Ferragamo Womens Bow Slingback Floral Heel Pumps 5FzTDGiyMh
, examples of summaries of implementation appraisals are presented for the higher scoring studies from each of the four reviews.

View this table:
Table 3 Numerical summary of the results of the implementation appraisal checklist
View this table:
Table 4 Examples of implementation appraisal summaries (higher scoring studies only)

Most studies achieved low scores (see Menbur High heeled sandals black/gold UkFRJ
). The median score was 3 out of 10 (range = 0 to 7; lower and upper quartiles  = 1 and 4). This varied slightly between reviews (from 2 to 4). The median score was 3 for studies published between 1996 and 2000 and 2 for studies published between 2001 and 2006, and between 1991 and 1995 and before 1991.

As few studies achieved a high implementation score, we have categorised the studies as follows: 14 “higher” scoring studies (scoring ⩾5 in our implementation appraisal), 38 “intermediate” scoring studies (scoring 3 or 4 in our appraisal) and 51 “lowest” scoring studies (scoring <3).

The most commonly reported implementation themes were “motivation for intervention” ( Steve Madden Mens Flyerz Perforated Sneaker 64VXBIEDuG
, criteria 1—appearing in 76% of included studies) and employee support of the intervention (criteria 8—appearing in 54% of the studies). All the other themes were reported in less than a third of the total studies. Criteria 10 (differential effects/population characteristics) was only reported in 8% of the studies, while no study described resourcing, costs or cost–benefits of interventions (criteria 9).

Forty-nine included studies were published in peer review health journals, 41 in other peer review journals (mainly social science, occupational and managerial studies journals) and 13 in edited books or theses. Twelve per cent of articles from health journals received higher implementation scores compared with 15% of studies from both other journals and books or theses. Forty-seven per cent of articles from health journals received lower implementation scores compared with 51% of studies from other journals and 54% from books or theses.

Implementation appraisal scores were not useful predictors of robust study designs. We identified 32 prospective cohort studies with appropriate controls and have classed these as the most robust study designs: 36% of the studies with “higher” implementation scores were “most robust” compared with 45% of studies with intermediate scores and 20% of studies with low scores.

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Coronary Artery Calcification anditsProgression
What Does it Really Mean?
Hiroyoshi Mori , Sho Torii , Matthew Kutyna , Atsushi Sakamoto , Aloke V. Finn and Renu Virmani

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vol. 11 no. 1 127-142
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2018 American College of Cardiology Foundation

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Abstract

Coronary artery calcification is concomitant with the development of advanced atherosclerosis. Coronary artery calcification pathologically begins as microcalcifications (0.5 to 15.0 μm) and grows into larger calcium fragments, which eventually result in sheet-like deposits (>3 mm). This evolution is observed to occur concurrently with the progression of plaque. These fragments and sheets of calcification can be easily identified by radiography as well as by computed tomography and intravascular imaging. Many imaging modalities have proposed spotty calcification to be a predictor of unstable plaque and have suggested more extensive calcification to be associated with stable plaques and perhaps the use of statin therapy. We will review the pathology of coronary calcification in humans with a focus on risk factors, relationship with plaque progression, correlation with plaque (in)stability, and effect of pharmacologic interventions.

Footnotes

This study was supported by CVPath Institute, Inc., a not-for-profit research organization dedicated to the study of cardiovascular disease. Dr. Mori has received honoraria from Terumo Corporation, Abbott Vascular Japan, and Goodman. Dr. Virmani has received research support from 480 Biomedical, Abbott Vascular, ART, BioSensors International, Biotronik, Boston Scientific, Celonova, Claret Medical, Cook Medical, Cordis, Edwards Lifescience, Medtronic, MicroPort, MicroVention, OrbusNeich, ReCore, SINO Medical Technology, Spectranetics, Surmodics, Terumo Corporation, W.L. Gore and Xeltis; and has received honoraria from 480 Biomedical, Abbott Vascular, Boston Scientific, Cook Medical, Lutonix, Medtronic, Terumo Corporation and W.L. Gore; and consults with 480 Biomedical, Abbott Vascular, Medtronic, and W.L. Gore. Dr. Finn has sponsored research agreements with Boston Scientific and Medtronic; and is an advisory board member to Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Companies should begin the scaling-up process by considering whether the required integration is even possible or feasible. If the application depends on special technology that is difficult to source, for example, that will limit scale-up. Make sure your business process owners discuss scaling considerations with the IT organization before or during the pilot phase: An end run around IT is unlikely to be successful, even for relatively simple technologies like RPA.

The health insurer Anthem, for example, is taking on the development of cognitive technologies as part of a major modernization of its existing systems. Rather than bolting new cognitive apps onto legacy technology, Anthem is using a holistic approach that maximizes the value being generated by the cognitive applications, reduces the overall cost of development and integration, and creates a halo effect on legacy systems. The company is also redesigning processes at the same time to, as CIO Tom Miller puts it, “use cognitive to move us to the next level.”

In scaling up, companies may face substantial change-management challenges. At one U.S. apparel retail chain, for example, the pilot project at a small subset of stores used machine learning for online product recommendations, predictions for optimal inventory and rapid replenishment models, and—most difficult of all—merchandising. Buyers, used to ordering product on the basis of their intuition, felt threatened and made comments like “If you’re going to trust this, what do you need me for?” After the pilot, the buyers went as a group to the chief merchandising officer and requested that the program be killed. The executive pointed out that the results were positive and warranted expanding the project. He assured the buyers that, freed of certain merchandising tasks, they could take on more high-value work that humans can still do better than machines, such as understanding younger customers’ desires and determining apparel manufacturers’ future plans. At the same time, he acknowledged that the merchandisers needed to be educated about a new way of working.

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If scale-up is to achieve the desired results, firms must also focus on improving productivity. Many, for example, plan to grow their way into productivity—adding customers and transactions without adding staff. Companies that cite head count reduction as the primary justification for the AI investment should ideally plan to realize that goal over time through attrition or from the elimination of outsourcing.

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