Genetic diversity and Population genetics An individual organism's phenotype results from both its genotype and the influence from the environment it has lived in. A substantial part of the phenotypic variation in a population is caused by genotypic variation.
Disclaimer Factors that promote or inhibit the implementation of e-health systems: Correspondence to Frances S Mair e-mail: Bulletin of the World Health Organization ; Enthusiasm for technological innovation around e-health among policy-makers and health officials has, however, not always been matched by uptake and utilization in practice.
Sometimes these studies describe important successes, but more often they are accounts of complex processes with ambiguous outcomes. Although the reviews have furthered knowledge by identifying factors thought to influence implementation processes and their outcomes, the underlying mechanisms at work have not been well characterized or explained.
The literature is fragmented across multiple subspecialty areas, so those charged with designing and implementing e-health systems may find it difficult to locate an appropriate body of evidence and to determine the relevance of that evidence to their specific circumstances.
In this meta-review we have sought to address these problems in two ways. First, we have performed a systematic review of reviews of e-health implementation studies, focusing on implementation processes rather than outcomes, to critically appraise such reviews, evaluate their methods, synthesize their results and highlight their key messages.
Our meta-review has enabled us to explore and evaluate a large and fragmented body of research in a coherent and economical way.
Second, we have interpreted our results in the light of an explanatory framework — Normalization Process Theory NPT 56 — that specifies mechanisms of importance in implementation processes.
This approach has facilitated the explanation of those factors shown to influence the implementation of e-health systems in practice and allowed us to identify important gaps in the literature and to make rational recommendations for further primary research. The objective of this review was to synthesize and summarize the findings of identified reviews and inform current and future e-health implementation programmes.
The review set out to answer two key questions: We used a previously developed method of categorization to classify e-health interventions into four domains: Qualitative meta-syntheses or meta-ethnographies: Exclusion Secondary analyses including qualitative meta-syntheses or meta-ethnographies of existing data sets for the purpose of presenting cumulative outcomes from personal research programmes.
Secondary analyses including qualitative meta-syntheses or meta-ethnographies of existing data sets for the purpose of presenting cumulative outcomes from personal research programmes.
Discussions of literature included in contributions to theory building or critique. Summaries of the literature for the purpose of information or commentary. Editorial discussions that argued the case for a field of research or a course of action. Papers whose abstract identified them as reviews but that lacked supporting evidence in the main text e.
Finding relevant studies We searched the following electronic bibliographic databases: Search terms used for systematic review of reviews on e-health implementation Thesaurus terms referring to e-health interventions were: Where appropriate, thesaurus terms were exploded to include all terms below the searched term in the thesaurus tree.
The lowest term was always exploded. There are no thesaurus terms for implementation, so this concept was searched for by looking for the following text words in title, keywords or abstract: The concepts of e-health intervention and implementation were combined, and then the search was limited by publication type i.
None of the non-English-language citations or of the papers published before were relevant. These limits were used for searching all other databases.
If either reviewer could not exclude the paper based on the abstract or citation, the full paper was obtained. All papers obtained were double screened. In case of disagreement about inclusion or exclusion of a given paper, all reviewers read the paper and reached agreement through discussion.
Data were extracted in two stages. First we used a standardized data extraction instrument to categorize papers on the basis of country of origin; e-health domain; publisher; date of publication; review aims and methods; databases searched within the review; inclusion and exclusion criteria of review; number of papers identified and number included in the review.
Second, as the literature under study focused on implementation processes rather than outcomes, we analysed the extracted data qualitatively using NPT, which has four constructs coherence, cognitive participation, collective action and reflexive monitoring as a coding framework.
As this was a qualitative content analysis, 11 we did not try to quantify the weight put on any one NPT construct in a given review.Last Updated: 07 January, Introduction This article provides an outline of the recruitment and selection process for individuals wishing to join the US Army as commissioned officers, i.e.
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Employee selection begins when a pool of applicants is generated by the organization’s recruitment efforts.
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A Selection and recruitment by David Baker •.