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Anyone, or any organization, can improve upon their abilities to become serial innovators. Innovators are both problem-identifiers and problem-solvers. Innovators create new, impactful solutions to clearly identified root-cause problems. Creative problem-solving is not enough. To generate impact those solutions must also be adopted. No adoption, no impact. No impact, no innovation.
Innovating is a learnable, not an innate, skill. Innovating takes the right people, in the right environment utilizing the right methodology. The focus of this book is the description of a learnable, repeatable, non-linear, iterative, knowledge-based methodology for generating innovations. It is the oft-missing guide necessary to becoming a serial innovator. A guide that integrates creation and adoption. A guide that includes root-cause problem identification and solution formulation. A guide that can be adopted by individuals, groups, or large organizations.
The design-thinking based Innovation Pyramid methodology is laid out in the first half of this book. Its implementation utilizes the creativity-based DOC (Diverge Organize Converge) Process described in the second half of this book. The appendices, in turn, describe specific techniques that apply to the DOC Process.
Reytory von Angola was taken from the west coast of Africa and carried to the island of Manhattan, to the infant Dutch town of New Amsterdam sometime between 1626 and 1640. What awaited her there was a life of struggle, loss, and love. Her life demonstrates the challenges of claiming freedom for those with female bodies. Freedom required claiming family, claiming land, claiming human affections, claiming a role as a wife and a widow and a mother, and also claiming the most intimate parts of her own body. Freedom meant the ability to snatch children out of the maw of enslavement. She would never have a document that “gave” her freedom. Instead, freedom was something she made over the course of her life, which she bestowed on the generations that followed by building and defending a claim to the many aspects of herself. Marriage, motherhood, land ownership, and church membership all served as preludes to her final act of positioning her adopted son to acquire his freedom.
To examine the association between physician–patient treatments shared decision making (SDM), patient satisfaction, and adoption of a new health technology.
A cross-sectional study was conducted from July 2016 to October 2016 in Fujian Province and Shanghai, in Eastern China. A total of 542 physicians and 619 patients in eleven hospitals were surveyed. Patients and their treating physicians completed self-reported questionnaires on patient–physician SDM, satisfaction with treatment decision making and adoption of a new health technology. Correlation analysis, multivariate logistic regression and multivariate linear regression were performed.
The majority (68.20 percent) of patients preferred SDM. Involvement of patients in SDM was positively associated with their satisfaction with treatment decision making (p < .001) and adoption of a new health technology (p < .05). Better concordance between their preference and actual SDM was positively associated with patients' adoption behavior (p < .05), but no statistically significant association was found between concordance and satisfaction.
SDM was the most important predictor of patients' satisfaction with decision making and adoption of a new health technology. Therefore, better communication between physicians and patients is recommended to improve their SDM, increase patient satisfaction and to assist with the adoption of new technologies. Training healthcare provider and teaching communication skills in working with patients in the initial stage of technology diffusion is required.
This study identified decision variables influencing fertilizer adoption and optimal fertilizer rates among smallholder farmers in the Ethiopian highlands. The fertilizer adoption and fertilizer use were examined in four regional states using a questionnaire survey, which was administered to 2880 farm households. A double hurdle model was used to analyze factors influencing the two independent decisions of adoption of fertilizers and use of fertilizers. The model estimates of the first hurdle revealed that the probability of fertilizer adoption increased by 1.2% as household education status improved, by 1.4% for an increased number of active family members, by 5.6% with improved access to credit, by 3.4% with cooperative membership, by 3.3% with an increase in farm size, by 4.6% when soil and water conservation practices are employed, and by 3.4% when agroecology of the farm is located in the medium to highland zone. Conversely, the probability of fertilizer adoption reduced by 0.9% for an increase in family size, 0.6% with 1 km distance from all-weather road, 1.6% for a kilometer further to farm plots, and 0.9% for an increase in number of parcels. The intensity of use of fertilizers was influenced by education status of the household head, family size, access to credit, membership to cooperatives, use of crop rotation, annual income, number of farm plots owned, use of soil and water conservation, and agroecology. Therefore, a concerted effort is needed to encourage fertilizer adoption and optimum fertilizer use intensity by improving households’ resource endowment, institutional capacity to deliver services, and infrastructure development.
There is a common misconception that our genomes - all unique, except for those in identical twins - have the upper hand in controlling our destiny. The latest genetic discoveries, however, do not support that view. Although genetic variation does influence differences in various human behaviours to a greater or lesser degree, most of the time this does not undermine our genuine free will. Genetic determinism comes into play only in various medical conditions, notably some psychiatric syndromes. Denis Alexander here demonstrates that we are not slaves to our genes. He shows how a predisposition to behave in certain ways is influenced at a molecular level by particular genes. Yet a far greater influence on our behaviours is our world-views that lie beyond science - and that have an impact on how we think the latest genetic discoveries should, or should not, be applied. Written in an engaging style, Alexander's book offers tools for understanding and assessing the latest genetic discoveries critically.
Children adopted internationally experience adverse conditions prior to adoption, placing them at risk for problematic social–emotional development. The Attachment and Biobehavioral Catch-up (ABC) intervention was designed to help internationally adoptive parents behave in ways that promote young children's social–emotional competence. Participants included 131 parent–child dyads randomly assigned to receive either ABC (n = 65) or a control intervention (n = 66). In addition, 48 low-risk biologically related parent–child dyads were included as a comparison group. At follow-up assessments conducted when children were 24 to 36 months old, internationally adopted children who received the ABC intervention had higher levels of parent-reported social–emotional competence than children who received a control intervention. In addition, observational assessments conducted when children were 48 and 60 months of age showed that internationally adopted children who received ABC demonstrated higher social–emotional competence than children who received a control intervention. Adopted children who received the control intervention, but not the ABC intervention, displayed more difficulties with social–emotional competence than low-risk children. Finally, postintervention parent sensitivity mediated the effect of ABC on observed child social–emotional competence in parent interactions, controlling for preintervention parent sensitivity. These results demonstrate the efficacy of a parenting-focused intervention in enhancing social–emotional competence among children adopted internationally.
The search for a bride, with all its complexities, its political implications and its possible cultural consequences, had a simple goal: the birth of a child. This was the biological event on which the fortunes of kingdoms turned. Rulers in the patriarchal and dynastic world of medieval Europe were expected to be brave, violent, aggressive, forceful – qualities that were associated with men. But the thing on which dynastic continuity, and indeed the very existence of dynasties, relied, was the female body, and what it alone could do: conceive and give birth. So, once the new bride had been chosen, attention focussed on her ability to conceive children, especially sons. The natural fertility and mortality of upper-class and lower-class people were probably quite similar, but age at marriage might be different. In late medieval England, it has been calculated, women of the top level of the aristocracy married, on average, at seventeen, men at twenty-two. It seems, however, that practices at the very apex of the social hierarchy, the rulers, often included much earlier marriage.
How can the political meaning of the family and its relationship with the state be redefined in the liberal era? This chapter explores three answers that rearticulate the standing of the family within the liberal commonweal and redraw the balance between family and state. The responses differ in their narration of the interest that the liberal state has in the institution of the family, depicting the latter as an agency of the state, an organ of the state, or an apolitical space that marks the state’s limits and dependence on prepolitical conditions. The three approaches are presented as concurrent trends representing discrepant versions of liberalism as a political theory.
Who was Paul? This essay places the apostle within his Diaspora social context of synagogue communities, gentile Judaizers, Roman authorities, hostile pagans and pagan gods, to reconstruct his mission and message. By turning the nations from their gods to his god, Paul was confirmed in his conviction that Christ was about to return to defeat cosmic powers; to accomplish that signature eschatological miracle, the resurrection of the dead; and to gather the twelve tribes of Israel and the seventy gentile nations under the universal sovereignty of God the father.
Children who are adopted from care are more likely to experience enduring emotional and behavioral problems across development; however, adoptees’ trajectories of mental health problems and factors that impact their trajectories are poorly understood. Therefore, we used multilevel growth analyses to chart adoptees’ internalizing and externalizing problems across childhood, and examined the associations between preadoptive risk and postadoptive protective factors on their trajectories. This was investigated in a prospective longitudinal study of case file records (N = 374) and questionnaire-based follow-ups (N = 96) at approximately 5, 21, and 36 months postadoptive placement. Preadoptive adversity (indexed by age at placement, days in care, and number of adverse childhood experiences) was associated with higher internalizing and externalizing scores; the decrease in internalizing scores over childhood was accelerated for those exposed to lower levels of preadoptive risk. Warm adoptive parenting was associated with a marked reduction in children's internalizing and externalizing problems over time. Although potentially limited by shared methods variance and lack of variability in parental warmth scores, these findings demonstrate the deleterious impact of preadoptive risk and the positive role of exceptionally warm adoptive parenting on children's trajectories of mental health problems and have relevance for prevention and intervention strategies.
Physicians' attitudes and adoption behavior toward the delivery of prenatal tests take vital significance for its influence on their professional practice and patient acceptance. This study aimed to identify how physicians have perceived the diffusion of non-invasive prenatal testing (NIPT) in China.
A cross-sectional study was conducted from July 2016 to October 2016 in Shanghai, and Fujian and Sichuan Provinces in China. Physicians working on prenatal screening completed a self-report questionnaire. Following Roger's diffusion of innovation model, multivariable logistic regressions were performed separately for the following key elements of the theory which influence diffusion: physician-perceived attributes of NIPT, communication channels, the nature of the social system, the extent of change agent (who introduces innovations into a society), promotion efforts, and physicians' benefits from adopting NIPT.
Most specialists had a positive attitude (53.2 percent) toward NIPT, whereas 58.9 percent of physicians had already adopted NIPT in their clinical practice. Physician adoption of NIPT was positively associated with the strength of HTA evidence (p = .03), perceived communication frequency with colleagues (p = .04), adoption by other physicians (p = .07), hospital competition (p = .06), hospital teaching status (p = .02), perceived for-profit genetic testing company's promotion (p < .001), and perceived clinical practice skill improvement (p = .02). However, the adoption behavior toward NIPT may be negatively associated with physician-perceived ethical concerns of NIPT (p = .06).
Obstetricians and gynecologists’ positive perceptions facilitate the adoption of NIPT. Combined with cost-effectiveness analysis of prenatal screening methods, health policy makers can promote the adoption of appropriate, cost-effective prenatal screening in pregnant women.
Although alcohol use disorder (AUD) runs strongly within families, studies examining the impact of rearing environment, unconfounded by genetic effects, are rare and, to date, contradictory. We here seek to conduct such a study using an adoptive co-sib control design.
Defining high-risk as having ⩾1 biological parent with an externalizing syndrome (AUD, drug abuse or crime), we identified 1316 high-risk full-sibships and 4623 high-risk half-sibships containing at least one member who was home-reared and one who was adopted-away. Adoptive families are carefully screened in Sweden to provide high-quality rearing environment for adoptees. AUD was assessed from national medical, criminal and pharmacy registries.
Controlling for sex, parental age at birth, and, for half-siblings, affection status of the non-shared parent, hazard ratios (±95% CI) for AUD in the matched adopted v. home-reared full- and half-siblings were, respectively, 0.76 (0.65–0.89) and 0.77 (0.70–0.84). The protective effect of adoption on AUD risk was stronger in the full- and half-sibling pairs with very high familial liability (two high-risk parents) and significantly weaker when the adoptive family was broken by death or divorce or contained a high-risk adoptive parent.
In both full- and half-sibling pairs, we found evidence that the rearing environment substantially impacts on the risk for AUD. High-quality rearing environments can meaningfully reduce the risk for AUD, especially in those at high familial risk.
Définir et spécifier la psychopathologie de l’adolescent quand il a été adopté, au-delà de la question de l’abandon, est délicat et complexe. Prenant appui sur des apports théoriques et une situation clinique, nous insisterons sur ce qui, hors la question de « l’amplification fantasmatique » décrite par Michel Soulé (amplification fantasmatique concernant les réaménagements des liens parents–enfants propres à cet âge de la vie), donne une tonalité particulière à la situation d’abandon–adoption lors du processus d’adolescence. Outre, le niveau primitif/archaïque du lien charnel qui a été manquant, nous mettrons en relief les aspects paradoxaux des projections parentales en lien avec la « double » filiation, la question de l’abord de la sexualité par le jeune dans ce contexte (contexte dans lequel le jeu des identifications est rendu plus acrobatique), enfin la manière dont les soignants sont interpellés dans ces situations où pèse souvent une menace de rupture du lien parent-enfant, pourtant symboliquement institué.
Behavioral genetic research unequivocally supports the influence of both genetic and environmental factors on psychopathology risk. Decomposition of the sources of these influences has largely been carried out using twin and adoption studies. Building off the results of these studies, molecular genetic methodologies have come to dominate the field with the goal of identifying genetic variants that causally influence psychopathology risk. The chapter summarizes the logic of both quantitative and molecular genetic methods as well as their major findings as related to clinical psychology. Traditional and modern methods for estimating heritability based on familial relationships are described. From there the challenge of finding causal genetic variants in the context of polygenic phenotypes, including psychopathology, emerges. The chapter concludes by discussing the interaction between genes and the environment as well as future directions in the field, including rare variant analysis and epigenetics. An emphasis is placed on interpretation of results and limitations of past and current methodologies. Behavioral genetic research has produced strong results regarding the importance of genetic factors on psychopathology while also highlighting the influence of the environment. Uncovering the causal sources of these effects remains a young but active area of research.
Quantitative genetic research includes a range of genetically sensitive research designs that rely on family samples to study the relative importance of genes and environments for individual difference in psychopathology. The past decades have seen an increase in quantitative genetic research focused on the origins of childhood and adolescent psychopathology. Evidence from this research univocally demonstrates that genetic factors play an important role in all forms of psychopathology, and that these genetic factors interact with the environment to shape the development of childhood and adolescent psychopathology. The goal of this chapter is to highlight how recent methodological developments and the accumulation of longitudinal data now allow quantitative genetic research to go beyond asking “if” genetic factors are important, to instead address important questions regarding gene-environment interplay in the development of childhood and adolescent psychopathology. It begins by introducing the family, adoption, and twin designs, and summarizing the main findings from these methods for child and adolescent psychopathology. It then provides concrete examples of how multivariate and longitudinal quantitative genetic research designs can be used to address important questions regarding etiology across different levels of symptom severity, comorbidity, and development, and to study gene-environment interplay in child and adolescent psychopathology. It concludes by highlighting important outstanding questions in childhood psychopathology that need to be addressed in future quantitative genetic research.
Chapter 4 examines the area of adoption law. The chapter argues that, from a children’s rights perspective, there is no logical basis for refusing to allow same-sex couples to access joint adoption and further that the best interests of the child may in fact demand that such access is made available. The suitability of adoption as a means to secure existing family relationships (so called ‘second parent adoption’) is also considered.
Legal transplantation is a common, though contested, method of legal development, connecting sometimes disparate legal cultures. The incorporation, in 2000, of authors’ moral rights into Australian copyright law was one such transplantation. The present chapter discusses the process, asking whether moral rights themselves have been affected by the transplantation, what effect the transplantation has had or might have on Australian copyright law and whether the transplant can be called a success.
This book is written for academics, students, policymakers, practitioners, and non-governmental organisations interested in the legal recognition of LGBT+ parenting. The book presents arguments in favour of the legal recognition of gay and lesbian families that are based on consideration of the best interests of the child. In this context, 'best interests' is informed by reference to children's rights and to social science data. Applied in this manner, it is argued that the best interests of children can be used to demand that same-sex parenting arrangements are afforded legal recognition and protection. Suggestions are also presented as to the most appropriate manner of providing for this recognition in the areas of parental responsibility, adoption, donor-conception and surrogacy. These suggestions are drawn from comparative case studies, focusing on England and Wales, Ireland and South Africa, that are used to facilitate assessment of the best interests principle.
By portraying Jesus both as a son of David through Joseph and as virginally conceived, Matthew and Luke suggest that Joseph adopted Jesus into the Davidic line. Most modern interpreters assume that Joseph adopted Jesus through some Jewish law or custom. However, Yigal Levin has argued that adoption did not exist in Judaism and therefore the First and Third Evangelists must have appealed to Roman law (implying a gentile provenance for Matthew and Luke). This article reviews and critiques Levin's study and argues that early Jews did have a concept and practice of adoption and therefore an appeal to Roman law is unnecessary.
We designed, developed, and implemented a new hospital-based health technology assessment (HB-HTA) program called Smart Innovation. Smart Innovation is a decision framework that reviews and makes technology adoption decisions. Smart Innovation was meant to replace the fragmented and complex process of procurement and adoption decisions at our institution. Because use of new medical technologies accounts for approximately 50 percent of the growth in healthcare spending, hospitals and integrated delivery systems are working to develop better processes and methods to sharpen their approach to adoption and management of high cost medical innovations.
The program has streamlined the decision-making process and added a robust evidence review for new medical technologies, aiming to balance efficiency with rigorous evidence standards. To promote system-wide adoption, the program engaged a broad representation of leaders, physicians, and administrators to gain support.
To date, Smart Innovation has conducted eleven HB-HTAs and made clinician-led adoption decisions that have resulted in over $5 million dollars in cost avoidance. These are comprised of five laboratory tests, three software-assisted systems, two surgical devices, and one capital purchase.
Smart Innovation has achieved cost savings, avoided uncertain or low-value technologies, and assisted in the implementation of new technologies that have strong evidence. The keys to its success have been the program's collaborative and efficient decision-making systems, partnerships with clinicians, executive support, and proactive role with vendors.