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But shortly thereafter it said that, rather than cease whaling, it would modify the programme to address the court's concerns and continue whaling in the sanctuary surrounding Antarctica.
The feasibility study provided an opportunity to refine and modify the programme and yielded important information on acceptability and feasibility of the intervention and measurements required for assessing outcomes in a definitive RCT.
The intention in this study was to implement the same '11 for Health' programme in both Mauritius and Zimbabwe; however, experience gained from this study indicated that in future interventions it would be beneficial to modify the programme content to match the major health concerns in individual countries.
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Wisely, instead of "shooting the messenger"—that is, the independent evaluators— the government took on board the findings from the first phase of impact evaluation, modified the programme, focusing more on quality child care and parent support via Children's Centres, and the change seems to be yielding benefits.
It was introduced in 1987, and a number of laws, decrees and bylaws have modified the programme since.8 What follows is a reconstruction of the structure of the programme at the time that the graduates in the GTS data were observed - based on conversations with relevant parties, the available legal documents, as well as descriptions of the programme on official websites and in government reports.
When generalising this programme to another context, the IM procedure can be applied to modify the existing programme.
These challenges may have expedited the decision to modify the TB programme.
The clinical challenge was to identify and address any possible factors that may have contributed to the recurrences, and to review and modify the rehabilitation programme accordingly.
Some felt the benefits of exercise had to be more strongly emphasised in addition to the benefits of standing more/sitting less and, again, this feedback was used to modify the education programme.
Instructions to carry out exercises for 5-10 minutwicewice daily for 12 weeks, or until symptoms resolve 3) Instructions given on how to monitor progress (using the weekly self test) and modify the exercise programme as appropriate.
58 59 The full meaning of kaizen the widely used mantra in improvement, that 'every defect is a treasure' becomes particularly apparent when an improvement intervention stalls, or creates as many problems as it solves, because these frustrations call for the creative use of formal and informal concepts to modify the prior programme theory (box 2).
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com