Adherence is defined as the extent to which a patient acts in accordance with the prescribed interval and dose of a dosing regimen, and is operationalized, in a retrospective assessment, as the number of doses dispensed in relation to the dispensing period, often called the "medication possession ratio (MPR)" [ 12, 17- 19].
However, our results suggest that even a more elaborate chart stamp, which prompts providers to refer and prescribe, may not be adequate to trigger clinician action without an accompanying referral system in place that is fully operationalized (i.e. staff training, technical assistance, staff roles defined in relation to the referral system, faxing process in place).
In relation to the second reason, i.e. 'attitude' is a hypothetical construct which is difficult to operationalize and measure, we believe it is important to apply the general theoretical frameworks of this construct in social psychology to the needs of a particular research situation (see also Fan & Ji, [2014]).
The reproducibility of the findings in relation to the frailty index is of some interest because none of the samples in which the frailty index has been operationalized has considered the same deficits.
In relation to the previous step, RAVE.
Further, the team would be well served to have literature review and other research skills, and be able to provide practical guidance in relation to operationalizing the economic principles outlined above.
To illustrate this, as well as to operationalize these indicators in relation to a continuum of participation, we have in Table 1 applied the principles of spider-grams to the CHPS programme.
Another limitation could be in relation to how we operationalized the definitions of MSMO and MSMW in this paper.
Team performance evaluation can be defined as, "the application of standard diagnostic measurement tools to assess the behaviors, cognitions and attitudes enacted by team members in relation to clearly operationalized criteria" [ 15].
The learning typology and measurement method operationalized in this research advances previous treatments of learning in relation to participatory decision-making processes, and supports adaptive co-management as a governance strategy that fosters learning and adaptive capacity.
