The intersection of these avenues suggests that sustainable systems change requires small-scale practice change, mid-level organizational change, and large-scale policy change.
Big ideas and the small-scale practices need to be integrated so that teachers can become thinkers themselves, curriculum creators, concerned counselors, and school leaders, rather than just people who follow scripts and hand out punishments and rewards.
Within a primary care context, trust-based collaboration approaches from the bottom-up are considered essential for stimulating the integration of different services [ 8, 10, 11] because they have traditionally been delivered by professionally-owned, disjointed, small-scale practices [ 23].
The main objective of the microfinance program has been to improve three dimensions of health care service provision and, subsequently, the viability and sustainability of the small-scale practices of private health care providers who received one or more loans.
While covering glaciers with plastic sheeting may prove advantageous to ski resorts on a small scale, this practice is not expected to be economically practical on a much larger scale.
Although mining operations are small scale, the practice of gold mining takes a toll on the forested regions because deep mining pits are often dug near or underneath large trees, disturbing the extensive root systems and ultimately killing the trees in the area.
Some household's practice small scale surface irrigation via micro dams and hand dug well water sources.
However, relatively small scale changes in agricultural practices may lead to a more functionally complex AMF community, potentially with the benefit of increasing productivity (Fig. 3).
Most of the student projects were limited in scope, which was a deliberate approach based on evidence [ 26, 27] that individuals need to slowly build their research capacity by starting off with small scale studies investigating useful, practice-based problems to gain the experience and confidence to successfully continue with future research projects.
Meanwhile, the newly added Square -based mobile payments feature is targeting the smaller scale doctors' practices (one to ten doctors).
