Practical Recommendations For Implementation Research Articles

Give the Neurological Impress Method Another Chance for One-to-One Fluency Interventions

Students who do not show growth from whole class (Tier 1) and small group (Tier 2) reading fluency interventions, may require one-on-one interventions that are designed to support the development of fluent oral reading. The authors of this article reintroduce the Neurological Impress Method (NIM) and provide a research-based protocol and practical recommendations for implementation. Existing research on the NIM provides evidence for giving it another chance for one-on-one reading fluency interventions.

Validation by citizens of the Catalan model of advance care planning

Introduction : Although in our cultural context death and end of life are still taboos, clinical approaches based on shared decision-making and person-centered care are emerging. Advance care planning (ACP) is a core example of these new approaches that mainly rely on knowledge and respect for the autonomy of patients. Respect for autonomy involves the active participation of the person in the caring process, being essential for professionals to apply the person-centered model to know in advance the values and preferences of patients and their families regarding their health problems and the way decisions will be taken, mainly in situations of advanced disease or when the patient can not decide for him o herself. These arguments justify the need to develop an ACP model to suit individual needs and, at the same time, to integrate the social and health components of each clinical stage. The basis of ACP is the recognition and respect for the autonomy of the other, encouraging the participation of persons in the management of their own existence and the creation of their own life plan. In this context, we still don’t have enough information about Catalan population`s experience and perspective on ACP. Objectives : Identify the perspectives, values and experiences of citizens related to ACP. Integrate the inputs from citizenship in order to validate both the conceptual framework as well as the practical guide of the Catalan model of ACP. Provide practical recommendations for the implementation of the ACP model in real practice. Object population : Persons older than 18 years living in Catalonia, of both genders, from rural and urban areas, with an appropriate distribution regarding levels of education and health status (healthy, non complex chronicity, complex chronicity, advanced disease and caregivers) that agreed to participate. A theoretical sampling seeking the maximum discoursing variability was selected. Recruitment of participants was from January to December 2015. Involved interested main ones : Catalan Ministry of Health, citizenship, patients, caregivers, social and health professionals. Method : Design: socio-constructivist qualitative study Data collection: eight focus groups from eight to twelve participants. Data analysis: successive readings of transcriptions (systematic, literal and anonymous), followed by a discourse analysis: formulation of pre-analytic intuitions, discoursing positions and fractions, textual overall interpretation (symbolic configurations), internalistic analysis searching the semantic attractors and the associative chains (semantic configurations). Aids to the research : Formal research grant from the College of Nurses of Barcelona. Impact : This qualitative approach is useful to provide: - Generation of new knowledge about citizenship’s position. - Integration of groups’ contributions on the conceptual framework. - Practical recommendations for implementation, adapted to the continuum of chronicity. - Encouragement of good practices in the clinical management of advanced disease and palliative needs, improving the experience of care for patients and their families. Conclusions : Although the complete results of the qualitative analysis will be available in April 2015, preliminary information shows its feasibility to identify the perspectives, values and experiences of the citizenship regarding ACP process and use them in the validation of both the ACP Catalan model’s conceptual frame as well as its practical guide. As a consequence, we’ll be able to compile useful recommendations for ACP implementation as a paradigmatic example of integrated person-centered good practices and of the collaborative work between patients and professionals.

Emergency radiology and mass casualty incidents-report of a mass casualty incident at a level 1 trauma center.

The aims of this article are to describe the events of a recent mass casualty incident (MCI) at our level 1 trauma center and to describe the radiology response to the event. We also describe the findings and recommendations of our radiology department after-action review. An MCI activation was triggered after an amphibious military vehicle, repurposed for tourist activities, carrying 37 passengers, collided with a charter bus carrying 45 passengers on a busy highway bridge in Seattle, WA, USA. There were 4 deaths at the scene, and 51 patients were transferred to local hospitals following prehospital scene triage. Nineteen patients were transferred to our level 1 trauma center. Eighteen casualties arrived within 72 min. Sixteen arrived within 1 h of the first patient arrival, and 1 casualty was transferred 3 h later having initially been assessed at another hospital. Eighteen casualties (94.7 %) underwent diagnostic imaging in the emergency department. Of these 18 casualties, 15 had a trauma series (portable chest x-ray and x-ray of pelvis). Whole-body trauma computed tomography scans (WBCT) were performed on 15 casualties (78.9 %), 12 were immediate and performed during the initial active phase of the MCI, and 3 WBCTs were delayed. The initial 12 WBCTs were completed in 101 min. The mean number of radiographic studies performed per patient was 3 (range 1-8), and the total number of injuries detected was 88. The surge in imaging requirements during an MCI can be significant and exceed normal operating capacity. This report of our radiology experience during a recent MCI and subsequent after-action review serves to provide an example of how radiology capacity and workflow functioned during an MCI, in order to provide emergency radiologists and response planners with practical recommendations for implementation in the event of a future MCI.

An Evaluation of Streaming Algorithms for Distinct Counting Over a Sliding Window

Counting the number of distinct elements in a data stream (``distinct counting'') is a fundamental aggregation task in database query processing, query optimization and network monitoring. On a stream of elements, it is commonly needed to compute an aggregate over only the most recent elements, leading to the problem of distinct counting over a ``sliding window'' of the stream. We present a detailed experimental study of the performance of different algorithms for distinct counting over a sliding window. We observe that the performance of an algorithm depends on the basic method used, as well as aspects such as the hash function, the mix of query and updates, and the method used to boost accuracy. We compare the performance of prominent algorithms, and evaluate the influence of these factors, leading to practical recommendations for implementation. To the best of our knowledge, this is the first detailed experimental study of distinct counting over a sliding window.

Best practices for genetic resources associated with natural history collections: Recommendations for practical implementation

Researchers associated with natural history museums have made the collection of genetic resources a priority due to their importance in molecular studies, but often the long-term curation of these collections is difficult due to decentralized curation over multiple storage locations and lack of community best practice guidelines for their stewardship. Unlike traditional natural history specimens, the research utility of genetic samples increases with lower storage temperatures and fewer freeze–thaw events and, in addition, their use is consumptive. Collection managers must, therefore, maximize the research potential of each sample by carefully considering use on a case-by-case basis. This paper presents standardized guidelines accumulated for the management of genetic collections associated with natural history collections. These recommended practices are informed by general standards for biorepositories and augmented by information unique to natural history collections with the goal of providing a foundation for those curating genetic samples. Information pertains to all aspects of genetic sample curation and will assist those in making decisions regarding how to collect, store, track, process, and distribute genetic specimen samples. These guidelines also will allow users to make informed decisions regarding how to apply and improve the curation of their collection given their institution's goals and available resources.

PaTz groups for primary palliative care: reinventing cooperation between general practitioners and district nurses in palliative care: an evaluation study combining data from focus groups and a questionnaire

BackgroundPaTz (an acronym for ‘PAlliatieve Thuis Zorg’; palliative care at home) is an intervention to improve palliative care provision and strengthen the generalist knowledge of palliative care. In PaTz general practitioners and district nurses meet on a regular basis to identify patients with palliative care needs and to discuss care for these patients. This study explores experiences with regard to collaboration between general practitioners and district nurses, and perceived benefits of and barriers for implementation of PaTz.MethodsThis study is conducted within the primary care setting. Participants were 24 general practitioners who filled in a questionnaire, and seven general practitioners, five district nurses and two palliative care consultants who attended one of two focus groups.ResultsPaTz led to improved collaboration. Participants felt informational and emotional support from other PaTz participants. Also they felt that continuity of care was enhanced by PaTz. Practical recommendations for implementation were: meetings every 6 to 8 weeks, regular attendance from both general practitioners and district nurses, presence of a palliative care consultant, and a strong chairman.ConclusionsPaTz is successful in enhancing collaboration in primary palliative care and easy to implement. Participants felt it improved continuity of care and knowledge on palliative care. Further research is needed to investigate whether patient and carer outcomes improve.

Best practices for genetic resources associated with natural history collections: Recommendations for practical implementation

Abstract Researchers associated with natural history museums have made the collection of genetic resources a priority due to their importance in molecular studies, but often the long-term curation of these collections is difficult due to decentralized curation over multiple storage locations and lack of community best practice guidelines for their stewardship. Unlike traditional natural history specimens, the research utility of genetic samples increases with lower storage temperatures and fewer freeze–thaw events and, in addition, their use is consumptive. Collection managers must, therefore, maximize the research potential of each sample by carefully considering use on a case-by-case basis. This paper presents standardized guidelines accumulated for the management of genetic collections associated with natural history collections. These recommended practices are informed by general standards for biorepositories and augmented by information unique to natural history collections with the goal of providing a foundation for those curating genetic samples. Information pertains to all aspects of genetic sample curation and will assist those in making decisions regarding how to collect, store, track, process, and distribute genetic specimen samples. These guidelines also will allow users to make informed decisions regarding how to apply and improve the curation of their collection given their institution's goals and available resources.

The impact of data transformations on concentration–response modeling

Concentration–response studies are performed to investigate the potency of the substance under investigation. Data are typically evaluated using non-linear regression. A common model is the log-logistic model which includes parameters for lower and upper boundary of mean response, EC50 and Hill slope. Often, response and/or concentration data are transformed before proceeding with the analysis of their relationship. This is motivated by practical reasons, including comparability of results across different assays. We prove mathematically that a linear transformation of data will not change the EC50 and Hill slope estimates and only results in an identical transformation of the estimated parameters for lower and upper boundary of mean response. However, fixing some of the parameters may lead to erroneous estimates. This is of practical relevance when data are corrected for background signal and normalized by background corrected solvent control and a reduced model is used in which the response range is fixed between 100% and 0%. Computer simulations and a real data example are used to illustrate the impact of data transformations on parameter estimation. We further shed light on some common problems arising in the analysis of concentration–response data. Recommendations for practical implementation in concentration–response analysis are provided.

(P2-90) Modified Delphi Study to Determine Optimal Data Elements for Inclusion in an Emergency Management Database System

TopicInformation and communication technology (ICT).ObjectivesICT are introduced into organizations with the goals of managing resources, increasing efficiency and work productivity and reducing workload. In the context of developing countries, these goals are accentuated given the existing conditions. The aim of this study was to identify hospital institutional capacity indicators to provide recommendations to an emergency management database system operating in the Western Cape province of South Africa as http://hospitalbedbureau.co.za/.MethodologyA two round modified Expert Delphi study was conducted by email. A panel of 16 experts drawn from the fields of emergency medicine, critical care, trauma surgery and disaster medicine were consulted. Participants were initially asked to propose hospital institutional capacity indicators that warranted inclusion in the emergency management database system currently operating in Cape Town, South Africa. In the second round these proposals were collated and scored using a 7 point Likert scale. Areas that did not reach consensus in the Delphi study will be presented as synopsis statements for discussion at the Emergency Medicine Symposium hosted by the department of Accident and Emergency Western Cape.ResultsRound 1 comprised 237 statements. Consensus was defined a priori to be > 80%. A total of 52 of 237 statements had reached consensus upon completion of the Delphi study. This represented 21.9% of the total number of statements. Of these 20 reached consensus at > 90% and 32 reached consensus at > 80%.ConclusionThe use of a Delphi study achieved consensus in aspects of hospital institutional capacity that can be translated into practical recommendations for implementation by the local emergency management database system. Additionally, areas of non-consensus have been identified where further work is required.

Environmental Kuznetz Curve: Evidence from Transition Economies

In spite of natural anomalies of the recent years and even the practical measures undertaken to limit the climate change impact on the economic development (signing and ratification of Kyoto Protocol by many countries) the problem of relationship between economic growth and environmental quality remains one of the most debatable in modern economics not only in theory but in working out of practical recommendations for implementation of economic policy as well.

An optical system and technique for position testing of segments of the compound parabolic mirror of the radio telescope of the millimetron space observatory

An optical system and technique for position testing of segments of the compound parabolic mirror of the telescope of the Millimetron space observatory are proposed. Results of an analysis of the testing precision assured by the proposed technique are presented and recommendations for practical implementation of the technique are given.

Research on blood circulation system identifiability

The problem of identifiability by periodic-motion measurements is formulated and solved by a simplest two-circuit mathematical model of blood circulation system. By computeraided symbolic mathematics, the initial point of periodic motion is computed and properties of this motion are studied. The measuring system, which makes enables solving the problem of blood circulation system parametric identification unambiguously, is mathematically strictly defined. Recommendations for practical implementation of this measuring system are given.

Hydrolysis of aluminum sulfates in the presence of ammonium sulfite

Hydrolysis of aluminum sulfate and potash alum in the presence of an ammonium sulfite additive in the temperature range T boil-200°C was studied. A possible reaction mechanism was suggested. The composition and structure of the precipitates formed were determined and certain differences in their morphology were noted. Recommendations for practical implementation of the method of hydrolytic recovery of aluminum from solutions of its sulfate salts were given.

Re-engineering the University

Re-engineering the university describes an attempt to introduce network-based learning on an institution-wide scale in a UK university. It covers the background leading up to the high level, strategic decision to develop an e-Campus, the rationale for this initiative, the development methodology and the outcomes. It goes on to review the lessons learned, with recommendations for practical implementation of such projects by others.

Rubberized Portland Cement Concrete

The use of recycled tire rubber in a portland cement concrete (PCC) mixture is investigated as a possible alternative for nonconventional PCC mixtures. This study is focused on the determination of the practicality of producing such mixes and evaluating their engineering properties. An experimental program was developed to use two types of tire rubber (fine crumb rubber and coarse tire chips) in PCC mixtures. A control PCC mix is designed using American Concrete Institute mix design methods, and three groups of rubberized PCC mixes were developed by partially replacing the aggregate with rubber. Eight tire rubber contents were used in each group. Mixes were tested in compressive and flexural strength in accordance to ASTM standards. Results show that rubberized PCC mixes can be made and are workable to a certain degree with the tire rubber content being as much as 57% of the total aggregate volume. However, strength results show that large reductions in strength would prohibit the use of such a high rubber content. It is suggested that rubber contents should not exceed 20% of the total aggregate volume. A characteristic function that quantifies the reduction in strength for rubberized concrete mixes was developed that could be useful for mix design purposes. Rubberized concrete mixes may be suitable for nonstructural purposes such as lightweight concrete walls, building facades, and architectural units. They could also be used as cement aggregate bases under flexible pavements. Fire hazards are of major concern and need to be thoroughly investigated before recommendations for practical implementation are drawn.

Regression Models For Evaluating Liquefaction Probability

Statistical models are developed to express the probability of liquefaction as a function of earthquake load and soil resistance parameters. Results are obtained based on a catalog compiled for this study, which consists of 278 cases of liquefaction/nonliquefaction occurrences. A method of binary regression is used to derive four models recommended for use in assessment of liquefaction probability. Two of them use the cyclic stress ratio (Seed and Idriss 1971) as the earthquake load parameter; the other two use, as load parameters, explicit functions of earthquake magnitude and distance, similar to the function proposed by Davis and Berrill (1981). All four models measure liquefaction resistance through the corrected/normalized SPT (N1)60 value. Recommendations for practical implementation are provided, and comparisons are made with other methods of liquefaction analysis.