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"Realist evaluation"

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https://www.readbyqxmd.com/read/28417517/evaluating-clinical-ethics-support-a-participatory-approach
#1
Suzanne Metselaar, Guy Widdershoven, Rouven Porz, Bert Molewijk
The current process towards formalization within evaluation research, in particular the use of pre-set standards and the focus on predefined outcomes, implies a shift of ownership from the people who are actually involved in real clinical ethics support services (CESS) in a specific context to external stakeholders who increasingly gain a say in what 'good CESS' should look like. The question is whether this does justice to the insights and needs of those who are directly involved in actual CESS practices, be it as receivers or providers...
May 2017: Bioethics
https://www.readbyqxmd.com/read/28411668/-realist-evaluation-for-implementation-research
#2
Cécile Marie Dupin
The realist approach to evaluation can be useful faced with the complexity of health interventions in populations. Implementation is the process by which these interventions are put into practice. Scientific realism can provide an important contribution to the development of programme theories through implementation research, and help to reveal the distal and proximal mechanisms of programmes aimed at combatting social inequalities in healthcare.
April 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/28394187/using-critical-realistic-evaluation-to-support-translation-of-research-into-clinical-practice
#3
Michelle C Swift, Marilyn Langevin, Alexander M Clark
A challenge that speech-language pathologists (SLPs) face is the translation of research into clinical practice. While randomised controlled trials (RCTs) are often touted as the "gold standard" of efficacy research, much valuable information is lost through the process; RCTs by nature are designed to wash out individual client factors and contexts that might influence the outcome in order to present the "true" impact of the intervention. However, in the area of behavioural interventions, the interaction of client factors and contexts with the treatment agent can substantially influence the outcome...
April 10, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28386432/calibration-with-confidence-a-principled-method-for-panel-assessment
#4
R S MacKay, R Kenna, R J Low, S Parker
Frequently, a set of objects has to be evaluated by a panel of assessors, but not every object is assessed by every assessor. A problem facing such panels is how to take into account different standards among panel members and varying levels of confidence in their scores. Here, a mathematically based algorithm is developed to calibrate the scores of such assessors, addressing both of these issues. The algorithm is based on the connectivity of the graph of assessors and objects evaluated, incorporating declared confidences as weights on its edges...
February 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28379088/realist-evaluation-of-faculty-development-for-medical-educators-what-works-for-whom-and-why-in-the-long-term
#5
Olanrewaju O Sorinola, Jill Thistlethwaite, David Davies, Ed Peile
PURPOSE: Realism is a perspective in which entities exist independently of being perceived or independently of our theories about them. The realist framework with its principle of explanatory causation was used for an in-depth exploration of faculty development (FD) since, despite the widespread investment in FD, the evidence that it enhances the effectiveness of teaching in the long-term is still limited. The study aimed to develop realist theories that explain the connections between contexts (C), mechanisms (M) and outcomes (O) to find out what works for whom and why in FD...
April 2017: Medical Teacher
https://www.readbyqxmd.com/read/28360249/understanding-the-acceptability-and-adherence-to-paediatric-antiretroviral-treatment-in-the-new-formulation-of-pellets-lpv-r-the-protocol-of-a-realist-evaluation
#6
Ariadna Nebot Giralt, Christiana Nöstlinger, Janice Lee, Olawale Salami, Marc Lallemant, Onyango Ouma, Isaac Nyamongo, Bruno Marchal
BACKGROUND: Improving access to paediatric HIV treatment requires both large-scale treatment programmes and medication that is adapted to infants and children's needs. The WHO recommends lopinavir/ritonavir as first-line antiretroviral therapy for all HIV-infected children younger than 3 years. There is currently little evidence on the acceptability of, and adherence to, a formulation of this combination treatment if given in the form of pellets. This protocol presents how we will carry a realist evaluation to assess the factors that contribute to the acceptability and adherence to the new pellets formulation in 3 hospitals in Kenya...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28351355/a-process-evaluation-plan-for-assessing-a-complex-community-based-maternal-health-intervention-in-ogun-state-nigeria
#7
Sumedha Sharma, Olalekan O Adetoro, Marianne Vidler, Sharla Drebit, Beth A Payne, David O Akeju, Akinmade Adepoju, Ebunoluwa Jaiyesimi, John Sotunsa, Zulfiqar A Bhutta, Laura A Magee, Peter von Dadelszen, Olukayode Dada
BACKGROUND: Despite increased investment in community-level maternal health interventions, process evaluations of such interventions are uncommon, and can be instrumental in understanding mediating factors leading to outcomes. In Nigeria, where an unacceptably number of maternal deaths occur (maternal mortality ratio of 814/100,000 livebirths), the Community Level Interventions for Pre-eclampsia (CLIP) study (NCT01911494) aimed to reduce maternal and neonatal mortality and morbidity with a complex intervention of five interrelated components...
March 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28288634/understanding-the-implementation-and-adoption-of-a-technological-intervention-to-improve-medication-safety-in-primary-care-a-realist-evaluation
#8
Mark Jeffries, Denham L Phipps, Rachel L Howard, Anthony J Avery, Sarah Rodgers, Darren M Ashcroft
BACKGROUND: Monitoring for potentially hazardous prescribing is increasingly important to improve medication safety. Healthcare information technology can be used to achieve this aim, for example by providing access to prescribing data through surveillance of patients' electronic health records. The aim of our study was to examine the implementation and adoption of an electronic medicines optimisation system that was intended to facilitate clinical audit in primary care by identifying patients at risk of an adverse drug event...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28280872/interventions-to-mitigate-the-effects-of-poverty-and-inequality-on-mental-health
#9
REVIEW
Kristian Wahlbeck, Johanna Cresswell-Smith, Peija Haaramo, Johannes Parkkonen
PURPOSE: To review psychosocial and policy interventions which mitigate the effects of poverty and inequality on mental health. METHODS: Systematic reviews, controlled trials and realist evaluations of the last 10 years are reviewed, without age or geographical restrictions. RESULTS: Effective psychosocial interventions on individual and family level, such as parenting support programmes, exist. The evidence for mental health impact of broader community-based interventions, e...
March 9, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/28270194/factors-associated-with-alcohol-reduction-in-harmful-and-hazardous-drinkers-following-alcohol-brief-intervention-in-scotland-a-qualitative-enquiry
#10
Jean M McQueen, Claire Ballinger, Tracey E Howe
BACKGROUND: Alcohol Brief Intervention (ABI) uses a motivational counselling approach to support individuals to reduce excessive alcohol consumption. There is growing evidence on ABI's use within various health care settings, although how they work and which components enhance success is largely unknown. This paper reports on the qualitative part of a mixed methods study. It explores enablers and barriers associated with alcohol reduction following an ABI. It focuses on alcohol's place within participants' lives and their personal perspectives on reducing consumption...
March 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28260412/the-work-is-never-ending-uncovering-teamwork-sustainability-using-realistic-evaluation
#11
Mandus Frykman, Ulrica von Thiele Schwarz, Åsa Muntlin Athlin, Henna Hasson, Pamela Mazzocato
Purpose The purpose of this paper is to uncover the mechanisms influencing the sustainability of behavior changes following the implementation of teamwork. Design/methodology/approach Realistic evaluation was combined with a framework (DCOM®) based on applied behavior analysis to study the sustainability of behavior changes two and a half years after the initial implementation of teamwork at an emergency department. The DCOM® framework was used to categorize the mechanisms of behavior change interventions (BCIs) into the four categories of direction, competence, opportunity, and motivation...
March 20, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28242168/monte-carlo-simulation-of-air-sampling-methods-for-the-measurement-of-radon-decay-products
#12
Octavian Sima, Aurelian Luca, Maria Sahagia
A stochastic model of the processes involved in the measurement of the activity of the (222)Rn decay products was developed. The distributions of the relevant factors, including air sampling and radionuclide collection, are propagated using Monte Carlo simulation to the final distribution of the measurement results. The uncertainties of the (222)Rn decay products concentrations in the air are realistically evaluated.
February 21, 2017: Applied Radiation and Isotopes
https://www.readbyqxmd.com/read/28237962/realist-evaluation-of-intersectoral-oral-health-promotion-interventions-for-schoolchildren-living-in-rural-andean-communities-a-research-protocol
#13
Dave A Bergeron, Lise R Talbot, Isabelle Gaboury
BACKGROUND: Intersectoral collaboration, known to promote more sustainable change within communities, will be examined in an oral health promotion program (OHPP). In Peru, an OHPP was implemented by the Ministry of Health, to reduce the incidence of caries in schoolchildren. In rural Andean communities, however, these initiatives achieved limited success. The objectives of this project are: (1) to understand the context and the underlying mechanisms associated with Peruvian OHPP's current effects among school children living in rural Andean communities and (2) to validate a theory explaining how and under which circumstances OHP intersectoral interventions on schoolchildren living in rural Andean communities produce their effects...
February 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28191618/ecotoxicological-bioassays-of-sediment-leachates-in-a-river-bed-flanked-by-decommissioned-pesticide-plants-in-nantong-city-east-china
#14
Yan Zhou, Fenghe Wang, Jinzhong Wan, Jian He, Qun Li, Qiang Chen, Jay Gao, Yusuo Lin, Shengtian Zhang
Traditionally, the toxicity of river contaminants is analyzed chemically or physically through river bed sediments. The biotoxicity of polluted sediment leachates has not caught our attention. This study aims to overcome this deficiency through a battery of biotests which were conducted to monitor comprehensive toxicity of sediment leachates for the Yaogang River in East Jiangsu Province of China, which is in close proximity to former pesticide plants. The general physical and chemical parameters of major pollutants were analyzed from river bed sediments collected at five strategic locations...
February 13, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28188349/on-line-dynamic-extraction-system-hyphenated-to-inductively-coupled-plasma-optical-emission-spectrometry-for-automatic-determination-of-oral-bioaccessible-trace-metal-fractions-in-airborne-particulate-matter
#15
Victoria Mohr, Manuel Miró, Andreas Limbeck
For a realistic evaluation of the potential hazard emanating from airborne particulate matter (APM), the determination of the total inhaled metal amounts associated with APM is insufficient in risk assessment. Additional information about metal fractions that can be mobilized by the human body is necessary, because only those soluble (also called bioaccessible) fractions can be absorbed by the human body, and thus potentially cause adverse health effects. In the present study, a dynamic flow-through approach as a front end to inductively coupled plasma optical emission spectrometry (ICP-OES) exploiting advanced flow analysis is employed for on-line handling of multiple APM samples and determination of bioaccessible trace metals under worst case extraction scenarios...
February 10, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/28179417/green-shoots-of-recovery-a-realist-evaluation-of-a-team-to-support-change-in-general-practice
#16
Maggie Bartlett, Ruth Basten, Robert K McKinley
OBJECTIVE: A multidisciplinary support team for general practice was established in April 2014 by a local National Health Service (NHS) England management team. This work evaluates the team's effectiveness in supporting and promoting change in its first 2 years, using realist methodology. SETTING: Primary care in one area of England. PARTICIPANTS: Semistructured interviews were conducted with staff from 14 practices, 3 key senior NHS England personnel and 5 members of the support team...
February 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28129004/interprofessional-education-in-a-student-led-emergency-department-a-realist-evaluation
#17
Anne Ericson, Susanne Löfgren, Gunilla Bolinder, Scott Reeves, Simon Kitto, Italo Masiello
This article reports a realist evaluation undertaken to identify factors that facilitated or hindered the successful implementation of interprofessional clinical training for undergraduate students in an emergency department. A realist evaluation provides a framework for understanding how the context and underlying mechanisms affect the outcome patterns of an intervention. The researchers gathered both qualitative and quantitative data from internal documents, semi-structured interviews, observations, and questionnaires to study what worked, for whom, and under what circumstances in this specific interprofessional setting...
January 27, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28107137/interprofessional-education-in-an-orthodontic-outreach-training-centre
#18
Richard Cure
Interprofessional education (IPE) describes those occasions when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. In the UK, orthodontic treatment is now delivered by a highly skilled team. Historically, education and training for orthodontic team members has been delivered 'uniprofessionally' in secondary care hospital settings, despite 96% of dental care, including orthodontics, being delivered in primary care. This paper describes an evaluation of IPE in Leamington Spa Orthodontics (LSO), a University-approved, primary care outreach training centre, where all members of the orthodontic team deliver patient care and are educated together in an IPE environment...
November 1, 2016: Primary Dental Journal
https://www.readbyqxmd.com/read/28077414/implementation-of-a-consumer-focused-ehealth-intervention-for-people-with-moderate-to-high-cardiovascular-disease-risk-protocol-for-a-mixed-methods-process-evaluation
#19
Genevieve M Coorey, Lis Neubeck, Timothy Usherwood, David Peiris, Sharon Parker, Annie Y S Lau, Clara Chow, Kathryn Panaretto, Mark Harris, Nicholas Zwar, Julie Redfern
INTRODUCTION: Technology-mediated strategies have potential to engage patients in modifying unhealthy behaviour and improving medication adherence to reduce morbidity and mortality from cardiovascular disease (CVD). Furthermore, electronic tools offer a medium by which consumers can more actively navigate personal healthcare information. Understanding how, why and among whom such strategies have an effect can help determine the requirements for implementing them at a scale. This paper aims to detail a process evaluation that will (1) assess implementation fidelity of a multicomponent eHealth intervention; (2) determine its effective features; (3) explore contextual factors influencing and maintaining user engagement; and (4) describe barriers, facilitators, preferences and acceptability of such interventions...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28069627/what-aspects-of-intentional-rounding-work-in-hospital-wards-for-whom-and-in-what-circumstances-a-realist-evaluation-protocol
#20
Ruth Harris, Sarah Sims, Ros Levenson, Stephen Gourlay, Fiona Ross Cbe, Nigel Davies, Sally Brearley, Giampiero Favato, Robert Grant
INTRODUCTION: Intentional rounding (IR) is a structured process whereby nurses in hospitals carry out regular checks, usually hourly, with individual patients using a standardised protocol to address issues of positioning, pain, personal needs and placement of items. The widespread implementation of IR across the UK has been driven by the recommendations of the Francis Inquiry although empirical evidence of its effectiveness is poor. This paper presents a protocol of a multimethod study using a realist evaluation approach to investigate the impact and effectiveness of IR in hospital wards on the organisation, delivery and experience of care from the perspective of patients, their family members and staff...
January 9, 2017: BMJ Open
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