Motorcycle safety research project interim report 2 : review of the Consistent Assessment Process (CAP)

Motorcycle trauma is a serious road safety issue in Queensland and throughout Australia. In 2009, Queensland Transport (later Transport and Main Roads or TMR) appointed CARRS-Q to provide a three-year program of Road Safety Research Services for Motorcycle Rider Safety. Funding for this research originated from the Motor Accident Insurance Commission. This program of research was undertaken to produce knowledge to assist TMR to improve motorcycle safety by further strengthening the licensing and training system to make learner riders safer by developing a pre-learner package (Deliverable 1), and by evaluating the Q-Ride CAP program to ensure that it is maximally effective and contributes to the best possible training for new riders (Deliverable 2), which is the focus of this report. Deliverable 3 of the program identified potential new licensing components that will reduce the incidence of risky riding and improve higher-order cognitive skills in new riders. This report provides a summary of Deliverables 2.1 through to 2.4

Building the System: Follow-up, monitoring & adaptive management

Does impact assessment (IA) end when the license has been granted? While societal resources tend to focus on rigorous project approvals, what happens to the project, to the public and to the environment once approval is granted? Follow up and monitoring are often an afterthought for legislators, public servants and proponents. But they are critical to public confidence and to ensuring that proponents live up to their commitments in a rapidly changing world."This report draws from research funded by the Impact Assessment Agency as part of the Social Sciences and Humanities Research Council of Canada Knowledge Mobilization Grant on Informing Best Practice in Environmental and Impact Assessment.

A review of interventions used to improve adherence with medication in older

Background: Medication mismanagement is a continuous problem particularly in older people. Numerous interventions have been developed and tested in an attempt to improve adherence with medication in this client group. Objectives: This review aimed to examine the simple to complex interventions that have been used to assess and improve adherence with medication in older people. Design: An extensive review of the literature was performed and 20 relevant research papers and one report were chosen. Findings: Research papers were evaluated according to design, RCTs were analysed using the JADAD scoring system, systematic reviews and reviews of the literature were reviewed using the Critical Appraisal Skills Programme and subjected to a narrative analysis. This process assisted the development to emerging themes. Four themes were developed: patient barriers, health professional involvement, and health related outcomes and formation giving. Conclusions: The salient findings of the review infer that there is no clear definition of non–adherent behavior. Quantitative interventions fail to assess patient choice in relation to medication taking. Pharmacist-driven interventions are resource intensive. Health care outcomes and clinical effectiveness are seldom addressed in interventions. Among the many difficulties encountered when attempting to use interventions to promote adherence with medication in older people is their perceptions and beliefs, the appropriateness of the medicines prescribed as well as the impact of lifestyle patterns; smoking, alcohol and diet. Many intervention studies are of poor quality and do not include a theoretical framework to underpin the interventions being used. More focused research is needed to improve understanding of the theoretical knowledge that underpins the complexities of adherence with medication in older people. In-depth qualitative studies can be used to develop such theory. In addition, the quality of intervention research can be improved by the inclusion of a research framework such as the Medical Research Council model

Sustainability Assessment Methods for the Gulf Region

This paper describes the development of a sustainability assessment framework designed to be used in the Gulf Region, which is an area which has experienced large scale building development and also a region in which sustainability assessment is not yet widely used. The complexity and time resources needed to apply existing methods act as a deterrent to active use. Three well-known methods available at the time of the study were investigated in some detail. These were: BREEAM Gulf; Green Building Council LEED; and Estidama Pearl. Cross comparisons of the factors involved in each method were carried out on several levels including: theoretical comparison; practical development and usability; compliance with regulations and standards; and ability to achieve synchronization. A considerable degree of compatibility was found to exist between the methods, particularly if focused on key criteria. As a result a new and specific framework was developed which grouped 24 indicators under five principal headings: site/location, biodiversity and accessibility; energy; water; occupant well-being; and resources and wastes. This new framework was then evaluated by testing with practitioners resulting in confirmation of 20 out of the 24 indicators, and identification of suitable benchmarks

Applying thematic synthesis to interpretation and commentary in epidemiological studies: identifying what contributes to successful interventions to promote hand hygiene in patient care

Objectives: Hand hygiene is considered the most important preventive measure for healthcare associated infections, but adherence is suboptimal. We previously undertook a Cochrane Review which demonstrated that interventions to improve adherence are moderately effective. Impact varied between organisations and sites with the same intervention and implementation approaches. This study seeks to explore these differences. Methods: A thematic synthesis was applied to the original authors’ interpretation and commentary that offered explanations of how hand hygiene interventions exerted their effects and suggested reasons why success varied. The synthesis used a published Cochrane Review followed by three-stage synthesis. Results: Twenty-one papers were reviewed: eleven randomised, one non-randomised and nine interrupted time series studies. Thirteen descriptive themes were identified. They reflected a range of factors perceived to influence effectiveness. Descriptive themes were synthesised into three analytical themes: Methodological Explanations for failure or success (e.g. Hawthorne Effect); and two related themes that address issues with implementing hand hygiene interventions: Successful implementation needs leadership and cooperation throughout the organisation (e.g. visible managerial support); and Understanding the context and aligning the intervention with it drives implementation (e.g. embedding the intervention into wider patient safety initiatives). Conclusions: The analytical themes help to explain the original authors’ perceptions of the degree to which interventions were effective and suggested new directions for research: exploring ways to avoid the Hawthorne effect; exploring the impact of components of multimodal interventions; the use of theoretical frameworks for behaviour change; potential to embed interventions into wider patient safety initiatives; adaptations to demonstrate sustainability; and the development of systematic approaches to implementation. Our findings corroborate studies exploring the success or failure of other clinical interventions: context and leadership are important

Interventions to improve healthcare workers’ hand hygiene compliance: a systematic review of systematic reviews

Objective: To synthesize the existing evidence base of systematic reviews of interventions to improve healthcare worker (HCW) hand hygiene compliance (HHC). Methods: PRISMA guidelines were followed, and 10 information sources were searched in September 2017, with no limits to language or date of publication, and papers were screened against inclusion criteria for relevance. Data were extracted and risk of bias was assessed. Results: Overall, 19 systematic reviews (n=20 articles) were included. Only 1 article had a low risk of bias. Moreover, 15 systematic reviews showed positive effects of interventions on HCW HHC, whereas 3 reviews evaluating monitoring technology did not. Findings regarding whether multimodal rather than single interventions are preferable were inconclusive. Targeting social influence, attitude, self-efficacy, and intention were associated with greater effectiveness. No clear link emerged between how educational interventions were delivered and effectiveness. Conclusions: This is the first systematic review of systematic reviews of interventions to improve HCW HHC. The evidence is sufficient to recommend the implementation of interventions to improve HCW HHC (except for monitoring technology), but it is insufficient to make specific recommendations regarding the content or how the content should be delivered. Future research should rigorously apply behavior change theory, and recommendations should be clearly described with respect to intervention content and how it is delivered. Such recommendations should be tested for longer terms using stronger study designs with clearly defined outcomes

Evaluation Framework for Water Quality Trading Programs in the Chesapeake Bay Watershed

Water quality trading programs are being proposed and implemented across the US in a variety of forms and with differing objectives. The programs being proposed and implemented in the Chesapeake Bay region are no exception. Against this background the Chesapeake Bay Program's Scientific and Technical Advisory Committee and the Mid-Atlantic Water Program requested a general framework to inform and guide the evaluation of the performance trading programs. This resulting report was developed by a workgroup comprised of ten individuals with extensive experience in the study, design, and evaluation of trading programs. While the impetus for this report was to improve evaluation of trading programs in the Chesapeake Bay region, the evaluation framework is broad enough to apply to trading programs in general