Improving the normalization of complex interventions: measure development based on normalization process theory (NoMAD): study protocol

<b>Background</b> Understanding implementation processes is key to ensuring that complex interventions in healthcare are taken up in practice and thus maximize intended benefits for service provision and (ultimately) care to patients. Normalization Process Theory (NPT) provides a framework for understanding how a new intervention becomes part of normal practice. This study aims to develop and validate simple generic tools derived from NPT, to be used to improve the implementation of complex healthcare interventions.<p></p> <b>Objectives</b> The objectives of this study are to: develop a set of NPT-based measures and formatively evaluate their use for identifying implementation problems and monitoring progress; conduct preliminary evaluation of these measures across a range of interventions and contexts, and identify factors that affect this process; explore the utility of these measures for predicting outcomes; and develop an online users’ manual for the measures.<p></p> <b>Methods</b> A combination of qualitative (workshops, item development, user feedback, cognitive interviews) and quantitative (survey) methods will be used to develop NPT measures, and test the utility of the measures in six healthcare intervention settings.<p></p> <b>Discussion</b> The measures developed in the study will be available for use by those involved in planning, implementing, and evaluating complex interventions in healthcare and have the potential to enhance the chances of their implementation, leading to sustained changes in working practices

Dyck Paths, Motzkin Paths and Traffic Jams

It has recently been observed that the normalization of a one-dimensional out-of-equilibrium model, the Asymmetric Exclusion Process (ASEP) with random sequential dynamics, is exactly equivalent to the partition function of a two-dimensional lattice path model of one-transit walks, or equivalently Dyck paths. This explains the applicability of the Lee-Yang theory of partition function zeros to the ASEP normalization. In this paper we consider the exact solution of the parallel-update ASEP, a special case of the Nagel-Schreckenberg model for traffic flow, in which the ASEP phase transitions can be intepreted as jamming transitions, and find that Lee-Yang theory still applies. We show that the parallel-update ASEP normalization can be expressed as one of several equivalent two-dimensional lattice path problems involving weighted Dyck or Motzkin paths. We introduce the notion of thermodynamic equivalence for such paths and show that the robustness of the general form of the ASEP phase diagram under various update dynamics is a consequence of this thermodynamic equivalence.Comment: Version accepted for publicatio

An exploration of the commissioning, development and implementation of early intervention services for first episode psychosis in England

The aim of this longitudinal, qualitative PhD was to explore the commissioning and implementation of early intervention services for first episode psychosis across a number of sites in England. Methods: After a literature review of policy, implementation, and empirical RCT and cohort studies, 147 semi-structured interviews and six focus groups involving 35 people from different managerial and operational levels of the health service were undertaken between February 2004 and March 2009. May’s Normalization Process Theory was used as the underpinning conceptual framework and data were analysed using the Framework Analytical Approach. Results: the main findings were the importance of partnership working, influenced positively by the role of a facilitator; challenges which arose when commissioning mental health services, alleviated by the involvement of senior managers acting in a mentor role and the ‘work’ undertaken, from the perspective of Normalization Process Theory. A new service model, called the ‘trailblazer’ early intervention service was identified, which is not accounted for within Normalization Process Theory. Conclusion: further work is needed to define the characteristics and qualities of the mentoring role of senior managers and the facilitator and explore how best to adapt and extend Normalization Process Theory to incorporate the new ‘trailblazer’ service model

The Normalization of Sin

This paper discusses the normalization of sin, specifically sex work. One question that emerges is how do some behaviors come to be seen as sinful, and then once those behaviors are accepted as sinful, how do they become normalized (ie., become socially acceptable again)? After identifying a gap in the existing literature pertaining to the lack of acknowledgement for the role of institutions in driving change, I seek to fill that gap by using pattern-matching to determine how closely aligned sex work is to the phases of Normalization Process Theory. Ultimately, I am expecting to find that, according to the phases of Normalization Process Theory, sex work is becoming normalized

Applying Normalization Process Theory to Explain Large-Scale Agile Transformation

Given the prevalence and effectiveness of agile methods at a team level, large organizations are now attempting to mimic this success at large-scale by adopting large-scale methods such as Scaled Agile Framework (SAFe), Spotify, and Large-Scale Scrum (LeSS). However, compared to insights on traditionally small-scale methods, the extant literature provides sparse coverage on theories to examine large-scale agile transformations. In this article, we focus on the challenge of normalizing large-scale agile transformations and apply Normalization Process Theory (NPT) to support theorize about this process. We present our initial case study findings and outline future research on the application of NPT for large-scale transformations. From a research and practice perspective, we explain how NPT can be adopted to focus on the processes of embedding and sustaining practices – activities which are very often ignored, yet central to the success or failure of transformations

Extracting (n,g) direct capture cross sections from Coulomb dissociation: application to 14^{14}C(n,γ\gamma)15^{15}C

A methodology for extracting neutron direct capture rates from Coulomb dissociation data is developed and applied to the Coulomb dissociation of 15C on 208Pb at 68 MeV/nucleon. Full Continuum Discretized Coupled Channel calculations are performed and an asymptotic normalization coefficient is determined from a fit to the breakup data. Direct neutron capture calculations using the extracted asymptotic normalization coefficient provide $(n,\gamma)$ cross sections consistent with direct measurements. Our results show that the Coulomb Dissociation data can be reliably used for extracting the cross section for 14C(n,g)15C if the appropriate reaction theory is used. The resulting error bars are of comparable magnitude to those from the direct measurement. This procedure can be used more generally to extract capture cross sections from breakup reactions whenever the desired capture process is fully peripheral.Comment: submitted to Phys. Rev. C (R

Partial normalizations of coxeter arrangements and discriminants

We study natural partial normalization spaces of Coxeter arrangements and discriminants and relate their geometry to representation theory. The underlying ring structures arise from Dubrovin’s Frobenius manifold structure which is lifted (without unit) to the space of the arrangement. We also describe an independent approach to these structures via duality of maximal Cohen–Macaulay fractional ideals. In the process, we find 3rd order differential relations for the basic invariants of the Coxeter group. Finally, we show that our partial normalizations give rise to new free divisors