Evaluating the process for deceased organ donation: a programme theory approach

– Organ donation and transplantation services represent a microcosm of modern healthcare organisations. They are complex adaptive systems. They face perpetual problems of matching supply and demand. They operate under fierce time and resource constraints. And yet they have received relatively little attention from a systems perspective. The purpose of this paper is to consider some of the fundamental issues in evaluating, improving and policy reform in such complex systems

RAMESES publication standards: realist syntheses

PMCID: PMC3558331This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

The Demography of the Native Population of an Alaskan City

Information from archival and census data shows that Alaskan natives, mainly Athapascans, started to move into Fairbanks over fifty years ago. During the Second World War, jobs available on construction projects attracted both Eskimos and Athapascans in family units. It appears from recent data that those now moving into the city are unmarried and younger than earlier migrants, that women outnumber men, and marriages between native and non-native Alaskans are becoming more common. Forty-four per cent of a sample of 1,029 persons lived in inter-racial households in 1972

Impacts of the Mount Pinatubo eruption on ENSO in the GEOS seasonal-to-subseasonal forecasting system

The eruption of Mount Pinatubo in June 1991 introduced a perturbation of the Earth's global energy budget by increasing the stratospheric aerosol loading by an order of magnitude, with effects on the global climate. In this presentation we analyze the effects of the Mt. Pinatubo eruption on the seasonal forecast performed with Goddard Earth Observing System Seasonal-to Subseasonal (GEOS-S2S) system, an Earth System Model that includes an interactive ocean and a bulk aerosol model coupled to radiation. We performed 10-member ensembles for the year after the eruption (June 1991-May 1992) at ~0.5 horizontal resolution, with and without the inclusion of the Mt. Pinatubo eruption. In GEOS-S2S, the eruption leads to ta strengthening of El Nino peaking in January 1992. The strengthening is mainly due to the weakening of the trade winds, which is caused by a attening of the temperature gradient across the Pacic due to a differential response to the volcanic forcing between the central and eastern Pacic (ocean-dynamical thermostat). This response largely depends on the assumed size for the volcanic aerosols. Indeed, we performed simulations assuming a volcanic aerosol effective radius of 0.35 m (similar to tropospheric aerosol, and the default in GEOS) and 0.6 m (closer to observations of volcanic aerosol from Pinatubo-sized eruptions). We nd that in the latter case the tropical radiative forcing is lower, since smaller aerosols scatter shortwave radiation more eciently than larger ones. Accordingly, the impact on ENSO is not statistically signicant when a larger and more realistic particle radius is assumed

Blurring the boundaries between synthesis and evaluation. A customized realist evaluative synthesis into adolescent risk behavior prevention

Realist methodologies have been increasingly advocated for the investigation of complex social issues. Public health programs, such as those designed to prevent adolescent risk behavior, are typically considered complex. In conducting a realist review of the empirical literature relating to such programs, we encountered several challenges, including (a) an overabundance of empirical evidence, (b) a problematic level of heterogeneity within and between methodological approaches, (c) discrepancies between theoretical underpinnings and program operationalization, (d) homogeneity of program outcomes, with very little variation in program effectiveness, and (d) a paucity of description relating to content and process. To overcome these challenges, we developed a customized approach to realist evidence synthesis, drawing on the VICTORE (Volition, Implementation, Contexts, Time, Outcomes, Rivalry, and Emergence) complexity checklist and incorporating stakeholder engagement as primary data to achieve greater depth of understanding relating to contextual and mechanistic factors, and the complex interactions between them. Here we discuss the benefits of this adapted methodology alongside an overview of the research through which the methodology was developed. A key finding from this research was that combining the complexity checklist with primary data from stakeholder engagement enabled us to systematically interrogate the data across data sources, uncovering and evidencing mechanisms which may otherwise have remained hidden, giving greater ontological depth to our research findings. This paper builds on key methodological developments in realist research, demonstrating how realist methodologies can be customized to overcome challenges in developing and refining program theory from the literature, and contributes to the broader literature of innovative approaches to realist research

Long-Term Ozone Variability and Trends from Reanalyses: Can It Be Done?

Stratospheric ozone concentrations have begun to show early signs of recovery following the implementation of the Montreal Protocol and its amendments as well as in response to decreasing upper-stratospheric temperatures. Secular trends in stratospheric ozone are modulated by considerable interannual variability and systematic changes in transport patterns that are expected under increasing concentrations of greenhouse gases, especially in the lower stratosphere. These factors necessitate the continued close monitoring of stratospheric ozone in upcoming decades, with a special focus on the lower stratosphere.As highly resolved data sets combining a plethora of observations with model simulations atmospheric reanalyses are, in principle, well suited for the task. All major reanalyses generate ozone output. However, significant spurious discontinuities that arise from step changes in the observing systems prevent a straightforward analysis of ozone trends and long-term variability. Building on our recent work, in this presentation we will demonstrate that trend detection is nonetheless possible using the ozone record from NASA's MERRA-2 (Modern-Era Retrospective Analysis for Research and Applications, Version 2) reanalysis bias-corrected using a chemistry model simulation as a transfer function. Next, we will outline several strategies to reduce artificial discontinuities in the ozone record in future NASA reanalyses. This discussion will be illustrated by an example of joint assimilation of bias-corrected ozone profiles from the Microwave Limb Sounder (MLS) on the Aura satellite (2004 to present) and the Ozone Mapping Profiler Suite Limb Profiler (OMPS-LP) sensors that are expected to operate on future NOAA platforms

An 8-Year, High-Resolution Reanalysis of Atmospheric CO2 Mixing Ratios Based on OCO-2 and GOSAT-ACOS Retrievals

The NASA GMAO (Global Modeling and Assimilation Office) reanalysis blends OCO-2 (Orbiting Carbon Observatory 2) and GOSAT-ACOS (Greenhouse Gases Observing Satellite-Atmospheric Carbon Observations from Space) retrievals (top) with GEOS (Goddard Earth Observing System) model predictions (bottom) to estimate the full 3D (three-dimensional) state of CO2 every 3 hours (middle). This poster describes monthly atmospheric growth rates derived from the reanalysis and an application to aircraft data with the potential to aid bias correction

Enterprise Education Competitions: A Theoretically Flawed Intervention?

The demand for including enterprise in the education system, at all levels and for all pupils is now a global phenomenon. Within this context, the use of competitions and competitive learning activities is presented as a popular and effective vehicle for learning. The purpose of this chapter is to illustrate how a realist method of enquiry – which utilises theory as the unit of analysis – can shed new light on the assumed and unintended outcomes of enterprise education competitions. The case developed here is that there are inherent flaws in assuming that competitions will ‘work’ in the ways set out in policy and guidance. Some of the most prevalent stated outcomes – that competitions will motivate and reward young people, that they will enable the development of entrepreneurial skills, and that learners will be inspired by their peers – are challenged by theory from psychology and education. The issue at stake is that the expansion of enterprise education policy into primary and secondary education increases the likelihood that more learners will be sheep dipped in competitions, and competitive activities, without a clear recognition of the potential unintended effects. In this chapter, we employ a realist-informed approach to critically evaluate the theoretical basis that underpins the use of competitions and competitive learning activities in school-based enterprise education. We believe that our findings and subsequent recommendations will provide those who promote and practice the use of competitions with a richer, more sophisticated picture of the potential flaws within such activities.Peer reviewedFinal Published versio

Design and performance of ropes for climbing and sailing

Ropes are an important part of the equipment used by climbers, mountaineers, and sailors. On first inspection, most modern polymer ropes appear similar, and it might be assumed that their designs, construction, and properties are governed by the same requirements. In reality, the properties required of climbing ropes are dominated by the requirement that they effectively absorb and dissipate the energy of the falling climber, in a manner that it does not transmit more than a critical amount of force to his body. This requirement is met by the use of ropes with relatively low longitudinal stiffness. In contrast, most sailing ropes require high stiffness values to maximize their effectiveness and enable sailors to control sails and equipment precisely. These conflicting requirements led to the use of different classes of materials and different construction methods for the two sports. This paper reviews in detail the use of ropes, the properties required, manufacturing techniques and materials utilized, and the effect of service conditions on the performance of ropes. A survey of research that has been carried out in the field reveals what progress has been made in the development of these essential components and identifies where further work may yield benefits in the future

Narrowing of the Upwelling Branch of the Brewer-Dobson Circulation and Hadley Cell in Chemistry-Climate Model Simulations of the 21st Century

Changes in the width of the upwelling branch of the Brewer-Dobson circulation and Hadley cell in the 21st Century are investigated using simulations from a coupled chemistry-climate model. In these model simulations the tropical upwelling region narrows in the troposphere and lower stratosphere. The narrowing of the Brewer-Dobson circulation is caused by an equatorward shift of Rossby wave critical latitudes and Eliassen-Palm flux convergence in the subtropical lower stratosphere. In the troposphere, the model projects an expansion of the Hadley cell's poleward boundary, but a narrowing of the Hadley rising branch. Model results suggest that the narrowing of the Hadley cell ascent is also eddy-driven