The rise of rapid implementation: a worked example of solving an existing problem with a new method by combining concept analysis with a systematic integrative review

Background The concept of rapid implementation has emerged in the literature recently, but without a precise definition. Further exploration is required to distinguish the concept’s unique meanings and significance from the perspective of implementation science. The study clarifies the concept of rapid implementation and identifies its attributes, antecedents, and consequences. We present a theoretical definition of rapid implementation to clarify its unique meaning and characteristics. Methods Rodgers evolutionary concept analysis method, combined with a systematic integrative review, were used to clarify the concept of rapid implementation. A comprehensive search of four databases, including EMBASE, MEDLINE, SCOPUS, and WEB OF SCIENCE was conducted, as well as relevant journals and reference lists of retrieved studies. After searching databases, 2442 papers were identified from 1963 to 2019; 24 articles were found to fit the inclusion criteria to capture data on rapid implementation from across healthcare settings in four countries. Data analysis was carried out using descriptive thematic analysis. Results The results locate the introduction of rapid implementation, informed by implementation science. Guidance for further conceptualisation to bridge the gap between research and practice and redefine rigour, adapting methods used (current approaches, procedures and frameworks), and challenging clinical trial design (efficacy-effectiveness-implementation pipeline) is provided. Conclusions It is possible that we are on the cusp of a paradigm shift within implementation brought about by the need for faster results into practice and policy. Researchers can benefit from a deeper understanding of the rapid implementation concept to guide future implementation of rapid actionable results in clinical practice

Livestock Raiding Among the Pastoral Turkana of Kenya:

Summaries The long?persisting and erroneous conception of famine among the pastoral Turkana of Kenya as an essentially ‘drought?driven’ event has given way to growing recognition today of the key role which livestock raiding plays in the breakdown of coping strategies. However, this article argues that the phenomenon of cattle raids per se is not the problem. Rather it is the fashion in which raiding has been transformed over the years, from a quasi?cultural practice with important livelihood?enhancing functions, into more predatory forms driven by an economic logic and modern forms of violence. This article seeks to understand predatory raiding and its effects in terms of the changing functions which raiding serves within pastoral society and, increasingly, outside it. The article uses a model of armed conflict and livelihood vulnerability to illustrate how violence and the threat of violence interact with drought to undermine the coping strategies of herders

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Supporting pastoralist livelihoods in Eastern Africa through peace building

Conflict reduction and peace building initiatives have become the latest development fashion to support insecure pastoralist livelihoods in eastern Africa. Jeremy Lind argues that common approaches in this area are weakened by the predominant understanding of conflicts involving pastoralists as competition over scarce resources as well as the relative inattention to the situation and particular needs of the destitute population

A monophyletic origin of the B chromosomes of Brachycome dichromosomatica (Asteraceae)

The A and B chromosomes of different karyotype variants(cytodemes A1, A2, A3 and A4) of Brachycome dichromosomatica were analysed by computer-aided chromosome image analysis and fluorescence in situ hybridisation (FISH). Ribosomal DNA and the B chromosome-specific sequence Bd49 were detected on all B chromosomes. In addition to minor size variation of the Bs, polymorphism of the rDNA and Bd49 position and copy number revealed two major types of B chromosomes. The B chromosomes of all the cytodemes were indistinguishable from each other in length, but that of A3 showed evidence of rearrangements consistent with its long-term geographic isolation. The results presented suggest a monophyletic origin of the B chromosomes of B. dichromosomatica.Houben, Andreas ; Thompson, Nicole ; Ahne, Richard ; Leach, Carolyn ; Verlin, Dawn ; Timmis, Jerem

Integration of the biophysical and social sciences using an indicator approach: Addressing water problems at different scales

To be operationally sustainable, any system of environmental management needs to be based on a truly holistic assessment of all of the relevant factors influencing it. This is of course a daunting task, demanding as it does detailed and reliable data, not only from both the physical and social sciences, but also incorporating some representation of that part of knowledge which could be described as non-scientific. This could be said to include the uncertainties of market forces and political will, as well as traditional knowledge systems, and artistic representation. Recognising the limitations of our own knowledge system is important if we are to make progress in the achievement of sustainability. The development of less deterministic models is a step forward in that direction. This paper provides some discussion on the challenges associated with the integration of data from different disciplines, and the application of that data at different scales. Alternative approaches to the assessment of water resources for policy making are highlighted, and the validity of using such assessments at different scales is discussed. Using the Water Poverty Index as illustration, examples are provided of how an integrated assessment framework can be used to provide consistency and transparency in decision-making, and how this can, in practice, be applied at a variety of scales