Examining the use of process evaluations of randomised controlled trials of complex interventions addressing chronic disease in primary health care-a systematic review protocol

© 2016 The Author(s). Background: Randomised controlled trials (RCTs) of complex interventions in primary health care (PHC) are needed to provide evidence-based programmes to achieve the Declaration of Alma Ata goal of making PHC equitable, accessible and universal and to effectively address the rising burden from chronic disease. Process evaluations of these RCTs can provide insight into the causal mechanisms of complex interventions, the contextual factors, and inform as to whether an intervention is ineffective due to implementation failure or failure of the intervention itself. To build on this emerging body of work, we aim to consolidate the methodology and methods from process evaluations of complex interventions in PHC and their findings of facilitators and barriers to intervention implementation in this important area of health service delivery. Methods: Systematic review of process evaluations of randomised controlled trials of complex interventions which address prevalent major chronic diseases in PHC settings. Published process evaluations of RCTs will be identified through database and clinical trial registry searches and contact with authors. Data from each study will be extracted by two reviewers using standardised forms. Data extracted include descriptive items about (1) the RCT, (2) about the process evaluations (such as methods, theories, risk of bias, analysis of process and outcome data, strengths and limitations) and (3) any stated barriers and facilitators to conducting complex interventions. A narrative synthesis of the findings will be presented. Discussion: Process evaluation findings are valuable in determining whether a complex intervention should be scaled up or modified for other contexts. Publishing this protocol serves to encourage transparency in the reporting of our synthesis of current literature on how process evaluations have been conducted thus far and a deeper understanding of potential challenges and solutions to aid in the implementation of effective interventions in PHC beyond the research setting. Systematic review registration: PROSPERO CRD42016035572

Recent advances in nature-inspired solutions for ground engineering (NiSE)

The ground is a natural grand system; it is composed of myriad constituents that aggregate to form several geologic and biogenic systems. These systems operate independently and interplay harmoniously via important networked structures over multiple spatial and temporal scales. This paper presents arguments and derivations couched by the authors, to first give a better understanding of these intertwined networked structures, and then to give an insight of why and how these can be imitated to develop a new generation of nature-symbiotic ground engineering techniques. The paper draws on numerous recent advances made by the authors, and others, in imitating forms (e.g., synthetic fibres that imitate plant roots), materials (e.g., living composite materials, or living soil that imitate fungi and microbes), generative processes (e.g., managed decomposition of construction rubble to mimic weathering of aragonites to calcites), and functions (e.g., recreating the self-healing, self-producing, and self-forming capacity of natural systems). Advances are reported in three categories of Materials, Models, and Methods (3Ms). A novel value-based appraisal tool is also presented, providing a means to vet the effectiveness of 3Ms as standalone units or in combinations

General framework for stability analysis of slopes

Different methods of slices have been proposed for the stability analysis of slopes. In this Paper a general framework for the stability of slopes is presented. The expressions for the factor of safety are presented in a manner that allows most of the current limit equilibrium based methods of slices to be studied within a single framework. The overall factor of safety of a slope against slip failure is found by an iterative procedure. Several analyses were made, based on the proposed method, and the existing methods of slices are investigated as special cases. It is shown theoretically and numerically that the value of the factor of safety is essentially the same for the different methods studied. This suggests that the differences in the forms used in many of the slice methods that use a single scaling parameter with a given distribution of the internal forces in the sliding soil mass have minimal influence on the final value of the factor of safety. Différentes méthodes de découpage ont été proposées pour l'analyse de la stabilité des pentes. Cet article présente une classification générale de la stabilité des pentes. Les expressions du facteur de sécurité sont présentées de telle sort que la plupart des équilibres limites basés sur des méthodes de découpage puissent être étudié selon un cadre identique. Une procédure itérative permet d'exprimer le facteur de sécurité global d'une pente en fonction de la rupture par glissement. Plusieurs analyses, basées sur la méthode présentée, ont été réalisées et les méthodes de dé- coupage existantes ont été étudiées en tant que cas particuliers. Il apparaît à la fois théoriquement et numériquement que le facteur de sécurité a pratiquement la même valeur quelle que soit la mé- thode étudiée. Ceci permet de supposer que les différentes formules utilisées dans beaucoup de mé- thodes de découpage faisant appel à un seul paramètre d'échelle ainsi qu'à une distribution donnée des forces à l'intérieur du sol en glissement n'ont que très peu d'influence sur la valeur finale du facteur de sécurité. </jats:p