Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study

<p>Abstract</p> <p>Background</p> <p>The use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs) are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs) to facilitate the use in clinical practice of four evidence-based measurement tools designed to evaluate and understand motor function in children with cerebral palsy (CP). The KB model evaluated in this study was designed to overcome many of the barriers to research transfer identified in the literature.</p> <p>Methods</p> <p>A mixed methods before-after study design was used to evaluate the impact of a six-month KB intervention by 25 KBs on 122 practicing PTs' self-reported knowledge and use of the measurement tools in 28 children's rehabilitation organizations in two regions of Canada. The model was that of PT KBs situated in clinical sites supported by a network of KBs and the research team through a broker to the KBs. Modest financial remuneration to the organizations for the KB time (two hours/week for six months), ongoing resource materials, and personal and intranet support was provided to the KBs. Survey data were collected by questionnaire prior to, immediately following the intervention (six months), and at 12 and 18 months. A mixed effects multinomial logistic regression was used to examine the impact of the intervention over time and by region. The impact of organizational factors was also explored.</p> <p>Results</p> <p>PTs' self-reported knowledge of all four measurement tools increased significantly over the six-month intervention, and reported use of three of the four measurement tools also increased. Changes were sustained 12 months later. Organizational culture for research and supervisor expectations were significantly associated with uptake of only one of the four measurement tools.</p> <p>Conclusions</p> <p>KBs positively influenced PTs' self-reported knowledge and self-reported use of the targeted measurement tools. Further research is warranted to investigate whether this is a feasible, cost-effective model that could be used more broadly in a rehabilitation setting to facilitate the uptake of other measurement tools or evidence-based intervention approaches.</p

Polymer ultrapermeability from the inefficient packing of 2D chains

The promise of ultrapermeable polymers, such as poly(trimethylsilylpropyne) (PTMSP), for reducing the size and increasing the efficiency of membranes for gas separations remains unfulfilled due to their poor selectivity. We report an ultrapermeable polymer of intrinsic microporosity (PIM-TMN-Trip) that is substantially more selective than PTMSP. From molecular simulations and experimental measurement we find that the inefficient packing of the two-dimensional (2D) chains of PIM-TMN-Trip generates a high concentration of both small (<0.7 nm) and large (0.7–1.0 nm) micropores, the former enhancing selectivity and the latter permeability. Gas permeability data for PIM-TMN-Trip surpass the 2008 Robeson upper bounds for O2/N2, H2/N2, CO2/N2, H2/CH4 and CO2/CH4, with the potential for biogas purification and carbon capture demonstrated for relevant gas mixtures. Comparisons between PIM-TMN-Trip and structurally similar polymers with three-dimensional (3D) contorted chains confirm that its additional intrinsic microporosity is generated from the awkward packing of its 2D polymer chains in a 3D amorphous solid. This strategy of shape-directed packing of chains of microporous polymers may be applied to other rigid polymers for gas separations

The application of ‘elite interviewing’ methodology in transdisciplinary research: A record of process and lessons learned during a 3-year pilot in urban planetary health research

This paper sets out the rationale and process for the interviewing methodology utilized during a 3-year research pilot, ‘Moving Health Upstream in Urban Development’ (UPSTREAM). The project had two primary aims: firstly, to attempt to value economically the health cost benefits associated with the quality of urban environments and secondly, to engage with those in control of urban development in the UK in order to determine what are the barriers to and opportunities for creating healthy urban environments, including those identified through the utilisation of economic valuation. Engagement at senior level with those who have most control over key facets of planning and development implementation—such as land disposal, investment, development delivery and planning permission—was central to the approach, which encompassed the adoption of ‘elite interviewing’, a method developed in the USA in the 1950s and used in the political sciences but relatively unutilized in the health and environmental sciences [1]. Two rounds of semi-structured interviews were undertaken with 15 senior decision-makers from the UK’s main urban development delivery agencies, both public and private. The ‘elite interviewing’ approach successfully enabled the UPSTREAM project to capture and analyse the information received from the interviewees, all of whom held influential or leadership posts in organisations that are important actors in the process of planning, developing and constructing the built environment in the UK. Having academic and practitioner research leads on an equal footing created some minor tensions, but it also appeared to strengthen the rigor of the approach through a broad knowledge of context ‘in-house’. This form of co-production at times challenged academic traditions in qualitative analysis, but it also appeared to build trust with interviewees and provided greater clarity of the real-world context under investigation. Findings from this study are written up in a separate paper

Long-term spatial and temporal trends in frost indices in Kansas, USA

Citation: Anandhi, A., Perumal, S., Gowda, P.H. et al. Climatic Change (2013) 120: 169. https://doi.org/10.1007/s10584-013-0794-4Frost indices such as number of frost days (nFDs), number of frost-free days (nFFDs), last spring freeze (LSF), first fall freeze (FFF), and growing-season length (GSL) were calculated using daily minimum air temperature (T[subscript min]) from 23 centennial weather stations across Kansas during four time periods (through 1919, 1920–1949, 1950–1979, and 1980–2009). A frost day is defined as a day with T[subscript min] < 0 °C. The long- and short-term trends in frost indices were analyzed at monthly, seasonal, and annual timescales. Probability of occurrence of the indices was analyzed at 5 %, 25 %, 50 %, 75 %, and 95 %. Results indicated a general increase in T[subscript min] from 1900 through 2009 causing a decrease in nFDs. LSF and FFF occurred earlier and later than normal in the year, respectively, thereby resulting in an increase in GSL. In general, northwest Kansas recorded the greatest nFD and lowest T[subscript min], whereas southeast Kansas had the lowest nFD and highest T[subscript min]; however, the magnitude of the trends in these indices varied with location, time period, and time scales. Based on the long-term records in most stations, LSF occurred earlier by 0.1–1.9 days/decade, FFF occurred later by 0.2–0.9 day/decade, and GSL was longer by 0.1–2.5 day/decade. At the 50 % probability level, Independence in the south-eastern part of Kansas had the earliest LSF (6 April), latest FFF (29 October) and longest GSL (207 days). Oberlin (north-western Kansas) recorded the shortest GSL (156 days) and earliest FFF (7 October) had the latest LSF (2 May) at the 50 % probability level. A positive correlation was observed for combinations of indices (LSF and GSL) and elevation, whereas a negative correlation was found between FFF and elevation