Research versus practice in quality improvement? Understanding how we can bridge the gap

The gap between implementers and researchers of quality improvement (QI) has hampered the degree and speed of change needed to reduce avoidable suffering and harm in health care. Underlying causes of this gap include differences in goals and incentives, preferred methodologies, level and types of evidence prioritized and targeted audiences. The Salzburg Global Seminar on 'Better Health Care: How do we learn about improvement?' brought together researchers, policy makers, funders, implementers, evaluators from low-, middle- and high-income countries to explore how to increase the impact of QI. In this paper, we describe some of the reasons for this gap and offer suggestions to better bridge the chasm between researchers and implementers. Effectively bridging this gap can increase the generalizability of QI interventions, accelerate the spread of effective approaches while also strengthening the local work of implementers. Increasing the effectiveness of research and work in the field will support the knowledge translation needed to achieve quality Universal Health Coverage and the Sustainable Development Goals.Fil: Hirschhorn, Lisa R.. Northwestern University; Estados UnidosFil: Ramaswamy, Rohit. University of North Carolina; Estados UnidosFil: Devnani, Mahesh. Post Graduate Institute of Medical Education & Research; IndiaFil: Wandersman, Abraham. University Of South Carolina; Estados UnidosFil: Simpson, Lisa A.. Academy Health; Estados UnidosFil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentin

A double bounded key identity for Goellnitz's (big) partition theorem

Given integers i,j,k,L,M, we establish a new double bounded q-series identity from which the three parameter (i,j,k) key identity of Alladi-Andrews-Gordon for Goellnitz's (big) theorem follows if L, M tend to infinity. When L = M, the identity yields a strong refinement of Goellnitz's theorem with a bound on the parts given by L. This is the first time a bounded version of Goellnitz's (big) theorem has been proved. This leads to new bounded versions of Jacobi's triple product identity for theta functions and other fundamental identities.Comment: 17 pages, to appear in Proceedings of Gainesville 1999 Conference on Symbolic Computation

Most Published Research Findings Are False—But a Little Replication Goes a Long Way

While the authors agree with John Ioannidis that "most research findings are false," here they show that replication of research findings enhances the positive predictive value of research findings being true

Parametrized spaces model locally constant homotopy sheaves

We prove that the homotopy theory of parametrized spaces embeds fully and faithfully in the homotopy theory of simplicial presheaves, and that its essential image consists of the locally homotopically constant objects. This gives a homotopy-theoretic version of the classical identification of covering spaces with locally constant sheaves. We also prove a new version of the classical result that spaces parametrized over X are equivalent to spaces with an action of the loop space of X. This gives a homotopy-theoretic version of the correspondence between covering spaces over X and sets with an action of the fundamental group of X. We then use these two equivalences to study base change functors for parametrized spaces.Comment: 26 pages; exposition improve

Excision for simplicial sheaves on the Stein site and Gromov's Oka principle

A complex manifold $X$ satisfies the Oka-Grauert property if the inclusion \Cal O(S,X) \hookrightarrow \Cal C(S,X) is a weak equivalence for every Stein manifold $S$, where the spaces of holomorphic and continuous maps from $S$ to $X$ are given the compact-open topology. Gromov's Oka principle states that if $X$ has a spray, then it has the Oka-Grauert property. The purpose of this paper is to investigate the Oka-Grauert property using homotopical algebra. We embed the category of complex manifolds into the model category of simplicial sheaves on the site of Stein manifolds. Our main result is that the Oka-Grauert property is equivalent to $X$ representing a finite homotopy sheaf on the Stein site. This expresses the Oka-Grauert property in purely holomorphic terms, without reference to continuous maps.Comment: Version 3 contains a few very minor improvement

The homotopy theory of dg-categories and derived Morita theory

The main purpose of this work is the study of the homotopy theory of dg-categories up to quasi-equivalences. Our main result provides a natural description of the mapping spaces between two dg-categories $C$ and $D$ in terms of the nerve of a certain category of $(C,D)$-bimodules. We also prove that the homotopy category $Ho(dg-Cat)$ is cartesian closed (i.e. possesses internal Hom's relative to the tensor product). We use these two results in order to prove a derived version of Morita theory, describing the morphisms between dg-categories of modules over two dg-categories $C$ and $D$ as the dg-category of $(C,D)$-bi-modules. Finally, we give three applications of our results. The first one expresses Hochschild cohomology as endomorphisms of the identity functor, as well as higher homotopy groups of the \emph{classifying space of dg-categories} (i.e. the nerve of the category of dg-categories and quasi-equivalences between them). The second application is the existence of a good theory of localization for dg-categories, defined in terms of a natural universal property. Our last application states that the dg-category of (continuous) morphisms between the dg-categories of quasi-coherent (resp. perfect) complexes on two schemes (resp. smooth and proper schemes) is quasi-equivalent to the dg-category of quasi-coherent complexes (resp. perfect) on their product.Comment: 50 pages. Few mistakes corrected, and some references added. Thm. 8.15 is new. Minor corrections. Final version, to appear in Inventione

Plastic Deformation of 2D Crumpled Wires

When a single long piece of elastic wire is injected trough channels into a confining two-dimensional cavity, a complex structure of hierarchical loops is formed. In the limit of maximum packing density, these structures are described by several scaling laws. In this paper it is investigated this packing process but using plastic wires which give origin to completely irreversible structures of different morphology. In particular, it is studied experimentally the plastic deformation from circular to oblate configurations of crumpled wires, obtained by the application of an axial strain. Among other things, it is shown that in spite of plasticity, irreversibility, and very large deformations, scaling is still observed.Comment: 5 pages, 6 figure

Small world effect in an epidemiological model

A model for the spread of an infection is analyzed for different population structures. The interactions within the population are described by small world networks, ranging from ordered lattices to random graphs. For the more ordered systems, there is a fluctuating endemic state of low infection. At a finite value of the disorder of the network, we find a transition to self-sustained oscillations in the size of the infected subpopulation