The development of the Canadian rural health research society: Creating capacity through connections

Context: The organization of rural health research in Canada has been a recent development. Over the past 8 years, rural and remote researchers from more than 15 universities and agencies across Canada have engaged in a process of research capacity building through the development of a network, the Canadian Rural Health Research Society (CRHRS) among the scientifically and geographically diverse researchers and their community partners. The purpose of this article is to discuss the development of the CRHRS as well as the challenges and lessons learned about creating networks and building capacity among rural and remote health researchers. Issue: Key elements of network development have included identifying and developing multidisciplinary research groupings, maintaining ongoing connections among researchers, and promoting the sharing of expertise and resources for research training. The focus has been on supporting research excellence among networks of researchers in smaller centres. Activities include a national annual scientific meeting, the informal formation of several regional and national research networks in specific areas, and the development of training opportunities. Challenges have included the issues of sustaining communication, addressing a range of networking and capacity-enhancement needs, cooperating in an environment that rewards competition, obtaining resources to support a secretariat and research activities, and balancing the demands to foster research excellence with the needs to create infrastructure and advocate for adequate research funding. Lessons learned: The CRHRS has learned how to begin to support researchers with diverse interests and needs across sectors and wide geographical areas, specifically by: (1) focusing on research development through creating and supporting trusting connections among researchers; (2) building the science first, followed by infrastructure development; (3) making individual researchers the nodes in the network; (4) being inclusive by accommodating a wide variety of researchers and researcher strengths; (5) emphasizing social exchange, knowledge exchange, and mentoring in annual scientific meetings; (6) taking opportunities to develop separate projects while finding ways to link them; (7) finding a balance between advancing the science and advocating for adequate funding and appropriate peer review; (8) developing a network organizational structure that is both stable and flexible; and (9) maintaining sustained visionary leadership.Jennifer Richmond (production editor for Rural and Remote Health

FIRE (facilitating implementation of research evidence) : a study protocol

Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS) framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated) affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids

Cluster randomised trial of a tailored intervention to improve the management of overweight and obesity in primary care in England

Background: Tailoring is a frequent component of approaches for implementing clinical practice guidelines, although evidence on how to maximise the effectiveness of tailoring is limited. In England, overweight and obesity are common, and national guidelines have been produced by the National Institute for Health and Care Excellence. However, the guidelines are not routinely followed in primary care. Methods: A tailored implementation intervention was developed following an analysis of the determinants of practice influencing the implementation of the guidelines on obesity and the selection of strategies to address the determinants. General practices in the East Midlands of England were invited to take part in a cluster randomised controlled trial of the intervention. The primary outcome measure was the proportion of overweight or obese patients offered a weight loss intervention. Secondary outcomes were the proportions of patients with (1) a BMI or waist circumference recorded, (2) record of lifestyle assessment, (3) referred to weight loss services, and (4) any change in weight during the study period. We also assessed the mean weight change over the study period. Follow-up was for 9 months after the intervention. A process evaluation was undertaken, involving interviews of samples of participating health professionals. Results: There were 16 general practices in the control group, and 12 in the intervention group. At follow-up, 15. 08 % in the control group and 13.19 % in the intervention group had been offered a weight loss intervention, odds ratio (OR) 1.16, 95 % confidence interval (CI) (0.72, 1.89). BMI/waist circumference measurement 42.71 % control, 39.56 % intervention, OR 1.15 (CI 0.89, 1.48), referral to weight loss services 5.10 % control, 3.67 % intervention, OR 1.45 (CI 0.81, 2.63), weight management in the practice 9.59 % control, 8.73 % intervention, OR 1.09 (CI 0.55, 2.15), lifestyle assessment 23.05 % control, 23.86 % intervention, OR 0.98 (CI 0.76, 1.26), weight loss of at least 1 kg 42.22 % control, 41.65 % intervention, OR 0.98 (CI 0.87, 1.09). Health professionals reported the interventions as increasing their confidence in managing obesity and providing them with practical resources. Conclusions: The tailored intervention did not improve the implementation of the guidelines on obesity, despite systematic approaches to the identification of the determinants of practice. The methods of tailoring require further development to ensure that interventions target those determinants that most influence implementation

Preventive evidence into practice (PEP) study: implementation of guidelines to prevent primary vascular disease in general practice protocol for a cluster randomised controlled trial

There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD) and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession.This study is funded by an Australian National Health and Medical Research Council (NHMRC) Partnership grant (ID 568978) together with the Australian National Heart Foundation, Royal Australian College of General Practitioners, and the BUPA Foundation. MH is supported by a NHMRC Senior Principle Research Fellowship

Physical structure and dust reprocessing in a sample of HH jets

Context. Stellar jets are an essential ingredient of the star formation process and a wealth of information can be derived from their characteristic emission-line spectra. Aims. We investigate the physical structure and dust reprocessing in the shocks along the beam of a number of classical Herbig-Haro (HH) jets in the Orion and Lupus molecular clouds (HH 111, HH 1/2, HH 83, HH 24 M/A/E/C, and Sz68). Parameters describing plasma conditions, as well as dust content, are derived as a function of distance from the source and, for HH 111, of gas velocity. Methods. Spectral diagnostic techniques are applied to obtain the jet physical conditions (the electron and total density, ne  and nH, the ionisation fraction, xe, and the temperature, Te) from the ratios of selected forbidden lines. The presence of dust grains is investigated by estimating the gas-phase abundance of calcium with respect to its solar value. Results. We find the electron density varies between 0.05–4$\times$103 cm-3, the ionisation fraction xe  from 0.01–0.7, the temperature ranges between 0.6–3$\times$104 K, and the hydrogen density between 0.01–6$\times$104 cm-3. Interestingly, in the HH 111 jet, ne, xe, and Te  peak in the high velocity interval (HVI) of the strongest working surfaces, confirming a prediction from shocks models. Calcium turns out to be depleted with respect to its solar value, but its gas-phase abundance is higher than estimates for the interstellar medium in Orion. The depletion is high (up to 80%) along the low-excited jets, while low or no depletion is measured in those jets which show higher excitation conditions. Moreover, for HH 111 the depletion is lower in the HVI of the fastest shock. Conclusions. Our results confirm the shock structure predicted by models and indicate that shocks occurring along jets, and presumably those present in the launch zone, only partially destroy dust grains and that the efficiency of dust reprocessing strongly depends on shock velocity. However, the high Ca gas-phase abundance estimated in some of the knots, is not well understood in terms of existing models of dust reprocessing in shocks, and indicates that the dust must have been partially reprocessed in the region where the flow originates

EPISCIENCES – an overlay publication platform

This paper delineates the main characteristics of the Episciences platform, an environment for overlay peer-reviewing that complements existing publication repositories, designed by the Centre pour la Communication Scientifique directe (CCSD is a joint service unit between the CNRS, Inria and the University of Lyon) service unit. We describe the main characteristics of the platform and present the first experiment of launching two journals in the computer science domain onto it. Finally, we address a series of open questions related to the actual changes in editorial models (open submission, open peer-review, augmented publication) that such a platform is likely to raise, as well as some hints as to the underlying business model