Facilitating the implementation of clinical technology in healthcare : what role does a national agency play?

Background: Accelerating the implementation of new technology in healthcare is typically complex and multi-faceted. One strategy is to charge a national agency with the responsibility for facilitating implementation. This study examines the role of such an agency in the English National Health Service. In particular, it compares two different facilitation strategies employed by the agency to support the implementation of insulin pump therapy. Methods: The research involved an empirical case study of four healthcare organisations receiving different levels of facilitation from the national agency: two received active hands-on facilitation; one was the intended recipient of a more passive, web-based facilitation strategy; the other implemented the technology without any external facilitation. The primary method of data collection was semi structured qualitative interviews with key individuals involved in implementation. The integrated-PARIHS framework was applied as a conceptual lens to analyse the data. Results: The two sites that received active facilitation from an Implementation Manager in the national agency made positive progress in implementing the technology. In both sites there was a high level of initial receptiveness to implementation. This was similar to a site that had successfully introduced insulin pump therapy without facilitation support from the national agency. By contrast, a site that did not have direct contact with the national agency made little progress with implementation, despite the availability of a web-based implementation resource. Clinicians expressed differences of opinion around the value and effectiveness of the technology and contextual barriers related to funding for implementation persisted. The national agency’s intended roll out strategy using passive web-based facilitation appeared to have little impact. Conclusions: When favourable conditions exist, in terms of agreement around the value of the technology, clinician receptiveness and motivation to change, active facilitation via an external agency can help to structure the implementation process and address contextual barriers. Passive facilitation using web-based implementation resources appears less effective. Moving from initial implementation to wider scale-up presents challenges and is an issue that warrants further attention

Crop updates 2006 - Farming Systems

This session covers nineteen papers from different authors: SOIL AND NUTRIENT MANAGEMENT 1. Inve$tigating fertili$er inve$tment, Wayne Pluske, Nutrient Management Systems 2. KASM, the potassium in Agricultural System Model,Bill Bowden and Craig Scanlan, DAWA Northam and UWA, School of Earth and Geographical Sciences 3. Long term productivity and economic benefits of subsurface acidity management from surface and subsurface liming, Stephen Davies, Chris Gazey and Peter Tozer, Department of Agriculture 4. Furrow and ridges to prevent waterlogging, Dr Derk Bakker, Department of Agriculture 5. Nitrous oxide emissions from a cropped soil in Western Australia, Louise Barton1, David Gatter2, Renee Buck1, Daniel Murphy1, Christoph Hinz1and Bill Porter2 1School of Earth and Geographical Sciences, The University of Western Australia, 2Department of Agriculture GROWER DECISIONS 6. Managing the unmanageable, Bill Bowden Department of Agriculture 7. Review of climate model summaries reported in Department of Agriculture’s Season Outlook, Meredith Fairbanks, Department of Agriculture 8. Mapping the frost risk in Western Australia, Nicolyn Short and Ian Foster, Department of Agriculture 9. .35 kg/ha.day and other myths, James Fisher, Doug Abrecht and Mario D’Antuono, Department of Agriculture 10. Gaining with growers – Lessons from a successful alliance of WA Grower Groups, Tracey M. Gianatti, Grower Group Alliance 11. WA Agribusiness Trial Network Roundup – 2005, Paul Carmody, Local Farmer Group Network, UWA 12. Drivers of no-till adoption, Frank D’Emdenabc, Rick Llewellynabdand Michael Burtonb,aCRC Australian Weed Management; bSchool of Agricultural and Resource Economics, UWA. cDepartment of Agriculture, dCSIRO Sustainable Ecosystems, Adelaide PRODUCTION SYSTEMS, PRECISION AGRICULTURE AND SUSTAINABILITY 13. Maintaining wheat and lupin yields using phase pastures and shielded sprayers to manage increasing herbicide resistance, Caroline Peek, Nadine Eva, Chris Carter and Megan Abrahams, Department of Agriculture 14. Analaysis of a wheat-pasture rotation in the 330mm annual rainfall zone using the STEP model, Andrew Blake and Caroline Peek, Department of Agriculture 15. Response to winter drought by wheat on shallow soil with low seeding rate and wide row spacing, Paul Blackwell1, Sylvain Pottier2and Bill Bowden1 1 Department of Agriculture; 2Esitpa (France) 16. How much yield variation do you need to justify zoning inputs? Michael Robertson and Greg Lyle, CSIRO Floreat, Bill Bowden, Department of Agriculture; Lisa Brennan, CSIRO Brisbane 17. Automatic guidance and wheat row position: On-row versus between-row seeding at various rates of banded P fertilisers, Tony J. Vyn1, Simon Teakle2, Peter Norris3and Paul Blackwell4,1Purdue University, USA; 2Landmark; 3Agronomy for Profit; 4 Department of Agriculture 18. Assessing the sustainability of high production systems (Avon Agricultural Systems Project), Jeff Russell and James Fisher, Department of Agriculture, Roy Murray-Prior and Deb Pritchard, Muresk Institute; Mike Collins, ex WANTFA, 19. The application of precision agriculture techniques to assess the effectiveness of raised beds on saline land in WA, Derk Bakker, Greg Hamilton, Rob Hetherington, Andrew Van Burgel and Cliff Spann, Department of Agricultur

Cord blood IgG and the risk of severe Plasmodium falciparum malaria in the first year of life

Young infants are less susceptible to severe episodes of malaria but the targets and mechanisms of protection are not clear. Cord blood antibodies may play an important role in mediating protection but many studies have examined their association with the outcome of infection or non-severe malaria. Here, we investigated whether cord blood IgG to Plasmodium falciparum merozoite antigens and antibody-mediated effector functions were associated with reduced odds of developing severe malaria at different time points during the first year of life. We conducted a case-control study of well-defined severe falciparum malaria nested within a longitudinal birth cohort of Kenyan children. We measured cord blood total IgG levels against five recombinant merozoite antigens and antibody function in the growth inhibition activity and neutrophil antibody-dependent respiratory burst assays. We also assessed the decay of maternal antibodies during the first 6months of life. The mean antibody half-life range was 2.51months (95% confidence interval (CI): 2.19-2.92) to 4.91months (95% CI: 4.47-6.07). The rate of decline of maternal antibodies was inversely proportional to the starting concentration. The functional assay of antibody-dependent respiratory burst activity predicted significantly reduced odds of developing severe malaria during the first 6months of life (Odds ratio (OR) 0.07, 95% CI: 0.007-0.74, P=0.007). Identification of the targets of antibodies mediating antibody-dependent respiratory burst activity could contribute to the development of malaria vaccines that protect against severe episodes of malaria in early infancy

Dynamics of Sticky Information and Sticky Price Models in a New Keynesian DSGE Framework

Recent literature on monetary policy analysis extensively uses the sticky price model of price adjustment in a New Keynesian Macroeconomic framework. This price setting model, however, has been criticized for producing implausible results regarding inflation and output dynamics. This paper examines and compares dynamic responses of the sticky price and sticky information models to a cost-push shock in a New Keynesian DSGE framework. It finds that the sticky information model produces more reasonable dynamics through lagged, gradual and hump-shaped responses to a shock as observed in data. However, these responses depend on the persistence of the shock

Crop Updates 2000 - Weeds

This session covers thirty six papers from different authors: INTRODUCTION, Vanessa Stewart Agriculture Western Australia INTEGRATED WEED MANAGEMENT Effect of seeding density, row spacing and Trifluralin on the competitive ability of Annual Ryegrass in a minimum tillage system, David Minkey, Abul Hashem, Glen Riethmuller and Martin Harries, Agriculture Western Australia High wheat seeding rates coupled with narrow row spacing increases yield and suppresses grass, Peter Newman1 and Cameron Weeks2,1Agronomist, Elders Limited 2Mingenew/Irwin Group Resistant ryegrass management in a wheat – lupin rotation, Abul Hashem, Harmohinder S. Dhammu, Aik Cheam, David Bowran and Terry Piper, Agriculture Western Australia Integrated weed management – Will it work with my rotation? Alexandra Wallace, Agriculture Western Australia Long term herbicide resistance trial – Mingenew, Peter Newman Elders, Cameron Weeks Mingenew-Irwin Group Is two years enough? Bill Roy, Agricultural Consulting and Research Services The fate of ryegrass seed when sheep graze chaff cart heaps, Keith L. Devenish1 and Lisa J. Leaver2 1 Agriculture Western Australia, 2Curtin University of Technology, Muresk Institute of Agriculture Can blanket wiping and crop topping prevent seed set of resistant wild radish and mustard? StAbul Hashem, Harmohinder Dhammu, Vanessa Stewart, Brad Rayner and Mike Collins, Agriculture Western Australia The value of green manuring in the integrated management of ryegrass, Marta Monjardino1,2, David Pannell2, Stephen Powles1 ,1Western Australia Herbicide Resistance Initiative, 2Agricultural and Resource Economics, University of Western Australia Some ways of increasing wheat competitiveness against ryegrass,, Mike Collins Centre for Cropping Systems, Agriculture Western Australia WEED BIOLOGY Understanding and driving weed seed banks to very low levels, Sally Peltzer, Agriculture Western Australi HERBICIDE RESISTANCE Cross resistance of chlorsulfuron-resistant wild radish to imidazolinones, Abul Hashem, Harmohinder Dhammu and David Bowran, Agriculture Western Australia Investigation of suspected triazine resistant ryegrass populations for cross-resistance and multiple resistance to herbicides, Michael Walsh, Charles Boyle and Stephen Powles, Western Australian Herbicide Resistance Initiative, University of Western Australia Genetics and fitness of glyphosate resistant ryegrass, S. Powles1, P. Neve1, D. Lorraine-Colwill2, C. Preston2 ,1WAHRI, University of Western Australia 2 CRC Weed Management Systems, University of Adelaide Managing herbicide resistance – the effect of local extinction of resistance genes, Art Diggle1, Paul B. Neve2, Stephen B. Powles2 ,1Agriculture Western Australia, 2WAHRI, Faculty of Agriculture, University of Western Australia The double knock - the best strategy for conserving glyphosate susceptibility? Paul B. Neve1, Art Diggle2, Stephen B. Powles1,1WAHRI, Faculty of Agriculture, University of Western Australia, 2Agriculture Western Australia Wild radish had evolved resistance to triazines, Abul Hashem, Harmohinder S. Dhammu, David Bowran and Aik Cheam, Agriculture Western Australia Ryegrass resistance in Western Australia – where and how much? Rick Llewellyn and Stephen Powles, Western Australian Herbicide Resistance Initiative, Faculty of Agriculture, University of Western Australia Wild radish herbicide resistance survey, Michael Walsh, Ryan Duane and Stephen Powles, Western Australian Herbicide Resistance Initiative, University of Western Australia Knockdown resistance in the Western Australian wheatbelt – a proposed survey, Paul B. Neve1, Abul Hashem2, Stephen B. Powles1,1Western Australian Herbicide Resistance Initiative, University of Western Australia, 2Agriculture Western Australia Diflufenican resistant wild radish, Aik Cheam, Siew Lee, David Bowran, David Nicholson and Abul Hashem, Agriculture Western Australi Multiple resistance to triazines and diflufenican further complicates wild radish control, Aik Cheam, Siew Lee, David Bowran, David Nicholson and Abul Hashem, Agriculture Western Australia HERBICIDE TOLERANCE 25. Herbicide tolerance of lupins, Terry Piper, Weed Science Group, Agriculture Western Australia 26. Tanjil lupins will tolerate metribuzin under the right conditions, Peter Newman, Agronomist Elders Limited and Cameron Weeks, Mingenew/Irwin Group 27. Herbicide damage does not mean lower yield in Lupins, Peter Carlton, Trials Coordinator, Elders Limited 28. Herbicide tolerance of new pea varieties, Dr Terry Piper, Agriculture Western Australia 29. Herbicide tolerance of (waterlogged) wheat, Dr Terry Piper, Agriculture Western Australia 30. Wheat tolerance trials – Mingenew 1999, Peter Newman1, Cameron Weeks2 and Stewart Smith3,1Elders, Mingenew, 2Mingenew-Irwin Group,3Agriculture Western Australia ISSUES OF TRIFLURALIN USE 31. Trifluralin works better on ryegrass when no-tilling into thick wheat stubbles as granules, or mixed with limesand, Bill Crabtree, WANTFA Scientific Officer 32. Increasing trifluralin rate did not compensate for delaying incorporation, Bill Crabtree, WANTFA Scientific Officer 33. Poor emergence survey, 1999, Terry Piper, Weed Science Group, Agriculture Western Australia HERBICIDES – ISSUES AND OPTIONS 34. AFFINITY 400DF – A new herbicide with a new mode of action (Group G) for Broadleaf Weed Control in Cereals, Gordon Cumming, Technical Officer, Crop Care Australasia 35 Herbicide screening for Marshmallow, David Minkey1 and David Cameron2,1Agriculture Western Australia, 2Elders Ltd, Merredin 36. The control of Capeweed in Clearfield Production System for Canola, Mike Jackson and Scott Paton, Cyanamid Agriculture Pty Ltd 37.Effect of herbicides Tordonä 75D and Lontrelä,used for eradication of Skeleton Weed, on production of Lupins I the following seasons, John R. Peirce and Brad J. Rayner, Agriculture Western Australia INDUSTRY PROTECTION 38. Graingaurd – Opportunities for agribusiness to help protect the West Australian grains industry, Greg Shea, Executive Officer, GrainGuard Agriculture Western Australi

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Future Engineers Australia Management Project: Turning high school students into engineering entrepreneurs

There has been a strong move towards entrepreneurial education in high schools and at universities over the past few years. This has been echoed by a call from state governments around Australia to promote enterprise thinking and education in high schools. It also parallels the push within engineering to learn across the traditional boundaries , particularly between engineering and business. To meet this call, The Engineering Link Group (TELG) developed the Future Engineers Australia Management Project (FEAMP) in 2003. The project is based around Enterprise Education, and was inspired by the Smallpeice Year 12 Engineering Management course in the UK. The idea was to take high school students in years 11 and 12 and turn them into ‘engineering entrepreneurs’. This paper presents the design, development and evaluation of FEAMP as a five day residential course for year 11 and 12 students who want to learn more about being entrepreneurs and managers. It is a hands-on activity where the students invent, develop and sell an engineering concept to venture capitalists and ultimately to customers at a trade fair. It has been run successfully for two years, going from strength to strength. © 2005, Australasian Association for Engineering Educatio

The engineering link project: Learning about engineering by becoming an engineer

There has been a greater emphasis over the past few years of encouraging high school students to take up engineering as a career. This is due to a greater need for engineers in society, particularly in areas that are suffering a skills shortage. Both the engineering profession and universities across Australia have moved to address this shortage, with a proliferation of engineering outreach activities and programs the result. The Engineering Link Group (TELG) began the Engineering Link Project (ELP) over a decade ago with a focus on helping motivated high school students make an informed choice about engineering as a career. It also aimed at encouraging more high school students to study maths and science at high school. From the start the ELP was designed so that the students became engineers, rather than just hear from or watch engineers. Real working engineers pose problems to groups of students for them solve over the course of a day. In this way, students experience what it is like to be an engineer. It has been found that the project does help high school students make more informed career choices about engineering. The project also gave the students real life and practical reasons for studying sciences and mathematics at high school. © 2005, Australasian Association for Engineering Educatio

Inheritance and QTL Mapping of Leaf Nutrient Concentration in a Cotton Inter-Specific Derived RIL Population.

Developing and deploying cotton cultivars with high nutrient uptake, use efficiency and tolerance to nutrient related soil stresses is desirable to assist sustainable soil management. Genetic variation, heritability, selection response and quantitative trait loci (QTLs) were investigated for five macronutrients (P, K, Ca, Mg, S) and five micronutrients (Fe, Mn, B, Zn, and Cu) in a recombinant inbred line (RIL) population from an inter-specific cross between Gossypium hirsutum cv. Guazuncho 2, and G. barbadense accession VH8-4602. Na and K/Na ratio were also studied as the imbalance between Na and other nutrients is detrimental to cotton growth and development. The concentrations of nutrients were measured for different plant parts of the two parents and for leaf samples of the whole population collected at early to peak flowering in field experiments over two years in a sodic Vertosol soil. Parental contrast was large for most nutrient concentrations in leaves when compared with other plant parts. Segregation for leaf nutrient concentration was observed within the population with transgression for P, K, K/Na ratio and all micronutrients. Genotypic difference was the major factor behind within-population variation for most nutrients, while narrow sense heritability was moderate (0.27 for Mn and Cu, and 0.43 for B). At least one significant QTL was identified for each nutrient except K and more than half of those QTLs were clustered on chromosomes 14, 18 and 22. Selection response was predicted to be low for P and all micronutrients except B, high for K, Na and B, and very high for K/Na ratio. Correlations were more common between macronutrients, Na and K/Na ratio where the nature and strength of the relations varied (r=-0.69 to 0.76). We conclude that there is sufficient genetic diversity between these two tetraploid cotton species that could be exploited to improve cotton nutrient status by introgressing species-unique favourable alleles