RAMESES publication standards: realist syntheses

PMCID: PMC3558331This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Are you serious? From fist bumping to hand hygiene: considering culture, context and complexity in infection prevention intervention research

Infection prevention is an under-resourced research and development topic, with limited evidence for practice in the most basic of measures. A survey of IPS R&D members indicated that what might appear to be simple interactions and interventions in healthcare, such as hand shaking and hand hygiene, should be considered complex interventions taking account of behaviour at the individual and social level as well as contextual factors. Future studies need to be designed utilising comprehensive approaches, for example, the Medical Research Council complex interventions framework, tailored to the country and more local cultural context, if we are to be serious about evidence for infection prevention and control practice

Global Assimilation of Loon Stratospheric Balloon Observations and Their Trajectories Relative to Tropical Waves

Project Loon has an overall goal of providing worldwide internet coverage using a network of long-duration super-pressure balloons. Beginning in 2013, Loon has launched over 1600 balloons from multiple tropical and middle latitude locations. These GPS tracked balloon trajectories provide lower stratospheric wind information over the oceans and remote land areas where traditional radiosonde soundings are sparse, thus providing unique coverage of lower stratospheric winds. To fully investigate these Loon winds we: 1) compare the Loon winds to winds produced by a global data assimilation system (DAS: NASA GEOS) and 2) assimilate the Loon winds into the same comprehensive DAS. During May through December 2016 Loon balloons were often able to remain near the equator by selectively adjusting the Loon altitude. Our results based on global wind analyses show that the expected mean poleward motion from the Brewer-Dobson circulation can be circumvented by vertically adjusting the Loon altitudes with the phasing with the meridional wind of equatorial Rossby waves, allowing the Loon balloons to remain in the tropics

Introducing EMMIE: An evidence rating scale to encourage mixed-method crime prevention synthesis reviews

Objectives This short report describes the need for, and the development of, a coding system to distil the quality and coverage of systematic reviews of the evidence relating to crime prevention interventions. The starting point for the coding system concerns the evidence needs of policymakers and practitioners. Methods The coding scheme (EMMIE) proposed builds on previous scales that have been developed to assess the probity, coverage and utility of evidence both in health and criminal justice. It also draws on the principles of realist synthesis and review. Results The proposed EMMIE scale identifies five dimensions to which systematic reviews intended to inform crime prevention should speak. These are the Effect of intervention, the identification of the causal Mechanism(s) through which interventions are intended to work, the factors that Moderate their impact, the articulation of practical Implementation issues, and the Economic costs of intervention

Using non-participant observation to uncover mechanisms: insights from a realist evaluation

This article outlines how a realist evaluation of dementia care in hospitals used non-participant observation to support the refinement and testing of mechanisms likely to lead to the use of person-centred care. We found that comments and explanations of their actions from hospital staff during observation periods provided insights into the reasoning that generated their actions for care in real time. This informed subsequent data collection and analysis. Two worked examples of mechanisms first identified during non-participant observation demonstrate (1) how they were uncovered, and (2) how this informed research activities for theory refinement. Early, iterative engagement with the analytic process, primarily involving reflection and debate with the research team, maximised the potential of observation data to support surfacing underlying mechanisms, linking them to specific contexts and outcomes.Peer reviewedFinal Accepted Versio

Developing a model to estimate the potential impact of municipal investment on city health

This article summarizes a process which exemplifies the potential impact of municipal investment on the burden of cardiovascular disease (CVD) in city populations. We report on Developing an evidence-based approach to city public health planning and investment in Europe (DECiPHEr), a project part funded by the European Union. It had twin objectives: first, to develop and validate a vocational educational training package for policy makers and political decision takers; second, to use this opportunity to iterate a robust and user-friendly investment tool for maximizing the public health impact of 'mainstream' municipal policies, programs and investments. There were seven stages in the development process shared by an academic team from Sheffield Hallam University and partners from four cities drawn from the WHO European Healthy Cities Network. There were five iterations of the model resulting from this process. The initial focus was CVD as the biggest cause of death and disability in Europe. Our original prototype 'cost offset' model was confined to proximal determinants of CVD, utilizing modified 'Framingham' equations to estimate the impact of population level cardiovascular risk factor reduction on future demand for acute hospital admissions. The DECiPHEr iterations first extended the scope of the model to distal determinants and then focused progressively on practical interventions. Six key domains of local influence on population health were introduced into the model by the development process: education, housing, environment, public health, economy and security. Deploying a realist synthesis methodology, the model then connected distal with proximal determinants of CVD. Existing scientific evidence and cities' experiential knowledge were 'plugged-in' or 'triangulated' to elaborate the causal pathways from domain interventions to public health impacts. A key product is an enhanced version of the cost offset model, named Sheffield Health Effectiveness Framework Tool, incorporating both proximal and distal determinants in estimating the cost benefits of domain interventions. A key message is that the insights of the policy community are essential in developing and then utilising such a predictive tool

Blurring the boundaries between synthesis and evaluation. A customized realist evaluative synthesis into adolescent risk behavior prevention

Realist methodologies have been increasingly advocated for the investigation of complex social issues. Public health programs, such as those designed to prevent adolescent risk behavior, are typically considered complex. In conducting a realist review of the empirical literature relating to such programs, we encountered several challenges, including (a) an overabundance of empirical evidence, (b) a problematic level of heterogeneity within and between methodological approaches, (c) discrepancies between theoretical underpinnings and program operationalization, (d) homogeneity of program outcomes, with very little variation in program effectiveness, and (d) a paucity of description relating to content and process. To overcome these challenges, we developed a customized approach to realist evidence synthesis, drawing on the VICTORE (Volition, Implementation, Contexts, Time, Outcomes, Rivalry, and Emergence) complexity checklist and incorporating stakeholder engagement as primary data to achieve greater depth of understanding relating to contextual and mechanistic factors, and the complex interactions between them. Here we discuss the benefits of this adapted methodology alongside an overview of the research through which the methodology was developed. A key finding from this research was that combining the complexity checklist with primary data from stakeholder engagement enabled us to systematically interrogate the data across data sources, uncovering and evidencing mechanisms which may otherwise have remained hidden, giving greater ontological depth to our research findings. This paper builds on key methodological developments in realist research, demonstrating how realist methodologies can be customized to overcome challenges in developing and refining program theory from the literature, and contributes to the broader literature of innovative approaches to realist research

Design and performance of ropes for climbing and sailing

Ropes are an important part of the equipment used by climbers, mountaineers, and sailors. On first inspection, most modern polymer ropes appear similar, and it might be assumed that their designs, construction, and properties are governed by the same requirements. In reality, the properties required of climbing ropes are dominated by the requirement that they effectively absorb and dissipate the energy of the falling climber, in a manner that it does not transmit more than a critical amount of force to his body. This requirement is met by the use of ropes with relatively low longitudinal stiffness. In contrast, most sailing ropes require high stiffness values to maximize their effectiveness and enable sailors to control sails and equipment precisely. These conflicting requirements led to the use of different classes of materials and different construction methods for the two sports. This paper reviews in detail the use of ropes, the properties required, manufacturing techniques and materials utilized, and the effect of service conditions on the performance of ropes. A survey of research that has been carried out in the field reveals what progress has been made in the development of these essential components and identifies where further work may yield benefits in the future

A phylogenetic revision of the New Zealand endemic ground beetle genus Oregus Putzeys 1868 (Carabidae : Broscini)

The genus Oregus is an endemic broscine ground beetle restricted in distribution to the east coast of the South Island of New Zealand. The taxonomic and phylogenetic relationships within the genus Oregus Putzeys and the abundance and distribution of Oregus inaequalis Castelnau were examined. A cladistic analysis of external morphological and genitalic characters was conducted, as well as genetic analysis using partial cytochrome oxidase I and NADH-dehydrogenase I mitochondrial DNA sequences. A total of 2,196 specimens were examined during the course of this study. Specimens were examined from the entire geographic range of the genus. The cladistic analysis was conducted from 17 populations for the morphological characters and 12 populations for the DNA sequences. Analysis of morphological characters indicated that male genitalic characters were less homoplasious than external morphology. Parsimony analysis of morphological data separated populations of Oregus into four species; O. aereus White, O. inaequalis Castelnau and two new species, subsequently described as O. septentrionalis n. sp. and O. crypticus n. sp. Mitochondrial DNA sequence data (analysed using parsimony and maximum likelihood) supported the morphological species designations, except for O. crypticus as fresh material for DNA analysis of this species was not available. Genetic diversity between species was between 3.05 and 5.36% across both gene regions. Intraspecific genetic diversity was generally low, except in O. aereus, which had extensive variation between populations (up to 2.48%). The genetic diversity in O. aereus was not reflected in genital morphology. An extensive pitfall trapping trial failed to collect enough individuals of O. inaequalis at Swampy Summit (Dunedin) to allow accurate estimation of abundance using either mark-removal or mark recapture methods. However, the number of O. inaequalis caught, the low probability of capture and the ratio of O. inaequalis caught to other species of Carabidae would still indicate a relatively large population at Swampy Summit. There was an apparent contraction to the geographical range of O. inaequalis based on the historical literature, which is merely a reflection of several misidentified specimens. Presence/absence pitfall trapping did not extend the historical distribution of O. inaequalis and confirmed that O. inaequalis is a narrow range endemic, restricted to the podocarp broadleaf forests and moist tussock/shrubland ecosystems immediately to the north of Dunedin City. Pitfall trapping did not show any significant contraction to the confirmed range of O. inaequalis. Oregus. inaequalis, though a distinct taxonomic entity is not regarded as threatened given the lack of range contraction and the apparently substantial population at Swampy Summit. As such it is not recommended as being a candidate for active conservation management