Facilitating implementation of research evidence (FIRE): A randomised controlled trial and process evaluation of two models of facilitation informed by the promoting action on research implementation in health services (PARIHS) framework

Background: The PARIHS framework proposes that successful implementation of research evidence results from the complex interplay between the evidence to be implemented, the context of implementation and the facilitation processes employed. Facilitation is defined as a role (the facilitator) and a process (facilitation strategies/methods). Empirical evidence comparing different facilitation approaches is limited; this paper reports a trial of two different types of facilitation represented in the PARIHS framework. Methods: A pragmatic cluster randomised controlled trial with embedded process evaluation was undertaken in 24 long-term nursing care settings in four European countries. In each country, sites were randomly allocated to standard dissemination of urinary incontinence guideline recommendations and one of two types of external-internal facilitation, labelled Type A and B. Type A facilitation was a less resource intensive approach, underpinned by improvement methodology; Type B was a more intensive, emancipatory model of facilitation, informed by critical social science. The primary outcome was percentage documented compliance with guideline recommendations. Process evaluation was framed by realist methodology and involved quantitative and qualitative data collection from multiple sources. Findings: Quantitative data were obtained from reviews of 2313 records. Qualitative data included over 332 hours of observations of care; 39 hours observation of facilitation activity; 471 staff interviews; 174 resident interviews; 120 next of kin/carer interviews; and 125 stakeholder interviews. There were no significant differences in the primary outcome between study arms and all study arms improved over time. Process data revealed three core mechanisms that influenced the trajectory of the facilitation intervention: alignment of the facilitation approach to the needs and expectations of the internal facilitator and colleagues; engagement of internal facilitators and staff in attitude and action; and learning over time. Data from external facilitators demonstrated that the facilitation interventions did not work as planned, issues were cumulative and maintenance of fidelity was problematic. Implications for D&I Research: Evaluating an intervention - in this case facilitation - that is fluid and dynamic within the methodology of a randomised controlled trial is complex and challenging. For future studies, we suggest a theoretical approach to fidelity, with a focus on mechanisms, as opposed to dose and intensity of the intervention

Route Level Evaluation of Queue Lengths Display at the Amsterdam Orbital Motorway: Evaluation of Route Information Amsterdam, Phase 4

Report published by the Delft University of Technology, Transportation Planning and Traffic Engineering Section, commissioned by the Ministry of Transportation, North Holland Directorate. The use of Variabie Message Signs (VMS's) is generally considered to be a powerful tool to influence (en-route) route choice in order to improve safety and comfort while driving, to improve the network performance, and optimally make use of the available capacity. Assessing whether such effects actually occur when VMS's are installed is a difficult task. This report presents the results of an extensive evaluation study carried out at installing 14 new VMS's at the Amsterdam orbital motorway. The study involves a number of issues. First, the relation between the messages displayed at the VMS and the travel times experienced by drivers is analyzed. Second, a stimulus response analysis is used to find out how drivers respond in reality to the messages is described. Finally, a network-wide analysis of aggregate performance indicators, like queue length, distance traveled, and time spent on the network is included. The study showed that the use of VMS's has a positive impact on network performance in the Amsterdam freeway system. Total congestion has slightly decreased, while traffic performance has slightly increased. Variation in congestion has decreased, as weil as variation in average travelspeed. This implies that travel time has become more reliable and that the traffic flow is more homogeneous. The technical assessment showed that the displayed queue lengths, if interpreted correctly by the drivers, are a good measure for the expected delay. User response analysis, measured by modeling route choice as a function of information provided, showed that information has a significant effect on route choice. In general, the VMS's were found to be a tooi to improve the efficiency and reliability of the system.Transport & PlanningCivil Engineering and Geoscience

Dynamic origin-destination matrix estimation on motorway networks

Civil Engineering and Geoscience

Path enumeration by finding the constrained K-shortest paths

This paper deals with algorithms for finding the constrained K-shortest paths (CKSP) and their application to the path enumeration problem. An attractive property of using Constrained Shortest Paths for path enumeration is that paths can be selected based on objective criteria. The conventional way of finding these paths is to compute a sufficiently large number of overall shortest paths, and deleting the ones that do not satisfy the constraints. However for realistically sized networks, combined with restrictive constraints this method becomes unfeasible because of CPU time restrictions. A new method is proposed that finds the feasible shortest paths directly and can be applied in combination with a wide class of constraints. The paper explains how this CKSP algorithm can be implemented using the ordinary shortest path computation as its elementary operation. An example is provided in which the method is used to enumerate paths while avoiding strongly overlapping and overly circuitous paths. In this context the computational performance of the CKSP method is compared with that of the conventional method. On a network consisting of 200 nodes a speed-up factor exceeding 62 has been demonstrated on a problem that involves finding the 200 constrained shortest paths. The speed-up factor increases sharply with the size of the network and the level of restriction of the constraints. As opposed to the conventional method, the proposed implementation of the CKSP method displays only a limited sensitivity to the level of restriction of the constraints. While the conventional method could only deal with small networks, the proposed method can also enumerate paths for more realistically sized networks.

Stormverslag Waddenzee: 11 januari 2007

Dit stormverslag heeft betrekking op de stormcondities van 11 januari 2007 in de Waddenzee en is opgesteld in het kader van het monitoring programma \u93Sterkte en Belasting Waterkeringen\u94 (SBW) conform het productblad stormverslag Waddenzee [1]. \u93Over de gehele kust kwam in de middag van 11 januari een zuidwesterstorm (9 Bft) te staan. In het begin van de middag passeerde het koufront van de depressie de Nederlandse kust. Na de passage van dit front ruimde de wind naar het westen en nam in kracht af tot stormachtig (8 Bft). Boven de Wadden ruimde de wind in de loop van de avond verder naar het west-noordwesten en nam weer toe tot storm (9 Bft). In de loop van de nacht van 12 januari nam de wind langs de hele kust af tot een krachtige wind (6 Bft) en kromp naar het zuidwesten.\u94 Kenmerkend voor deze storm was vooral de grote wateropzet. Omdat er sprake was van doodtij zijn extreem hoge waterstanden echter uitgebleven. De hoogste scheve opzet is gemeten in de nacht van 11 op 12 januari. Voor de analyseperiode is daarom de periode 11 januari 00:00 tot en met 12 januari 24:00 genomen op de locaties Texel Noordzee en Huibertgat.SB

Stormverslag Waddenzee: 18 januari 2007

Dit stormverslag heeft betrekking op de stormcondities van 18 januari 2007 in de Waddenzee. Dit verslag is opgesteld in het kader van het monitoring programma \u93Sterkte en Belasting Waterkeringen\u94 (SBW) conform het productblad stormverslag Waddenzee. \u93Op de zuidelijke Noordzee en langs de hele kust kwam in de loop van de ochtend een zware zuidwesterstorm (10 Bft) te staan, windstoten bereikten zelfs orkaankracht. Aan het einde van de middag ruimde de wind naar west. In de loop van de avond ruimde de wind ten noorden van de Wadden zelfs nog voor korte tijd naar noordwest. De windkracht bleef vrijwel de hele dag rond 10 Bft. Na de passage van de back-bent occlusie nam de wind langs de hele kust in zeer snel tempo af. Rond middernacht was de wind langs de hele kust afgenomen tot een krachtige tot harde westenwind (6 á 7 Bft).\u94 Het maximale effect van de zware (zuid)westerstorm viel in de avond van 18 januari gelijk met het hoogwater in het noordelijk kustgebied. De bijdrage van het getij aan de stormvloedstanden is gemiddeld te noemen. De hoogste scheve opzet is gemeten in de nacht van 18 op 19 januari. Voor de analyseperiode is daarom de periode 18 januari 00:00 tot en met 19 januari 24:00 genomen op de locaties Texel Noordzee en Huibertgat.SB

Stormverslag Waddenzee: 18 maart 2007

Dit stormverslag heeft betrekking op de stormcondities van 18 maart 2007 in de Waddenzee. Dit verslag is opgesteld in het kader van het monitoring programma \u93Sterkte en Belasting Waterkeringen\u94 (SBW) conform het productblad stormverslag Waddenzee. \u93Boven de noordelijke Noordzee stond er op 18 maart rond het middaguur een zware noordwesterstorm (10 Bft). Boven het zeegebied tussen Nederland en Noorwegen stond er toen een westerstorm (9 Bft). In de loop van de nacht van 18 op 19 maart ruimde de wind naar het noorden en nam op zee af tot een krachtige wind (6 Bft). In de vroege ochtend van 20 maart nam de wind boven het westelijke deel van de Noordzee weer toe tot een harde noordenwind (7 Bft). In de loop van de nacht van 20 op 21 maart nam de wind over de hele Noordzee af tot een vrij krachtige tot krachtige noordenwind (5 á 6 Bft).\u94 Doordat de astronomische getijden vanwege springtij erg hoog waren veroorzaakte de storm met name in het noordelijke kustgebied een grote wateropzet. De hoogste opzet vond plaats bij Delfzijl (213 cm). Gezien in het licht van de veeljarige statistieken komt de opzet die is opgetreden bij Den Helder (163 cm) het minst voor (3 maal per 10 jaar). De hoogste scheve opzet is gemeten in de avond van 18 maart. Voor de analyseperiode is daarom de periode 18 maart 00:00 tot en met 19 maart 24:00 genomen op de locaties Texel Noordzee en Huibertgat.SB

Traffic monitoring using handheld GSM phones. Part B: Simulation study

Revised version of LVV rapport, VK 2001.004. This report contains the description of a novel map-matching algorithm, and the results of a simulation study into the feasibility of traffic monitoring using handheld mobile phones.Transport & PlanningCivil Engineering and Geoscience

Co-ordinated traffic control in freeway corridors: A proposed evaluation approach

In the course of the Telematics implications Programme Transport of the European Commission Fourth Framework Research Programme much attention is devoted to evaluation and demonstration. This report is part of the DACCORD project TR1017, devoted to the development and application of co-ordinated traffic control in freeway corridors. The report presents an evaluation plan for the Fourth Framework programme DACCORD. An extensive methodology has been applied to prepare a systematic and comprehensive evaluation plan. It contains an analysis assessment objectives, specification of performance indicators enabling evaluation at distinct levels of assessment (i.e. technical level, user-acceptance, impact analysis, and socio-economic assessment) and a description of various tools for validation. The plan has been developed to be site-independent to a large extent, thereby maximising the potential for cross-comparison, by proposal of common verification and demonstration plans for distinct sites. Additionally, the evaluation plan enables harmonisation of results from other European ATT-projects.Transport and PlanningCivil Engineering and Geoscience