Improving the normalization of complex interventions: measure development based on normalization process theory (NoMAD): study protocol

<b>Background</b> Understanding implementation processes is key to ensuring that complex interventions in healthcare are taken up in practice and thus maximize intended benefits for service provision and (ultimately) care to patients. Normalization Process Theory (NPT) provides a framework for understanding how a new intervention becomes part of normal practice. This study aims to develop and validate simple generic tools derived from NPT, to be used to improve the implementation of complex healthcare interventions.<p></p> <b>Objectives</b> The objectives of this study are to: develop a set of NPT-based measures and formatively evaluate their use for identifying implementation problems and monitoring progress; conduct preliminary evaluation of these measures across a range of interventions and contexts, and identify factors that affect this process; explore the utility of these measures for predicting outcomes; and develop an online users’ manual for the measures.<p></p> <b>Methods</b> A combination of qualitative (workshops, item development, user feedback, cognitive interviews) and quantitative (survey) methods will be used to develop NPT measures, and test the utility of the measures in six healthcare intervention settings.<p></p> <b>Discussion</b> The measures developed in the study will be available for use by those involved in planning, implementing, and evaluating complex interventions in healthcare and have the potential to enhance the chances of their implementation, leading to sustained changes in working practices

The future for sheep

In the 1960\u27s the sheep industry has been described as being at a crossroads. Serious concern has been expressed over the future of the entire industry. Declining numbers, competition from other meats and fabrics and low returns have all been cited as reasons for pessimism. But recent developments in product improvement and industrywide efforts to a~tack problems have given rise to a degree of cautious optimism about the future.https://lib.dr.iastate.edu/card_reports/1022/thumbnail.jp

1960: Abilene Christian College Lectures - Full Text

Table of Contents: Theme Speeches: Christian Faith in the Modern World Basis of Faith - Leonard Mullens - 9 Authority in Christianity - John T. Smithson, Jr. - 27 Origin and Preservation of the Bible - Neil R. Lightfoot - 44 Alleged Discrepancies of the Bible - David H. Bobo - 62 The Unity of the Bible - Jack Meyer - 91 Faith and Reason - Joe Sanders - 115 The Reasonableness of Supernaturalism - Virgil Trout - 126 The Present Statue of the Doctrine of Organic Evolution - J.D. Thomas - 146 The Nature of Man - Roy F. Osborne, Jr. - 181 Modern Challenges to Christian Morals - Carl Spain - 199 The Christ, Whose Son is He? - Gordon Teel - 232 Special Speeches Teaching the Word of God in Korea - L. Haskell Chessfire - 255 The Influence of Christian Education - Judge Jack Pope - 276 Mission Opportunities in the Far East - Harry Robert Fox - 288 Mission Work in Austria - Robert Skelton - 303 Report from Switzerland - Heinrich Blum - 313 The Work in Nigeria - Rees Byrant - 320 The Training of Evangelists in Foreign Fields - Reiner Kallus - 331 Christian Scholarships - Everett Ferguson - 340 Evangelizing the World - A.R. Holton - 349 Panel Discussions The Significance of the Dead Sea Scrolls The Scrolls and the Text of the Bible - Paul Rotenberry - 357 The Relation between the Religion of the Essenes and that of Early Christians - Jay Smith - 366 Biblical Interpretation Expediency and Pattern Authority - J.W. Roberts - 381 Examples in Pattern Authority - Thomas B. Warren - 392 Mental Health and Sin The Present State of Mental Health Knowledge - Donald R. Sime - 409 The Relationship of Mental Health Problems to Sin - Paul Easley - 421 The Teenager The Problems of Youth - Mack Wayne Craig - 432 Influences for Good - Wyatt Sawyer - 443 The Benefits of Abilene Christian College To the Church - Hulen Jackson - 451 To The Home - Robert S. Bell - 459 \u27To the Community - Louie Welch - 465 Expenses At Abilene Christian College - James C. Kerr - 469 The Graduate School at Abilene Christian College What I Am Getting Now in the ACC Graduate Program - Harold Vanderpool - 475 How the ACC Graduate Program Has Stood Up - Everett Ferguson - 481 What the ACC Graduate Program Ought To Be - Frank Pack - 486 The Importance to the Church of the ACC Graduate Program A.R. Holton - 490 Beware: Large File Size Uploaded by Jackson Hage

Challenges for Implementing an Ecosystem Approach to Fisheries Management

The ecosystem approach is being promoted as the foundation of solutions to the unsustainability of fisheries. However, because the ecosystem approach is broadly inclusive, the science for its implementation is often considered to be overly complex and difficult. When the science needed for an ecosystem approach to fisheries is perceived this way, science products cannot keep pace with fisheries critics, thus encouraging partisan political interference in fisheries management and proliferation of “faith-based solutions. In this paper we argue that one way to effectively counter politicization of fisheries decision-making is to ensure that new ecosystem-based approaches in fisheries are viewed only as an emergent property of innovation in science and policy. We organize our essay using three major themes to focus the discussion: empirical, jurisdictional, and societal challenges. We undertake at least partial answers to the following questions: (1) has conventional fisheries management really failed?; (2) can short-comings in conventional fisheries management be augmented with new tools, such as allocation of rights?; (3) is the Ecosystem Approach to Fisheries (EAF) equivalent to Ecosystem-Based Management?; and (4) is restoration of degraded ecosystems a necessary component of an EAF

Transancestral mapping and genetic load in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease with marked gender and ethnic disparities. We report a large transancestral association study of SLE using Immunochip genotype data from 27,574 individuals of European (EA), African (AA) and Hispanic Amerindian (HA) ancestry. We identify 58 distinct non-HLA regions in EA, 9 in AA and 16 in HA (B50% of these regions have multiple independent associations); these include 24 novel SLE regions (Po5 10 8), refined association signals in established regions, extended associations to additional ancestries, and a disentangled complex HLA multigenic effect. The risk allele count (genetic load) exhibits an accelerating pattern of SLE risk, leading us to posit a cumulative hit hypothesis for autoimmune disease. Comparing results across the three ancestries identifies both ancestry-dependent and ancestry-independent contributions to SLE risk. Our results are consistent with the unique and complex histories of the populations sampled, and collectively help clarify the genetic architecture and ethnic disparities in SL

The Sloan Digital Sky Survey: Technical Summary

The Sloan Digital Sky Survey (SDSS) will provide the data to support detailed investigations of the distribution of luminous and non- luminous matter in the Universe: a photometrically and astrometrically calibrated digital imaging survey of pi steradians above about Galactic latitude 30 degrees in five broad optical bands to a depth of g' about 23 magnitudes, and a spectroscopic survey of the approximately one million brightest galaxies and 10^5 brightest quasars found in the photometric object catalog produced by the imaging survey. This paper summarizes the observational parameters and data products of the SDSS, and serves as an introduction to extensive technical on-line documentation.Comment: 9 pages, 7 figures, AAS Latex. To appear in AJ, Sept 200

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Reflections on the Methodological Approach of Systematic Reviews

The concept of systematic reviewing of research literatures became influential in the second half of the 20th century, in the context of the longstanding, and challenging, issue of how to ‘translate’ research findings into reliable guidance for practical decision-making—to determine which policies, programs, and strategies should (and should not) be adopted (Hammersley 2014; Nisbet and Broadfoot 1980)

Prioritizing multiple therapeutic targets in parallel using automated DNA-encoded library screening

AbstractThe identification and prioritization of chemically tractable therapeutic targets is a significant challenge in the discovery of new medicines. We have developed a novel method that rapidly screens multiple proteins in parallel using DNA-encoded library technology (ELT). Initial efforts were focused on the efficient discovery of antibacterial leads against 119 targets from Acinetobacter baumannii and Staphylococcus aureus. The success of this effort led to the hypothesis that the relative number of ELT binders alone could be used to assess the ligandability of large sets of proteins. This concept was further explored by screening 42 targets from Mycobacterium tuberculosis. Active chemical series for six targets from our initial effort as well as three chemotypes for DHFR from M. tuberculosis are reported. The findings demonstrate that parallel ELT selections can be used to assess ligandability and highlight opportunities for successful lead and tool discovery.</jats:p