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

RAMESES publication standards: meta-narrative reviews

PMCID: PMC3558334This 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

Evaluating the process for deceased organ donation: a programme theory approach

– Organ donation and transplantation services represent a microcosm of modern healthcare organisations. They are complex adaptive systems. They face perpetual problems of matching supply and demand. They operate under fierce time and resource constraints. And yet they have received relatively little attention from a systems perspective. The purpose of this paper is to consider some of the fundamental issues in evaluating, improving and policy reform in such complex systems

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

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

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

Overview of NASA's Carbon Monitoring System Flux-Pilot Project

NASA's space-based observations of physical, chemical and biological parameters in the Earth System along with state-of-the-art modeling capabilities provide unique capabilities for analyses of the carbon cycle. The Carbon Monitoring System is developing an exploratory framework for detecting carbon in the environment and its changes, with a view towards contributing to national and international monitoring activities. The Flux-Pilot Project aims to provide a unified view of land-atmosphere and ocean-atmosphere carbon exchange, using observation-constrained models. Central to the project is the application of NASA's satellite observations (especially MODIS), the ACOS retrievals of the JAXA-GOSAT observations, and the "MERRA" meteorological reanalysis produced with GEOS-S. With a primary objective of estimating uncertainty in computed fluxes, two land- and two ocean-systems are run for 2009-2010 and compared with existing flux estimates. An transport model is used to evaluate simulated CO2 concentrations with in-situ and space-based observations, in order to assess the realism of the fluxes and how uncertainties in fluxes propagate into atmospheric concentrations that can be more readily evaluated. Finally, the atmospheric partial CO2 columns observed from space are inverted to give new estimates of surface fluxes, which are evaluated using the bottom-up estimates and independent datasets. The focus of this presentation will be on the science goals and current achievements of the pilot project, with emphasis on how policy-relevant questions help focus the scientific direction. Examples include the issue of what spatio-temporal resolution of fluxes can be detected from polar-orbiting satellites and whether it is possible to use space-based observations to separate contributions to atmospheric concentrations of (say) fossil-fuel and biological activit

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

The Global Observing System in the Assimilation Context

Weather and climate analyses and predictions all rely on the global observing system. However, the observing system, whether atmosphere, ocean, or land surface, yields a diverse set of incomplete observations of the different components of Earth s environment. Data assimilation systems are essential to synthesize the wide diversity of in situ and remotely sensed observations into four-dimensional state estimates by combining the various observations with model-based estimates. Assimilation, or associated tools and products, are also useful in providing guidance for the evolution of the observing system of the future. This paper provides a brief overview of the global observing system and information gleaned through assimilation tools, and presents some evaluations of observing system gaps and issues