Bulletin No. 15: Integration in DPMP: An organising principle and an expanded set of tools

DPMP involves various levels of integration: • across law enforcement, treatment, harm reduction and prevention, as both approaches and sectors; • across global, national, state and local scales; • between research, policy and other practice; and • across an array of disciplinary and epistemological research approaches. Although the need for integration to better deal with complex problems, like illicit drug use, is now widely recognised and discussed, formalised processes for achieving this have been slow to develop. A unique aspect of DPMP is its close link with the new cross-cutting specialisation of Integration and Implementation Sciences. The specialisation draws from a range of disciplines, such as political science, systems thinking, complexity science, participatory methods, management, and information science, and aims to help make better-founded decisions on complex social problems by applying integrative methods to: • tackling problems systemically; • deepening understanding of problems based on all the relevant disciplines and interests; • applying knowledge management strategies to cope with both information overload and diverse epistemologies; and • applying understanding of how action occurs, in other words how policy is made, how business operates, how activism succeeds; as well as how action can be influenced by evidence. Thus the new specialisation provides theory, methods and skills to facilitate comprehensive examination of issues and problems, as well as effective mobilisation to action. Integration and Implementation Sciences also seeks to incorporate the effective use of research-based knowledge to help bring about change. Specifically, Integration and Implementation Sciences is developing theory and methods for: 1. Comprehensive scoping of problems and issues. 2. Application of appropriate integrative concepts and methods. 3. Involvement of the strengths of different research epistemologies. 4. Attention to emergent properties, i.e. to identifying and understanding properties that disappear when a system is studied in disaggregated segments. 5. Understanding of policy, product development and action and how these can be influenced by research. 6. Application of knowledge management concepts and tools. 7. Development and application of expanded ways of taking uncertainty into account. 8. Managing the inevitability of less than perfect outcomes. 9. Application of concepts and methods from change management and innovation, including developing new roles such as boundary spanners and knowledge brokers to apply research to changed practice. 10. Development and application of collaborative processes. DPMP has built on the insights gained as Integration and Implementation Sciences have developed. This has allowed some of the best leading edge ideas and methods developed in other areas to be introduced to the illicit drugs field

Bulletin No. 13: Popular culture and the prevention of illicit drug use

In terms of the four key strategies underpinning drug policy – law enforcement, treatment, harm reduction and prevention – prevention is arguably the weakest. It is currently narrowly conceived and does not have an effective guiding idea, in contrast to substitution therapy for drug treatment. It also does not have a dedicated practice sector, unlike law enforcement. It is noteworthy that popular culture is key in normalising attitudes to illicit drugs, and that this is largely ignored in the prevention literature. We are not suggesting that there is a simple or direct causal link, but instead that the cultural milieu can influence the acceptability of illicit drug use. Our aim was to determine if it was feasible to investigate the impact of popular culture on illicit drug use and we therefore undertook a pilot study on popular music

Bulletin No.1: Drug Policy - Mapping structures and enhancing processes

We understand very little about how research informs policy and how to improve that process, especially in highly politicised areas such as illicit drugs. One aim of DPMP is to significantly increase production of the highest quality evidence, which takes complexities and dynamic interactions into account. For this evidence to impact on Australian policy, we need to better understand how policy is made; the kinds of research that are most valued; and how research is best inserted into policy processes. Lack of appreciation of how policies are made is a major barrier to providing good decision support resources and processes. While we do not subscribe to a naïve view that research should be the only, or even the most important, factor in policy making, we are keen to see research assume its proper role and, within that, to be maximally effective. Surprisingly, there has been relatively little examination of what ‘evidence-informed’ policy is, in drugs, public health, criminal justice or more broadly. There has also been very limited research to shine a light on the collective experience of policy making in an attempt to learn from that experience, so that we may pursue it more wisely in the future

Don't know, can't know: Embracing deeper uncertainties when analysing risks

This article is available open access through the publisher’s website at the link below. Copyright @ 2011 The Royal Society.Numerous types of uncertainty arise when using formal models in the analysis of risks. Uncertainty is best seen as a relation, allowing a clear separation of the object, source and ‘owner’ of the uncertainty, and we argue that all expressions of uncertainty are constructed from judgements based on possibly inadequate assumptions, and are therefore contingent. We consider a five-level structure for assessing and communicating uncertainties, distinguishing three within-model levels—event, parameter and model uncertainty—and two extra-model levels concerning acknowledged and unknown inadequacies in the modelling process, including possible disagreements about the framing of the problem. We consider the forms of expression of uncertainty within the five levels, providing numerous examples of the way in which inadequacies in understanding are handled, and examining criticisms of the attempts taken by the Intergovernmental Panel on Climate Change to separate the likelihood of events from the confidence in the science. Expressing our confidence in the adequacy of the modelling process requires an assessment of the quality of the underlying evidence, and we draw on a scale that is widely used within evidence-based medicine. We conclude that the contingent nature of risk-modelling needs to be explicitly acknowledged in advice given to policy-makers, and that unconditional expressions of uncertainty remain an aspiration

Issues for designing and evaluating a 'heroin trial': three discussion papers

Report on a workshop on trial evaluation / G. Bammer and D.N. McDonald -- An evaluation of possible designs for a heroin trial / R.G. Jarrett and P.J. Solomon -- Service provision considerations for the evaluation of a heroin trial. A discussion paper / D.N. McDonald, G. Bammer, D.G. Legge and B.M. Sibthorpe

Relationship among research collaboration, number of documents and number of citations. A case study in Spanish computer science production in 2000-2009.

This paper analyzes the relationship among research collaboration, number of documents and number of citations of computer science research activity. It analyzes the number of documents and citations and how they vary by number of authors. They are also analyzed (according to author set cardinality) under different circumstances, that is, when documents are written in different types of collaboration, when documents are published in different document types, when documents are published in different computer science subdisciplines, and, finally, when documents are published by journals with different impact factor quartiles. To investigate the above relationships, this paper analyzes the publications listed in the Web of Science and produced by active Spanish university professors between 2000 and 2009, working in the computer science field. Analyzing all documents, we show that the highest percentage of documents are published by three authors, whereas single-authored documents account for the lowest percentage. By number of citations, there is no positive association between the author cardinality and citation impact. Statistical tests show that documents written by two authors receive more citations per document and year than documents published by more authors. In contrast, results do not show statistically significant differences between documents published by two authors and one author. The research findings suggest that international collaboration results on average in publications with higher citation rates than national and institutional collaborations. We also find differences regarding citation rates between journals and conferences, across different computer science subdisciplines and journal quartiles as expected. Finally, our impression is that the collaborative level (number of authors per document) will increase in the coming years, and documents published by three or four authors will be the trend in computer science literature

A holistic multi-methodology for sustainable renovation

A review of the barriers for building renovation has revealed a lack of methodologies, which can promote sustainability objectives and assist various stakeholders during the design stage of building renovation/retrofitting projects. The purpose of this paper is to develop a Holistic Multi-methodology for Sustainable Renovation, which aims to deal with complexity of renovation projects. It provides a framework through which to involve the different stakeholders in the design process to improve group learning and group decision-making, and hence make the building renovation design process more robust and efficient. Therefore, the paper discusses the essence of multifaceted barriers in building renovation regarding cultural changes and technological/physical changes. The outcome is a proposal for a multi-methodology framework, which is developed by introducing, evaluating and mixing methods from Soft Systems Methodologies (SSM) with Multiple Criteria Decision Making (MCDM). The potential of applying the proposed methodology in renovation projects is demonstrated through a case study

Managing clinical trials

Managing clinical trials, of whatever size and complexity, requires efficient trial management. Trials fail because tried and tested systems handed down through apprenticeships have not been documented, evaluated or published to guide new trialists starting out in this important field. For the past three decades, trialists have invented and reinvented the trial management wheel. We suggest that to improve the successful, timely delivery of important clinical trials for patient benefit, it is time to produce standard trial management guidelines and develop robust methods of evaluation

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Abstract Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.http://deepblue.lib.umich.edu/bitstream/2027.42/78272/1/1748-5908-4-50.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/2/1748-5908-4-50-S1.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/3/1748-5908-4-50-S3.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/4/1748-5908-4-50-S4.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/5/1748-5908-4-50.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/6/1748-5908-4-50-S2.PDFPeer Reviewe

A cross-sectional study of the number and frequency of terms used to refer to knowledge translation in a body of health literature in 2006: a Tower of Babel?

<p/> <p>Background</p> <p>The study of implementing research findings into practice is rapidly growing and has acquired many competing names (<it>e.g</it>., dissemination, uptake, utilization, translation) and contributing disciplines. The use of multiple terms across disciplines pose barriers to communication and progress for applying research findings. We sought to establish an inventory of terms describing this field and how often authors use them in a collection of health literature published in 2006.</p> <p>Methods</p> <p>We refer to this field as knowledge translation (KT). Terms describing aspects of KT and their definitions were collected from literature, the internet, reports, textbooks, and contact with experts. We compiled a database of KT and other articles by reading 12 healthcare journals representing multiple disciplines. All articles published in these journals in 2006 were categorized as being KT or not. The KT articles (all KT) were further categorized, if possible, for whether they described KT projects or implementations (KT application articles), or presented the theoretical basis, models, tools, methods, or techniques of KT (KT theory articles). Accuracy was checked using duplicate reading. Custom designed software determined how often KT terms were used in the titles and abstracts of articles categorized as being KT.</p> <p>Results</p> <p>A total of 2,603 articles were assessed, and 581 were identified as KT articles. Of these, 201 described KT applications, and 153 included KT theory. Of the 100 KT terms collected, 46 were used by the authors in the titles or abstracts of articles categorized as being KT. For all 581 KT articles, eight terms or term variations used by authors were highly discriminating for separating KT and non-KT articles (p < 0.001): implementation, adoption, quality improvement, dissemination, complex intervention (with multiple endings), implementation (within three words of) research, and complex intervention. More KT terms were associated with KT application articles (n = 13) and KT theory articles (n = 18).</p> <p>Conclusions</p> <p>We collected 100 terms describing KT research. Authors used 46 of them in titles and abstracts of KT articles. Of these, approximately half discriminated between KT and non-KT articles. Thus, the need for consolidation and consistent use of fewer terms related to KT research is evident.</p