2,339 research outputs found

    Heteroatom-doped core/shell carbonaceous framework materials : synthesis, characterization and electrochemical properties

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    Organic-inorganic hybrid core@shell nanospherical particles with 200 nm to 600 nm in diameter were formed between cyclomatrix poly(organophosphazenes) (POP) and zeolitic imidazolate framework-8 (ZIF-8) in a methanol solution at room temperature. This facile synthesis route produced core@shell spheres with controlled structure and properties, such as mono-dispersed particles, 50 nm to 100 nm shell thickness, surface area of 1557 m2 g-1 and homogenously doped Zn and heteroatoms (N, S, P, O, Cl). The POP/ZIF-8 core@shell structures were subsequently converted into porous carbonaceous materials, and investigated as anode materials in a lithium-ion coin cell battery. It showed a stable discharge capacity of 538 mA h g-1 over 250 cycles, high rate capability (0.1 C to 1 C) and excellent capacity retention, which are promising for rapid charge-discharge applications. Higher ZIF-8 loading ratio in the core@shell structure increased the capacity of the electrode material and stablised the lithiated active materials. The facile synthesis method and the carbonaceous framework materials are applicable for high performance energy storage materials in electrochemical power devices

    A framework for synthesis of safety justification for digitally enabled healthcare services

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    Digitally enabled healthcare services combine socio-technical resources to deliver the required outcomes to patients. Unintended operation of these services may result in adverse effects to the patient. Eliminating avoidable harm requires a systematic way of analysing the causal conditions, identifying opportunities for intervention. Operators of such services may be required to justify, and communicate, their safety. For example, the UK Standardisation Committee for Care Information (SCCI) standards 0129 and 0160 require a safety justification for health IT (superseded versions were known as the Information Standards Board (ISB) 0129 & 0160. Initial as well as current standards are maintained by the NHS Digital.MethodA framework was designed, and applied as proof of concept, to an IT-supported clinical emergencies (A&E) service. Evaluation was done qualitatively based on the authors? experience, identifying potential benefits of the approach.ResultsThe applied framework encapsulates analysis, and structures the generated information, into a skeleton of an evidence-based case for safety. The framework improved management of the safety activities, assigning ownership to stakeholders (e.g. IT developer), also creating a clear and compelling safety justification.ConclusionsApplication of the framework significantly contributed to systematising an exploratory approach for analysing the service, in addition to existing methods such as reporting. Its application made the causal chain to harm more diaphanous. Constructing a safety case contributed to: (a) identifying potential assurance gaps, (b) planning production of information and evidence, and (c) communication of the justification by graphical unambiguous means

    Innovation in systematic review methods: successive developments in framework synthesis

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    Background: Systematic reviews are used increasingly to synthesise research for policy and practice decisions. Systematic reviews use transparent, explicit and consistent methods to identify, appraise and integrate research evidence, to inform existing assumptions. Traditionally used to examine the effects of health care, systematic review methods have evolved to address more complex issues across health and social policy. Framework synthesis is one systematic review method employed to address such complexity. Adapted from framework analysis used in primary research, framework synthesis begins with an a priori conceptual framework, which develops iteratively as new data are incorporated and themes derived from the data. Framework synthesis has been used increasingly in qualitative and mixed-method systematic reviews, sometimes incorporating stakeholder consultation to describe and interpret review findings. Aims: This thesis will demonstrate how my development of framework synthesis methods is situated within, and contributes to, wider debates about research synthesis methods in systematic reviews. Methods: I conducted an overview of systematic reviews. A systematic review of the literature discussing or employing framework synthesis methods was conducted. Included studies were ordered and synthesised using framework synthesis methods. The resulting conceptual framework structured the assessment of each of the submitted publications (the ‘thesis reviews’). Findings were subsequently incorporated into the conceptual framework and higher order themes derived using constant comparative analysis. Results: This thesis distinguishes two key approaches to framework synthesis: one approach that constructs a framework (often in discussion with stakeholders) to accommodate research from across academic disciplines and/or policy sectors; and the ‘best-fit’ approach that borrows a framework from a related area to initiate synthesis within a narrower disciplinary or policy scope. Its utility is demonstrated in handling mixed methods and mixed sources reviews, using diverse data types and synthesis methods in order to generate, explore and/or test theory in collaboration with stakeholders. I conclude that framework synthesis is a very flexible research synthesis method that can meet the complex conditions and epistemology arising from public health policy issues

    "Best fit" framework synthesis: refining the method

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    Background Following publication of the first worked example of the “best fit” method of evidence synthesis for the systematic review of qualitative evidence in this journal, the originators of the method identified a need to specify more fully some aspects of this particular derivative of framework synthesis. Methods and Results We therefore present a second such worked example in which all techniques are defined and explained, and their appropriateness is assessed. Specified features of the method include the development of new techniques to identify theories in a systematic manner; the creation of an a priori framework for the synthesis; and the “testing” of the synthesis. An innovative combination of existing methods of quality assessment, analysis and synthesis is used to complete the process. This second worked example was a qualitative evidence synthesis of employees’ views of workplace smoking cessation interventions, in which the “best fit” method was found to be practical and fit for purpose. Conclusions The method is suited to producing context-specific conceptual models for describing or explaining the decision-making and health behaviours of patients and other groups. It offers a pragmatic means of conducting rapid qualitative evidence synthesis and generating programme theories relating to intervention effectiveness, which might be of relevance both to researchers and policy-makers

    Patients’ perceptions and experiences of cardiovascular disease and diabetes prevention programmes:a systematic review and framework synthesis using the Theoretical Domains Framework

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    Background - This review provides a worked example of ‘best fit’ framework synthesis using the Theoretical Domains Framework (TDF) of health psychology theories as an a priori framework in the synthesis of qualitative evidence. Framework synthesis works best with ‘policy urgent’ questions. Objective - The review question selected was: what are patients’ experiences of prevention programmes for cardiovascular disease (CVD) and diabetes? The significance of these conditions is clear: CVD claims more deaths worldwide than any other; diabetes is a risk factor for CVD and leading cause of death. Method - A systematic review and framework synthesis were conducted. This novel method for synthesizing qualitative evidence aims to make health psychology theory accessible to implementation science and advance the application of qualitative research findings in evidence-based healthcare. Results - Findings from 14 original studies were coded deductively into the TDF and subsequently an inductive thematic analysis was conducted. Synthesized findings produced six themes relating to: knowledge, beliefs, cues to (in)action, social influences, role and identity, and context. A conceptual model was generated illustrating combinations of factors that produce cues to (in)action. This model demonstrated interrelationships between individual (beliefs and knowledge) and societal (social influences, role and identity, context) factors. Conclusion - Several intervention points were highlighted where factors could be manipulated to produce favourable cues to action. However, a lack of transparency of behavioural components of published interventions needs to be corrected and further evaluations of acceptability in relation to patient experience are required. Further work is needed to test the comprehensiveness of the TDF as an a priori framework for ‘policy urgent’ questions using ‘best fit’ framework synthesis

    A worked example of "best fit" framework synthesis: A systematic review of views concerning the taking of some potential chemopreventive agents

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    <p>Abstract</p> <p>Background</p> <p>A variety of different approaches to the synthesis of qualitative data are advocated in the literature. The aim of this paper is to describe the application of a pragmatic method of qualitative evidence synthesis and the lessons learned from adopting this "best fit" framework synthesis approach.</p> <p>Methods</p> <p>An evaluation of framework synthesis as an approach to the qualitative systematic review of evidence exploring the views of adults to the taking of potential agents within the context of the primary prevention of colorectal cancer.</p> <p>Results</p> <p>Twenty papers from North America, Australia, the UK and Europe met the criteria for inclusion. Fourteen themes were identified <it>a priori </it>from a related, existing conceptual model identified in the literature, which were then used to code the extracted data. Further analysis resulted in the generation of a more sophisticated model with additional themes. The synthesis required a combination of secondary framework and thematic analysis approaches and was conducted within a health technology assessment timeframe.</p> <p>Conclusion</p> <p>The novel and pragmatic "best fit" approach to framework synthesis developed and described here was found to be fit for purpose. Future research should seek to test further this approach to qualitative data synthesis.</p

    Determining Force Field Parameters Involved with Metal Organic Framework Synthesis

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    Metal organic frameworks (MOFs) are synthetic materials made of a cage-like lattice with consistently spaced pores. The size of these pores are the defining characteristic of a MOF, as it determines which gases are allowed to pass through and which can be trapped. Examples of their potential use can be greenhouse gas sequestration or storage. Currently, the synthesis of MOFs is based on trial-and-error, and the successes are not well understood. We are working on building the theoretical framework that describes how a particular MOF, MIL-101, comes together during synthesis. Our initial approach was to simulate the possible reactions with chemical kinetics through Cantera (a software suite that works through Python). To do this, a list of all possible intermediates with their thermodynamic properties is required. Another approach is to calculate the chemical force field potentials, and simulate how the atoms themselves behave during the synthesis process. For both purposes we minimized the energy of the structure of one known intermediate, called ML3 (a metal core with three linkers) through Assisted Model Building with Energy Refinement (AMBER) and with electronic structure calculations through Gaussian 09. In the end, the parameters that defined this minimized structure of ML3 were found. These can be used further to build the MIL-101 mechanism for use in Cantera, as well as the force field simulations

    Improving quality of care and outcome at very preterm birth: the Preterm Birth research programme, including the Cord pilot RCT

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    BACKGROUND:Being born very premature (i.e. before 32 weeks’ gestation) has an impact on survival and quality of life. Improving care at birth may improve outcomes and parents’ experiences. OBJECTIVES:To improve the quality of care and outcomes following very preterm birth. DESIGN:We used mixed methods, including a James Lind Alliance prioritisation, a systematic review, a framework synthesis, a comparative review, qualitative studies, development of a questionnaire tool and a medical device (a neonatal resuscitation trolley), a survey of practice, a randomised trial and a protocol for a prospective meta-analysis using individual participant data. SETTING:For the prioritisation, this included people affected by preterm birth and health-care practitioners in the UK relevant to preterm birth. The qualitative work on preterm birth and the development of the questionnaire involved parents of infants born at three maternity hospitals in southern England. The medical device was developed at Liverpool Women’s Hospital. The survey of practice involved UK neonatal units. The randomised trial was conducted at eight UK tertiary maternity hospitals. PARTICIPANTS:For prioritisation, 26 organisations and 386 individuals; for the interviews and questionnaire tool, 32 mothers and seven fathers who had a baby born before 32 weeks’ gestation for interviews evaluating the trolley, 30 people who had experienced it being used at the birth of their baby (19 mothers, 10 partners and 1 grandmother) and 20 clinicians who were present when it was being used; for the trial, 261 women expected to have a live birth before 32 weeks’ gestation, and their 276 babies. INTERVENTIONS:Providing neonatal care at very preterm birth beside the mother, and with the umbilical cord intact; timing of cord clamping at very preterm birth. MAIN OUTCOME MEASURES:Research priorities for preterm birth; feasibility and acceptability of the trolley; feasibility of a randomised trial, death and intraventricular haemorrhage. REVIEW METHODS:Systematic review of Cochrane reviews (umbrella review); framework synthesis of ethics aspects of consent, with conceptual framework to inform selection criteria for empirical and analytical studies. The comparative review included studies using a questionnaire to assess satisfaction with care during childbirth, and provided psychometric information. RESULTS:Our prioritisation identified 104 research topics for preterm birth, with the top 30 ranked. An ethnographic analysis of decision-making during this process suggested ways that it might be improved. Qualitative interviews with parents about their experiences of very preterm birth identified two differences with term births: the importance of the staff appearing calm and of staff taking control. Following a comparative review, this led to the development of a questionnaire to assess parents’ views of care during very preterm birth. A systematic overview summarised evidence for delivery room neonatal care and revealed significant evidence gaps. The framework synthesis explored ethics issues in consent for trials involving sick or preterm infants, concluding that no existing process is ideal and identifying three important gaps. This led to the development of a two-stage consent pathway (oral assent followed by written consent), subsequently evaluated in our randomised trial. Our survey of practice for care at the time of birth showed variation in approaches to cord clamping, and that no hospitals were providing neonatal care with the cord intact. We showed that neonatal care could be provided beside the mother using either the mobile neonatal resuscitation trolley we developed or existing equipment. Qualitative interviews suggested that neonatal care beside the mother is valued by parents and acceptable to clinicians. Our pilot randomised trial compared cord clamping after 2 minutes and initial neonatal care, if needed, with the cord intact, with clamping within 20 seconds and initial neonatal care after clamping. This study demonstrated feasibility of a large UK randomised trial. Of 135 infants allocated to cord clamping ≥ 2 minutes, 7 (5.2%) died and, of 135 allocated to cord clamping ≤ 20 seconds, 15 (11.1%) died (risk difference –5.9%, 95% confidence interval –12.4% to 0.6%). Of live births, 43 out of 134 (32%) allocated to cord clamping ≥ 2 minutes had intraventricular haemorrhage compared with 47 out of 132 (36%) allocated to cord clamping ≤ 20 seconds (risk difference –3.5%, 95% CI –14.9% to 7.8%). LIMITATIONS:Small sample for the qualitative interviews about preterm birth, single-centre evaluation of neonatal care beside the mother, and a pilot trial. CONCLUSIONS:Our programme of research has improved understanding of parent experiences of very preterm birth, and informed clinical guidelines and the research agenda. Our two-stage consent pathway is recommended for intrapartum clinical research trials. Our pilot trial will contribute to the individual participant data meta-analysis, results of which will guide design of future trials. FUTURE WORK:Research in preterm birth should take account of the top priorities. Further evaluation of neonatal care beside the mother is merited, and future trial of alternative policies for management of cord clamping should take account of the meta-analysis. STUDY REGISTRATION:This study is registered as PROSPERO CRD42012003038 and CRD42013004405. In addition, Current Controlled Trials ISRCTN21456601. FUNDING:This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 7, No. 8. See the NIHR Journals Library website for further project information

    From Screening to Synthesis: Using NVivo to Enhance Transparency in Qualitative Evidence Synthesis

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    Aims and objectives The aim of this qualitative evidence synthesis was to explore the experiences and perceptions of health care staff caring for people with dementia in the acute setting. This paper focuses on the methodological process of conducting framework synthesis using NVivo for each stage of the review: screening, data extraction, synthesis and critical appraisal. Background Qualitative evidence synthesis brings together many research findings in a meaningful way that can be used to guide practice and policy development. For this purpose, synthesis must be conducted in a comprehensive and rigorous way. There has been previous discussion on how using NVivo can assist in enhancing and illustrate the rigorous processes involved. Design Qualitative Framework Synthesis. Methods Twelve documents, or research reports, based on nine studies, were included for synthesis. Conclusion The benefits of using NVivo are outlined in terms of facilitating teams of researchers to systematically and rigorously synthesise findings. NVivo functions were used to conduct a sensitivity analysis. Some valuable lessons were learned and these are presented to assist and guide researchers who wish to use similar methods in future
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