Electron-impact excitation of Ni II: Collision strengths and effective collision strengths for low lying fine-structure forbidden transitions

Context. Considerable demand exists for electron excitation data for Ni ii, since lines from this abundant ion are observed in a wide variety of laboratory and astrophysical spectra. The accurate theoretical determination of these data can present a significant challenge however, due to complications arising from the presence of an open 3d-shell in the description of the target ion. Aims. In this work we present collision strengths and Maxwellian averaged effective collision strengths for the electron-impact ex- citation of Ni ii. Attention is concentrated on the 153 forbidden fine-structure transitions between the energetically lowest 18 levels of Ni ii. Effective collision strengths have been evaluated at 27 individual electron temperatures ranging from 30–100 000 K. To our knowledge this is the most extensive theoretical collisional study carried out on this ion to date.Methods. The parallel R-matrix package RMATRX II has recently been extended to allow for the inclusion of relativistic effects. This suite of codes has been utilised in the present work in conjunction with PSTGF to evaluate collision strengths and effective collision strengths for all of the low-lying forbidden fine-structure transitions. The following basis configurations were included in the target model – 3d9 , 3d8 4s, 3d8 4p, 3d7 4s2 and 3d7 4s4p – giving rise to a sophisticated 295 j j-level, 1930 coupled channel scattering problem. Results. Comprehensive comparisons are made between the present collisional data and those obtained from earlier theoretical evaluations. While the effective collision strengths agree well for some transitions, significant discrepancies exist for others.

Assessing and measuring impact of a digital collection in the humanities: An analysis of the SPHERE (Stormont Parliamentary Hansards: Embedded in Research and Education) Project

Although a substantial corpus of digital materials is now available to scholarship across the disciplines, objective evidence of their use, impact, and value, based on a robust assessment, is sparse. Traditional methods of assessment of impact in the humanities, notably citation in scholarly publications, are not an effective way of assessing impact of digital content. These issues are problematic in the field of Digital Humanities where there is a need to effectively assess impact to justify its continued funding and existence. A number of qualitative and quantitative methods exist that can be used to monitor the use of digital resources in various contexts although they have yet to be applied widely. These have been made available to the creators, managers, and funders of digital content in an accessible form through the TIDSR (Toolkit for the Impact of Digital Scholarly Resources) developed by the Oxford Internet Institute. In 2011, the authors of this article developed the SPHERE project (Stormont Parliamentary Hansards: Embedded in Research and Education) specifically to use TIDSR to evaluate the use and impact of The Stormont Papers, a digital collection of the Hansards of the Stormont Northern Irish Parliament from 1921 to 1972. This article presents the methodology, findings, and analysis of the project. The authors argue that TIDSR is a useful and, critically, transferrable method to understand and increase the impact of digital resources. The findings of the project are modified into a series of wider recommendations on protecting the investment in digital resources by increasing their use, value, and impact. It is reasonable to suggest that effectively showing the impact of Digital Humanities is critical to its survival.

PAlliative Care in chronic Kidney diSease: the PACKS study—quality of life, decision making, costs and impact on carers in people managed without dialysis

BACKGROUND: The number of patients with advanced chronic kidney disease opting for conservative management rather than dialysis is unknown but likely to be growing as increasingly frail patients with advanced renal disease present to renal services. Conservative kidney management includes ongoing medical input and support from a multidisciplinary team. There is limited evidence concerning patient and carer experience of this choice. This study will explore quality of life, symptoms, cognition, frailty, performance decision making, costs and impact on carers in people with advanced chronic kidney disease managed without dialysis and is funded by the National Institute of Health Research in the UK.

METHODS: In this prospective, multicentre, longitudinal study, patients will be recruited in the UK, by renal research nurses, once they have made the decision not to embark on dialysis. Carers will be asked to 'opt-in' with consent from patients. The approach includes longitudinal quantitative surveys of quality of life, symptoms, decision making and costs for patients and quality of life and costs for carers, with questionnaires administered quarterly over 12 months. Additionally, the decision making process will be explored via qualitative interviews with renal physicians/clinical nurse specialists.

DISCUSSION: The study is designed to capture patient and carer profiles when conservative kidney management is implemented, and understand trajectories of care-receiving and care-giving with the aim of optimising palliative care for this population. It will explore the interactions that lead to clinical care decisions and the impact of these decisions on informal carers with the intention of improving clinical outcomes for patients and the experiences of care givers.

Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: a qualitative-evidence synthesis

Background:
Prolonged mechanical ventilation is associated with a longer intensive care unit (ICU) length of stay and higher mortality. Consequently, methods to improve ventilator weaning processes have been sought. Two recent Cochrane systematic reviews in ICU adult and paediatric populations concluded that protocols can be effective in reducing the duration of mechanical ventilation, but there was significant heterogeneity in study findings. Growing awareness of the benefits of understanding the contextual factors impacting on effectiveness has encouraged the integration of qualitative evidence syntheses with effectiveness reviews, which has delivered important insights into the reasons underpinning (differential) effectiveness of healthcare interventions.

Objectives:
1. To locate, appraise and synthesize qualitative evidence concerning the barriers and facilitators of the use of protocols for weaning critically-ill adults and children from mechanical ventilation;

2. To integrate this synthesis with two Cochrane effectiveness reviews of protocolized weaning to help explain observed heterogeneity by identifying contextual factors that impact on the use of protocols for weaning critically-ill adults and children from mechanical ventilation;

3. To use the integrated body of evidence to suggest the circumstances in which weaning protocols are most likely to be used.

Search methods:
We used a range of search terms identified with the help of the SPICE (Setting, Perspective, Intervention, Comparison, Evaluation) mnemonic. Where available, we used appropriate methodological filters for specific databases. We searched the following databases: Ovid MEDLINE, Embase, OVID, PsycINFO, CINAHL Plus, EBSCOHost, Web of Science Core Collection, ASSIA, IBSS, Sociological Abstracts, ProQuest and LILACS on the 26th February 2015. In addition, we searched: the grey literature; the websites of professional associations for relevant publications; and the reference lists of all publications reviewed. We also contacted authors of the trials included in the effectiveness reviews as well as of studies (potentially) included in the qualitative synthesis, conducted citation searches of the publications reporting these studies, and contacted content experts.

We reran the search on 3rd July 2016 and found three studies, which are awaiting classification.

Selection criteria:
We included qualitative studies that described: the circumstances in which protocols are designed, implemented or used, or both, and the views and experiences of healthcare professionals either involved in the design, implementation or use of weaning protocols or involved in the weaning of critically-ill adults and children from mechanical ventilation not using protocols. We included studies that: reflected on any aspect of the use of protocols, explored contextual factors relevant to the development, implementation or use of weaning protocols, and reported contextual phenomena and outcomes identified as relevant to the effectiveness of protocolized weaning from mechanical ventilation.

Data collection and analysis:
At each stage, two review authors undertook designated tasks, with the results shared amongst the wider team for discussion and final development. We independently reviewed all retrieved titles, abstracts and full papers for inclusion, and independently extracted selected data from included studies. We used the findings of the included studies to develop a new set of analytic themes focused on the barriers and facilitators to the use of protocols, and further refined them to produce a set of summary statements. We used the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) framework to arrive at a final assessment of the overall confidence of the evidence used in the synthesis. We included all studies but undertook two sensitivity analyses to determine how the removal of certain bodies of evidence impacted on the content and confidence of the synthesis. We deployed a logic model to integrate the findings of the qualitative evidence synthesis with those of the Cochrane effectiveness reviews.

Main results:
We included 11 studies in our synthesis, involving 267 participants (one study did not report the number of participants). Five more studies are awaiting classification and will be dealt with when we update the review.

The quality of the evidence was mixed; of the 35 summary statements, we assessed 17 as ‘low’, 13 as ‘moderate’ and five as ‘high’ confidence. Our synthesis produced nine analytical themes, which report potential barriers and facilitators to the use of protocols. The themes are: the need for continual staff training and development; clinical experience as this promotes felt and perceived competence and confidence to wean; the vulnerability of weaning to disparate interprofessional working; an understanding of protocols as militating against a necessary proactivity in clinical practice; perceived nursing scope of practice and professional risk; ICU structure and processes of care; the ability of protocols to act as a prompt for shared care and consistency in weaning practice; maximizing the use of protocols through visibility and ease of implementation; and the ability of protocols to act as a framework for communication with parents.

Authors' conclusions:
There is a clear need for weaning protocols to take account of the social and cultural environment in which they are to be implemented. Irrespective of its inherent strengths, a protocol will not be used if it does not accommodate these complexities. In terms of protocol development, comprehensive interprofessional input will help to ensure broad-based understanding and a sense of ‘ownership’. In terms of implementation, all relevant ICU staff will benefit from general weaning as well as protocol-specific training; not only will this help secure a relevant clinical knowledge base and operational understanding, but will also demonstrate to others that this knowledge and understanding is in place. In order to maximize relevance and acceptability, protocols should be designed with the patient profile and requirements of the target ICU in mind. Predictably, an under-resourced ICU will impact adversely on protocol implementation, as staff will prioritize management of acutely deteriorating and critically-ill patients.