How do primary health care teams learn to integrate intimate partner violence (IPV) management? A realist evaluation protocol

Background: Despite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues—such as IPV management—get integrated into health systems, and that focuses on healthcare teams’ learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services. Methods: This study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management. Discussion: Evaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning and how team learning is connected with changes in organizational culture and values, and in service delivery. This realist evaluation protocol aims to contribute to this knowledge by conducting this project in a country, Spain, where great endeavours have been made towards the integration of IPV management within the health system.

Reproducibility comparison among multiangle spectrophotometers

New color-measuring instruments known as multiangle spectrophotometers have been recently created to measure and characterize the goniochromism of special-effect pigments in many materials with a particular visual appearance (metallic, interference, pearlescent, sparkle, or glitter). These devices measure the gonioapparent color from the spectral relative reflectance factor and the L*a*b* values of the sample with different illumination and observation angles. These angles usually coincide with requirements marked in American Society for Testing and Materials (ASTM) and Deutsches Institut Für Normung standards relating to the gonioapparent color, but the results of comparisons between these instruments are still inconclusive. Therefore, the main purpose of this study is to compare several multiangle spectrophotometers at a reproducibility level according to ASTM E2214-08 guidelines. In particular, we compared two X-Rite multi-gonio spectrophotometers (MA98 and MA68II), a Datacolor multi-gonio spectrophotometer (FX10), and a BYK multi-gonio spectrophotometer (BYK-mac). These instruments share only five common measurement geometries: 45° × −30° (as 15°), 45° × −20° (as 25°), 45° × 0° (as 45°), 45° × 30° (as 75°), 45° × 65° (as 110°). Specific statistical studies were used for the reproducibility comparison, including a Hotelling test and a statistical intercomparison test to determine the confidence interval of the partial color differences ΔL*, Δa*, Δb*, and the total color difference ΔE*ab. This was conducted using a database collection of 88 metallic and pearlescent samples that were measured 20 times without the replacement of all the instruments. The final findings show that in most measurement geometries, the reproducibility differences between pairs of instruments are statistically significant, although in general, there is a better reproducibility level at certain common geometries for newer instruments (MA98 and BYK-mac). This means that these differences are due to systematic or bias errors (angle tolerances for each geometry, photometric scales, white standards, etc.), but not exclusively to random errors. However, neither of the statistical tests used is valid to discriminate and quantify the detected bias errors in this comparison between instruments.

Visibility of sparkle in metallic paints

For suitable illumination and observation conditions, sparkles may be observed in metallic coatings. The visibility of these sparkles depends critically on their intensity, and on the paint medium surrounding the metallic flakes. Based on previous perception studies from other disciplines, we derive equations for the threshold for sparkles to be visible. The resulting equations show how the visibility of sparkles varies with the luminosity and distance of the light source, the diameter of the metallic flakes, and the reflection properties of the paint medium. The predictions are confirmed by common observations on metallic sparkle. For example, under appropriate conditions even metallic flakes as small as 1 μm diameter may be visible as sparkle, whereas under intense spot light the finer grades of metallic coatings do not show sparkle. We show that in direct sunlight, dark coarse metallic coatings show sparkles that are brighter than the brightest stars and planets in the night sky. Finally, we give equations to predict the number of visually distinguishable flake intensities, depending on local conditions. These equations are confirmed by previous results. Several practical examples for applying the equations derived in this article are provided.