Improving allied health professionals' research implementation behaviours for children with cerebral palsy: protocol for a before-after study

BACKGROUND: Cerebral palsy is a permanent disorder of posture and movement caused by disturbances in the developing brain. It affects approximately 1 in every 500 children in developed countries and is the most common form of childhood physical disability. People with cerebral palsy may also have problems with speech, vision and hearing, intellectual difficulties and epilepsy. Health and therapy services are frequently required throughout life, and this care should be effective and evidence informed; however, accessing and adopting new research findings into day-to-day clinical practice is often delayed.

METHODS/DESIGN: This 3-year study employs a before and after design to evaluate if a multi-strategy intervention can improve research implementation among allied health professionals (AHPs) who work with children and young people with cerebral palsy and to establish if children's health outcomes can be improved by routine clinical assessment. The intervention comprises (1) knowledge brokering with AHPs, (2) access to an online research evidence library, (3) provision of negotiated evidence-based training and education, and (4) routine use of evidence-based measures with children and young people aged 3-18 years with cerebral palsy. The study is being implemented in four organisations, with a fifth organisation acting as a comparison site, across four Australian states. Effectiveness will be assessed using questionnaires completed by AHPs at baseline, 6, 12 and 24 months, and by monitoring the extent of use of evidence-based measures. Children's health outcomes will be evaluated by longitudinal analyses.

DISCUSSION: Government, policy makers and service providers all seek evidence-based information to support decision-making about how to distribute scarce resources, and families are seeking information to support intervention choices. This study will provide knowledge about what constitutes an efficient, evidence-informed service and which allied health interventions are implemented for children with cerebral palsy.

TRIAL REGISTRATION: Trial is not a controlled healthcare intervention and is not registered.

The design and implementation of a study to investigate the effectiveness of community vs hospital eye service follow-up for patients with neovascular age-related macular degeneration with quiescent disease

Introduction
Standard treatment for neovascular age-related macular degeneration (nAMD) is intravitreal injections of anti-VEGF drugs. Following multiple injections, nAMD lesions often become quiescent but there is a high risk of reactivation, and regular review by hospital ophthalmologists is the norm. The present trial examines the feasibility of community optometrists making lesion reactivation decisions.

Methods
The Effectiveness of Community vs Hospital Eye Service (ECHoES) trial is a virtual trial; lesion reactivation decisions were made about vignettes that comprised clinical data, colour fundus photographs, and optical coherence tomograms displayed on a web-based platform. Participants were either hospital ophthalmologists or community optometrists. All participants were provided with webinar training on the disease, its management, and assessment of the retinal imaging outputs. In a balanced design, 96 participants each assessed 42 vignettes; a total of 288 vignettes were assessed seven times by each professional group.The primary outcome is a participant's judgement of lesion reactivation compared with a reference standard. Secondary outcomes are the frequency of sight threatening errors; judgements about specific lesion components; participant-rated confidence in their decisions about the primary outcome; cost effectiveness of follow-up by optometrists rather than ophthalmologists.

Discussion
This trial addresses an important question for the NHS, namely whether, with appropriate training, community optometrists can make retreatment decisions for patients with nAMD to the same standard as hospital ophthalmologists. The trial employed a novel approach as participation was entirely through a web-based application; the trial required very few resources compared with those that would have been needed for a conventional randomised controlled clinical trial.

Implementation of a cogeneration plant for a food processing facility. A case study

The present work presents an investigation regarding the feasibility analysis of a cogeneration plant for a food processing facility with the aim to decrease the cost of energy supply. The monthly electricity and heat consumption profiles are analyzed, in order to understand the consumption profiles, as well as the costs of the current furniture of electricity and gas. Then, a detailed thermodynamic model of the cogeneration cycle is implemented and the investment costs are linked to the thermodynamic variables by means of cost functions. The optimal electricity power of the co-generator is determined with reference to various investment indexes. The analysis highlights that the optimal dimension varies according to the chosen indicator, therefore it is not possible to establish it univocally, but it depends on the financial/economic strategy of the company through the considered investment index.

Follow up on the local implementation of an MPA in the small fishing village of San Felipe, Yucatan

Dissertação mest., Biologia Marinha, Universidade do Algarve, 2007

Water framework directive implementation: intercalibration exercise for biological quality elements: a case study for the south coast of Portugal

This work summarises the Intercalibration Exercise (IE) required for the Common Implementation Strategy of the Water Framework Directive (WFD; 2000/60/EC) that was carried out in Portugal, and applied to a coastal region. The WFD aims to achieve good ec ological status for all waters in the European Community by 2015. The Ecological Status of a water body is determined us ing a range of Hydromorphological and Physico-Chemical Quality Elements as well Biological Quality Elements (BQE ). In coastal waters, the Biological Elements include Phytoplankton, Other Aquatic Flora and Benthic Inverteb rate Fauna. Good cooperation with the other Member States allowed the IE to proceed without a complete da ta set, and Portugal was ab le to intercalibrate and harmonise methods within the North Ea st Atlantic Geographica l Intercalibration Group for most of the BQE. The appropriate metrics and corre sponding methods were agreed under the framework of the RECITAL (Reference Conditions and Intercalibra tion) project, funded by the Port uguese Water Institu te, INAG. Some preliminary sampling was undertaken, but not su fficient to establish the Reference Conditions. The study area was a coastal lagoon in the southern part of Portugal. The focus was on the Phytoplankton Quality Element, but other BQE were also taken into account. Two sampli ng stations in Ria Formosa coastal lagoon were considered in this exercise: Ramalhete a nd Ponte. The metrics adopted by the Intercalibration Exercise groups were applied enabli ng the classification for the two sta tions of Good/High Status for the majority of the BQE parameters.

Implementation of a service quality strategy: application to the Algarve hotel industry

Tese dout., Doctor of Philisophy, Sheffield Hallam University, 2001

Design and implementation of a real-time data acquisition system for the identification of dynamic temperature models in a hydroponic greenhouse

This text describes a real data acquisition and identification system implemented in a soilless greenhouse located at the University of Algarve (south of Portugal). Using the Real Time Workshop, Simulink, Matlab and the C programming language a system was developed to perform real-time data acquisition from a set of sensors.

Implementation of an daptive generalized predictive control algorithm over an heterogeneous parallel architecture

In this paper a parallel implementation of an Adaprtive Generalized Predictive Control (AGPC) algorithm is presented. Since the AGPC algorithm needs to be fed with knowledge of the plant transfer function, the parallelization of a standard Recursive Least Squares (RLS) estimator and a GPC predictor is discussed here.

Parallel implementation of an adaptive generalized predictive control algorithm

The Adaptive Generalized Predictive Control (AGPC) algorithm can be speeded up using parallel processing. Since the AGPC algorithm needs to be fed with the knowledge of the plant transfer function, the parallelization of a standard Recursive Least Squares (RLS) estimator and a GPC predictor is discussed here.

Parallel implementation of an adaptive generalized predictive control algorithm

The Adaptive Generalized Predictive Control (GPC) algorithm can be speeded up using parallel processing. Since the GPC algorithm needs to be fed with knowledge of the plant transfer function, the parallelization of a standard Recursive Least Squares (RLS) estimator and a GPC predictor is discussed here.

An efficient parallel implementation of a least squares problem

Least squares solutions are a very important problem, which appear in a broad range of disciplines (for instance, control systems, statistics, signal processing). Our interest in this kind of problems lies in their use of training neural network controllers.

An efficient parallel implementation of a least squares problem

Least squares solutions are a very important problem, which appear in a broad range of disciplines (for instance, control systems, statistics, signal processing). Our interest in this kind of problems lies in their use of training neural network controllers.

Parallel implementation of a learning algorithm for multilayer perceptrons using transputers

In this paper the parallelization of a new learning algorithm for multilayer perceptrons, specifically targeted for nonlinear function approximation purposes, is discussed. Each major step of the algorithm is parallelized, a special emphasis being put in the most computationally intensive task, a least-squares solution of linear systems of equations.