Using realist evaluation to assess primary healthcare teams’ responses to intimate partner violence in Spain

Objective: Few evaluations have assessed the factors triggering an adequate health care response to intimate partner violence. This article aimed to: 1) describe a realist evaluation carried out in Spain to ascertain why, how and under what circumstances primary health care teams respond to intimate partner violence, and 2) discuss the strengths and challenges of its application. Methods: We carried out a series of case studies in four steps. First, we developed an initial programme theory (PT1), based on interviews with managers. Second, we refined PT1 into PT2 by testing it in a primary healthcare team that was actively responding to violence. Third, we tested the refined PT2 by incorporating three other cases located in the same region. Qualitative and quantitative data were collected and thick descriptions were produced and analysed using a retroduction approach. Fourth, we analysed a total of 15 cases, and identified combinations of contextual factors and mechanisms that triggered an adequate response to violence by using qualitative comparative analysis. Results: There were several key mechanisms —the teams’ self-efficacy, perceived preparation, women-centred care—, and contextual factors —an enabling team environment and managerial style, the presence of motivated professionals, the use of the protocol and accumulated experience in primary health care—that should be considered to develop adequate primary health-care responses to violence. Conclusion: The full application of this realist evaluation was demanding, but also well suited to explore a complex intervention reflecting the situation in natural settings.

Evaluation of the potential of InSAR time series to study the spatio-temporal evolution of piezometric levels in the Madrid aquifer

The Tertiary detritic aquifer of Madrid (TDAM), with an average thickness of 1500 m and a heterogeneous, anisotropic structure, supplies water to Madrid, the most populated city of Spain (3.2 million inhabitants in the metropolitan area). Besides its complex structure, a previous work focused in the north-northwest of Madrid city showed that the aquifer behaves quasi elastically trough extraction/recovery cycles and ground uplifting during recovery periods compensates most of the ground subsidence measured during previous extraction periods (Ezquerro et al., 2014). Therefore, the relationship between ground deformation and groundwater level through time can be simulated using simple elastic models. In this work, we model the temporal evolution of the piezometric level in 19 wells of the TDAM in the period 1997–2010. Using InSAR and piezometric time series spanning the studied period, we first estimate the elastic storage coefficient (Ske) for every well. Both, the Ske of each well and the average Ske of all wells, are used to predict hydraulic heads at the different well locations during the study period and compared against the measured hydraulic heads, leading to very similar errors when using the Ske of each well and the average Ske of all wells: 14 and 16 % on average respectively. This result suggests that an average Ske can be used to estimate piezometric level variations in all the points where ground deformation has been measured by InSAR, thus allowing production of piezometric level maps for the different extraction/recovery cycles in the TDAM.

Evaluation of sampling method effects in 3D non-rigid registration

Since the beginning of 3D computer vision problems, the use of techniques to reduce the data to make it treatable preserving the important aspects of the scene has been necessary. Currently, with the new low-cost RGB-D sensors, which provide a stream of color and 3D data of approximately 30 frames per second, this is getting more relevance. Many applications make use of these sensors and need a preprocessing to downsample the data in order to either reduce the processing time or improve the data (e.g., reducing noise or enhancing the important features). In this paper, we present a comparison of different downsampling techniques which are based on different principles. Concretely, five different downsampling methods are included: a bilinear-based method, a normal-based, a color-based, a combination of the normal and color-based samplings, and a growing neural gas (GNG)-based approach. For the comparison, two different models have been used acquired with the Blensor software. Moreover, to evaluate the effect of the downsampling in a real application, a 3D non-rigid registration is performed with the data sampled. From the experimentation we can conclude that depending on the purpose of the application some kernels of the sampling methods can improve drastically the results. Bilinear- and GNG-based methods provide homogeneous point clouds, but color-based and normal-based provide datasets with higher density of points in areas with specific features. In the non-rigid application, if a color-based sampled point cloud is used, it is possible to properly register two datasets for cases where intensity data are relevant in the model and outperform the results if only a homogeneous sampling is used.

Computational models for improved diagnosis and prognosis of stroke using robot-based biomarkers

Stroke is a leading cause of death and permanent disability worldwide, affecting millions of individuals. Traditional clinical scores for assessment of stroke-related impairments are inherently subjective and limited by inter-rater and intra-rater reliability, as well as floor and ceiling effects. In contrast, robotic technologies provide objective, highly repeatable tools for quantification of neurological impairments following stroke. KINARM is an exoskeleton robotic device that provides objective, reliable tools for assessment of sensorimotor, proprioceptive and cognitive brain function by means of a battery of behavioral tasks. As such, KINARM is particularly useful for assessment of neurological impairments following stroke. This thesis introduces a computational framework for assessment of neurological impairments using the data provided by KINARM. This is done by achieving two main objectives. First, to investigate how robotic measurements can be used to estimate current and future abilities to perform daily activities for subjects with stroke. We are able to predict clinical scores related to activities of daily living at present and future time points using a set of robotic biomarkers. The findings of this analysis provide a proof of principle that robotic evaluation can be an effective tool for clinical decision support and target-based rehabilitation therapy. The second main objective of this thesis is to address the emerging problem of long assessment time, which can potentially lead to fatigue when assessing subjects with stroke. To address this issue, we examine two time reduction strategies. The first strategy focuses on task selection, whereby KINARM tasks are arranged in a hierarchical structure so that an earlier task in the assessment procedure can be used to decide whether or not subsequent tasks should be performed. The second strategy focuses on time reduction on the longest two individual KINARM tasks. Both reduction strategies are shown to provide significant time savings, ranging from 30% to 90% using task selection and 50% using individual task reductions, thereby establishing a framework for reduction of assessment time on a broader set of KINARM tasks. All in all, findings of this thesis establish an improved platform for diagnosis and prognosis of stroke using robot-based biomarkers.

Development and experimental evaluation of a steel tube vehicle impact attenuation system. Final report.

Connecticut Department of Transportation, Bureau of Planning and Research, Wethersfield

Design and evaluation of a terrestrial model ecosystem for evaluation substitute pesticide chemicals /

Mode of access: Internet.

Freight transportation petroleum conservation - viability evaluation. Final report.

Mode of access: Internet.

Evaluation of flared outlet transitions : hydraulic model investigation /

"June 1972."

Operational and geometric evaluation of exclusive truck lanes. Final report.

Texas State Department of Highways and Public Transportation, Transportation Planning Division, Austin

Evaluation of three energy dissipators for storm-drain outlets : hydraulic laboratory investigation /

"April 1971."

Development and use of a computer simulation model for the evaluation of design and control alternatives for intersections of minor roads with multi-lane rural highways: field studies and model validation. Interim report.

Federal Highway Administration, Washington, D.C.

Development and use of a computer simulation model for the evaluation of design and control alternatives for intersections of minor roads with multi-lane rural highways: model application. Interim report.

Federal Highway Administration, Washington, D.C.

Development and use of a computer simulation model for the evaluation of design and control alternatives for intersections of minor roads with multi-lane rural highways: selection of the simulation model. Interim report.

Federal Highway Administration, Washington, D.C.

Application of radiochemistry techniques in food processing research : radioisotopic tracer techniques in evaluation and improvement of industry practices for removal of pesticide residues from foods /

Report prepared by project team and edited by Walter A. Mercer.

Shades of CORDS in the Kush : the false hope of "unity of effort" in American counterinsurgency /

"Counterinsurgency (COIN) requires an integrated military, political, and economic program best developed by teams that field both civilians and soldiers. These units should operate with some independence but under a coherent command. In Vietnam, after several false starts, the United States developed an effective unified organization, Civil Operations and Revolutionary Development Support (CORDS), to guide the counterinsurgency. CORDS had three components absent from our efforts in Afghanistan today: sufficient personnel (particularly civilian), numerous teams, and a single chain of command that united the separate COIN programs of the disparate American departments at the district, provincial, regional, and national levels. This paper focuses on the third issue and describes the benefits that unity of command at every level would bring to the American war in Afghanistan. The work begins with a brief introduction to counterinsurgency theory, using a population-centric model, and examines how this warfare challenges the United States. It traces the evolution of the Provincial Reconstruction Teams (PRTs) and the country team, describing problems at both levels. Similar efforts in Vietnam are compared, where persistent executive attention finally integrated the government's counterinsurgency campaign under the unified command of the CORDS program. The next section attributes the American tendency towards a segregated response to cultural differences between the primary departments, executive neglect, and societal concepts of war. The paper argues that, in its approach to COIN, the United States has forsaken the military concept of unity of command in favor of 'unity of effort' expressed in multiagency literature. The final sections describe how unified authority would improve our efforts in Afghanistan and propose a model for the future."--P. iii.