Background and aims. Approved by the 34th General Conference of UNESCO in October 2007, an International Research Center on Karst (IRCK) under the auspices of UNESCO (Category II) was established in Guilin China, the Agreement between the Chinese government and UNESCO concerning the Establishment and Operation of the IRCK was signed in Paris on February 11, 2008 and the Center was officially inaugurated in December 2008. IRCK is based at the Institute of Karst Geology, Chinese Academy of Geological Sciences (CAGS), located at Xx. 00 Xxxxxx Xxxx, Xxxxxx, Xxxxxxx 000000, P. R. China. It is committed, among other objections and functions, to providing advisory activities, technical information and training as a basis to develop and implement new integrated methods of desertification rehabilitation and ecological restoration and undertaking international technical consultation and organizing international workshops and symposia on special subjects, scientific field investigations and lecture tours. It organized an international training course on karst hydrogeology and karst ecosystem in Guilin, China on November 8 – December 5, 2009, which was attended by 17 trainees from Uganda, Ethiopia, Kenya, India, Indonesia, Viet Nam, Romania and Peru. To keep on the implementation of its mandates and tasks, with the sponsorship of the Institute of Karst Geology, CAGS, IRCK will organize an International Training Course on Karst Hydrogeology and Karst Carbon Cycle Monitoring in Guilin, China to be scheduled on November 29 – December 10, with the aim of enhancing research cooperation and academic exchange between China and other countries, and sharing Chinese successful experience in karst scientific research with colleagues overseas. The Chinese karst scientists warmly welcome fellow geologists, hydrological engineers and related administrators from developing countries across the world, who are interested, to participate in this training course.
Background and aims. This chapter addresses the first part of the secondary research objective, which was to summarise and develop estimators of efficacy in a randomised trial with non-adherence. This work focuses on trials that contrast an active intervention with a control condition, where departures from randomised treatment lead to receipt of some or all of the comparator condition. The work relates to trials with continuous outcomes. The perfect randomised trial comparing a new treatment (intervention arm) with a control treatment (control arm) should use random treatment allocation, be double blind, feature full adherence with randomly allocated treatment, and collect outcome data from every trial participant. These features are important because they guard against bias and therefore enable a study to provide a valid answer to the research question. Judged by such a standard, trials in mental health are often far from ideal. It may be impossible to blind clinicians or participants to treatment (especially for psychotherapies), patients may not attend all or any treatment sessions, and participants may be lost to follow-up before the end of data collection. This has led to recent development in methods that account for the challenges of non-adherence with allocated treatments and missing data in particular. Non-adherence is used here as an umbrella term covering contamination (receipt of intervention) in the control arm and non-compliance (non- receipt of intervention) in the active intervention arm of a trial. When compliance is described as partial, this implies that some active intervention participants did not receive treatment. The results of the scoping review of methods for addressing contamination (Chapter 2) suggested a scarcity of applications of analytical approaches in this context. It appears that methods from the causal inference literature are not being utilised by researchers to address the problem of contamination in trials of complex interventions in mental health. Thus, this chapter will explore whether such methods can be employed when adherence with randomly allocated treatment has been measured for each trial participant. The adherence measure could be either a binary treatment receipt measure or a continuous treatment dose measure. This chapter aims to:
1. Review existing approaches for addressing non-compliance (in the active arm),
2. Extend these approaches to provide novel efficacy estimators that allow for conta- mination in the control arm,
3. ...
Background and aims. NHS Boards have a statutory duty to involve patients and the public in the planning and development of Health services. Scottish Government guidance sets out how this should be done CEL 4(2010) Informing, Engaging, and Consulting People in developing Health and Community Care. These two wards as an element of the Mental Health Clinical Services Review do not represent a major service change, however furtherengagement has continued to take place and will continue to build on the extensive consultation with the community that was undertaken as part of the Clinical Services Review. Aims of further engagement:- We will involve service user and carer representation as well as community interests as appropriate in the planning process throughout all stages of the development. We will also engage with third sector partners as appropriate in the planning and construction stages. Our engagement is supported by the Mental Health Network. This is local a service-user led charity which acts as a collective advocacy voice for people with a lived experience of mental-ill health and their carers in the Greater Glasgow area. In addition, local meetings with service users and carers have been delivered relating to the proposals. We will aim to ensure that all service users and carer are informed and consulted about the development particularly those who are seldom heard. We will aim to find different ways to support engagement that everyone who has or could have an interest in the development. We shall make use of social media to ensure that the wider community is kept informed. We shall ensure that local service users and carers feel engaged throughout the process and are supported, in a way that suits them. We shall also aim to ensure that local service users and carers feel listened to and valued throughout the whole process and be flexible in our approach to engagement.
Background and aims. The thesis uses the D6 study as a motivating dataset of a trial of a complex intervention in mental health. D6 was a cluster RCT set in primary care evaluating the effectiveness of an intervention combining motivational interviewing (MI) and cognitive behavioural therapy (CBT) skills delivered by practice nurses compared to an attention control which did not include any psychological components. One reason for using cluster randomisation at the level of the primary care nurse was to avoid treatment contamination that was anticipated if a given nurse were asked to provide both control and active treatments. Treatment in the control arm consisted of standard diabetes care, with primary care nurses scheduled to meet participants for the same number of times and same duration as those in the active intervention arm. There was a strong rationale for conducting a large fidelity assessment. Despite the trial having set out to avoid contamination, there was some anecdotal evidence of delivery of psychological treatment by standard care nurses. This was supported by the treatment fidelity evaluation in the primary assessment of the trial which showed some treatment receipt in the control arm (Xxxxxx et al., 2018). In addition, the lack of evidence of effectiveness warranted a detailed evaluation of treatment fidelity in both arms of the trial. Therefore I set out to construct a measure of treatment receipt for as many participants as possible in the study. The trial provided an opportunity to assess treatment fidelity due to the fact that many treatment sessions had been audio recorded. The goal was to use individual-level fidelity ratings to assess what level of psychological treatment participants received and then to evaluate whether the treatments delivered to the intervention and control arms represented what was expected given the results of random treatment allocation. From a clinical perspective this treatment fidelity assessment, which was larger in terms of sample size than that reported in the primary assessment of the trial, enabled an examination of whether primary care nurses in the trial could be trained to deliver psychological therapy competently to participants within the active intervention arm. It also allowed an assessment of whether competencies improved over time. This chapter describes the fidelity assessment of the treatments delivered to participants in the two trial arms. The main aims of this chapter were to measure treatment fidelity ...
