Exploring and understanding the scope and value of the Parkinson's nurse in the UK (The USP Project): a realist economic evaluation protocol.

INTRODUCTION: There are multiple configurations of specialist nurses working in the field of Parkinson's. Parkinson's Nurse Specialists (PNSs) are recognised as playing a pivotal role; however, there is little published evidence to demonstrate their effectiveness. Further evidence is needed to establish which aspects of the PNSs provide the greatest benefit to people with Parkinson's and their families, and the cost-effectiveness of different models of care. METHODS AND ANALYSIS: Realist approaches explain how and why programmes work (or not) through striving to answer the question: what works, for whom and under what circumstances. This research uses a realist evaluation and aims to integrate an economic analysis within the realist framework. We refer to this as 'realist economic evaluation'. It comprises four phases: (1) developing resource-sensitive initial programme theories (IPTs) using surveys to gain a better understanding of the role and impact (costs and benefits) of the PNSs; (2) testing the IPTs through qualitative interviews and quantitative data analysis; (3) evaluating the cost and resource use implications alongside the benefits associated with the role of the PNSs and (4) iteratively refining the IPTs throughout the project. The IPTs will draw on both quantitative and qualitative data. The result of the study will be a series of refined programme theories, which will explain how specialist nurses work in the field of Parkinson's in the UK, what impact they have on people with Parkinson's and their families and carers, and at what cost. ETHICS AND DISSEMINATION: Northumbria University, the Health Research Authority and Health and Care Research Wales have approved this study. Key findings will be disseminated throughout the duration of the project online and through social media, and via annual and regional Parkinson's meetings and the Parkinson's UK Excellence Network. Academic dissemination will occur through publication and conference presentations.

Quantifying fish behaviour and commercial catch rates in relation to a marine seismic survey.

The impact of seismic surveys on the catchability of marine fish is a contentious issue, with some claims that seismic surveys may negatively affect catch rates. However little empirical evidence exists to quantify the impacts or identify the mechanisms of such impact. In this study, we used a 2-D seismic survey in the Gippsland Basin, Bass Strait, Australia in April 2015 as an opportunity to quantify fish behaviour (field-based) and commercial fisheries catch (desktop study) across the region before and after airgun operations. Three species found in abundance (gummy shark, swell shark, tiger flathead) were acoustically tagged and released within one of two acoustic arrays (experimental and control zone) and monitored before, during and after the seismic survey. In the field study, only 35% of the gummy sharks and 30% of the swell sharks were subsequently detected two days after release, suggesting movement outside the study area. Various tagged individuals returned sporadically over the monitoring period, including during the seismic survey operations. Behaviour consistent with a possible response to the seismic survey operations was observed for flathead which increased their swimming speed during the seismic survey period and changed their diel movement patterns after the survey. We also investigated the potential impacts of the seismic survey on catch rates using Commonwealth fisheries logbook data from Jan 2012-Oct 2015. Fifteen species and two gear types (Danish seine, gillnet) were modelled to examine differences in catch rates before and after the seismic survey. The catch rates in the six months following the seismic survey were significantly different than predicted in nine out of the 15 species examined, with six species (tiger flathead, goatfish, elephantfish, boarfish, broadnose shark and school shark) showing increases in catch following the seismic survey, and three species (gummy shark, red gurnard, and sawshark) showing reductions. With the exception of flathead movement, we found little evidence for consistent behavioural or catch rate changes induced by the seismic survey in the targeted species, although behavioural data were limited because many sharks left the acoustic receiver array prior to the commencement of the seismic survey.