Competitive champions versus cooperative advocates: Understanding advocates for evaluation

Abstract Background: Evaluation offers non-profit organizations an opportunity to improve their services, demonstrate achievements, and be accountable. The extant literature identifies individuals who can enhance the uptake of evaluation as evaluation champions. However, a paucity of detail is available regarding how to identify them and the support they require. Purpose: This research investigated the characteristics and motivations of evaluation champions and examined how they promoted and embedded evaluation in an organizational system. Setting: Australian human and social service non-profit organizations. Research design: Drawing upon the literature and social interdependence theory, the research took an interpretivist perspective to collaboratively generate knowledge about evaluation champions. The aim was to understand and develop a reconstruction of the characteristics of individuals. This article constitutes a component of a larger research project. Data Collection and Analysis: This research used purposive sampling to recruit champions working in Australian non-profit organizations, who were identified via descriptive criteria gleaned from a literature review. The research involved interviewing 17 champions, four of whom also participated in organizational case studies. Analysis of the semi-structured interviews and case studies generated information about the activities, strategies, motivations, and attributes of individuals who championed and advocated for evaluation. Findings: This article argues that evaluation advocates is a preferable descriptor when attempting to embed evaluation by cultivating mutually beneficial interactions and cooperative working relationships. This research defines evaluation advocates as individuals who motivate others and provide energy, interest, and enthusiasm by connecting evaluation with colleagues’ personal aspirations and the organizational goals to make judgements about effectiveness. This article includes a field guide to facilitate evaluation advocates’ identification, recruitment, support, and development

Study protocol: Home-based physical rehabilitation for survivors of a critical illness [ACTRN12605000166673]

INTRODUCTION: Numerous primary studies and several review papers have highlighted delayed physical and psychological recovery for survivors of critical illness, often beyond 6 months after discharge. This randomized controlled trial with blinded assessment aims to test the effects of an 8-week, home-based, individually tailored physical rehabilitation programme on physical and psychological recovery for survivors of a critical illness after discharge from hospital. METHOD: Participants are survivors of a critical illness discharged from nine intensive care units (ICUs) in Australia, who are aged 18 years or older, in an ICU longer than 48 hours, discharged home to self-care or carer (non-institutional care), able to participate in physical rehabilitation, and within the hospitals' local geographical areas for home visits. The study is based in participants' home environments. Blinded assessments at weeks 1, 8 and 26 after hospital discharge examine physical functioning, exercise capacity, health-related quality of life and psychological well being. The intervention is graded, individualized endurance and strength training prescribed by a pulmonary rehabilitation physiotherapist over an 8-week period, with three home visits, five follow-up phone calls, and a printed exercise manual supporting the training. Initial focus is on lower limb exercises and walking, with warm-up stretches, and progresses to the addition of core stabilization and upper limb exercises. RESULTS: The burden of a critical illness is well documented. This novel study will determine whether a home-based physical rehabilitation programme improves the recovery trajectory for survivors of critical illness. The projected sample size of 200 patients aims to detect a clinically important 10% improvement in physical functioning. The study will also examine whether other important physical and psychological measures are improved. CONCLUSION: This multicentre, randomized controlled trial will examine outcomes that are meaningful to patients, their family and society, namely functional ability and well being. The study will also target a health problem that is likely to increase as the population ages. If the programme is effective, it will provide a model that can be easily adapted and adopted by existing primary care or community services to improve the recovery of individuals following critical illness

Competitive champions versus cooperative advocates

Abstract Background: Evaluation offers non-profit organizations an opportunity to improve their services, demonstrate achievements, and be accountable. The extant literature identifies individuals who can enhance the uptake of evaluation as evaluation champions. However, a paucity of detail is available regarding how to identify them and the support they require. Purpose: This research investigated the characteristics and motivations of evaluation champions and examined how they promoted and embedded evaluation in an organizational system. Setting: Australian human and social service non-profit organizations. Research design: Drawing upon the literature and social interdependence theory, the research took an interpretivist perspective to collaboratively generate knowledge about evaluation champions. The aim was to understand and develop a reconstruction of the characteristics of individuals. This article constitutes a component of a larger research project. Data Collection and Analysis: This research used purposive sampling to recruit champions working in Australian non-profit organizations, who were identified via descriptive criteria gleaned from a literature review. The research involved interviewing 17 champions, four of whom also participated in organizational case studies. Analysis of the semi-structured interviews and case studies generated information about the activities, strategies, motivations, and attributes of individuals who championed and advocated for evaluation. Findings: This article argues that evaluation advocates is a preferable descriptor when attempting to embed evaluation by cultivating mutually beneficial interactions and cooperative working relationships. This research defines evaluation advocates as individuals who motivate others and provide energy, interest, and enthusiasm by connecting evaluation with colleagues’ personal aspirations and the organizational goals to make judgements about effectiveness. This article includes a field guide to facilitate evaluation advocates’ identification, recruitment, support, and development

Game of Stones:feasibility randomised controlled trial of how to engage men with obesity in text message and incentive interventions for weight loss

Objectives To examine the acceptability and feasibility of narrative text messages with or without financial incentives to support weight loss for men. Design Individually randomised three-arm feasibility trial with 12 months’ follow-up. Setting Two sites in Scotland with high levels of disadvantage according to Scottish Index for Multiple Deprivation (SIMD). Participants Men with obesity (n=105) recruited through community outreach and general practitioner registers. Interventions Participants randomised to: (A) narrative text messages plus financial incentive for 12 months (short message service (SMS)+I), (B) narrative text messages for 12 months (SMS only), or (C) waiting list control. Outcomes Acceptability and feasibility of recruitment, retention, intervention components and trial procedures assessed by analysing quantitative and qualitative data at 3, 6 and 12 months. Results 105 men were recruited, 60% from more disadvantaged areas (SIMD quintiles 1 or 2). Retention at 12 months was 74%. Fewer SMS+I participants (64%) completed 12-month assessments compared with SMS only (79%) and control (83%). Narrative texts were acceptable to many men, but some reported negative reactions. No evidence emerged that level of disadvantage was related to acceptability of narrative texts. Eleven SMS+I participants (31%) successfully met or partially met weight loss targets. The cost of the incentive per participant was £81.94 (95% CI £34.59 to £129.30). Incentives were acceptable, but improving health was reported as the key motivator for weight loss. All groups lost weight (SMS+I: −2.51 kg (SD=4.94); SMS only: −1.29 kg (SD=5.03); control: −0.86 kg (SD=5.64) at 12 months). Conclusions This three-arm weight management feasibility trial recruited and retained men from across the socioeconomic spectrum, with the majority from areas of disadvantage, was broadly acceptable to most participants and feasible to deliver

Health-related quality of life and physical recovery after a critical illness: a multi-centre randomised controlled trial of a home-based physical rehabilitation program

Introduction: Significant physical sequelae exist for some survivors of a critical illness. There are, however, few studies that have examined specific interventions to improve their recovery, and none have tested a home-based physical rehabilitation program incorporating trainer visits to participants' homes. This study was designed to test the effect of an individualised eight-week home-based physical rehabilitation program on recovery. Methods: A multi-centre randomised controlled trial design was used. Adult intensive care patients (length of stay of at least 48 hours and mechanically ventilated for 24 hours or more) were recruited from 12 Australian hospitals between 2005 and 2008. Graded, individualised endurance and strength training intervention was prescribed over eight weeks, with three physical trainer home visits, four follow-up phone calls, and supported by a printed exercise manual. The main outcome measures were blinded assessments of physical function; SF-36 physical function (PF) scale and six-minute walk test (6MWT), and health-related quality of life (SF-36) conducted at 1, 8 and 26 weeks after hospital discharge. Results: Of the 195 participants randomised, 183, 173 and 161 completed the 1, 8 and 26 weeks assessments, respectively. Study groups were similar at Week 1 post-hospital; for the intervention and control groups respectively, mean norm-based PF scores were 27 and 29 and the 6MWT distance was 291 and 324 metres. Both groups experienced significant and clinically important improvements in PF scores and 6MWT distance at 8 weeks, which persisted at 26 weeks. Mixed model analysis showed no significant group effects (P = 0.84) or group by time interactions (P = 0.68) for PF. Similar results were found for 6MWT and the SF-36 summary scores. Conclusions: This individualised eight-week home-based physical rehabilitation program did not increase the underlying rate of recovery in this sample, with both groups of critically ill survivors improving their physical function over the 26 weeks of follow-up. Further research should explore improving effectiveness of the intervention by increasing exercise intensity and frequency, and identifying individuals who would benefit most from this intervention. Trial registration: Australia and New Zealand Clinical Trials Register ACTRN1260500016667

Text Messages With Financial Incentives for Men With Obesity : A Randomized Clinical Trial

Peer reviewe

Text messaging and financial incentives to encourage weight loss in men with obesity: the Game of Stones feasibility RCT

Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 11. See the NIHR Journals Library website for further project information.Peer reviewedPublisher PD

Repeatability of the Six-Minute Walk Test and Relation to Physical Function in Survivors of a Critical Illness

Background: The Six-Minute Walk Test (6MWT) is widely used as an outcome measure in exercise rehabilitation. However, the repeatability of the 6MWT performed at home in survivors of a critical illness has not been evaluated. Objective: The purpose of this study was to evaluate, in survivors of a critical illness: (1) the repeatability of the 6MWT performed at home, (2) the effect on estimates of change in functional exercise capacity if only one 6MWT was performed at follow-up assessments, and (3) the relationship between the physical functioning (PF) score of the 36-Item Short-Form Health Survey questionnaire (SF-36) and the 6MWT. Design: Repeated measures of the 6MWT and SF-36 were obtained. Methods: Eligible participants had an intensive care unit (ICU) length of stay of ≥48 hours and were mechanically ventilated for ≥24 hours. Two 6MWTs and the SF-36 were conducted in participants' homes at weeks 1, 8, and 26 after hospital discharge. Results: One hundred seventy-three participants completed the study. The participants had a mean age of 57 years (SD=16), a mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score on admission of 19 (SD=10), a mean ICU length of stay of 9 days (SD=8), and a mean mechanical ventilation time of 140 hours (SD=137). Of the 173 participants, 110 performed two 6MWTs at weeks 1, 8, and 26. There were significant mean increases in 6-minute walk distance in the second test of 15 m (P<.0001) at week 1, 13 m (P<.0001) at week 8, and 9 m (P=.04) at week 26. If only one 6MWT was performed at weeks 8 and 26, the estimate of change in 6-minute walk distance from week 1 was 19 m less (P<.001) at both weeks 8 and 26. There was a moderate to strong correlation between SF-36 PF score and 6-minute walk distance at each assessment (week 1: r=.62, P<.001; week 8: r=.55, P<.001; and week 26: r=.47, P<.001).Limitations: Some study participants were unable to perform a second 6MWT, and these participants may have differed in important aspects of function compared with those individuals who completed two 6MWTs. Conclusions: In survivors of a critical illness, the 6MWT in the home environment should be performed twice at each assessment to give an accurate reflection of change in exercise capacity over time. The SF-36 PF score was a strong indicator of 6-minute walk distance in early recovery from a critical illness

Contributions to conservation outcomes by natural history museum-led citizen science: Examining evidence and next steps

publisher: Elsevier articletitle: Contributions to conservation outcomes by natural history museum-led citizen science: Examining evidence and next steps journaltitle: Biological Conservation articlelink: http://dx.doi.org/10.1016/j.biocon.2016.08.040 content_type: article copyright: © 2016 The Authors. Published by Elsevier Ltd.The file attached is the published version of the article

Urinary α1-Antichymotrypsin: A Biomarker of Prion Infection

The occurrence of blood-borne prion transmission incidents calls for identification of potential prion carriers. However, current methods for intravital diagnosis of prion disease rely on invasive tissue biopsies and are unsuitable for large-scale screening. Sensitive biomarkers may help meeting this need. Here we scanned the genome for transcripts elevated upon prion infection and encoding secreted proteins. We found that α1-antichymotrypsin (α1-ACT) was highly upregulated in brains of scrapie-infected mice. Furthermore, α1-ACT levels were dramatically increased in urine of patients suffering from sporadic Creutzfeldt-Jakob disease, and increased progressively throughout the disease. Increased α1-ACT excretion was also found in cases of natural prion disease of animals. Therefore measurement of urinary α1-ACT levels may be useful for monitoring the efficacy of therapeutic regimens for prion disease, and possibly also for deferring blood and organ donors that may be at risk of transmitting prion infections