Evaluation Literacy: Perspectives of Internal Evaluators in Non-Government Organizations

While there is an abundance of literature on evaluation use, there has been little discussion regarding internal evaluators’ role in promoting evaluation use. Evaluation can be undervalued if context is not taken into consideration. Evalua­tion literacy is needed to make evaluation more appropriate, understandable, and accessible, particularly in non-government organizations (NGOs) where there is a growing focus on demonstrable outcomes. Evaluation literacy refers to an individ­ual’s understanding and knowledge of evaluation and is an essential component of embedding evaluation into organizational culture. In recognition of the value of the internal perspective, a small exploratory exercise was undertaken to reveal internal evaluator roles and ways of engaging with colleagues around evaluation. Th e exercise examined a key question: What is the role of evaluation literacy in internal evalua­tion in the non-government sector? Three Australian auto-narrative examples from internal evaluators highlight evaluation literacy and locate it among the multiplicity of roles required for optimal evaluation uptake. Analysis of the narratives revealed the underlying issues affecting evaluation use in NGOs and the skills needed to motivate and enable others to access, understand, and use evaluation information. Responding to the call for expanded research into internal evaluation from a practice perspective, the authors hope that the findings will stimulate a wider conversation and further advance understanding of evaluation literacy.

Wound hydration versus maceration: understanding the differences

Abstract: This article provides an explanation and visual demonstration of the differences between the pathology and presentation of hydration versus maceration in wounds. This is described in order that the clinician can distinguish between the two and optimise wound treatment

Paramedics\u27 perceptions and educational needs with respect to palliative care

Introduction: In recent years the scope of palliative care has been redefined to include patients earlier in the course of their illness, and those suffering from life-limiting conditions. Paramedics may be involved in the care of these patients, especially in situations of carer distress, sudden deterioration and imminent death, as well as in non-emergent situations such as inter-facility transfers. In these scenarios, clinical decisions regarding patient care initiated by paramedics may set the trajectory for subsequent care. Objective: To identify and measure paramedics’ perspectives and educational needs regarding palliative care provision, as well as their understanding of the common causes of death. Methods: All St John Ambulance Western Australia paramedics were invited to complete a mixed methods qualitative and quantitative survey using a tool previously validated in studies involving other emergency care providers. Quantitative results are reported using descriptive statistics, while Likert-type scales were converted to ordinal variables and expressed as means +/- SD. Qualitative data was analysed using content analysis techniques and reported as themes. Results: Twenty-nine paramedics returned completed surveys. They considered palliative care to be strongly focused on end-of-life care, symptom control and holistic care. The dominant educational needs identified were ethical issues, end-of-life communication and the use of structured patient care pathways. Cancer diagnoses were overrepresented as conditions considered most suitable for palliative care, compared with their frequency as a cause of death. Conditions often experienced in ambulance practice, such as heart failure, trauma and cardiac arrhythmias were overestimated in their frequency as causes of death. Conclusions: Paramedics have a sound grasp of some important aspects of palliative care including symptom control and the holistic nature of the palliative approach. They did, however, tend to equate palliative care with care occurring in the terminal phase and saw it as being particularly applied to cancer diagnoses. Paramedic palliative care educational efforts should be focused on: ethical issues, end-of-life communication, increasing understanding of the common causes of death, and education regarding those illnesses where a palliative approach might be beneficial

Noble gas solubility in silicate melts:a review of experimentation and theory, and implications regarding magma degassing processes

Noble gas solubility in silicate melts and glasses has gained a crucial role in Earth Sciences investigations and in the studies of non-crystalline materials on a micro to a macro-scale. Due to their special geochemical features, noble gases are in fact ideal tracers of magma degassing. Their inert nature also allows them to be used to probe the structure of silicate melts. Owing to the development of modern high pressure and temperature technologies, a large number of experimental investigations have been performed on this subject in recent times. This paper reviews the related literature, and tries to define our present state of knowledge, the problems encountered in the experimental procedures and the theoretical questions which remain unresolved. Throughout the manuscript I will also try to show how the thermodynamic and structural interpretations of the growing experimental dataset are greatly improving our understanding of the dissolution mechanisms, although there are still several points under discussion. Our improved capability of predicting noble gas solubilities in conditions closer to those found in magma has allowed scientists to develop quantitative models of magma degassing, which provide constraints on a number of questions of geological impact. Despite these recent improvements, noble gas solubility in more complex systems involving the main volatiles in magmas, is poorly known and a lot of work must be done. Expertise from other fields would be extremely valuable to upcoming research, thus focus should be placed on the structural aspects and the practical and commercial interests of the study of noble gas solubility

A new valuation school : Integrating diverse values of nature in resource and land use decisions

We are increasingly confronted with severe social and economic impacts of environmental degradation all over the world. From a valuation perspective, environmental problems and conflicts originate from trade-offs between values. The urgency and importance to integrate nature's diverse values in decisions and actions stand out more than ever. Valuation, in its broad sense of 'assigning importance', is inherently part of most decisions on natural resource and land use. Scholars from different traditions -while moving from heuristic interdisciplinary debate to applied transdisciplinary science- now acknowledge the need for combining multiple disciplines and methods to represent the diverse set of values of nature. This growing group of scientists and practitioners share the ambition to explore how combinations of ecological, socio-cultural and economic valuation tools can support real-life resource and land use decision-making. The current sustainability challenges and the ineffectiveness of single-value approaches to offer relief demonstrate that continuing along a single path is no option. We advocate for the adherence of a plural valuation culture and its establishment as a common practice, by contesting and complementing ineffective and discriminatory single-value approaches. In policy and decision contexts with a willingness to improve sustainability, integrated valuation approaches can be blended in existing processes, whereas in contexts of power asymmetries or environmental conflicts, integrated valuation can promote the inclusion of diverse values through action research and support the struggle for social and environmental justice. The special issue and this editorial synthesis paper bring together lessons from pioneer case studies and research papers, synthesizing main challenges and setting out priorities for the years to come for the field of integrated valuation.Peer reviewe

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

A Bayesian Belief Network to assess rate of changes in coral reef ecosystems

It is crucial to identify sources of impacts and degradation to maintain functions and services that the physical structure of coral reef provides. Here, a Bayesian Network approach is used to evaluate effects that anthropogenic and climate change disturbances have on coral reef structure. The network was constructed on knowledge derived from the literature and elicited from experts, and parameterised on independent data. Evaluation of the model was conducted through sensitivity analyses and data integration was fundamental to obtain a balanced dataset. Scenario analyses, conducted to assess the effects of stressors on the reef framework state, suggested that calcifying organisms and carbonate production, rather than bioerosion, had the largest influence on the reef carbonate budgetary state. Despite the overall budget remaining positive, anthropogenic pressures, particularly deterioration of water quality, affected reef carbonate production, representing a warning signal for potential changes in the reef state

Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial.

BACKGROUND: Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes. METHODS: In this multicentre, open-label, randomised controlled trial, we recruited women aged 18-40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy. Participants were pregnant (≤13 weeks and 6 days' gestation) or planning pregnancy from 31 hospitals in Canada, England, Scotland, Spain, Italy, Ireland, and the USA. We ran two trials in parallel for pregnant participants and for participants planning pregnancy. In both trials, participants were randomly assigned to either CGM in addition to capillary glucose monitoring or capillary glucose monitoring alone. Randomisation was stratified by insulin delivery (pump or injections) and baseline glycated haemoglobin (HbA1c). The primary outcome was change in HbA1c from randomisation to 34 weeks' gestation in pregnant women and to 24 weeks or conception in women planning pregnancy, and was assessed in all randomised participants with baseline assessments. Secondary outcomes included obstetric and neonatal health outcomes, assessed with all available data without imputation. This trial is registered with ClinicalTrials.gov, number NCT01788527. FINDINGS: Between March 25, 2013, and March 22, 2016, we randomly assigned 325 women (215 pregnant, 110 planning pregnancy) to capillary glucose monitoring with CGM (108 pregnant and 53 planning pregnancy) or without (107 pregnant and 57 planning pregnancy). We found a small difference in HbA1c in pregnant women using CGM (mean difference -0·19%; 95% CI -0·34 to -0·03; p=0·0207). Pregnant CGM users spent more time in target (68% vs 61%; p=0·0034) and less time hyperglycaemic (27% vs 32%; p=0·0279) than did pregnant control participants, with comparable severe hypoglycaemia episodes (18 CGM and 21 control) and time spent hypoglycaemic (3% vs 4%; p=0·10). Neonatal health outcomes were significantly improved, with lower incidence of large for gestational age (odds ratio 0·51, 95% CI 0·28 to 0·90; p=0·0210), fewer neonatal intensive care admissions lasting more than 24 h (0·48; 0·26 to 0·86; p=0·0157), fewer incidences of neonatal hypoglycaemia (0·45; 0·22 to 0·89; p=0·0250), and 1-day shorter length of hospital stay (p=0·0091). We found no apparent benefit of CGM in women planning pregnancy. Adverse events occurred in 51 (48%) of CGM participants and 43 (40%) of control participants in the pregnancy trial, and in 12 (27%) of CGM participants and 21 (37%) of control participants in the planning pregnancy trial. Serious adverse events occurred in 13 (6%) participants in the pregnancy trial (eight [7%] CGM, five [5%] control) and in three (3%) participants in the planning pregnancy trial (two [4%] CGM and one [2%] control). The most common adverse events were skin reactions occurring in 49 (48%) of 103 CGM participants and eight (8%) of 104 control participants during pregnancy and in 23 (44%) of 52 CGM participants and five (9%) of 57 control participants in the planning pregnancy trial. The most common serious adverse events were gastrointestinal (nausea and vomiting in four participants during pregnancy and three participants planning pregnancy). INTERPRETATION: Use of CGM during pregnancy in patients with type 1 diabetes is associated with improved neonatal outcomes, which are likely to be attributed to reduced exposure to maternal hyperglycaemia. CGM should be offered to all pregnant women with type 1 diabetes using intensive insulin therapy. This study is the first to indicate potential for improvements in non-glycaemic health outcomes from CGM use. FUNDING: Juvenile Diabetes Research Foundation, Canadian Clinical Trials Network, and National Institute for Health Research

The impact of an "equal opportunities" ideological framework on coaches’ knowledge and practice

This study focuses upon UK professional coaches’ experiences of equity training and the impact of the conceptualisation of equity as a matter of equal opportunities on this education and subsequent coaching practice. The research employs a critical feminist approach to connect the ideological framing of gender equity by sporting organisations to coaches’ ability to understand, identify and manage issues of gender equity, equality and diversity. The discussions are based on interviews with four coaches, Jack, Peter, Charlotte and Tony, who had all recently undertaken equity training, and all of whom represented sports and different stages of the coaching pathway. The data highlights that seeing gender equity through an “equal opportunities” lens results in a narrow conceptualisation of such issues by coaches, fails to challenge dominant and discriminative ideologies, and does not enable coaches to address equity within their practices. Consequently, coaches struggle to understand the importance of and manage such issues. The participants’ experiences reveal that gender relations, intersected principally with religion and ethnicity, underpinned their everyday coaching practices. The findings illustrate the need for sporting organisations to redefine how they approach equality and equity and for a more sophisticated sociocultural educational programme for coaches