Linda Cabral and Judy Savageau on Improve Your Surveys by Conducting Cognitive Interviews

Blog post to AEA365, a blog sponsored by the American Evaluation Association (AEA) dedicated to highlighting Hot Tips, Cool Tricks, Rad Resources, and Lessons Learned for evaluators. The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness

Judy Savageau and Linda Cabral on Using Journal Clubs to Promote Best Practices in Evaluation

Blog post to AEA365, a blog sponsored by the American Evaluation Association (AEA) dedicated to highlighting Hot Tips, Cool Tricks, Rad Resources, and Lessons Learned for evaluators. The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness

Convergence Acceleration Techniques

This work describes numerical methods that are useful in many areas: examples include statistical modelling (bioinformatics, computational biology), theoretical physics, and even pure mathematics. The methods are primarily useful for the acceleration of slowly convergent and the summation of divergent series that are ubiquitous in relevant applications. The computing time is reduced in many cases by orders of magnitude.Comment: 6 pages, LaTeX; provides an easy-to-understand introduction to the field of convergence acceleratio

Post-Project Debriefings as Part of Performance Improvement

Blog post to AEA365, a blog sponsored by the American Evaluation Association (AEA) dedicated to highlighting Hot Tips, Cool Tricks, Rad Resources, and Lessons Learned for evaluators. The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness

Seeing Recovery Through the Eyes of Ethnic and Cultural Minorities

Describes a study that sought to better understand how persons with mental health conditions from two cultural groups, Latino and Deaf/Heard of Hearing (D/HH), access recovery-oriented and peer support services. Results from this study helped to inform the Massachusetts Department of Mental Health regarding system improvements that could be made to better serve these populations

Quantifying Global Tolerance of Biochemical Systems: Design Implications for Moiety-Transfer Cycles

Robustness of organisms is widely observed although difficult to precisely characterize. Performance can remain nearly constant within some neighborhood of the normal operating regime, leading to homeostasis, but then abruptly break down with pathological consequences beyond this neighborhood. Currently, there is no generic approach to identifying boundaries where local performance deteriorates abruptly, and this has hampered understanding of the molecular basis of biological robustness. Here we introduce a generic approach for characterizing boundaries between operational regimes based on the piecewise power-law representation of the system's components. This conceptual framework allows us to define “global tolerance” as the ratio between the normal value of a parameter and the value at such a boundary. We illustrate the utility of this concept for a class of moiety-transfer cycles, which is a widespread module in biology. Our results show a region of “best” local performance surrounded by “poor” regions; also, selection for improved local performance often pushes the operating values away from regime boundaries, thus increasing global tolerance. These predictions agree with experimental data from the reduced nicotinamide adenine dinucleotide phosphate (NADPH) redox cycle of human erythrocytes

Evaluation of the Massachusetts Peer Specialist Training and Certification Program (Phase Two)

Most public mental health systems are shifting to a recovery-oriented system of care; however, offering recovery-oriented and peer support services to various cultural and linguistic groups is challenging. This study sought to better understand how persons with mental health conditions from two cultural groups – Latinos and Deaf and Hard of Hearing (D/HH) - access recovery-based services. Interviews with national key informants were conducted prior to data collection to better formulate instruments. Cultural brokers, identified as leaders in their communities who also have mental health conditions, were hired to aid in recruitment and data collection. Interviews and focus groups were conducted with persons with mental health conditions from both cultural groups. Across both cultural groups, language barriers pose the biggest challenge in accessing mental health services. There is a lack of qualified professionals who speak Spanish or use American Sign Language. Among both groups, the preference is to work with someone in the language they feel most comfortable with and to avoid the use of interpreters. Feelings of isolation and stigma are high among persons who are D/HH, while many Latinos cite problems with family members\u27 understanding of mental health. Many are accessing peer support services and value what it has offered them. Access to adequate mental health services, not just recovery-oriented and peer support services, are not widely available for Latinos and persons who are D/HH. Public mental health systems need to adapt and expand services for these and other cultural groups to insure recovery

Evaluating One Strategy for Including Reflection in Medical Education and Practice

BACKGROUND AND OBJECTIVES: Reflective writing in medicine allows for the opportunity to analyze, interpret, and learn from clinical experiences. The purpose of this study was to evaluate the beneficial effects of reflective reading and writing for a department using a weekly listserve. METHODS: The Department of Family Medicine and Community Health at the University of Massachusetts Medical School sends out a weekly reflective writing story written by its members to celebrate clinical/teaching success. We conducted a 19-item questionnaire in the summer of 2014 among all 402 members. RESULTS: Questionnaires were completed by 161 of 402 (40%) readers and 50 of 122 (41%) writers. Readers found many benefits; 84% reported learning a lot about how a colleague handled a certain clinical situation, while 79% found that the reflective writing listserve helped them feel more connected to colleagues. A total of 83% reported that reading the weekly story positively affected their empathy and patient centeredness. Those who reported reading the stories most often were more likely to report achieving the most benefits. The majority of respondents who wrote stories agreed with all suggested benefits of writing; 73% reported that writing allowed them to celebrate a patient/research/teaching encounter that they were proud of, and 72% reported that it gave them better perspective or clarity about a patient experience a lot of the time. CONCLUSIONS: As departments struggle with provider burnout and feelings of being overwhelmed and disconnected, strategies like a reflective writing listserve may be a means to improve support and inspire clinicians and learners to feel fulfilled

Relating Mutant Genotype to Phenotype via Quantitative Behavior of the NADPH Redox Cycle in Human Erythrocytes

The NADPH redox cycle plays a key role in antioxidant protection of human erythrocytes. It consists of two enzymes: glucose-6-phosphate dehydrogenase (G6PD) and glutathione reductase. Over 160 G6PD variants have been characterized and associated with several distinct clinical manifestations. However, the mechanistic link between the genotype and the phenotype remains poorly understood.We address this issue through a novel framework (design space) that integrates information at the genetic, biochemical and clinical levels. Our analysis predicts three qualitatively-distinct phenotypic regions that can be ranked according to fitness. When G6PD variants are analyzed in design space, a correlation is revealed between the phenotypic region and the clinical manifestation: the best region with normal physiology, the second best region with a pathology, and the worst region with a potential lethality. We also show that Plasmodium falciparum, by induction of its own G6PD gene in G6PD-deficient erythrocytes, moves the operation of the cycle to a region of the design space that yields robust performance.In conclusion, the design space for the NADPH redox cycle, which includes relationships among genotype, phenotype and environment, illuminates the function, design and fitness of the cycle, and its phenotypic regions correlate with the organism's clinical status

Inquiring into our past: when the doctor is a survivor of abuse

BACKGROUND: Health care professionals like other adults have a substantial exposure to childhood and adult victimization, but the prevalence of abuse experiences among practicing family physicians has not been examined. Also unclear is the impact of such personal experiences of abuse on physicians\u27 screening practices for childhood abuse among their patients and the personal and professional barriers to such screening. METHODS: We surveyed Massachusetts family physicians about their screening practices of adult patients for a history of childhood abuse and found that 33.6% had some experience of personal trauma, with 42.4% of women and 24.3% of men reporting some kind of lifetime personal abuse, including witnessing violence between their parents. These rates are comparable to or higher than those reported in prior studies of physicians\u27 histories of abuse. RESULTS: Physicians with a past history of trauma were more likely to feel confident in screening and less likely to perceive time as a barrier to screening. CONCLUSIONS: Given the high prevalence of prior childhood and victimization of both men and women physicians with the associated effects on their clinical work, we recommend that educational and training settings adopt specific competencies to provide safe and confidential environments where trainees can safely explore these issues and the potential impact on their clinical practice and well-being