Rethinking Models of Evaluation: Sustainability as the Goal of International Cultural Organisations

The purpose and conduct of organisational evaluation is variously defined and understood. With the shift to the ‘new managerialism’ and the steady advance of audit culture in the public sector, evaluation models have proliferated but they are often narrowed to crude measures of impact and performance. They subject people to unhelpful, top-down forms of appraisal and accountability in the interests of transparency and economic efficiency with little respect afforded to the multiple perspectives and divergent goals of the actors involved. There is often a lack of clarity about what is being evaluated and from whose perspective. This paper traces the development of the Cultural Value Model (CVM). It was developed as part of UK-wide research programme aimed at rethinking how we assess the value of cultural activities. The primary objective of the CVM is to provide an analytical and methodological framework for re-conceiving models of evaluation. In particular, it shifts the frame of analysis away from impact to value. Our project aimed to deliver a robust, evidence-based understanding of the changing cultural value of the British Council (BC) and BBC World Service (BBCWS). These publically funded international organisations are an integral part of the UK’s diplomatic infrastructure and subject to stringent accountability measures to satisfy diverse stakeholders. They are experiencing rapid and convulsive change in response to financial, technological and geopolitical forces and their purpose and value is being questioned. In the paper we argue that the CVM, in fostering a more engaged, participatory approach to performance evaluation challenged and even subverted existing practices but with mixed results. In the case of the BC, it generated a high degree of interest and engagement to the extent that it is currently being adopted and integrated into organisational practices. In contrast, the BBCWS were more resistant to innovation believing that their audience ratings and internal reviews suffice. The flexible adaptability of the CVM presents an opportunity for other organisations to move from away from top-down performance and impact assessment towards a more inclusive, reflective and sustainable model of value. However we need to get a better understanding the organisational constraints that obstruct innovation if more participatory models of learning, monitoring and evaluation are to intervene in social and organisational processes and achieve sustainable models of good practice

Understanding the Changing Cultural Value of the BBC World Service and the British Council

This project investigated the changing cultural value of the BBC World Service (WS) and the British Council (BC) and how their cultural value can be assessed and measured. For eight decades, these organisations have been the face and voice of Britain overseas. Our research found that their attraction and influence abroad remains strong, but is on the wane, reflecting the UK’s declining economic and political significance on the world stage. Among the key findings of our historical and contemporary research: Cultural value is the catalyst of all aspects of value at WS and BC, founded on their capacity to act as transcultural intermediaries, fostering international understanding, and setting benchmarks in global standards for journalism and cultural relations work. Cultural value is relational, never independent of political and economic value. It is perspectival: audiences trust the quality and credibility of outputs; high professional standards and prestige benefit staff; funders appreciate the diplomatic and soft power assets. Cultural value accrues slowly over time but can be quickly lost. Social media afford new ways of connecting, informing and engaging citizens at home and abroad. Our case studies analysing the uses of Twitter and Facebook by BC and WS around global media events underscore the so far limited role of social media in democratising participation and promoting intercultural dialogue. We developed an innovative, theoretically grounded and empirically informed Cultural Value Model (CVM). This is an innovative device for conceptualising, analysing and assessing value in a multidimensional, composite, visual way. The CVM is designed for planning, monitoring and evaluating projects and organisations over time, alongside existing performance indicators and impact measures. It is currently being tested and developed on further projects at WS and BC as well as at the Swedish Institute

Reverse engineering: transaminase biocatalystdevelopment using ancestral sequencereconstruction

The development of new biocatalysts using ancestral sequence reconstruction is reported. When applied to an ω-transaminase, the ancestral proteins demonstrated novel and superior activities with eighty percent of the forty compounds tested compared to the modern day protein, and improvements in activity of up to twenty fold. These included a range of compounds pertinent as feedstocks in polyamide manufacture.MW and SK were supported by CSIRO Research Office Postdoctoral Fellowships

Researching transitions to distance higher education with students from refugee backgrounds: A case from the Sanctuary programme at the Open University

The research project investigated the transition processes of students from refugee backgrounds as they enter higher education (HE). The aim of the project was to expand our understanding of the concept of educational transition: firstly, in relation to transitions to distance and online higher education among students from diverse educational backgrounds and experiences, and secondly, in relation to the nature of socio-cultural transitions involved for students with ‘lived experience’ of displacement, and precarious migration statuses (i.e. refugees, asylum seekers). The project explored the concept of transitions from these angles in order to assess its importance in creating inclusive institutional policies and educational practices. The research was conducted as part of a major initiative within the Open University UK - the Open Futures Sanctuary Scholarships. In doing so, this project contributes to the growing body of research examining the challenges of transition to higher education for diverse groups, and pre-requisites for promoting and enhancing access and participation to HE for displaced students

The cultural value project cultural relations in ‘societies in transition’

The Cultural Value Project (CVP) is a joint research project commissioned by the British Council and the Goethe-Institut (January 2017-June 2018). It aims to build a better understanding of the value of cultural relations (CR) in societies facing difficult challenges–in particular, in Egypt and Ukraine. The project seeks to identify the difference cultural relations activities make to important international challenges, including supporting stability and prosperity in societies going through substantial change. It aims to contribute to current political, policy and academic debates about the role of culture in conflict, diplomacy and development. The British Council and Goethe-Institut wish to collaborate on this research in order to gain a better understanding of how different forms of cultural relations work in different contexts, and explore wider possibilities for partnerships in the field of cultural relations. This initiative occurs at a time when challenging transnational issues of conflict, security, migration, poverty and environmental degradation, beyond the control of any nation-state, make cooperation in international relations more difficult but more important than ever

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

The Influence of Bioactive Oxylipins from Marine Diatoms on Invertebrate Reproduction and Development

Diatoms are one of the main primary producers in aquatic ecosystems and occupy a vital link in the transfer of photosynthetically-fixed carbon through aquatic food webs. Diatoms produce an array of biologically-active metabolites, many of which have been attributed as a form of chemical defence and may offer potential as candidate marine drugs. Of considerable interest are molecules belonging to the oxylipin family which are broadly disruptive to reproductive and developmental processes. The range of reproductive impacts includes; oocyte maturation; sperm motility; fertilization; embryogenesis and larval competence. Much of the observed bioactivity may be ascribed to disruption of intracellular calcium signalling, induction of cytoskeletal instability and promotion of apoptotic pathways. From an ecological perspective, the primary interest in diatom-oxylipins is in relation to the potential impact on energy flow in planktonic systems whereby the reproductive success of copepods (the main grazers of diatoms) is compromised. Much data exists providing evidence for and against diatom reproductive effects; however detailed knowledge of the physiological and molecular processes involved remains poor. This paper provides a review of the current state of knowledge of the mechanistic impacts of diatom-oxylipins on marine invertebrate reproduction and development

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention