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Abstract Performing longitudinal and consistent risk assessments for patients with pulmonary arterial hypertension (PAH) is important to help guide treatment decisions to achieve early on and maintain a low‐risk status and improve patient morbidity and mortality. Clinical gestalt or expert perception alone may over or underestimate a patient's risk status. Indeed, regular and continued use of validated risk assessment tools more accurately predict patients' survival. Effective PAH risk assessments are often underutilized even though many seasoned clinicians will attest to using these tools routinely. We present recommendations based on real‐world experience in varied clinical practice settings around the United States for overcoming barriers to facilitate regular, serial formal risk assessment. Expert advanced practice provider clinicians from mid to large‐size medical centers collaborated to formulate recommendations based on multiple discourses and discussions. Enlisting the help of support staff, such as medical assistants and nurses, to fill in available risk parameters in risk assessment tools can save time for providers and increase efficiency, as can technology‐based solutions such as integrating risk assessments into electronic medical records. Modified, abbreviated risk assessment tools can be applied to a patient's clinical scenario when all of a patient's data are not available to complete a more comprehensive assessment. Initial discussions regarding the overall meaning and prognostic importance of risk scores may assist patients to take on a more active role in terms of informed decision‐making regarding their care. A collaborative approach can help clinics establish consistent use of risk assessment.

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.

Background: Numerous studies call for the identification and engagement of evaluation champions in the implementation of an evaluation initiative. However, no agreed definition of an evaluation champion exists in the extant literature. Published studies on evaluation champions are limited and motivations of evaluation champions are not well understood. Understanding of how evaluation champions interact with their colleagues to generate momentum for change is lacking. Purpose: This article explores champions in organizational settings and highlights the need for an increased understanding of evaluation champions. The research question posed is, ‘What does the literature tell us about evaluation champions in organizational settings?’ Setting: Not Applicable. Intervention: Not Applicable. Research Design: Relevant articles were identified through systematic searches of selected databases and reference reviews of retrieved articles from the evaluation and organizational development bodies of evidence. Theories that could assist with understanding the role of evaluation champions were also drawn upon. Data Collection and Analysis: Not Applicable. Findings: The analysis indicates evaluators and organizations value champions because they work to bring evaluative thinking into their practice and positively promote evaluation among their colleagues. A list of activities that may be indicative of the behaviours of champions has been compiled to contribute to the evidence base. Keywords: evaluation champions; social interdependence theory; evaluation use; evaluation capacity building.

Background: Ado-trastuzumab emtansine (T-DM1) is standard of care for patients with advanced HER2+ breast cancer who relapse within 6 months of adjuvant trastuzumab or progress on first-line anti-HER2 therapy. We evaluated its safety and efficacy in our real-world population. Methods: We identified patients on T-DM1 from 01/01/2014 to 12/03/2018 from our electronic records. Patients’, tumour characteristics, safety and efficacy outcomes were recorded. Chi-squared/Fishers exact test and Kaplan-Meier methods were utilised. Results: 128 patients receiving T-DM1 were included in the analysis with a median age of 55 years (26–85). 89.8% of patients had ECOG PS 0-1 and 21.1% had presented with de novo metastatic disease. 57.8% had ER-positive disease and 38.3% central nervous system involvement. 88.3% of patients had received trastuzumab for advanced disease (with pertuzumab in 28.9%) and 11.7% had only received trastuzumab in the adjuvant setting.Grade ≥3 adverse events occurred in 35.9% of patients. These were liver toxicity (19.5%), anaemia (6.2%) and thrombocytopenia (4.7%). Peripheral neuropathy of any grade was reported in 21.9% of cases, bleeding in 9.4% and ejection fraction decline in 5 patients.Median progression-free survival was 8.7 months and overall survival 20.4 months. Prior pertuzumab did not influence survival outcomes. Conclusions: The safety of T-DM1 in our population is similar to available literature, although we observed higher rates of peripheral neuropathy and deranged liver function. These findings are relevant for the potential role of TDM-1 in the curative setting.

Abstract  Giant knotweeds (Reynoutria spp.) are highly productive and aggressive invaders in riparian wetlands of Europe and North America. We sampled ground-dwelling beetles by pitfall traps from six sites comparing monotypic Reynoutria stands with the invaded native Urtica-dominated stands. Three sites were located in a semi-natural softwood forest and three sites were on a ruderal embankment. The analyses are based on a total of 13,244 individuals from 218 species. Location and site significantly influenced beetle assemblages. Moreover, there were pronounced differences between vegetation stands. The monotypic Reynoutria stands exhibited lower beetle abundance, species richness and rarefaction diversity irrespective of location. However, the negative effect on species richness, abundance and assemblage similarities were stronger on the transformed ruderal embankment than in the semi-natural softwood forest. Reynoutria invasion seems to influence microclimatic conditions. We found a higher abundance of silvicolous and a lower abundance of xerophilous ground beetles in the Reyountria stands than in the Urtica-dominated stands. Feeding guilds reacted differently to Reynoutria invasion that reduced the abundance of predators and herbivores but enhanced that of detritivores. Detritivores assumingly profit from the perennial presence of the large quantities of Reynoutria litter. We conclude that highly productive invaders pauperise the arthropod fauna and alter link strengths in trophic cascades shifting primary producer-based food webs to detritus-based food webs. [ABSTRACT FROM AUTHOR]