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Providing aid in times of increasing humanitarian need, limited budgets, and mounting security risks is challenging. This paper explores in what organisational circumstances evaluators judge, positively and negatively, the performance of international non-governmental organisations (INGOs) in response to disasters triggered by natural hazards. It assesses whether and how, as perceived by expert evaluators, CARE and Oxfam successfully met multiple institutional requirements concerning beneficiary needs and organisational demands. It utilises the Competing Values Framework to analyse evaluator statements about project performance and organisational control and flexibility issues, using seven CARE and four Oxfam evaluation reports from 2005-11. The reports are compared using fuzzy-set Qualitative Comparative Analysis. The resulting configurations show that positive evaluations of an INGO's internal and external flexibility relate to satisfying beneficiary needs and organisational demands, whereas negative evaluations of external flexibility pertain to not meeting beneficiary needs and negative statements about internal control concerning not fulfilling organisational demands.

Participation has long been considered important for post‐disaster recovery. Establishing what constitutes participation in post‐disaster shelter projects, however, has remained elusive, and the links between different types of participation and shelter programme outcomes are not well understood. Furthermore, recent case studies suggest that misguided participation strategies may be to blame for failures. This study analysed 19 shelter projects implemented in the Philippines following Typhoon Haiyan in November 2013 to identify the forms of participation employed. Using fuzzy‐set qualitative comparative analysis, it assessed how household participation in the planning, design, and construction phases of shelter reconstruction led to outcomes of household satisfaction and safe shelter design. Participation was operationalised via eight central project tasks, revealing that the involvement of households in the early planning stages of projects and in construction activities were important for satisfaction and design outcomes, whereas engagement during the design phase of projects had little impact on the selected outcomes. National Science Foundation, United States Agency for International Development Office of U.S. Foreign Disaster Assistance, Nicolas R. and Nancy D. Petry Fellowship in Construction Engineering and Management

© 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd. Objective: Despite the physical and psychological health benefits associated with physical activity (PA) for breast cancer (BC) survivors, up to 70% of female BC survivors are not meeting minimum recommended PA guidelines. The objective of this study was to evaluate acceptability and satisfaction with Project MOVE, an innovative approach to increase PA among BC survivors through the combination of microgrants and financial incentives. Methods: A mixed-methods design was used. Participants were BC survivors and support individuals with a mean age of 58.5 years. At 6-month follow-up, participants completed a program evaluation questionnaire (n = 72) and participated in focus groups (n = 52) to explore their experience with Project MOVE. Results: Participants reported that they were satisfied with Project MOVE (86.6%) and that the program was appropriate for BC survivors (96.3%). Four main themes emerged from focus groups: (1) acceptability and satisfaction of Project MOVE, detailing the value of the model in developing tailored group-base PA programs; (2) the importance of Project MOVE leaders, highlighting the value of a leader that was organized and a good communicator; (3) breaking down barriers with Project MOVE, describing how the program helped to address common BC related barriers; and (4) motivation to MOVE, outlining how the microgrants enabled survivors to be active, while the financial incentive motivated them to increase and maintain their PA. Conclusion: The findings provide support for the acceptability of Project MOVE as a strategy for increasing PA among BC survivors.

The humanitarian sector is increasingly aware of the role that good quality evidence plays in the underpinning of effective and accountable practice. This review addresses the need for reliable evidence by evaluating current knowledge about the intersection of two key outcome targets of post-disaster shelter response: supporting shelter self-recovery and building back safer. Evidence about post-disaster shelter programmes that aim to improve hazard resistance while supporting shelter self-recovery has been systematically analysed and evaluated. Technical support, especially training in safer construction techniques, was found to be a central programme feature, but the impact of this and other programme attributes on building safety was largely not ascertainable. Programme reports and studies lack sufficient detail, especially on the hazard resistance of repaired houses. Accounts of shelter programmes need to include more reliable reporting of key activities and assessment of outcomes, in order to contribute to the growing evidence base in this field.

Construct:The study compares paper and online ratings of instructional units and analyses, with the G-study using the symmetry principle, the response rates needed to ensure acceptable precision of the measure when compliance is low. Background: Students' ratings of teaching contribute to the quality of medical training programs. To date, many schools have replaced pen-and-paper questionnaires with electronic forms, despite the lower response rates consistently reported with the latter. Few available studies have examined the effects of low response rates on the reliability and precision of the evaluation measure. Moreover, the minimum number of raters to target when response rates are low remains unclear. Approach: Descriptive data were derived from 799 students' paper and online ratings of 11 preclinical instructional units (PIUs). Reliability was assessed by Cronbach's alpha coefficients. The generalizability method applying the symmetry principle approach was used to analyze the precision of the measure with a reference standard error of mean (SEM) set at 0.10; optimization models were built to estimate minimum response rates. Results: Overall, response rates were 74% and 30% (p < .001) and PIUs ratings were 3.8 ± 0.5 and 3.6 ± 0.5 (p = .02), respectively in paper and online questionnaires. Higher SEM levels and significantly larger 95% confidence intervals of PIUs rating scores were observed with online evaluations. To keep the SEM within preset limits of precision, a minimum of 48% response rate was estimated for online formats. Conclusions: The proposed generalizability analysis allowed estimating the minimum response needed to maintain acceptable precision in online evaluations. The effects of response rates on accuracy are discussed.

Small ruminant lentivirus infections in goats affect both production and animal welfare. This represents a threat to the qualitative and quantitative growth of goat farming, recently observed in mountainous regions such as the Autonomous Province of Bolzano - South Tyrol (Italy). To monitor and eradicate the caprine arthritis encephalitis virus in this goat population, a compulsory eradication campaign was launched, based on a strict census of small ruminants and yearly serological testing of all animals, followed by the consequent culling of seropositive individuals. The campaign succeeded in completely eliminating cases of clinical disease in goats, while drastically reducing the seroprevalence at the herd as well as individual animal level. The serological outcome of the introduced control measures was determined using commercially available ELISA kits, demonstrating their suitability for use in this type of campaign, aimed at reducing seroprevalence as well as clinical manifestations of these infections. However, this clear success is diminished by the failure to achieve a complete eradication of these viruses. The reasons leading to the observed tailing phenomenon and the occurrence of new infections in already sanitised flocks are discussed and implementation of further measures are proposed.

The transition from medical student to junior doctor is well recognised to be a difficult and stressful period. To ease this transition, most UK universities have a work-shadowing period (WSP), during which students can learn practical skills needed for forthcoming employment. The aim of this study was to evaluate the WSP at Queen's University Belfast, and gain the views of both students and Foundation Programme Supervisors and Directors (FPSDs). The study utilised both qualitative (focus groups) and quantitative (questionnaires) approaches. The FPSDs completed a specific questionnaire designed for this study, while the students completed the university's internal quality assurance questionnaire. Twenty-eight of the 37 (76%) FPSDs and 106 / 196 (54%) students completed the questionnaires. Focus groups were conducted with up to 10 students in each group in both a regional centre and a district general hospital at the start and the end of the WSP as well as 8 weeks into working life. The transcripts of the focus groups were analysed and themes identified. A number of deficiencies with the current WSP were identified, including concerns about the use of log books, the timing of the attachment and relatively low levels of supervision provided by senior hospital staff members. As a result, students felt unprepared for commencing work, with particular mention given to medical emergencies, prescribing, and the emotional aspects of the job. A number of recommendations are made, including the need for more senior input to ensure better student attendance, participation and clinical interaction. Furthermore, students should be offered additional supervised responsibility for delivery of patient care and more experiential learning with respect to drug prescribing and administration. The study also suggests that more needs to be done to help ease the emotional and psychological stresses of the early FY1 period. These issues have been resolved to a large extent with the introduction of the new final year Student Assistantship module in the academic year 2010-2011.

The National Health Service in England and Wales has recently adopted a policy aimed at embedding continuous quality improvement (CQI) at all levels and across all services. The key goal is to achieve changes in practice which improve patient outcomes. This paper describes the use of a training course for multiprofessional groups of participants tailored to offer them relevant knowledge, management and team working skills, and approaches to personal and career development. These were intended to assist them in changing their practice for the benefit of patients. The participants rated the course highly in fulfilling its objectives. One cohort followed up for 6 months named changes in practice which related specifically to learning from the course. This paper shows the important contribution of multiprofessional learning to CQI and presents a useful method of evaluating links between learning and performance.

To evaluate a programme introducing quality improvement (QI) in nursing education.Betanien College of Nursing and clinical practices at hospitals in Bergen.52 nursing students from a second year class working in 16 groups undertaking hospital based practical studies.Second year nursing students were assigned to follow a patient during a day's work and to record the processes of care from the patient's perspective. Data collected included waiting times, patient information, people in contact with the patient, investigations, and procedures performed. Students also identified aspects of practice that could be improved. They then attended a 2 day theoretical introductory course in QI and each group produced flow charts, cause/effect diagrams, and outlines of quality goals using structure, process, and results criteria to describe potential improvements. Each group produced a report of their findings. Main measures-A two-part questionnaire completed by the students before and after the intervention was used to assess the development of their understanding of QI. Evidence that students could apply a range of QI tools and techniques in the specific setting of a hospital ward was assessed from the final reports of their clinical attachments.The students had a significantly better knowledge of QI after the introductory course and group work than before it, and most students indicated that they considered the topic highly relevant for their later career. They reported that it was quite useful to observe one patient throughout one shift and, to some extent, they learned something new. Students found the introductory course and working in groups useful, and most thought the programme should be included in the curriculum for other nursing students. They considered it important for nurses in general to have knowledge about QI, indicating a high perceived relevance of the course. All 16 groups delivered reports of their group work which were approved by the tutors. Through the reports, all the groups demonstrated knowledge and ability to apply tools and techniques in their practical studies in a hospital setting.The introduction of a short experience-based programme into the practical studies of second year nursing students enabled them to learn about the concepts, tools, and techniques of continuous QI in a way that should provide them with the skills to undertake it as part of routine practice.

Objective To identify variations in current antenatal screening programmes across one region and compare results with a previous survey. Design A cross section descriptive survey. Setting All maternity units within the region of Northern Ireland. Sample Eleven maternity units were invited and ten agreed to participate. Main outcome measures The number of written policies for individual screening tests; the range of screening tests offered; the frequency of training opportunities for health professionals; and the information systems in place to record data. Results There is variation in service provision across maternity units and, in particular, inconsistency in the offer of serum screening tests for Down syndrome. A lack of training opportunities for health professionals involved in offering screening was highlighted, and no common information system employed. Conclusion While improvements have been made since 2002, variations persist. This is leading to inequalities in the provision of antenatal screening services across Northern Ireland.

A pilot study was performed to assess the effectiveness of treatment in an opioid dependent population using the Maudsley Addiction Profile (MAP) tool1. The primary outcome of the study was to assess if treatment had an effect on 1. Substance use (quantity and frequency of use), 2. Health risk behaviour (injecting and sharing injecting equipment), 3. Health symptoms (physical and psychological) and 4. Personal /Social functioning (relationships, employment and crime). A secondary outcome was also sought. The study took place in 2007 in an inner city Belfast hospital specialising in the treatment of addiction, over a two month period. Fifteen patients, all opioid dependent and receiving outpatient community treatment, were interviewed at baseline (prior to the commencement of treatment) and at eight weeks follow up. Three patients were lost to follow up. Two patients stopped using altogether. Of the remaining patients, improvements were seen in most areas. There was a decrease in the use of heroin (71.28%), cocaine (99.72%), crack cocaine (100%), cannabis (99.94%) and alcohol (33.17%). There was a reduction in injecting behaviour (60.93%). Improvements were observed in health with a reduction in physical (41.35%) and psychological (35%) symptoms. Overall personal and social functioning improved regarding interactions with family and friends. A reduction in crime was also observed (75%). Opinions and views of staff involved in the study were generally positive. This patient population presents with multiple and complex needs. Effective treatment needs to address these needs and not just drug addiction alone. The Maudsley Addiction Profile tool highlights this.

This article describes rates of missing item responses in personal digital assistant (PDA) assessments as compared to paper assessments. Data come from the evaluation of a classroom-based leisure, life skills, and sexuality education program delivered to high school students in Cape Town, South Africa. Analyses show that the paper assessments had much higher rates of missing-ness than PDA assessments. This association is moderated by item order. Certain analyses also suggest that paper assessments have higher rates of missingness for items pertaining to participants' sexual behavior. Implications of these results for evaluation research will be discussed.

To develop and evaluate an information service in which a "clinical informaticist" (a GP with training in evidence-based medicine) provided evidence-based answers to questions posed by GPs and nurse practitioners.Descriptive pilot study with systematic recording of the process involved in searching for and critically appraising literature. Evaluation by questionnaire and semi-structured interview.General practice.34 clinicians from two London primary care groups (Fulham and Hammersmith).Number and origin of questions; process and time involved in producing summaries; satisfaction with the service.All 100 clinicians in two primary care groups were approached. Thirty four agreed to participate, of whom 22 asked 60 questions over 10 months. Participants were highly satisfied with the summaries they received. For one third of questions the clinicians stated they would change practice in the index patient, and for 55% the participants stated they would change practice in other patients. Answering questions thoroughly was time consuming (median 130 minutes). The median turnaround time was 9 days; 82% of questions were answered within the timeframe specified by the questioner. Without the informaticist, one third of questions would not have been pursued.The clinical informaticist service increased access to evidence for busy clinicians. Satisfaction was high among users and clinicians stated that changes in practice would occur. However, uptake of the service was lower than expected (22% of those offered the service). Further research is needed into how this method of increasing access to evidence compares with other strategies, and whether it results in improved health outcomes for patients.

Educating healthcare professionals is a key issue in the provision of quality healthcare services, and interprofessional education (IPE) has been proposed as a means of meeting this challenge. Evidence that collaborative working can be essential for good clinical outcomes underpins the real need to find out how best to develop a work force that can work together effectively. We identify barriers to mounting successful IPE programmes, report on recent educational initiatives that have aimed to develop collaborative working, and discuss the lessons learned. To develop education strategies that really prepare learners to collaborate we must: agree on the goals of IPE, identify effective methods of delivery, establish what should be learned when, attend to the needs of educators and clinicians regarding their own competence in interprofessional work, and advance our knowledge by robust evaluation using both qualitative and quantitative approaches. We must ensure that our education strategies allow students to recognise, value, and engage with the difference arising from the practice of a range of health professionals. This means tackling some long held assumptions about education and identifying where it fosters norms and attitudes that interfere with collaboration or fails to engender interprofessional knowledge and skill. We need to work together to establish education strategies that enhance collaborative working along with profession specific skills to produce a highly skilled, proactive, and respectful work force focused on providing safe and effective health for patients and communities.

A randomized, crossover study comparing the acceptance of and attitudes towards two dosage forms of the same oral contraceptive product - a paper presentation and the conventional tablet, was carried out in a network of rural and suburban research centers in the State of Durango, México. The results failed to show any significant advantage (in terms of acceptability or continuation) of the paper formulation. Although two-thirds of the participants indicated a preference for the conventional tablet, there was a high degree of acceptance of the paper formulation among new oral contraceptive acceptors.A randomized, crossover study comparing the acceptance of and attitude towards 2 dosage forms of the same oral contraceptive product -- a paper presentation and the conventional tablet -- was carried out in a network of rural and suburban research centers in the State of Durango, Mexico. 68 women used the paper pill for 3 months and then switched to the tablet for another 3, while 70 women took the tablet 1st and switched to the paper pill. The results failed to show any significant advantage in terms of acceptability or continuation for the paper formulation. Both formulations were perceived as effective and easy to use. 2/3 of the participants indicated a preference for the tablets at the end of the study, but there was a high degree of acceptance of the paper formulation among new oral contraceptive acceptors. The authors believe that an improved paper formulation could be successfully introduced into a national program, if there were substantial savings in cost associated with the "paper pill."