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This essay explores the emerging field of rapid evaluation in health and social care, drawing out the ways in which it is distinctive from or similar to other forms of applied research. It draws closely on the experience of two National Institute for Health and Care Research rapid service evaluation teams established in 2018, of which all authors of this essay are members. Reflection on the rapid evaluation teams’ body of work is used to highlight methodological and operational considerations for researchers, practitioners and policy-makers interested in the commissioning, conduct and application of rapid evaluations in health and social care. The essay is organised according to the ‘evaluation pathway’, from project selection and scoping, stakeholder involvement, research methods and activity, through skills and team working to feedback and dissemination. Its conceptual framing draws on Riley et al.’s rapidity, responsiveness and relevance framework, proposing a fourth dimension of rigour.1 Novel insights include: the primacy of scoping thoroughly a rapid evaluation; the trade-offs to be made in respect of patient and community engagement and rapid working; the opportunities presented by virtual and mixed research methods; the particular challenges of supervising and leading multiple studies undertaken simultaneously; and the need for flexible and dynamic approaches to disseminating emerging findings in as close to real time. The essay concludes by setting out key lessons about how to conduct rapid evaluations. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (RSET: 16/138/17; BRACE: 16/138/31). Scientific summary Rapid evaluation is increasingly used in health and social care to provide evidence about the design, implementation, experience and early outcomes of service innovations in a complex and typically fast-moving context. The methods used in rapid evaluation are often those of applied health and care research, adapted to enable or mitigate the rapid approach. This essay reports on the work over five years of two National Institute for Health and Care Research (NIHR)-funded rapid service evaluation teams [Birmingham RAND and Cambridge Rapid Evaluation (BRACE) team and Rapid Service Evaluation Team (RSET) from University College London and the Nuffield Trust)] using the combined experience of undertaking 19 studies to assert the importance of responsiveness, relevance and rigour in the practice of rapid evaluation (the ‘4 Rs’, drawing on the work of Riley et al.).1 Rapid evaluation is a field of research that is subject to debate in relation to its definition, design and implementation. Within the overall conceptualisation of the 4 Rs, ‘rapid evaluation’ can be defined as: early evaluation of an intervention, an evaluation with a short timescale, a study that is mobilised more quickly or one that provides early and rapid cycles of feedback. In addition to this timescale-based typology, the experience of the two NIHR-funded teams is that rapid evaluation can helpfully be conceptualised within a relational-based approach where it may be the precursor to a longer study, the follow-up to a longer study, a nested project within a longer-term evaluation or a stand-alone research project. A methodology-based typology may also be applied when planning, designing and undertaking rapid evaluation. Hence researchers may: use a methodology designed specifically for rapid evaluation, increase rapidity of the evaluation by doing less, use alternative technologies and/or data to increase the speed of an existing evaluation method, or adapt methods from a non-rapid evaluation. These typologies are not exhaustive but are offered as an illustration of the wider and sometimes contested debate about different ways to define, plan and undertake rapid evaluation research. An analysis is made of the methodological challenges specific to rapid evaluation with a particular focus on the selection, scoping and co-design of such studies. It is asserted that the process of scoping evaluations must be thorough and inclusive, being critical to determining when a rapid approach is required and if so, the questions to be examined and methods to adopt. Despite this process of scoping in close partnership with stakeholders, trade-offs will be inevitable in rapid evaluation studies and may lead to more uncertain or ambiguous findings. Researchers must therefore be clear and open about the limitations of their findings and ensure a clear focus on using a flexible and proportionate approach. A larger multi-skilled and experienced team will be required for rapid evaluation and especially where multiple projects are being undertaken in parallel. This in turn calls for senior academic and robust project management expertise and capacity to support effective team-working, complex and sometimes politicised stakeholder engagement, and the assurance of high-quality research delivery. The skills required of these teams extend beyond those usually taught in health and care research development programmes and encompass rapid uses of qualitative, quantitative and mixed methods, and proficiency in interpersonal skills for effective engagement, communication and dissemination. The importance of ensuring rapidity across all stages of the evaluation approach is emphasised, including: how to speed up data collection and analysis while preserving rigour; planning dissemination, uptake and impact from the earliest stages of scoping; and working in close partnership with patient, public and professional stakeholders to co-design the aims, approach and outputs. Outcomes of rapid evaluation may include assertion that intended benefits are likely to accrue, proposals for modifying or even halting a service innovation, planning a longer term study, or offering advice to local stakeholders about next steps. In all cases, the need for rapidity, responsiveness and relevance identified by Riley et al. will underpin the approach along with the additional dimension of rigour devised from the experience of the BRACE and RSET teams.1 The essay concludes with methodological and operational lessons for the conduction of rapid evaluation. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (RSET: 16/138/17; BRACE: 16/138/31).

Abstract In this paper, we examined the effects of an 11-bp mutation within the GDF-8 gene, originally identified in Belgian Blue cattle, in the South Devon breed. The mutation was found at moderate frequency (0.37) in the South Devon population. We quantified the effects of this mutation on growth, body composition and calving traits in South Devon cattle. We found that the mutation significantly increased muscle score and calving difficulty and decreased fat depth. The mutation did not significantly affect weight at 200 and 400 days or muscle depth. Its effect on muscle score and fat depth was additive while its effect on calving difficulty was recessive. The mutation accounted for a significant proportion of the phenotypic variance in muscle score and calving difficulty. There was an economic benefit of the mutation for this data set, however, calculations were sensitive to changes in the parameter values. Additional data would be required to refine these calculations.

INTRODUCTION: Type 2 diabetes (T2D) is one of the leading causes of death among Asian Americans. Despite being a culturally diverse racial group with differences in history, language, religion, and values, Asian Americans are often viewed as a monolith. With the high prevalence rate of T2D, a careful examination of self-management interventions across Asian Americans is needed to develop effective and culturally sensitive interventions. OBJECTIVE: To describe existing literature by examining study characteristics, different intervention components, and outcome measures of various T2D interventions among Asian Americans. METHODS: Using Arksey and OMalleys framework to ground this review, six online databases were used to identify studies. RESULTS: A total of 18 publications were included. Thirteen studies were published after 2013, with 44% and 22% of these studies focused on Chinese Americans and Korean Americans. We found a lack of geographic diversity in the location of the studies. Majority of the participants were females. Most of the interventions were implemented in person. Licensed health care providers were the most common interventionists, with a number of studies using community health workers. Outcome measures focused on three key areas: physiological, psychosocial and behavioral, and program-related outcomes. Many of the studies measured changes in HbA1C, self-efficacy, distress, depression, and quality of life. Overall, we saw improvements in physiological measures in most of the studies. For example, majority of the studies showed a decline in the participants HbA1C. Most studies showed an increase or improvement in healthy behaviors. Studies that measured efficacy, knowledge, attitude, motivation, quality of life, or general health showed improvement from baseline. All the studies that measured distress or depression showed a reduction of symptoms postintervention. CONCLUSION: Overall, we found that culturally tailored interventions that focus on specific Asian American subpopulations saw an improvement in physiological, psychosocial, or behavioral measures. There were several gaps in the existing T2D self-management programs or interventions among Asian Americans studied in the United States. Based on our analysis, we recommend when designing or implementing self-management interventions among Asian Americans, considerations should be made for targeted recruitment for understudied Asian American subgroups, gender, and location.

Abstract Background Sex-ratio distorting parasites are of interest due to their effects upon host population dynamics and their potential to influence the evolution of host sex determination systems. In theory, the ability to distort host sex-ratios allows a parasite with efficient vertical (hereditary) transmission to dispense completely with horizontal (infectious) transmission. However, recent empirical studies indicate that some sex-ratio distorting parasites have retained the capability for horizontal transmission. Results Numerical simulations using biologically realistic parameters suggest that a feminising parasite is only likely to lose the capability for horizontal transmission if its host occurs at low density and/or has a male-biased primary sex ratio. It is also demonstrated that even a small amount of horizontal transmission can allow multiple feminising parasites to coexist within a single host population. Finally it is shown that, by boosting its host's rate of population growth, a feminising parasite can increase its own horizontal transmission and allow the invasion of other, more virulent parasites. Conclusions The prediction that sex-ratio distorting parasites are likely to retain a degree of horizontal transmission has important implications for the epidemiology and host-parasite interactions of these organisms. It may also explain the frequent co-occurrence of several sex-ratio distorting parasite species in nature.

Work-integrated learning (WIL) is a national priority and a strategic direction for Australian universities. To increase industry engagement, there is a need to identify emerging WIL models that enable flexibility while optimizing outcomes for stakeholders. This Australian Technology Network (ATN) project explored approaches that overcome constraints to engagement, particularly for small to medium enterprises (SMEs). The preliminary qualitative phase comprised a literature review, workshops and interviews. Examples of emerging WIL models, both curricula and co-curricular, were clustered into five models: micro-placements, online projects or placements, hackathons, competitions and events, incubators/start-ups and consulting. This paper outlines these models and summarizes defining features, enablers, challenges and opportunities. Contemporary trends informing innovative WIL design and implementation emerged. Features fell into three broad areas, stakeholder engagement, design elements and co-design with partners. Enablers, challenges and opportunities in the implementation of these WIL models that respond to the changing nature of work were documented.

Abstract Background Members of the M2 family of peptidases, related to mammalian angiotensin converting enzyme (ACE), play important roles in regulating a number of physiological processes. As more invertebrate genomes are sequenced, there is increasing evidence of a variety of M2 peptidase genes, even within a single species. The function of these ACE-like proteins is largely unknown. Sequencing of the A. gambiae genome has revealed a number of ACE-like genes but probable errors in the Ensembl annotation have left the number of ACE-like genes, and their structure, unclear. Results TBLASTN and sequence analysis of cDNAs revealed that the A. gambiae genome contains nine genes (AnoACE genes) which code for proteins with similarity to mammalian ACE. Eight of these genes code for putative single domain enzymes similar to other insect ACEs described so far. AnoACE9, however, has several features in common with mammalian somatic ACE such as a two domain structure and a hydrophobic C terminus. Four of the AnoACE genes (2, 3, 7 and 9) were shown to be expressed at a variety of developmental stages. Expression of AnoACE3, AnoACE7 and AnoACE9 is induced by a blood meal, with AnoACE7 showing the largest (approximately 10-fold) induction. Conclusion Genes coding for two-domain ACEs have arisen several times during the course of evolution suggesting a common selective advantage to having an ACE with two active-sites in tandem in a single protein. AnoACE7 belongs to a sub-group of insect ACEs which are likely to be membrane-bound and which have an unusual, conserved gene structure.

Members of the blowfly family (Calliphoridae) are usually the first insect species to arrive at a corpse, using the body as an oviposition site, and, as such, they are the most important group of insects used to estimate the post-mortem interval (PMI). PMI estimations are based on species-specific developmental timings; therefore, accurate species identification is crucial. Current identification methods are based on morphological characteristics, which are time-consuming and difficult to perform on damaged, immature specimens and closely related species. Advances have led to specimens being identified via a host of molecular techniques, mainly DNA sequencing. Although molecular identification is becoming increasingly more common, there is currently a lack of genetic data regarding UK Calliphoridae species. This study aimed to address this issue. We present the development and validation of an identification assay capable of differentiating six UK species (Calliphora vicina, Calliphora vomitoria, Lucilia sericata, Lucilia illustris, Lucilia caesar, and Protophormia terranovae). The sequencing of six genes, including both nuclear (28S rRNA and Elongation factor 1 alpha) and mitochondrial markers (Cytochrome oxidase I and II, Cytochrome b and 16S rRNA) identified 298 species-specific single nucleotide polymorphisms (SNPs). Fifteen SNPs from six genes were chosen for inclusion in a SNaPshot™ multiplex assay. The developed assay is capable of differentiating the species based on between 4 and 12 SNPs. Validation following guidelines by the International Society of Forensic Genetics (ISFG) demonstrated the assay to be accurate, reproducible, sensitive, and specific. [ABSTRACT FROM AUTHOR]

Objective: The goal was to develop and validate classification criteria for axial juvenile spondyloarthritis (SpA; AxJSpA). Methods: This international initiative consisted of four phases: (1) item generation, (2) item reduction, (3) criteria development, and (4) validation of the AxJSpA criteria by an independent team of experts in an internationally representative validation cohort. Results: These criteria are intended to be used on youth with a physician diagnosis of juvenile SpA and for whom axial disease is suspected. Item generation consisted of a systematic literature review and a free‐listing exercise using input from international physicians, which collectively resulted in 108 items. After the item reduction exercise and expert panel input, 37 items remained for further consideration. The final AxJSpA criteria domains included the following: imaging of active inflammation, imaging of structural lesions, pain chronicity, pain pattern, pain location, stiffness, and genetics. The most heavily weighted domains were active inflammation and structural lesions on imaging. Imaging typical of sacroiliitis was deemed necessary, but not sufficient, to classify a youth with AxJSpA. The threshold for classification of AxJSpA was a score of ≥55 (out of 100). When tested in the validation data set, the final criteria had a specificity of 97.5% (95% confidence interval [CI] 91.4%–99.7%), sensitivity of 64.3% (95% CI 54.9%–73.1%), and area under the receiver operating characteristic curve of 0.81 (95% CI 0.76%–0.86%). Conclusion: The new AxJSpA classification criteria require an entry criterion and a physician diagnosis of juvenile SpA and include seven weighted domains. The AxJSpA classification criteria are validated and designed to identify participants for research studies. [ABSTRACT FROM AUTHOR]

Friedreichs ataxia (FRDA) is an incurable autosomal recessive neurodegenerative disease caused by reduced expression of the mitochondrial protein frataxin due to an intronic GAA-repeat expansion in the FXN gene. We report the therapeutic efficacy of transplanting wild-type mouse hematopoietic stem and progenitor cells (HSPCs) into the YG8R mouse model of FRDA. In the HSPC-transplanted YG8R mice, development of muscle weakness and locomotor deficits was abrogated as was degeneration of large sensory neurons in the dorsal root ganglia (DRGs) and mitochondrial capacity was improved in brain, skeletal muscle, and heart. Transplanted HSPCs engrafted and then differentiated into microglia in the brain and spinal cord and into macrophages in the DRGs, heart, and muscle of YG8R FRDA mice. We observed the transfer of wild-type frataxin and Cox8 mitochondrial proteins from HSPC-derived microglia/macrophages to FRDA mouse neurons and muscle myocytes in vivo. Our results show the HSPC-mediated phenotypic rescue of FRDA in YG8R mice and suggest that this approach should be investigated further as a strategy for treating FRDA.

Understanding multilevel predictors of colorectal cancer (CRC) screening test modality can help inform screening program design and implementation. We used North Carolina Medicare, Medicaid, and private, commercially available, health plan insurance claims data from 2003 to 2008 to ascertain CRC test modality among people who received CRC screening around their 50th birthday, when guidelines recommend that screening should commence for normal risk individuals. We ascertained receipt of colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) from billing codes. Person-level and county-level contextual variables were included in multilevel random intercepts models to understand predictors of CRC test modality, stratified by insurance type. Of 12,570 publicly-insured persons turning 50 during the study period who received CRC testing, 57% received colonoscopy, whereas 43% received FOBT/FIT, with significant regional variation. In multivariable models, females with public insurance had lower odds of colonoscopy than males (odds ratio [OR] = 0.68; p

Many issues influence reform in teacher preparation including national accountability efforts, professional teaching standards, and local or regional factors. This study examines a rurally-located teacher education program's efforts to reform clinical preparation through co-teaching. Researchers argue that their adaption of the typical one-to-one (1:1) model of co-teaching to a two-to-one (2:1) model, where two teacher candidates work collaboratively with one cooperating teacher, greatly enhances the student teaching experience. This phenomenological research describes the first year of implementation. Despite cooperating teacher concerns about teacher candidates being prepared for their own classrooms, student teachers learned valuable lessons in collaboration and co-planning, built strong relationships with peers and cooperating teachers, and greatly impacted K-6 student learning. Implications suggest a 2:1 co-teaching model of student teaching allows for fewer placements, which ultimately allows selection of quality cooperating teachers who mentor teacher candidates in powerful ways.

Nutrition is vital to health, but while the link between diet and body nutritional composition is well explored in humans and other vertebrates, this information is not well understood in insects, despite the vital roles they play in ecosystems, and their increasing use as experimental models. Here we used Nutritional Geometry to explore the rapid physiological response to ingested nutrients in the haemolymph nutritional profile of Spodoptera littoralis caterpillars. We ask whether blood nutrients are maintained homeostatically in the face of variable nutritional intake, or if regulation is more flexible for some nutrients than others (allostasis), which allows animals to adapt to stress by responding in a way that prioritises efficiency of responses in the face of trade‐offs. Caterpillars were placed on 1 of 20 diets, systematically varying in their nutrient ratios (protein: carbohydrate) and density (calorie content), and their consumption was measured. After 48 h, caterpillars were bled, and the macronutrient (protein, carbohydrates and lipids) and nutrient metabolite (amino acids and simple sugars) content of the haemolymph was measured. Proteins comprised 93% of the haemolymph macronutrient pool on average and their concentration increased with protein eaten. The amino acid (AA) pool was dominated by five AAs, and the total pool increased with total nutrient intake. However, the ratio of essential to non‐essential AAs increased as the proportion of protein consumed increased. Carbohydrates were tightly controlled, increasing only on the most extreme carbohydrate intakes. Simple sugars were dominated by glucose and trehalose, and overall, the simple sugar pool showed high levels of homeostasis. Rather than strict homeostasis of blood nutritional properties, an allostatic model seemed to be a better fit for blood nutrient regulation in this generalist herbivore. This flexibility in response to the nutritional composition of the diet may, in part, explain how this species has evolved to extreme dietary generalism and may play a role in its worldwide pest status. Given the range of fitness‐related processes affected by the haemolymph, future studies should examine the physiological impacts of blood nutrient variation on reproduction, growth and response to infection and the trade‐offs between them. [ABSTRACT FROM AUTHOR]

The following discussion will explore the impact of technology on perioperative nursing roles and the development of the phenomenon coined 'technology stress'. We will begin by reviewing the ongoing debate [...]

ObjectiveTo provide evidence-based recommendations for the treatment of patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (SpA).MethodsA core group led the development of the recommendations, starting with the treatment questions. A literature review group conducted systematic literature reviews of studies that addressed 57 specific treatment questions, based on searches conducted in OVID Medline (1946-2014), PubMed (1966-2014), and the Cochrane Library. We assessed the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method. A separate voting group reviewed the evidence and voted on recommendations for each question using the GRADE framework.ResultsIn patients with active AS, the strong recommendations included use of nonsteroidal antiinflammatory drugs (NSAIDs), use of tumor necrosis factor inhibitors (TNFi) when activity persists despite NSAID treatment, not to use systemic glucocorticoids, use of physical therapy, and use of hip arthroplasty for patients with advanced hip arthritis. Among the conditional recommendations was that no particular TNFi was preferred except in patients with concomitant inflammatory bowel disease or recurrent iritis, in whom TNFi monoclonal antibodies should be used. In patients with active nonradiographic axial SpA despite treatment with NSAIDs, we conditionally recommend treatment with TNFi. Other recommendations for patients with nonradiographic axial SpA were based on indirect evidence and were the same as for patients with AS.ConclusionThese recommendations provide guidance for the management of common clinical questions in AS and nonradiographic axial SpA. Additional research on optimal medication management over time, disease monitoring, and preventive care is needed to help establish best practices in these areas.

Art educators have a unique opportunity to develop and strengthen a cross-curricular foundation in literacy through art education. Enrolled in a content area reading course, pre-service teachers in art education at one, large southeastern university discovered that using language skills as a lens sharpened their observations of student performance in art classes at the elementary and high school levels. The inclusion of brief lessons featuring listening, reading, speaking, or writing strategies revealed unanticipated academic needs, which impacted classroom performance and artistic development. This increased awareness deepened preservice teachers' understanding of young students as learners and allowed the preservice teachers to adjust their lesson planning and classroom management skills. The pre-service teachers were more confident in their practice as they witnessed the results of their efforts in terms of students' improved levels of artistic achievements. (Contains 6 tables.)

Within Australian higher education, there has been an evolving of employability policy, realised in curriculum, at an intersection of the constructs of employment, work-readiness, life-long learning, and career development. The enactment of employability policy has driven an evolution in the practices of higher education in both curriculum and student support. This paper presents a case study of an Australian university which has reimagined the delivery of career and student support services through a framework that envisions preparing students for future worlds of work. The emergent policy framework has transformed organisational structures, human resources, and connections between student support practices and curriculum design. This transformation has generated new intersections of practice and is challenging institutional constructs of expertise. This case study provides transferrable learnings for broader considerations of higher education policy and practice as employability becomes the core driver of student success, and explores layered discourses of policymaking across an institution.