Out of the Margins

This chapter starts from the observation that, to address the destitution of any community successfully, the sociopolitical interactions that exist around that community need to be addressed as well. It offers three reasons why youth development policies for young Roma who live in poverty may have an impact on these interactions by changing patterns of social mobility among children and adolescents to facilitate greater, large-scale change. These policies may be pivotal in bringing about new experiences and perceptions of Roma identity. And finally, they may inform and help expand international actions on Roma. By studying the opportunities inherent in youth development initiatives, researchers may gain a deeper understanding not only of the dynamics of exclusion and marginalization facing many Roma but also of the potential positive change within and around their communities.

Capability building for large-scale transformational change: learning from an evaluation of a national programme

BackgroundThe Long Term Plan presents an ambitious vision for England’s National Health Service which will require a sustained programme of transformational change. The Virtual Academy of Large-Scale Change (VALSC) was developed to build capability in health and care system teams involved in transformation or redesign programmes.MethodsTo evaluate the VALSC, quantitative and qualitative data were collected and reviewed against the Kirkpatrick model. Quantitative data were collected via end-of-session surveys to assess individual knowledge before and after participating in capability-building interventions. Qualitative data were also collected and included post-intervention surveys and interviews. Interviews were transcribed and analysed using an inductive approach to identify themes that were subsequently assessed against the Kirkpatrick model.ResultsResults suggest that the VALSC programme has helped build capability for large-scale change in terms of learning, behaviour change and impact. Participants’ ipsative self-assessment of knowledge demonstrated a significant change (p<0.001) and qualitative data suggested three broad themes in which the VALSC made an impact. First, participants were empowered with transformation and change skills which they applied to local health and care challenges. Second, VALSC helped strengthen connections within and between transformational change teams. Third, VALSC helped transformational change teams to engage more effectively with their stakeholders.ConclusionsThe VALSC developed knowledge, skills, behavioural change and application impact that built capability in individuals and teams. Therefore, continuing to develop capability-building offers that empower and build agency in front-line staff working on service transformation and equip them with approaches, methods and tools to increase their chances of success, is recommended.

Image registration comparative analysis: normalized correlation versus SIFT-based registration

The paper compares the image registration algorithms: the classical normalized correlation (as a representative of intensity-based algorithms) and the SIFT-based algorithm (feature-based registration). A gradient subpixel correction algorithm was also used for normalized correlation. We compared the effectiveness of their work on real images (including a terrain map) when modeling artificial distortions. The accuracy of determining the position (shift) of one image relative to another in the presence of rotation and scale changes was studied. The experiment was carried out using a simulation model created in the Python programming language using the OpenCV computer vision library. The results of the experiments show that in the absence of rotation and scale changes between the registered images the normalized correlation provides a slightly smaller root-mean-square error. At the same time, if there are even small such distortions, for example, a rotation of more than 2 degrees and a scale change of more than 2 percent, the probability of correct registration for the normalized correlation drops sharply. It was also noted that the advantages of normalized correlation are almost 5 times higher speed and the possibility of using it for small fragments (50x50 or less), where it is problematic for the SIFT algorithm to allocate a sufficient number of keypoints. It was also shown that the use of a two-stage algorithm (SIFT-based registration at the first stage, and optimization with normalized correlation as a criterion at the second) allows you to get both high accuracy and stability to rotation and scale change, but this will be accompanied by high computational costs.

Programme theory and linked intervention strategy for large-scale change to improve hospital care in a low and middle-income country - A Study Pre-Protocol

In low and middle-income countries (LMIC) general hospitals are important for delivering some key acute care services. Neonatal care is emblematic of these acute services as averting deaths requires skilled care over many days from multiple professionals with at least basic equipment. However, hospital care is often of poor quality and large-scale change is needed to improve outcomes. In this manuscript we aim to show how we have drawn upon our understanding of contexts of care in Kenyan general hospital NBUs, and on social and behavioural theories that offer potential mechanisms of change in these settings, to develop an initial programme theory guiding a large scale change intervention to improve neonatal care and outcomes. Our programme theory is an expression of our assumptions about what actions will be both useful and feasible. It incorporates a recognition of our strengths and limitations as a research-practitioner partnership to influence change. The steps we employ represent the initial programme theory development phase commonly undertaken in many Realist Evaluations. However, unlike many Realist Evaluations that develop initial programme theories focused on pre-existing interventions or programmes, our programme theory informs the design of a new intervention that we plan to execute. Within this paper we articulate briefly how we propose to operationalise this new intervention. Finally, we outline the quantitative and qualitative research activities that we will use to address specific questions related to the delivery and effects of this new intervention, discussing some of the challenges of such study designs. We intend that this research on the intervention will inform future efforts to revise the programme theory and yield transferable learning.