A Housing First evaluation project for homeless Veterans in Canada: Quantitative findings

LAY SUMMARY This study sought to evaluate a Housing First program for Veterans experiencing homelessness. Housing First is an approach made up of many different aspects of care including peer support and greater access to care resources within the home. These aspects of care are offered in order to address underlying issues and maintain housing stability. The program was implemented across four cities in Canada including London, Toronto, Calgary, and Victoria. To assess the program, interviews with Veterans were conducted at time of enrollment, 3, 9, and 15 months. The Veterans in this study demonstrated a significant reduction in homelessness. As well, a significant reduction in emergency room visits was reported. Other health care interactions and quality-of-life scores remained stable. These findings could, therefore, lead to potential future cost savings in the health care sector. This study demonstrates why this approach to housing for Veterans can be a highly effective and useful way to ensure housing stability.

Non-collagen pathogenic variants resulting in the osteogenesis imperfecta phenotype in children: a single-country observational cohort study

Background/ObjectivesIn England, children (0–18 years) with severe, complex and atypical osteogenesis imperfecta (OI) are managed by four centres (Birmingham, Bristol, London, Sheffield) in a ‘Highly Specialised Service’ (HSS OI); affected children with a genetic origin for their disease that is not in COL1A1 or COL1A2 form the majority of the ‘atypical’ group, which has set criteria for entry into the service. We have used the data from the service to assess the range and frequency of non-collagen pathogenic variants resulting in OI in a single country.MethodsChildren with atypical OI were identified through the HSS OI service database. All genetic testing for children with OI in the service were undertaken at the Sheffield Diagnostic Genetics Service. Variant data were extracted and matched to individual patients. This study was done as part of a service evaluation project registered with the Sheffield Children’s Hospital Clinical Governance Department.ResultsOne hundred of 337 children in the HSS met the ‘atypical’ criteria. Eighty have had genetic testing undertaken; 72 had genetic changes detected, 67 in 13 genes known to be causative for OI. The most frequently affected genes were IFITM5 (22), P3H1 (12), SERPINF1 (8) and BMP1 (6).ConclusionAmong children with more severe forms of OI (approximately one-third of all children with OI), around 20% have pathogenic variants in non-collagen genes. IFITM5 was the most commonly affected gene, followed by genes within the P3H1 complex. These data provide additional information regarding the likelihood of different genetic origins of the disease in children with OI, which may influence clinical care.

Five ways to get a grip on the drawbacks of logic models in program evaluation

Logic models are perhaps the most widely used tools in program evaluation work. They provide reasonably straightforward, visual illustrations of plausible links between program activities and outcomes. Consequently, they are employed frequently in stakeholder engagement, communication, and evaluation project planning. However, their relative simplicity comes with multiple drawbacks that can compromise the integrity of evaluation studies. In this Black Ice article, we outline key considerations and provide practical strategies that can help those engaged in evaluation work to identify and mitigate the limitations of logic models.

Implementing QDAS Throughout an Evaluation Project Using the Five-Level QDA Method

The purpose of this paper is to introduce the Five-Level Qualitative Data Analysis (5LQDA) method for ATLAS.ti as a way to intentionally design methodological approaches applicable to the field of evaluation. To demonstrate my analytical process using ATLAS.ti, I use examples from an existing evaluation of a STEM Peer Learning Assistant program. Aligned with the 5LQDA method for ATLAS.ti, I first contextualize the strategies used to develop the analytical framework (Levels 1 & 2) and then deconstruct the translation process (Level 3) of pairing conceptual strategies with software tools. I then demonstrate the potential of the software in terms of selected and constructed tools (Levels 4 & 5) and discuss the importance of choosing tools aligned with the project's conceptual strategies. This paper acts as a resource to convey the value of integrating 5LQDA for ATLAS.ti throughout qualitative evaluation by engaging in an iterative process that creates opportunity for engagement.

Developing research knowledge and capability in undergraduate nurses: evaluation of targeted placements

Background There are few opportunities for undergraduate nurses to undertake experiential learning about research design and conduct. The project aim was to implement and evaluate a placement to support the development of research knowledge and skills. Methods Establishment of a four-week placement, with allocation to a registered quality improvement/service evaluation project. Evaluation was obtained through questionnaires; student experience (pre, post and one year), supervisor experience and organisational impact (presentations, conference and grant submissions). Results 24 students (five cohorts) were allocated to 17 projects (2017–2019). 100% of students enjoyed the placement, gained research knowledge and insight into clinical care. At one year ( n = 15), 88% of students would consider undertaking a service evaluation and 65% ( n = 11) would consider further post-graduate study. All supervisors ( n = 20) reported the initiative valuable for student development. All project results were shared with relevant local teams to enable service planning and results from five projects been presented at eight national and international conferences. Three projects have contributed directly to further research grant submissions. Conclusion The programme supports the development of undergraduate nurses to be research ready and facilitates organisations to address high-priority safety and quality topics. Further resources are required to be able to increase placement capacity.

Estimating the Absolute Salinity of Chinese offshore waters using nutrients and inorganic carbon data

In June 2009, the Intergovernmental Oceanographic Commission of UNESCO released The international thermodynamic equation of seawater – 2010 (TEOS-10 for short; IOC et al., 2010) to define, describe and calculate the thermodynamic properties of seawater. Compared to the Equation of State-1980 (EOS-80 for short), the most obvious change with TEOS-10 is the use of Absolute Salinity as salinity argument, replacing the Practical Salinity used in the oceanographic community for 30 years. Due to the lack of observational data, the applicability of the potentially increased accuracy in Absolute Salinity algorithms for coastal and semi-enclosed seas is not very clear to date. Here, we discuss the magnitude, distribution characteristics, and formation mechanism of Absolute Salinity and Absolute Salinity Anomaly in Chinese shelf waters, based on the Marine Integrated Investigation and Evaluation Project of the China Sea and other relevant data. The Absolute Salinity SA ranges from 0.1 to 34.66 g kg−1. Instead of silicate, the main composition anomaly in the open sea, CaCO3 originating from terrestrial input and re-dissolution of shelf sediment is most likely the main composition anomaly relative to SSW and the primary contributor to the Absolute Salinity Anomaly δSA. Finally, relevant suggestions are proposed for the accurate measurement and expression of Absolute Salinity of the China offshore waters.

EVALUATION OF DIGITAL TECHNOLOGY FROM THE STUDENTS` PERSPECTIVE IN THE CASE OF PROJECT WORK IN GEOGRAPHY

The aim of the research is to evaluate a project on the subject of reliefs, which included the use of modern digital technology from the perspective of secondary school students. Since the formative assessment of students also includes a critical self-evaluation of the final products, anonymous surveys were used to determine how the students evaluated the project work, and the use and usefulness of digital technology in geography lessons. Results of this research showed that digital technology encourages students to become more engaged and interested in learning, to reflect on their work and learning, to follow the evaluation criteria, and to achieve better learning outcomes. Keywords: digital technology, evaluation criteria, (self-) evaluation, project work, geography teaching

Mariposa House service evaluation project & co-production: new women's NHS forensic community step-down hostel

AimsTo understand and learn from patients’ views and experiences. Ultimately, to improve quality, safety, and patients’ experiences and outcomes.Service evaluation project of Mariposa House, London, the new women's forensic high support community step-down hostel after hospital admission. Run in partnership with Langley House (charitable) Trust. It is a co-produced, rare and innovative service- to our knowledge the only NHS women's service of its kind in England. In female and forensic community populations: transitions are the highest risk periods; the same treatment as men is unlikely to produce the same outcomes; and performance indicators and outcome measures are poorly understood.MethodConfidential patient questionnaire and self-reported Recovering Quality of Life (ReQoL) measure. Given to all patients in Mariposa House, before (in hospital) and 2-3 months after transfer to hostel. Themes included “my: care; voice (co-production); transition; & gender”. 12 questionnaires were received from 9 patients: 5 completed both pre- & post-; 3 (20%) were given but not received. Analysed by thematic content analysis. Additional focus group feedback session with patients and staff.ResultOverall, patients had very positive and similar views about both hostel and hospital(s), and similar views about both. Generally, patients feel treated with compassion, dignity and respect, and listened to and understood by staff members. They feel involved in and positive about their care.There was a huge amount of involvement in co-producing the service and feeding back experiences, which has been very helpful. Co-production activities included: interviewing for staff and tenders; choosing hostel building; stakeholder meetings; and participating in meetings about training, policies and expectations. “I've been in hospital for so long moving was scary! But helping set up the project has given me confidence to move.”There was strong agreement that transitions are difficult. Views on gender-specific needs being met were very positive, for both hostel and hospital. The main area for improvement was having better awareness of local neighbourhood and facilities- booklet now produced. Quality of life measures were at least maintained from hospital to hostel: 80% (n = 4) showed no reliable improvement/ deterioration, and 20% (n = 1) showed reliable improvement.ConclusionThere are very positive and similar views about the hostel and hospital(s). Co-production and service user involvement has been very helpful. The new hostel has maintained patient satisfaction and quality of life measures compared to established inpatient services. These are positive findings, and crucially: in a less- secure, contained, established, and cheaper new community setting, involving complex and challenging transitions.

Physical health monitoring in antipsychotic depot clinic

AimsA service evaluation project to look at if annual bloods, ECG, physical examination, and medical review was completed within the last year for patients attending anti-psychotic depot clinic at Bassetlaw mental health services in Nottinghamshire HealthCare NHS Foundation Trust.MethodElectronic notes were examined in October 2020 for 25 patients who attend anti-psychotic depot clinic to ascertain if medical review and physical examination had been completed along with annual bloods and ECG.ResultOut of 25 patients attending depot clinic in 2020 at Bassetlaw Hospital, 21 had all their blood tests done, 1 patient had refused bloods and 2 patients did not have blood tests done. ECG was completed for 3 patients at Bassetlaw hospital and 8 patients had it requested from primary care with 2 patients refusing to have ECG done. For 12 patients there was no evidence of ECG being requested or completed. 8 patients had physical examination completed and rest 17 patients did not have the physical examination completed including due to refusal. Out of 25, only 14 patients had a medical review conducted.ConclusionPatients who attend depot clinic may have an allocated community psychiatric nurse (CPN) or get reviewed by medics in outpatient clinics and would usually have their blood tests, physical health examination and ECGs requested and monitored by them. Patients who do not have any allocated CPN or medic tend to miss out on blood tests and ECG. General Practitioners are expected to complete physical health checks for patients who do not have CPN or regular outpatient review. The results of these investigations may not always be received in depot clinic, hence there is no documentation on electronic RIO system. When these patients disengage from the depot clinic, it is often very difficult to track them. As a follow-up from this service evaluation, all depot clinic patients will be allocated a key worker/CPN. This will ensure that they have a responsible person to facilitate annual checks. This will be reviewed in a years' time to evaluate the effectiveness of this intervention.