Pihl Newell (cakeappeal96)

Findings from a small EvalPractice pilot suggest that it may be possible to improve foundational situation awareness skills using deliberate practice, but that further research is required to understand strategies for building higher-level situation awareness skills in evaluation. HX531 mouse The article presents a mixed-methods evaluation of regional libraries in Namibia, which incorporates three perspectives the patron perspective (library users), the library perspective (library staff, management, and related officials), and the external perspective (including evaluators and monitoring data). Seven data collection methods were used patron surveys, patron panel studies, focus group discussions, key informant and staff interviews, secondary data analysis, media analysis, and observations. The goal of the evaluation was to assess library performance for both formative and summative purposes by addressing evaluation questions on areas such as library services, use, and operations. Building upon the literature review of how mixed-methods approaches can contribute to library evaluation, the aim of this article is to show how a mixed-methods evaluation can be designed to examine multi-faceted library performance and to illustrate how the evaluation design allows information complementarity and can be utilized to present diverse viewpoints of the above three perspectives. The evaluation design, analysis process, and lessons learned from this study may be useful to evaluators engaged in evaluation of public services or programs (including public libraries) that examine multiple aspects of service performance and involve a variety of stakeholders. PURPOSE First metatarsophalangeal (MTPJ1) fusion represents the gold standard treatment for end-stage hallux rigidus (HR). The aim of this study was to assess efficacy and safety of A-PRF in promoting union after MTPJ1 arthrodesis. Our hypothesis was that the use of A-PRF may reduce the non-union rate and the time to fusion in the treatment of HR. METHODS 14 patients that had undergone MTPJ1 arthrodesis with A-PRF adjunction with 21 standard MTPJ1 fusions were retrospectively reviewed. The fusion rate and time to fusion (clinically and radiographically) were assessed at 6, 12 weeks and at the longest follow-up; the clinical status at final follow-up through forefoot AOFAS, EQ5d, SEFAS and VAS-pain scores; the complication rate. RESULTS At 6-weeks, bony union was achieved in 100% of patients in the A-PRF group compared to 70% in the control group, but this difference was not statistically significant (p=0.22). At final follow-up (41 months), union rate in the control group reached 92% (one non-union). AOFAS, VAS and EQ-5d scores showed similar results for the two groups (p=0.86, p=0.12 and p=0.61, respectively); only SEFAS score revealed a difference favoring the A-PRF group (p=0.04). No revision surgery or complication was recorded in any group. CONCLUSIONS A tendency for increased union rate was mainly found at 6 weeks in patients treated with MTPJ1 fusion associated to A-PRF compared to isolated fusion. The use of A-PRF was not associated with an increased complication rate at final follow-up. LEVEL OF EVIDENCE Level 3, therapeutic study, retrospective comparative study. Osteonecrosis (ON) is a disabling complication of acute lymphoblastic leukemia (ALL) treatment in children and young adults. Isolated talus involvement is thought to be uncommon. A unique case of a 11-year-old female patient with ON in her left talus which developed six months after the completion of chemotherapy that she received for ALL is reported. A conservative treatment protocol was followed including activity modification, analgesia and prevention of weight-bearing. However, the disease significantly progressed during follow-up period. The present study makes an important contribution to the literature with unusual involvement pattern and location of ON after ALL treatment and with a long follow-up duration. LE