bluuebunny/crossref_metadata_2025 huggingface dataset:
Lessons Learnt from An Evaluation of An Unexploded Ordnance Removal Program in Lao PDR
Authors: Durham Jo , Tan B-K
Published: January 2018

The purpose of this article is to describe lessons learnt when the first author, an ‘outsider’, was undertaking a theory-based, mixed-methods evaluation of an unexploded ordnance (UXO) clearance program in Lao People's Democratic Republic (PDR). The lessons learnt comprised: 1) issues related to using a theory-based mixed-methods evaluation design; 2) contextualising languages, meaning and translation; and 3) cultural interpretation of ethical issues. Finally, it is proposed that reflexivity is an essential quality that evaluators need to develop in order to manage such challenges.
Social Transformation and Evaluation
Authors: Mertens Donna M
Published: January 2018

Evaluators work in contexts in which social inequities create tensions with regard to decisions about programs and their evaluation. In this article, Donna Mertens explores the meaning of ethics for evaluators who consciously position themselves as promoters of human rights and social justice. The transformative paradigm is offered as a framework for considering the assumptions that guide evaluators who take such a position in terms of methodological implications. This brings evaluators into the complex territory of cultural beliefs and norms that might support or inhibit transformative social change.
The Development of Benchmarking Policies and Practices in Education
Authors: Przybylak Betina
Published: January 2018

This article examines benchmarking policies and practices in education from the 1990s until today. A brief definition of benchmarking, as defined by experts in the commercial sector, provides a context for an examination of such evaluative work in educational settings. Following this definition, the article investigates the uses of benchmarking in international and domestic higher education settings, in order to set the scene for an assessment of benchmarking practices and policy in Australian compulsory education settings. In conclusion, the article endeavours to draw together the learning from established benchmarking practices in education in order to support aspirations for the future.
Using an Empowerment Evaluation Approach with Community-based Programs: Reflections from the Front Line
Authors: Newell Sallie , Graham Anne
Published: January 2018

Identifying the most appropriate approach for small-scale program evaluation remains a vexed issue for both the researchers who design and implement evaluations, and for the service provider organisations that seek to ensure that they can use the findings as evidence for further program funding. This article reflects on our experiences and the issues encountered in attempting to undertake useful small-scale, community-based program evaluation, particularly in regional settings, where the evaluation capacity, practices and cultures of organisations are still evolving.

Cognisant of increasing funder-fundee tensions arising from more externally controlled social program evaluations and considering varied organisational, program, personnel, funding and broader political needs and influences, we have focused on tailoring evaluation approaches to ensure they are robust, relevant and responsive to the varied organisational contexts in which we are endeavouring to strengthen evaluation capacity. The approach that has emerged over the past eight years fits most closely with an empowerment evaluation framework that, although theoretically well suited, has had to be adapted in order to respect, and work productively with the frequently competing imperatives of the different stakeholders involved.
Building Evaluation Capability in the Public Health Workforce
Authors: Dickinson Pauline , Adams Jeffery
Published: January 2018

Building evaluation capability and capacity is a complex task involving enhancing and building technical skills and working closely with individuals and groups to ensure evaluation learning is embedded in organisational philosophy and practice. In this article, we present the evaluation findings of the ‘Easy Evaluation’ initiative, which provides evaluation training workshops and organisational coaching and support, in order to address our central question: Are evaluation training workshops effective and what else is needed?

The findings are organised in line with three levels of Kirkpatrick's four-level evaluation model: trainee reactions, learning and behaviour. The ‘reaction’ and ‘learning’ data indicate that workshops were found to be effective in developing positive responses and enhancing trainee learning for most participants. Evaluation data relating to ‘behaviour’ indicated that just over half the training participants, at least three months following the training, were implementing evaluation activities.

In summary, to build sustainable evaluation practice within organisations, training needs to be supplemented with other evaluation capacity-building strategies.
Editorial
Authors: Alderman Lyn , Clinton Janet , Harvey Graeme
Published: January 2018

This edition of the Evaluation Journal of Australasia (EJA) provides a range of articles where evaluators describe innovations in their practice as they seek to resolve issues associated with the specific context of their evaluation or introduce new approaches to improve and extend the practice of evaluation. EJA also presents the inaugural Rosalind Hurworth Prize, which recognises an outstanding contribution to evaluation from the long papers submitted to the 2013 AES International Conference. The winning paper was selected by the Editors of EJA from a strong field of submissions, and congratulations are extended to Lesley Greenaway from the University of Dundee as the first recipient of the award.
Using Benchmark Principles as a Formative Evaluation Strategy to Build a Leadership Development Culture in the Australian Rail Industry
Authors: Short Tom , Piip Janene , Harris Roger
Published: January 2018

Australian organisations are concerned about the global shortage of leadership talent and the increasing mobility of leaders. At the same time, studies are raising awareness among executives of the need to develop a cohort of leaders for the future. The rail industry is one sector that has been deliberating on how leadership capability can be enhanced by putting aside organisational and/or state differences in favour of a national, harmonised approach to nurture leadership development. At a time when Australian leadership talent is in short supply, this article draws on findings from research involving six major rail organisations working in partnership with universities within an Australian Government Cooperative Research Centre (CRC). The article finds that leadership development programs within the industry are infrequent, undervalued and under-resourced. It highlights the critical importance of gaining executive commitment, and develops a formative evaluation tool of 10 principles and evaluation criteria forming observable, measurable and evidence-based standards that can be appraised at the start of leadership development initiatives and programs and monitored as they unfold. The article illustrates how engaging executives in a ‘formative evaluation’ process before embarking on leadership development initiatives has the potential to promote successful and sustainable programs.
Developing Symbiotic Clinical Educators: Using Program Logic to Evaluate a Clinical Education Course
Authors: Berryman Carolyn , Sweet Linda , Wearne Susan , Greenhill Jennene
Published: January 2018

Developing health professional clinical educators able to meet the shifting health care requirements of this century is a current government priority. To change practices in the clinic, those who teach need to change and that is best achieved by specific curricula designed for faculty development. Principles revealed during an investigation of a successful community-based medical education program underpin the Master of Clinical Education (MCE) course, a new faculty development curriculum. After six years, it is timely to evaluate whether the educational goals of the MCE course are being met.

The MCE faculty employed an independent research officer to conduct the study. A two-phase approach used semi-structured interviews and content analysis to develop and assess outcomes against an outcomes logic model.

The program achieved all short-term goals: understanding the symbiotic model; commitment to self as teacher; and changes in the way to give feedback. It achieved two of three medium-term goals: belief of transformation; and relationship development. One medium-term goal was not met: developing a sense of community.

This evaluation of the MCE course shows the program develops clinicians as committed educators and also as change agents who see building relationships as the key to operating effectively within complex health services and systems.
Bridging the Divide between Upward Accountability and Learning-Based Approaches to Development Evaluation: Strategies for an Enabling Environment
Authors: Lennie June , Tacchi Jo
Published: January 2018

A more complex and unstable development context and major shifts in development theory and practice over the past 20 years have created major challenges for evaluation. There remains a vast gap between the theory and practice of development evaluation that needs to be resolved. This indicates a vital need to bridge the divide between dominant results-based, upward accountability evaluation approaches and emergent learning, participatory and complexity-based approaches to more effectively achieve development goals. In this article we explore this divide and contrast these approaches, highlighting some of the key challenges that each face.

Drawing on our recent research, we identify key challenges, tensions and contradictions in evaluating communication for development (C4D) that need to be better understood and addressed. We outline a new conceptual framework for evaluating C4D and other complex development initiatives as a strategy to address these challenges. We argue that achieving change requires reconceptualising accountability and learning, developing evaluation capacities that enable learning and multiple forms of accountability, and drawing on local knowledge, ideas and innovation to develop and implement more appropriate and effective evaluation approaches. These strategies can create an enabling environment in which these new ideas and approaches can flourish and complex development issues can be better addressed.
Combining Realism with Rigour: An Evaluation of a National Kitchen Garden Program in Australian Primary Schools
Authors: Yeatman Heather , Quinsey Karen , Dawber James , Nielsen Wendy , Condon-Paoloni Deanne , Eckermann Simon , Morris Darcy , Grootemaat Pam , Fildes David
Published: January 2018

School garden and kitchen-based activities have potential as health-promoting school initiatives but lack well-designed evaluation frameworks. This article outlines an evaluation of a national kitchen garden program conducted in Australian primary schools. The aim was to evaluate the implementation and impact of a national garden and kitchen program in Australia, including child and health-related impacts of the program, and program implementation factors. The evaluation was undertaken using a multi-component, hierarchical evaluation framework that incorporated a modified case-control design and mixed methods. A cross-section of initiative (N=28) and comparison (N=14) schools was included.

The Stephanie Alexander Kitchen Garden model achieved overall improvements in students’ food choices (as reported by students; t=2.26, p=0.024) and kitchen lifestyle behaviours (as reported by parents; t=2.35, p=0.019); female students and students from provincial schools had statistically greater improvements in food choices than other students and girls showed higher scores than boys (t=6.19, p<0.001).

The evaluation framework generated data that addressed the evaluation questions. Program integrity was maintained. Factors related to the program's implementation, sustainability, generalisability and return on investment were reported. Factors impacting the evaluation included lack of baseline data, specific data collection methods and time issues.

The main conclusion drawn from the study is that structured hierarchical, multi-component evaluation is needed to provide practical insights into effective health promotion initiatives in schools.
Finding the common thread: The charms and challenges of evaluation for a consortium-run international development program
Authors: Dinh Kathryn , Keys Tricia , Thomson Naomi
Published: January 2018

This article explores the opportunities and challenges in designing and implementing a monitoring and evaluation (M&E) framework for a consortium-run, multi-country international development program.

The East Asia Vision Program (EAVP), a three-year program of the Vision 2020 Australia Global Consortium, aims to improve capacity in the delivery of eye health and vision care services in Vietnam, Cambodia, and Timor-Leste. Funded by the Australian Government, the EAVP began in 2013 and consists of five Australian organisations working with government and other stakeholders in each country.

The Consortium members have been working in collaboration to support national government planning, health professional training, patient treatment, and research capacity through monitoring and evaluation. An M&E Reference Group helped with initial drafts of an M&E framework. Australian and in-country staff were then consulted to ensure availability of data and understanding of the Framework. Early drafts of data entered into the framework were shared between the participating organisations and the evaluator in order to detect errors and share good practice examples using online program management software.

Monitoring the program provided an opportunity for Consortium members to improve program implementation and strengthen their capacity for M&E, by sharing examples of evaluation tools and expertise in the monitoring of cross-cutting issues and data collection.

The combined work of the organisations within each country provided a rich dataset of outcomes at a health systems strengthening level. Challenges faced during the evaluation included: aligning the evaluation systems of all organisations (including data that were feasible to collect); monitoring a large range of activities; and developing an evaluation tool that was usable by a diverse range of staff.

This article reports the perspectives of the M&E Advisor for EAVP and those of a program implementer to share learnings regarding the M&E for a consortium-run program. Consortia are used globally to implement international development programs and they present a unique challenge for evaluators. These consortia also provide the opportunity to build the monitoring and evaluation capacity of participating organisations, leading to improved data quality and better-informed program implementation.
Meta-analysis as a method of multi-site evaluation: An example from international development
Authors: Coryn Chris , Hobson Kristin , McCowen Robert
Published: January 2018

Interest in multi-site evaluation has seemingly grown, with a now nascent body of literature. Even so, most of the literature on multi-site evaluation has come from writings about place-, group-, and cluster-randomized controlled trials. Guidance on how to execute uncontrolled multi-site evaluations is sparse and usually treats sites as homogeneous. In this paper, metaanalysis is used to demonstrate the method's potential for multi-site evaluation using Heifer International sites in Albania, Nepal, and Uganda as an exemplar, with an emphasis on nutritional outcomes for site participants.
Editorial
Authors: Alderman Lyn , Clinton Janet
Published: January 2018

Welcome everyone to our fourth and final issue of the Evaluation Journal of Australasia (EJA) for 2015—the ‘Year of Evaluation’.
Editorial
Authors: Alderman Lyn , Clinton Janet
Published: January 2018

This edition of the EJA will elicit many thoughts about the notion of evaluation. The articles seek to challenge our thinking and thus raise a number of questions about the nature of our discipline. Each article presents a specific context or particular aspect of evaluation that needs enhancement—clearly, we have much to do! The issues raised encourage us to consider the fundamental meaning of evaluation, its approaches and applications.
Editorial
Authors: Alderman Lyn , Clinton Janet
Published: January 2018

Welcome to the latest edition of the Evaluation Journal of Australasia. In 2015, evaluators worldwide celebrated the International Year of Evaluation, with over 200 events held around the world and a final summit held in Kathmandu, Nepal.
BUZZING—A Theory-Based Impact Evaluation Design
Authors: Beaton Susan
Published: January 2018

BUZZING is a pilot project which introduces a new way of working with disengaged and long-term unemployed young people (aged 15 to 24 years) to support their transition into employment using gamification and online platforms to drive engagement. The project is funded by the Australian Government's Department of Employment under their Empowering YOUth Initiatives, and delivered by not-for-profit organisation United Synergies. This article gives focus to the design considerations that underpin the work of an internal evaluator working on the BUZZING project, and enrolled in an evaluation unit within a postgraduate course. The step-by-step process used to create an evaluation plan inclusive of purpose, context, scope, method and methodology are illustrated, supported by evidence-based justifications. Furthermore, counter-bias design considerations such as a mix of different methodology inquiry, data sources and researchers (triangulation) are discussed and recommendations given for an ethical evaluation framework. The practice of using evidence-based rigour in evaluation is promoted for organisations which seek to demonstrate positive social change within complex environments. The capacity building and professional development of internal evaluators in the not-for-profit sector is therefore recommended to drive accountability, ethical practices and continual improvement for public good from within the organisation. Finally, White's (2009) theory-based impact evaluation is adopted as the evaluation method as it maps out the causal chain from inputs to outcomes and impact, testing the underlying assumptions to understand why a program has, or has not, had an impact.
Working Both-Ways: Using Participatory and Standardised Methodologies with Indigenous Australians in a Study of Remote Community Safety and Wellbeing
Authors: Sutton Sue , Baxter Nathalie , Grey Kim , Putt Judy
Published: January 2018

This paper offers reflections on our experience and learning arising from implementing a study design that used evaluation research to pursue multiple benefits. The Community Safety and Wellbeing Study adopted a mixed methods approach, referred to as a ‘both-ways’ (or two-ways) research model, that addressed decision maker's needs and heard the people's voice. The study design was inspired by a both-ways learning model and attempted to address both needs together. The aim of the study was to involve local people in communities and encourage them to share their views about changes in community safety. Through systematic research it provided a voice for Indigenous Australians affected by the Northern Territory Emergency Response (NTER), often called ‘the intervention’. Regardless of views about the intervention, this paper aims to share the lessons learned from conducting this study.

The mixed method approach involved a community based standardised survey and qualitative data collection techniques. The study was undertaken in a representative sample of 17 NTER communities with over 1300 local residents, around five percent of the relevant population. Over 60 Indigenous people were employed in conducting the study; the majority lived in or had strong ties with remote communities in the study and around 10 had significant experience with social research projects.

The research had many objectives in addition to providing evidence on outcomes on a multi-faceted and sometimes controversial government policy. Ethically the research had to have benefit for the people and communities involved. In addition, the community had to be able to see there were benefits from the research for them, not just for government. This paper documents how these objectives were achieved in relation to the methodology, content, data collection and reporting aspects of the research, and discusses what worked and what could be done differently in the future.
Establishing and Embedding Evaluation as a Central Landmark on the Organisational Horizon
Authors: Sheffield Joanne
Published: January 2018

This paper explores the cultural and organisational conditions required to drive evaluation capacity building (ECB). It shares the principles used to measure current organisational readiness for evaluation, in order to inform the ongoing development of realistic ECB initiatives. The project is driven by the need to improve evaluation literacy and awareness across New Zealand Defence Force (NZDF) Learning Providers and the New Zealand Defence College (the College). Current evaluation ‘readiness’ will be assessed through a diagnostic instrument which focuses on six domains. The results of the organisational readiness assessment will feed into an organisational maturity matrix to provide a benchmark from which to measure future progress, and prescribe a systematic range of ECB initiatives which align with organisational readiness and understanding. The NZDF is a unique organisation, combining three distinct individual service cultures—Army, Navy and Air—together with a growing contingent of civilian staff. It is against this landscape that the NZDF College Performance and Evaluation Team works to embed its core learning evaluation framework. This paper shares a starting point, discusses some challenges encountered along the way and offers potential to provide a foundation for other organisations starting on their own unique ECB journey.
Context and Culture in Evaluation: A Case Study of Evaluation Anthropology
Authors: Howard Elise
Published: January 2018

Designing programs to address poverty and inequality for Australian Aboriginal communities over recent decades has proved problematic. There is a need for greater consideration of different cultural perspectives. A culturally appropriate evaluation framework can provide a range of strategies to embrace cultural difference. Evaluation anthropology, one of many culturally appropriate approaches, emphasises understanding of socio-cultural environments and contexts, and reflective practice to draw attention to cultural bias. This paper will define evaluation anthropology and then reflect on its usefulness in establishing an evaluation framework for a preliteracy program located in a remote Aboriginal community in Australia. The aims of the program are to improve school readiness through developing preliteracy (English language) skills in children aged 0-3 years. Developing an evaluation framework for the program required an approach that accounted for the socio-cultural aspects of literacy development. The lessons from this case study demonstrate the need for place-specific theory to inform program design and evaluation practice.
A Case for the Advancement of Utilisation of Realist Evaluation in International Development: An Oxfam Focused Illustration
Authors: Mukova-Moses Maud
Published: January 2018

Grounded in scientific realist philosophy and expounded by Pawson and Tilley (1997), realist evaluation is founded on the assertion that community development programs seek to address real problems, and not social constructs. It is therefore a realistic approach to evaluation that informs policy and decision makers of the effectiveness of programs, examining the program's specific mechanisms, contexts and outcomes. Pawson and Tilley (1997) place people at the centre of the realist approach to evaluation, emphasising that the effectiveness of programs is dependent on the respondents’ willingness to engage, as well as the existence of an environment that enables them to participate. This paper seeks to reinforce the significance of realist evaluation in international development programs, illustrating its value in informing programs that are effective and responsive, and employing contextually appropriate mechanisms that enhance communities’ benefits.

Realist philosophy asserts that, ‘entities exist independently of being perceived, or independently of our theories about them’ (Phillips, 1987, p. 205). It is this reality, outside of our knowledge and experiences, that we seek to define, as best we can and never absolutely, through scientific approaches and social inquiry (Ball, MUller & Nelson, 2014). It is within this framework that realist evaluation exists. As championed by Pawson and Tilley (2004), realist evaluation is theory based and seeks to answer the question, ‘what works for whom in what circumstances and in what respects, and how’ (p. 2). Pawson and Tilley (1994) note that unlike experimental research which focuses primarily on addressing what works using a successionist approach1, realistic evaluation takes a generative approach and examines underlying causal linkages to changes observed (p. 291). Examining mechanisms, contexts and outcomes, realistic evaluation presents a methodological approach that amplifies the role of people in bringing about change. For Pawson and Tilley (1994), ‘programmes ‘work, if subjects choose to make them work and are placed in the right conditions to enable them to do so’ (p. 294). This is useful to Oxfam Australia's (2014) focus on ‘a just world without poverty, where people influence decisions that affect their lives, enjoy their rights, and assume their responsibilities—a world in which everyone is valued, and everyone is treated equally’ (p. 6). Inspired by the Australasian Evaluation Society's (2016) priority to influence and promote evaluation practice, this article seeks to contribute to the discourse on realist evaluation in an endeavour to advance its application in evaluation practice within the international development sector.
The Capacity Development Evaluation Framework: Tested on Three Initiatives
Authors: Kotvojs Fiona
Published: January 2018

Adoption of effective capacity development has long been considered critical to reducing poverty through international development assistance activities (World Bank, 2005). Consequently, annual global investment in capacity development now exceeds US$30 billion (Ling & Roberts, 2012). However, capacity development results have been questionable and evaluation findings have contributed little to addressing this due to their poor quality and inability to provide the information users require.

Using evaluation of capacity development to address these weaknesses, this research sought to determine whether the application of the Capacity Development Evaluation Framework (referred to hereafter as the Framework) provided users with the information, and demonstrated the characteristics, they required. The research adopted a case study approach to three initiatives that applied the Framework. Data was collected from 37 documents and through repeated interviews with 50 users over at least 18 months. The research also considered alternative explanations for the findings.

The research found that application of the Framework identified: the changes to which the initiative contributed, progress toward the objectives, effectiveness of different capacity development strategies, and lessons learnt. The Framework did not identify unintended changes or changes in the environment that may influence outcomes. Users identified that application of the Framework provided numerous immediate and future benefits and consequently, many had since applied the Framework elsewhere. The research concluded that because application of the Framework provided users with the information they required, its use should contribute to strengthened capacity development outcomes.
Building Evaluation Capital in Government: A Queensland Departmental Approach
Authors: Goswami Sarah , Lane Vicki
Published: January 2018

Increasingly, government departments are being held accountable for investment in public services. In Queensland the Financial Accountability Act 2009 (Queensland Treasury, 2016) requires that accountable officers and statutory bodies ‘achieve reasonable value for money by ensuring the operations of the department or statutory body are carried out efficiently, effectively and economically’ (Section 61).

Whilst there is a directive for agencies to evaluate and demonstrate value for money, it has in practice been difficult to embed long term, as many systems and decision makers have neglected the role of organisation-wide evaluation capital.

This paper will outline the work being undertaken in the Queensland Department of Agriculture and Fisheries (DAF) to implement an Impact and Investment Framework, which will support and embed evaluation in a multidisciplinary setting. A central tenant of this framework is ‘business empowerment and learning'—building the evaluation culture in the organisation by first establishing evaluation building blocks, through business empowerment, support and utility.

The framework is comprised of five key elements and is built on the principles of evaluation and evaluation capacity building disciplines. It has been designed to be low-cost, effective and efficient, whilst enabling business improvement, meeting accountability needs and allowing the department to demonstrate the value of its work.
Trends and repetition of non-fatal suicidal behaviour: analyses of the Gold Coast University Hospital’s Emergency Department
Authors: Kõlves Kairi , Crompton David , Turner Kathryn , Stapelberg Nicolas JC , Khan Ashar , Robinson Gail , de Leo Diego
Published: January 2018

Objective

The aim of the current paper is to analyse time trends of non-fatal suicidal behaviour (NFSB) and its repetition at the Gold Coast in 2005–2015.

Methods

Data on presentations for NFSB were obtained from the Emergency Department (ED) Information System. Potential cases were identified through keyword searches, which were further scrutinised and coded. Annual person-based age-standardised rates for NFSB were calculated. Chi-square test, Poisson regression and Cox proportional hazards regression were used.

Results:

There was a significant increase in the age-standardised rates of NFSB for males (incidence Rate Ratio = 1.05; 95% confidence interval (CI): 1.04–1.07) and females (iRR = 1.06; 95% CI: 1.04–1.07). Age-specific rates showed significant increases for all age groups, except 25–34 and 55+ for females. Different types of poisoning were the predominant method of NFSB (poisoning only – 61.7% of episodes), followed by cutting (23%). Within the first year after the index episode, 13.4% of subjects repeated NFSB. Multivariate Cox regression model showed that sex, age and method predicted repetition.

Conclusion:

The increasing trends of NFSB and relatively high repetition rates emphasise the need for preventative actions. Monitoring of NFSB at the ED level should be further extended in Australia.
A New Technique in Alveolar Cleft Bone Grafting for Dental Implant Placement in Patients With Cleft Lip and Palate
Authors: Van Nhan Vo , Van Son Le , Tuan Ta Anh , Son Nguyen Tai , Hai Trinh Dinh , Lanh Le Duc , Ha Nguyen Manh , Phong Lam Dai
Published: January 2018

Objective:

To evaluate 2 iliac corticocancellous-block grafting techniques for dental implant placement in residual alveolar clefts.

Design:

Nonrandomized prospective clinical trial between March 2010 and December 2014.

Setting:

National Hospital of Odonto-Stomatology, Hanoi, Vietnam.

Participants:

Thirty-two patients (23 female, 9 male; mean age, 21.28 years; range, 16-31 years) with unilateral complete alveolar cleft after reconstructive surgery for cleft lip and palate (CLP).

Interventions:

Harvested iliac crest bone was cut into 2 corticocancellous blocks. The smaller block was adapted against the sutured nasal mucoperiosteum and overlaid with cancellous bone; the larger one overlapped the labial cleft margin and was fixed with screws. Endosteal dental implants were placed after 4 to 6 months, and final restorations were delivered 6 months later.

Main Outcome Measures:

Flap statuses were assessed clinically. Bone formation was assessed using the Enemark scale. Cone-beam computed tomography was used for graft height and width measurements. Implant health was assessed by the Misch criteria.

Results:

The mean postgrafting follow-up period was 36.7 ± 10.4 (range, 18-53) months. Three patients (9.4%) showed flap dehiscence but no infection 7 days after bone grafting. Twenty-nine patients (90.6%) had 75% to 100% bone fill (Enemark score of 1). The mean graft height and width were 11.4 ± 2.4 and 6.1 ± 1.0 mm, respectively. Sufficient bone for implant placement was noted in 29 patients (90.6%); the others required partially fixed prostheses. All implants functioned for at least 18 months.

Conclusion:

The proposed technique is reliable to reconstruct the alveolar cleft for implant placement in CLP patients.
Crouzon with Acanthosis Nigricans and Odontogenic Tumors
Authors: Xu Wen , McDonald-McGinn Donna M. , Melchiorre Alexandra J. , Zackai Elaine H. , Bartlett Scott P. , Taylor Jesse A.
Published: January 2018

Crouzon syndrome with acanthosis nigricans (CAN) is caused by a mutation in the fibroblast growth factor receptor ( FGFR) 3 gene that presents clinically as Crouzonoid craniofacial features in association with other anomalies such as acanthosis nigricans and benign odontogenic tumors. Diagnosis through the use of genetic mutational analysis is critical, as it alerts the surgeon to the need for careful screening for jaw tumors so that timely treatment in the form of curettage or segmental resection can be provided.
Resorbable Plates in Secondary Cleft Nasal Reconstruction
Authors: Lin Pey-Yi , Gibson Anthony P. , Teichgraeber John F. , Greives Matthew R.
Published: January 2018

Objective:

The authors report on the use and complications of alloplastic resorbable plates and compare their use to autologous cartilage grafts in secondary cleft nasal reconstruction.

Design:

Institutional review board (IRB)–approved retrospective chart review.

Setting:

Texas Cleft-Craniofacial Center at the McGovern Medical School at the University of Texas Health Sciences Center at Houston.

Patients:

Patients with unilateral or bilateral cleft lip nasal deformity who have undergone secondary correction of their nasal deformity with at least 1-year follow-up.

Interventions:

During their reconstruction, some patients had cartilage grafts used for support, whereas others were reconstructed using resorbable plates.

Main Outcome Measure(s):

Complications (exposure, infection, malposition, hematoma/seroma) and rates of tertiary revisions.

Results:

197 patients underwent secondary cleft nasal reconstruction, with 30 patients in the resorbable plate group and 32 in the cartilage graft group. Age at surgery was 8.5±4.1 years with resorbable plates and 11.0±4.8 years with cartilage graft ( P = .03). Infection rate in the resorbable plate group and cartilage graft group were 0% and 3.25% ( P = 1). Extrusion occurred in 3 of the absorbable plate group and 2 patients with cartilage graft ( P = .67). Additional surgery was recorded in 43.3% of the resorbable plate group versus 53.1% of the cartilage graft group ( P = .459).

Conclusion:

The data provide evidence that the use of alloplastic resorbable plate in the pediatric population is a safe alternative to autologous septal cartilage in secondary cleft nasal reconstruction. There is no statistical difference in short-term complications or the incidence of additional nasal surgery.
3D Assessment of Nasolabial Appearance in Patients With Complete Unilateral Cleft Lip and Palate
Authors: Bagante Ieva , Zepa Inta , Akota Ilze
Published: January 2018

Objective:

Rhinoplasty in patients with complete unilateral cleft lip and palate (UCLP) is challenging, and the surgical outcome of the nose is complicated to evaluate. The aim of this study was to assess the nasolabial appearance of patients with UCLP compared with a control group.

Design:

Cross-sectional study.

Setting:

Riga Cleft Lip and Palate Centre, Latvia.

Participants:

All consecutive 35 patients born between 1994 and 2004 with nonsyndromic complete UCLP were included. Of 35 patients, 29 came for checkup; the mean age was 14.7 years (range 10-18). In the control group, 35 noncleft participants at 10 years of age were included.

Interventions:

Nasolabial appearance was evaluated from 3-dimensional images using a 3-dimensional stereo-photogrammetric camera setup (3dMDface System), the results being analysed statistically.

Results:

In UCLP group, a statistically significant difference between cleft and noncleft side was found only in alar wing length ( P < .05). The difference of nasolabial anthropometric distances in the control group between the left and right side was not significant. The difference between the UCLP group and the control group was significant in all anthropometric distances except the lateral lip length to cupid’s bow.

Conclusions:

The nasolabial appearance with acceptable symmetry after cleft lip and reconstructive surgery of the nose was achieved. Symmetry of the nasolabial appearance in patients with UCLP differed from those in the control group. The 3D photographs with a proposed set of anthropometric landmarks for evaluation of nasolabial appearance seems to be a convenient, accurate, and noninvasive way to follow and evaluate patients after surgery.
Secondary Alveolar Bone Grafting in Patients Born With Unilateral Cleft Lip and Palate
Authors: Jabbari Fatemeh , Wiklander Laila , Reiser Erika , Thor Andreas , Hakelius Malin , Nowinski Daniel
Published: January 2018

Objective:

To identify factors of oral health important for the final outcome, after secondary alveolar bone grafting in patients born with unilateral cleft lip and palate and compare occlusal radiographs with cone beam computed tomography (CBCT) in assessment of alveolar bone height.

Design:

Observational follow-up study.

Setting:

Cleft Lip and Palate Team, Craniofacial Center, Uppsala University Hospital, Sweden.

Patients:

40 nonsyndromic, Caucasian patients with unilateral complete cleft lip and palate.

Interventions:

Clinical examination, CBCT, and occlusal radiographs.

Main Outcome Measurements:

Alveolar bone height was evaluated according to Bergland index at a 20-year follow-up.

Results:

The alveolar bone height in the cleft area was significantly reduced compared to a previously reported 10-year follow-up in the same cohort by total ( P = .045) and by subgroup with dental restoration ( P = .0078). This was positively correlated with the gingival bleeding index (GBI) ( r = 0.51, P = .0008) and presence of dental restorations in the cleft area ( r = 0.45, P = .0170). There was no difference in the Bergland index generated from scoring the alveolar bone height on occlusal radiographs as with the equivalent index on CBCT.

Conclusion:

Patients rehabilitated with complex dental restoration seems to be at higher risk for progression of bone loss in the cleft area. Supportive periodontal therapy should be implemented after complex dental restorations in cleft patients. Conventional occlusal radiographs provide an adequate image for evaluating postoperative bone height in clinical follow-up.
Closing the Loop on Centralization of Cleft Care in the United Kingdom
Authors: Ness Andrew R. , Wills Andrew R. , Waylen Andrea , Smallridge Jackie , Hall Amanda J. , Sell Debbie , Sandy Jonathan R.
Published: January 2018

Objective:

We highlight a major study that investigated the impact of reconfigured cleft care in the United Kingdom some 15 years after centralization. We argue that centralization as an intervention has a major impact on outcomes.

Setting:

Audit clinics held in Cleft Centers in the United Kingdom.

Patients, Participants:

Five-year-olds born between April 1, 2005, and March 31, 2007, with nonsyndromic unilateral cleft lip and palate.

Interventions:

Centralization of cleft care.

Main Outcome Measure(s):

We collected routine clinical measures (speech recordings, hearing, photographs, models, oral health, psychosocial factors) in a very similar way to a previous survey.

Results:

We identified 359 eligible children and recruited 268 (74.7%) to the study. Overall, their outcomes were better post-centralization. There have been marked improvements in dentoalveolar arch relationships and in speech whereas the prevalence of dental caries and hearing loss are unchanged.

Conclusions:

Centralized cleft care has changed UK outcomes considerably and there is no argument for returning to a dispersed model of treatment.
A Survey of Orthodontic Treatment in Team Care for Patients With Syndromic Craniosynostosis in Japan
Authors: Susami Takafumi , Fukawa Toshihiko , Miyazaki Haruyo , Sakamoto Teruo , Morishita Tadashi , Sato Yoshiaki , Kinno Yoshiaki , Kurata Kazuyuki , Watanabe Keiichiro , Asahito Toshikazu , Saito Isao
Published: January 2018

Objective:

To understand the actual condition of orthodontic treatment in team care for patients with syndromic craniosynostosis (SCS) in Japan.

Design:

A nationwide collaborative survey.

Setting:

Twenty-four orthodontic clinics in Japan.

Patients:

A total of 246 patients with SCS.

Main Outcome Measure:

Treatment history was examined based on orthodontic records using common survey sheets.

Results:

Most patients first visited the orthodontic clinic in the deciduous or mixed dentition phase. Midface advancement was performed without visiting the orthodontic clinic in about a quarter of the patients, and more than a half of the patients underwent “surgery-first” midface advancement. First-phase orthodontic treatment was carried out in about a half of the patients, and maxillary expansion and protraction were performed. Tooth extraction was required in about two-thirds of patients, and the extraction of maxillary teeth was required in most patients. Tooth abnormalities were found in 37.8% of patients, and abnormalities of maxillary molars were frequently (58.3%) found in patients who had undergone midface surgery below the age of 6 years.

Conclusions:

Many patients underwent “surgery-first” midface advancement, and visiting the orthodontic clinic at least before advancement was considered desirable. First-phase orthodontic treatment should be performed considering the burden of care. Midface advancement below the age of 6 years had a high risk of injury to the maxillary molars. This survey is considered useful for improving orthodontic treatment in team care of patients with SCS.
Systematic Review of the Effect of Adherence to Statin Treatment on Critical Cardiovascular Events and Mortality in Primary Prevention
Authors: Martin-Ruiz Eva , Olry-de-Labry-Lima Antonio , Ocaña-Riola Ricardo , Epstein David
Published: January 2018

Aim:

Analyze the relative risks of critical cardiovascular outcomes and mortality associated with adherence to statin treatment in a clinical setting in people with no history of prior cardiovascular disease (CVD).

Methods:

A systematic review of the literature was conducted up to December 2016. The outcomes of interest were cardiovascular fatal or nonfatal events and all-cause mortality.

Results:

A total of 17 articles were included in a qualitative synthesis. Four were case–control nested in a retrospective cohort design and the other 11 were a cohort design. Seven studies compared the best adherer patients with the worst adherers. In the 3 studies (317 603 participants) that considered ischemic heart disease in this group, the pooled reduction in risk was 18% (95% confidence interval [CI]: 14%-22%, I2 = 0%); for the CVD outcome, 2 studies (131 477 participants) showed a pooled reduction in risk of 47% (95% CI: 36%-56%, I2 = 84.7%) with 1 included study showing a much larger reduction than the others; for the cerebrovascular event (CeVD) outcome, 2 studies (155 726 participants) showed a pooled reduction in risk of 26% (95% CI: 18%-34%, I2 = 0%); and for mortality, the reduction in risk was 49% (95% CI: 39%-57%, I2 = 62.4%). The other 4 studies (147 859 participants) compared the most adherent group with the rest. These showed a pooled risk reduction of CVD of 22% (95% CI: 6%-27%, I2 = 0).

Conclusion:

Adherence to statins treatment is shown as a key element for primary prevention, although these are observational data and the risk of bias from confounding cannot be ruled out. Standardization of measures of adherence to treatment would improve comparability between studies. Further research is warranted to design effective interventions to improve patients’ adherence.
Cryptococcal infections in two patients receiving ibrutinib therapy for chronic lymphocytic leukemia
Authors: Stankowicz Matthew , Banaszynski Megan , Crawford Russell
Published: January 2018

Cryptococcal infections are responsible for significant morbidity and mortality in immunocompromised patients. Reports of these infections in patients on small molecular kinase inhibitors have not been widely reported in clinical trials. We describe one case of cryptococcal meningoencephalitis and one case of cryptococcal pneumonia in two patients who were receiving ibrutinib for chronic lymphocytic leukemia. Despite different sites of cryptococcal infection, both patients had similar presentations of acute illness. Patient 1 was worked up for health care–associated pneumonia, as well as acute sinusitis prior to the diagnosis of cryptococcal meningoencephalitis. He also had a more complex past medical history than patient 2. Patient 2 developed atrial fibrillation from ibrutinib prior to admission for presumed health care–associated pneumonia. Cryptococcal antigen testing was done sooner in this patient due to patient receiving high-dose steroids for the treatment of underlying hemolytic anemia. We conclude that patients who develop acute illness while receiving ibrutinib should be considered for cryptococcal antigen testing.
Effects of Applicant Faking on Forced-Choice and Likert Scores
Authors: Pavlov Goran , Maydeu-Olivares Alberto , Fairchild Amanda J.
Published: January 2018

We introduce a novel, regression-based moderation framework to model faking effects that incorporates evaluation of faking tendency as a moderator. We also consider how perceived trait desirability may be factored into the framework and provide programming code for applied researchers to utilize the method in their research. Using this framework, we revisit a well-known response format (i.e., forced-choice) to formally evaluate its ability to mitigate the effects of applicant faking as compared to the widely used Likert format. The impetus for the latter evaluation stems from the use of item response theory (IRT) modeling to yield non-ipsative scores from forced-choice measures. We found strong support for the need to incorporate moderating effects of faking tendency and desirability in predicting applicants’ responses. Also, we found that the only substantial difference across formats lies in forced-choice scores yielding a lower mean inflation at high faking values. As a result, forced-choice scores do not outperform Likert scores when selection ratios are used but may be beneficial when cutoff scores are used. Application of the moderation framework presented extends to self-reported construct measures of varied kinds.