RAISE: A Management and Organizational Sustainability Tool for Local Governments to Systematically Self-Evaluate the Effectiveness of Their Programs.

CONTEXT: Many donor-driven public health programs are now seeking evidence for sustainability prior to investment, creating the need for tools to better appraise these capabilities. Assessing the sustainability of programs and interventions at the local level remains a community-wide challenge. PROGRAM: This article presents a new self-assessment tool, the Reflection and Action to Improve Self-reliance and Effectiveness (RAISE) Tool ("the Tool"), modeled after The Challenge Initiative's (TCI) Sustainability Pillars. It describes the evolution of the Tool, explores its structure and applications, demonstrates its data analysis capabilities, and illustrates how it can be used for continuous program self-assessment by local governments, which TCI considers an indicator of program sustainability at the local level. IMPLEMENTATION: Developed in 2019, the Tool has been adapted, adopted, and implemented by 92 local governments across 11 countries. The Challenge Initiative works with these local governments over a minimum of 3 years, providing management and technical coaching on high-impact interventions. Using the Tool, local governments self-assess and evaluate the quality and effectiveness of their activity implementation and identify gaps for improvement. The Tool helps both local governments and TCI track their readiness toward becoming self-reliant and taking ownership of their family planning programs. EVALUATION: As of June 30, 2021, 39 of the 92 local governments reached the final stage of maturity, self-reliance. DISCUSSION: Experts have stated that it can take 15 years for a sustainability assessment tool such as RAISE to be adopted into government policies. After 2 years of using the Tool on a quarterly basis, on average 87.3% of eligible local governments completed the self-assessments, made course corrections, and have taken steps toward program independence. The 39 local governments that successfully progressed to self-reliance continue to use the Tool without TCI's coaching support and have expressed interest in adapting the Tool for other health interventions.

Optimising backscatter from multiple beam interference.

Optical sensing applications are usually reliant on the intensity of the measured signal. For remote sensing applications where a target is probed with a laser beam, the sensitivity will be limited by the amount of backscattered light returned from the target to the detector. We demonstrate a method of increasing the signal returned to the detector by illuminating the target with a number of independently controlled beams, where both the position and phase are optimised. We show an improvement in the backscattered signal that is proportional to the number of beams used. The method is demonstrated within a laser microphone, measuring audio signal due to vibrations in surfaces, showing a significant improvement in the signal-to-noise of the measurement.

Femtometer-resolved simultaneous measurement of multiple laser wavelengths in a speckle wavemeter.

Many areas of optical science require an accurate measurement of optical spectra. Devices based on laser speckle promise compact wavelength measurement, with attometer-level sensitivity demonstrated for single wavelength laser fields. The measurement of multimode spectra using this approach would be attractive, yet this is currently limited to picometer resolution. Here, we present a method to improve the resolution and precision of speckle-based multi-wavelength measurements. We measure multiple wavelengths simultaneously, in a device comprising a single 1-m-long step-index multimode fiber and a fast camera. Independent wavelengths separated by as little as 1 fm are retrieved with 0.2 fm precision using principal component analysis. The method offers a viable way to measure sparse spectra containing multiple individual lines and may find application in the tracking of multiple lasers in fields such as quantum technologies and optical telecommunications.

Overcoming the speckle correlation limit to achieve a fiber wavemeter with attometer resolution.

The measurement of the wavelength of light using speckle is a promising tool for the realization of compact and precise wavemeters and spectrometers. However, the resolution of these devices is limited by strong correlations between the speckle patterns produced by closely spaced wavelengths. Here, we show how principal component analysis of speckle images provides a route to overcome this limit. Using this, we demonstrate a compact wavemeter that measures attometer-scale wavelength changes of a stabilized diode laser, eight orders of magnitude below the speckle correlation limit.

A seven-day diabetes service for inpatients and the emergency department in an acute hospital setting - the East and North Herts Diabetes Outreach Team (DOT).

There is evidence that all hospital-based care needs to improve across 7 days. Inpatients with diabetes require better specialist attention and improved clinical outcomes. The East and North Herts inpatient diabetes service has responded to this challenge with care now delivered by consultants and diabetes nurses, 365 days per year. We set out to provide a prospectively measurable improvement in ascertainment of appropriate patients alongside a 'care bundle' to ensure they receive a better quality experience. We also set out to document quantifiable changes in clinical data. A seven-day service is now in place and provides a variety of benefits to both professionals and patients alike.

Longitudinal impact of yoga on chemotherapy-related cognitive impairment and quality of life in women with early stage breast cancer: a case series.

PURPOSE: Adjuvant chemotherapy for women with breast cancer has significantly improved the cure rate; however, it has been associated with chemotherapy-related cognitive impact (CRCI). The literature provides preliminary support for the feasibility and efficacy of yoga interventions for the general cancer population, however, controlled trials are scarce and no studies have examined the effect of yoga on cognition for women with breast cancer during chemotherapy. This case series aims to identify the impact of yoga on measures of cognition, functional outcomes, and quality of life (QOL) for breast cancer survivors (BCS). METHODS: Four women with a diagnosis of early-stage breast cancer prior to chemotherapy treatment were administered the following physiologic measures at baseline, 6, and 12 weeks during chemotherapy, and at one and three months after the conclusion of the study: Functional Reach test (balance) and Sit and Reach test (flexibility), and QOL, POMS (Mood) and FACT-B (QOL), at baseline. Primary outcomes of cognition were measured with the Perceived Cognition Questionnaire (PCQ) and CogState, a computerized measurement of cognition. Women attended an Iyengar-inspired yoga program twice a week for 12 weeks. Qualitative questionnaires were administered after the completion of the study to determine perceived benefits and challenges of the yoga program. RESULTS: Four women with Stage II breast cancer ranged in age from 44-65 years. CogState computerized testing showed changes in varying domains of cognition through treatment and follow-up. Improved balance, flexibility, and QOL were also noted over time. No adverse events were observed. Analysis of qualitative data revealed the yoga classes were helpful and subjects continued the practice elements of yoga including relaxation, breathing, and stretching. The most challenging aspect of the study was physical limitations due to various medical complications and included fatigue, decreased range of motion, and pain. CONCLUSION: This case series suggests that yoga may impact various aspects of cognition during and after chemotherapy administration as noted through quantitative measures. Women describe yoga as improving various domains of QOL through the treatment trajectory. This mind-body intervention may stave off CRCI; however, further investigation is needed for additional randomized controlled trials on the effects of yoga on cognition for women with breast cancer undergoing adjuvant chemotherapy treatment.