Translating Evaluation Policy Into Practice in Government Organizations

Organizational evaluation policies describe how evaluation practices should be structured and implemented. As such, they provide key insights into organizational priorities and values regarding evaluation. However, the link between evaluation policies and how evaluation policies translate into concrete practices has seldom been explored until now. Our study examines the implementation of two Canadian federal government evaluation policies over a 10-year timespan, through the secondary analysis of reports produced on behalf of governmental evaluation functions. Our findings show that some policy elements have been fully implemented, but the way in which these have been implemented varies between organizations. Further, we observed that the level of control of various organizational members responsible for implementing policy elements, as well as time, can influence implementation of certain policy requirements. We conclude by proposing further directions for research to examine the policy-practice link.

Identity and COVID-19 in Canada: Gender, ethnicity, and minority status

BACKGROUND

During the COVID-19 pandemic, growing evidence from the United States, the United Kingdom, and China has demonstrated the unequal social and economic burden of this health crisis. Yet, in Canada, studies assessing the socioeconomic and demographic determinants of COVID-19, and how these determinants vary by gender and ethnic minority status, remain scarce. As new strains of COVID-19 emerge, it is important to understand the disparities to be able to initiate policies and interventions that target and prioritise the most at-risk sub-populations.

AIM

The objective of this study is to assess the socioeconomic and demographic factors associated with COVID-19-related symptoms in Canada, and how these determinants vary by identity factors including gender and visible minority status.

METHODS

We implemented an online survey and collected a nationally representative sample of 2,829 individual responses. The original data collected via the SurveyMonkey platform were analysed using a cross-sectional study. The outcome variables were COVID-19-related symptoms among respondents and their household members. The exposure variables were socioeconomic and demographic factors including gender and ethnicity as well as age, province, minority status, level of education, total annual income in 2019, and number of household members. Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were performed to test the associations. The results were presented as adjusted odds ratios (aORs) at p < 0.05 and a 95% confidence interval.

RESULTS

We found that the odds of having COVID-19-related symptoms were higher among respondents who belong to mixed race [aOR = 2.77; CI = 1.18-6.48] and among those who lived in provinces other than Ontario and Quebec [aOR = 1.88; CI = 1.08-3.28]. There were no significant differences in COVID-19 symptoms between males and females, however, we did find a significant association between the province, ethnicity, and reported COVID-19 symptoms for female respondents but not for males. The likelihood of having COVID-19-related symptoms was also lower among respondents whose total income was $100,000 or more in 2019 [aOR = 0.18; CI = 0.07-0.45], and among those aged 45-64 [aOR = 0.63; CI = 0.41-0.98] and 65-84 [aOR = 0.42; CI = 0.28-0.64]. These latter associations were stronger among non-visible minorities. Among visible minorities, being black or of the mixed race and living in Alberta were associated with higher odds of COVID-19-related symptoms.

CONCLUSION

We conclude that ethnicity, age, total income in 2019, and province were significantly associated with experiencing COVID-19 symptoms in Canada. The significance of these determinants varied by gender and minority status. Considering our findings, it will be prudent to have COVID-19 mitigation strategies including screening, testing, and other prevention policies targeted toward the vulnerable populations. These strategies should also be designed to be specific to each gender category and ethnic group, and to account for minority status.

Comment la résilience post-Ebola en Guinée contribue à la gestion de la COVID-19 ?

Introduction&#160;: The case of Ebola in Guinea (2013-2016) revealed weaknesses in the resilience of the health system and highlighted the challenge of coordinating all actors in the response. After the epidemic, national authorities and their international partners began to strengthen the health system. In 2021, Guinea faced COVID-19 simultaneously with the resurgence of Ebola and other diseases with epidemic potential.Purpose of research&#160;: The objective of this article is to analyze the evolution of the five characteristics of health resilience of Kruk et al. (2015) in the Guinean context. To do this, data triangulation was carried out through a literature review, 41 semi-structured interviews with international, national and local stakeholders, and 37 events observed in the post-Ebola period.Results&#160;: Our results show that the characteristic of integration was the most important in our study. This is because of the importance of coordination, communication and information sharing among stakeholders during crises. Then, diversity exposes the need to be able to face several health challenges simultaneously. Efforts were focused on Ebola during the first outbreak, but since the COVID-19 pandemic, Guinea has been able to cope with several health challenges. Raising awareness, on the other hand, necessitates an understanding of the context, its strengths, and weaknesses. Guinea learned lessons from Ebola and implemented a program to strengthen the emergency response system. On self-regulation, the speed of the response relies on mechanisms for early detection, notification, and response. The country is now well resourced and has proven information and response mechanisms. Finally, constant adaptability by taking into account lessons learned allows us to set course and prepare for other potential crises and this is what is being done constantly.Conclusions&#160;: Given Guinea&#8217;s ubiquitous fragility before Ebola, the health system is still not fully resilient. However, gains in each of the characteristics of resilience improve the response to COVID-19.

Analyse comparative des initiatives One Health en Guinée et en République Démocratique du Congo : Un appel à l’opérationnalisation/ Comparative analysis of One Health initiatives in Guinea and the Democratic Republic of Congo: A call for operationalization

La Guinée et la République Démocratique du Congo (RDC) sont deux pays confrontés à des maladies zoonotiques (ré)émergentes, lesquelles représentent de graves menaces pour la santé publique et pour l’économie. Cela renforce l’importance de mettre l'accent sur les approches interdisciplinaires pour la prévention, la détection et l’atténuation des maladies infectieuses afin de mettre en place des systèmes de réponses adéquats. Dans les dernières années, des efforts ont été fournis dans les deux pays pour la conception, la mise en œuvre et la promotion de l’approche “Une Seule Santé” (One Health) qui offre des solutions à l’interface homme-animal-plante-écosystèmes. Cependant, dans ces pays, il n’existe pas une approche systémique “Une Seule Santé” qui soit réellement opérationnelle. Ainsi, cet article vise à faire une analyse comparative des initiatives « One Health » (OH) en Guinée et en RDC. Les résultats suggèrent qu'il existe un engagement fort de la part du gouvernement guinéen à signer un ordre conjoint de collaboration entre les trois départements clés, mais la coopération et la collaboration entre les différents secteurs et disciplines font défaut. En RDC, trois plateformes existent, mais leurs actions ne sont pas coordonnées, ce qui démontre les lacunes dans la vision globale que devrait avoir l’approche OH. Le défi majeur dans ces deux pays est d'adopter une approche holistique pour dépasser les structures et les paradigmes organisationnels et disciplinaires pour développer une véritable coopération entre tous les secteurs directement ou indirectement touchés par les maladies à potentiel épidémique.   Guinea and the Democratic Republic of Congo (DRC) are two countries facing (re)emerging zoonotic diseases, which pose serious threats to public health and the economy. This reinforces the importance of emphasizing interdisciplinary approaches for the prevention, detection, and mitigation of infectious diseases to put in place adequate response systems. In recent years, efforts have been made in both countries for the design, implementation, and promotion of the “One Health” (OH) approach which offers solutions at the human-animal-animal-plant-ecosystems interface. However, in these countries, there is no operational OH systemic approach. Thus, this article aims to make a comparative analysis of the OH initiatives in Guinea and the DRC. Findings suggest there is a strong commitment on the part of the government of Guinea to sign a joint order of collaboration between the three key departments, but cooperation and collaboration between different sectors and disciplines is lacking. In the DRC, three platforms exist but are not coordinated, which shows gaps in the overall vision that OH should be in the country. The major challenge in these two countries is to adopt a holistic approach to go beyond organizational and disciplinary structures and paradigms to develop real coordination and cooperation between all the sectors directly or indirectly affected by diseases with epidemic potential.

Back table outflow graft anastomosis technique for HeartWare HVAD implantation

The management of concomitant aortic and aortic valve disease with left ventricular assist device (LVAD) implantation for patients with severe cardiomyopathy is challenging, and has not been established given the complexity of LVAD surgery with concomitant aortic interventions. A 45-year-old patient presented to our institution with end-stage heart failure symptoms and non-ischemic cardiomyopathy. The patient was found to have a bicuspid aortic valve, severe native aortic regurgitation, a significant ascending aortic aneurysm, and severely depressed left ventricular (LV) function requiring two inotropes. He underwent a successful hemiarch repair of the ascending aortic aneurysm using a back table outflow graft anastomosis technique, and subsequent placement of a HeartWare Ventricular Assist Device (HVAD) with concomitant aortic valve closure with a modified Park's stitch. The patient did well postoperatively and is currently listed for heart transplantation.