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This paper builds on a recent strand of critical social theory – Sassen's [Expulsions: Brutality and complexity in the global economy. Harvard University Press; At the systemic edge. Cultural Dynamics, 27(1), 173–181] expulsions and systemic edge perspective – to argue that a sociological theory of climate change needs to start from the critical sites where change takes place. To this end, we propose the concept of climate edge as the intersection of accelerating environmental injustices and future climate change vulnerabilities. We use data from the Environmental Justice Atlas and the Climate Adapt platform to select 17 cases that approximate, to various degrees, the climate edge concept. We conclude that these sites deserve closer attention as they signal the transformative potential of long expulsion chains that may define the characteristics of future climate-related conflicts. The climate edge is simultaneously a site of social struggle. [ABSTRACT FROM AUTHOR]

To explore the nature and extent of learning attained as a result of unaccompanied-by-faculty clinical nursing study abroad experiences and to answer the research question 'what is the nature and extent of learning during study abroad?'. Following the Covid-19 restrictions, international placement opportunities for student nurses are now resuming. In light of this, it is an opportune time for nurse educators to reflect and consider the effectiveness of clinical study abroad placements as contexts of learning, especially in relation to attainment of desired learning outcomes such as personal and professional growth and the development of culturally competent global graduates. This is an important area to research as specific understanding in relation to the extent of learning and variations in learning between students is limited. The study was situated within the interpretivist paradigm to elicit experiences of study abroad. Aligned to this, a hermeneutic phenomenological methodology was applied to ensure these experiences emerged from the subjective horizon of student nurses. Following ethical approval, two semi-structured interviews per student (post-return and follow-up) were conducted with student nurses who had undertaken a study abroad experience. Phenomenological hermeneutical data analysis for multiple context research was undertaken and a change-transformative learning theory lens was additionally employed to the analysis to differentiate between the extent of and variations in, learning attained. Twenty UK and European student nurses, who were registered onto a study abroad programme prior to the Covid-19 restrictions participated. Variations between participants were identified in relation to the nature and extent of learning. Participants experienced personal and professional growth and they experienced transformation in relation to self as a person, learner and nurse. However, variations existed when considering the attributes of global graduateness and cultural competence development. Whilst participants changed by expanding their knowledge in relation to global and cultural issues, some participants also appear to have concurrently experienced a reinforcement of ethnocentric frames of reference. Analysis revealed that study abroad offered opportunities for students to experience change and transformation. Whilst students demonstrated learning in both the domains of change and transformation, transformative learning in all identified outcome areas was not guaranteed. Whilst transformative learning was apparent when considering personal and professional growth, less extensive learning was demonstrated when considering development of the attributes of global graduateness and cultural competence. The paper therefore recognises the complex nature of study abroad experiences and recommends continued investigation in this field. [ABSTRACT FROM AUTHOR]

Background: Since 2017, PERFORM2Scale, a research consortium with partners from seven countries in Africa and Europe, has steered the implementation and scale-up of a district-level health management strengthening intervention in Ghana, Malawi and Uganda. This article presents PERFORM2Scale's theory of change (ToC) and reflections upon and adaptations of the ToC over time. The article aims to contribute to understanding the benefits and challenges of using a ToC-based approach for monitoring and evaluating the scale-up of health system strengthening interventions, because there is limited documentation of this in the literature.Methods: The consortium held annual ToC reflections that entailed multiple participatory methods, including individual scoring exercises, country and consortium-wide group discussions and visualizations. The reflections were captured in detailed annual reports, on which this article is based.Results: The PERFORM2Scale ToC describes how the management strengthening intervention, which targets district health management teams, was expected to improve health workforce performance and service delivery at scale, and which assumptions were instrumental to track over time. The annual ToC reflections proved valuable in gaining a nuanced understanding of how change did (and did not) happen. This helped in strategizing on actions to further steer the scale-up the intervention. It also led to adaptations of the ToC over time. Based on the annual reflections, these actions and adaptations related to: assessing the scalability of the intervention, documentation and dissemination of evidence about the effects of the intervention, understanding power relationships between key stakeholders, the importance of developing and monitoring a scale-up strategy and identification of opportunities to integrate (parts of) the intervention into existing structures and strategies.Conclusions: PERFORM2Scale's experience provides lessons for using ToCs to monitor and evaluate the scale-up of health system strengthening interventions. ToCs can help in establishing a common vision on intervention scale-up. ToC-based approaches should include a variety of stakeholders and require their continued commitment to reflection and learning on intervention implementation and scale-up. ToC-based approaches can help in adapting interventions as well as scale-up processes to be in tune with contextual changes and stakeholders involved, to potentially increase chances for successful scale-up. [ABSTRACT FROM AUTHOR]

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