This presentation has a vivid description of the basics of doing a program evaluation, with detailed explanation of the " Log Frame work " ( LFA) with practical example from the CLICS project. This presentation also includes the CDC framework for evaluation of program.
N.B: Kindly open the ppt in slide share mode to fully use all the animations wheresoever made.
This presentation has a vivid description of the basics of doing a program evaluation, with detailed explanation of the " Log Frame work " ( LFA) with practical example from the CLICS project. This presentation also includes the CDC framework for evaluation of program.
N.B: Kindly open the ppt in slide share mode to fully use all the animations wheresoever made.
Expertise, Consumer-Oriented, and Program-Oriented Evaluation Approachesdctrcurry
All information referenced from: Fitzpatrick, J., Sanders, J., & Worthen, B. (2011). Program evaluation: Alternative approaches and practical guidelines (4th ed.). Upper Saddle River, N.J.: Pearson Education.
Information may be time-sensitive. Subscribers should use the information contained at their own risk. Please check latest information with Dr. A by emailing bugdoctor@auburn.edu.
The presentation is a systematic and comprehensive formative evaluation plan to investigate the implementation of social studies education for Democratic citizenship (SSEDC) in the mature stage. The lead evaluator will select a team to guide and conduct key actions throughout the evaluation process. The plan will begin with the Grades K-6 program description, followed by the theoretical framework, including the research questions that will guide the project over a 12-week period. The methodology will be mixed method survey design, using multiple methods to collect quantitative and qualitative data. The sampled target group will include various stakeholders in the school community, including the implementers and others as the need arises. Content and descriptive data analyses will be the suggested methods to extract themes and concepts and highlight possible findings influenced by (a) teachers’ understanding of SSEDC goal; (b) methods used by teachers; and (c) problems the teachers are experiencing during the implementation process. The evidence will form the basis for findings and conclusions, and for recommending strategies for improvement of SSEDC. The evaluation team will put measures in place to promote accurate results, and efficient reporting procedures. The evaluation team will put efficient reporting procedures or measures in place respected by the internal stakeholders – designers and implementers.
A textbook must provide, first and foremost, information to assist the reader in better understanding the topic. Second, it ought to provide the information in a way that can be easily accessed and digested, and it needs to be credible. Textbooks
that have gone through multiple editions continue to improve as a result of reviewers’ comments and readers’ feedback, and this one is no exception. Looking back over the efforts associated with this Fifth Edition, the old wedding custom of “something old, something new, something borrowed, something blue” comes to
mind. We have built upon the solid foundation of previous editions, but then added “something new.” It almost goes without saying that we have “borrowed” from others in that we both cite and quote examples of program evaluation studies
from the literature. “Something blue” . . . well, we’re not sure about that. Those who have used the Fourth Edition might be interested in knowing what has changed in this new edition. Based on reviewers’ comments we have:
• Created a new chapter to explain sampling.
• Incorporated new material on designing questionnaires.
• Overhauled the chapter on qualitative evaluation. It is now “Qualitative and Mixed Methods in Evaluation.”
• Reworked the “Formative and Process Evaluation” chapter with expanded coverage on developing logic models.
• Added new studies and references; new Internet sources of information.
• Included new examples of measurement instruments (scales) with a macro
focus.
• Inserted new checklists and guides (such as ways to minimize and monitor for potential fidelity problems—Chapter 13).
• Revised the chapter “Writing Evaluation Proposals, Reports, and Journal Articles” to give it less of an academic slant. There’s new material on writing
executive summaries and considerations in planning and writing evaluation
reports for agencies.
• Deleted the chapter on Goal Attainment Scalin
This presentation is the continuation of the first part, which was all about the basics of program evaluation. This ppt contains slides describing the impact evaluation in details and also the logical framework is also explained with practical examples.
N.B: Please go through it, using slide view to use the animation effects.
Expertise, Consumer-Oriented, and Program-Oriented Evaluation Approachesdctrcurry
All information referenced from: Fitzpatrick, J., Sanders, J., & Worthen, B. (2011). Program evaluation: Alternative approaches and practical guidelines (4th ed.). Upper Saddle River, N.J.: Pearson Education.
Information may be time-sensitive. Subscribers should use the information contained at their own risk. Please check latest information with Dr. A by emailing bugdoctor@auburn.edu.
The presentation is a systematic and comprehensive formative evaluation plan to investigate the implementation of social studies education for Democratic citizenship (SSEDC) in the mature stage. The lead evaluator will select a team to guide and conduct key actions throughout the evaluation process. The plan will begin with the Grades K-6 program description, followed by the theoretical framework, including the research questions that will guide the project over a 12-week period. The methodology will be mixed method survey design, using multiple methods to collect quantitative and qualitative data. The sampled target group will include various stakeholders in the school community, including the implementers and others as the need arises. Content and descriptive data analyses will be the suggested methods to extract themes and concepts and highlight possible findings influenced by (a) teachers’ understanding of SSEDC goal; (b) methods used by teachers; and (c) problems the teachers are experiencing during the implementation process. The evidence will form the basis for findings and conclusions, and for recommending strategies for improvement of SSEDC. The evaluation team will put measures in place to promote accurate results, and efficient reporting procedures. The evaluation team will put efficient reporting procedures or measures in place respected by the internal stakeholders – designers and implementers.
A textbook must provide, first and foremost, information to assist the reader in better understanding the topic. Second, it ought to provide the information in a way that can be easily accessed and digested, and it needs to be credible. Textbooks
that have gone through multiple editions continue to improve as a result of reviewers’ comments and readers’ feedback, and this one is no exception. Looking back over the efforts associated with this Fifth Edition, the old wedding custom of “something old, something new, something borrowed, something blue” comes to
mind. We have built upon the solid foundation of previous editions, but then added “something new.” It almost goes without saying that we have “borrowed” from others in that we both cite and quote examples of program evaluation studies
from the literature. “Something blue” . . . well, we’re not sure about that. Those who have used the Fourth Edition might be interested in knowing what has changed in this new edition. Based on reviewers’ comments we have:
• Created a new chapter to explain sampling.
• Incorporated new material on designing questionnaires.
• Overhauled the chapter on qualitative evaluation. It is now “Qualitative and Mixed Methods in Evaluation.”
• Reworked the “Formative and Process Evaluation” chapter with expanded coverage on developing logic models.
• Added new studies and references; new Internet sources of information.
• Included new examples of measurement instruments (scales) with a macro
focus.
• Inserted new checklists and guides (such as ways to minimize and monitor for potential fidelity problems—Chapter 13).
• Revised the chapter “Writing Evaluation Proposals, Reports, and Journal Articles” to give it less of an academic slant. There’s new material on writing
executive summaries and considerations in planning and writing evaluation
reports for agencies.
• Deleted the chapter on Goal Attainment Scalin
This presentation is the continuation of the first part, which was all about the basics of program evaluation. This ppt contains slides describing the impact evaluation in details and also the logical framework is also explained with practical examples.
N.B: Please go through it, using slide view to use the animation effects.
A Good Program Can Improve Educational Outcomes.pdfnoblex1
We hope this guide helps practitioners and others strengthen programs designed to increase academic achievement, ultimately broadening access to higher education for youth and adults.
We believe that evaluation is a critical part of program design and is necessary for ongoing program improvement. Evaluation requires collecting reliable, current and compelling information to empower stakeholders to make better decisions about programs and organizational practices that directly affect students. A good evaluation is an effective way of gathering information that strengthens programs, identifies problems, and assesses the extent of change over time. A sound evaluation that prompts program improvement is also a positive sign to funders and other stakeholders, and can help to sustain their commitment to your program.
Theories of change are conceptual maps that show how and why program activities will achieve short-term, interim, and long-term outcomes. The underlying assumptions that promote, support, and sustain a program often seem self-evident to program planners. Consequently, they spend too little time clarifying those assumptions for implementers and participants. Explicit theories of change provoke continuous reflection and shared ownership of the work to be accomplished. Even the most experienced program planners sometimes make the mistake of thinking an innovative design will accomplish goals without checking the linkages among assumptions and plans.
Developing a theory of change is a team effort. The collective knowledge and experience of program staff, stakeholders, and participants contribute to formulating a clear, precise statement about how and why a program will work. Using a theory-based approach, program collaborators state what they are doing and why by working backwards from the outcomes they seek to the interventions they plan, and forward from interventions to desired outcomes. When defining a theory of change, program planners usually begin by deciding expected outcomes, aligning outcomes with goals, deciding on the best indicators to evaluate progress toward desired outcomes, and developing specific measures for evaluating results. The end product is a statement of the expected change that specifies how implementation, resources, and evaluation translate into desired outcomes.
Continuously evaluating a theory of change encourages program planners to keep an eye on their goals. Statements about how and why a program will work must be established using the knowledge of program staff, stakeholders, and participants. This statement represents the theory underlying the program plan and shows planners how resources and activities translate to desired improvements and outcomes. It also becomes a framework for program implementation and evaluation.
Source: https://ebookscheaper.com/2022/04/06/a-good-program-can-improve-educational-outcomes/
This presentation is all about the project Management which includes level of success of a project, Monitoring & evaluation, LFA in view of development sector. This presentation has been prepared in view of development/Social or Non-profit sector.
Note: Any kind of feedback from industry experts will always be appreciated.
The field of program evaluation presents a diversity of images a.docxcherry686017
The field of program evaluation presents a diversity of images and claims about the nature and role of evaluation that confounds any attempt to construct a coher- ent account of its methods or confidently identify important new developments. We take the view that the overarching goal of the program evaluation enterprise is to contribute to the improvement of social conditions by providing scientifically credible information and balanced judgment to legitimate social agents about the effectiveness of interventions intended to produce social benefits. Because of its centrality in this perspective, this review focuses on outcome evaluation, that is, the assessment of the effects of interventions upon the populations they are intended to benefit. The coverage of this topic is concentrated on literature published within the last decade with particular attention to the period subsequent to the related reviews by Cook and Shadish (1994) on social experiments and Sechrest & Figueredo (1993) on program evaluation.
The word ‘evaluation’ has become increasingly used in the language of community, health and social services and programs. The growth of talk and practice of evaluation in these fields has often been promoted and encouraged by funders and commissioners of services and programs. Following the interest of funders, has been a growth in the study and practice of evaluation by community, health and social service practitioners and academics. When we consider why this move in evaluative thinking and practice has occurred, we can assume the position of the funder and simply answer, ‘...because we want to know if this program or service works’. Practitioners, specialists and academics in these fields have been called upon by governments and philanthropists to aid the development of effective evaluation. Over time, they have led their own thinking and practice independently. Evaluation in its simplest form is about understanding the effect and impact of a program, service, or indeed a whole organization. Evaluation as a practice is not so simple however, largely because in order to assess impact, we need to be very clear at the beginning what effect or difference we are trying to achieve.
The literature review begins with an overview of qualitative and quantitative research methods, followed by a description of key forms of evaluation. Health promotion evaluation and advocacy and policy evaluation will then be explored as two specific domains. These domains are not evaluation methodologies, but forms of evaluation that present unique requirements for effective community development evaluation. Following this discussion, the review will explore eight key evaluation methodologies: appreciative enquiry, empowerment evaluation, social capital,
social return on investment, outcomes based evaluation, performance dashboards and scorecards and developmental evaluation. Each of these sections will include specific methods, the values base of each methodo ...
Evaluation for week 1, 2 and 3 mong nursing care after kidney transplantation (immediate, mediated, late), the material studied has as main findings to control hemodynamic status, blood pressure, respiratory function and capillary glucose levels; monitor the hydration situation; perform volume replacement, diuresis control every hour; fasting weigh Promote sodium and fluid restriction as indicated.
Restriction of salt and fluid becomes crucial in the management of oliguric kidney failure, wherein the kidneys do not adequately excrete either toxins or fluids (Workeneh & Batuman, 2022). What is the most important assessment for a nurse to make when caring for a client with AKI who has an elevated potassium level?
Nursing assessment for hyperkalemia patients focuses on monitoring for signs and symptoms of life-threatening cardiac dysrhythmias, as well as identifying and addressing the underlying cause of hyperkalemia. 1. Monitor heart rate and rhythm. Be aware that cardiac arrest can occur Furosemide can be used to correct volume overload when the kidneys are still responsive; this often requires high intravenous (IV) doses. Furosemide plays no role in converting an oliguric AKI to a nonoliguric AKI or in increasing urine output when a patient is not hypervolemic. Usually the presenting symptom is grossly bloody urine; the caregiver may describe the urine as smoky or bloody. Periorbital edema. Periorbital edema and/or pedal edema may accompany or precede hematuria. Fever. Glomerulonephritis signs and symptoms may include: Pink or cola-colored urine from red blood cells in your urine (hematuria) Foamy or bubbly urine due to excess protein in the urine (proteinuria) High blood pressure (hypertension) The hallmark of myasthenia gravis is muscle weakness that worsens after periods of activity and improves after periods of rest. Certain muscles are often (but not always) involved in the disorder such as those that control: Eye and eyelid movement General signs and symptoms include numbness or weakness of face, arm, or leg (especially on one side of the body); confusion or change in mental status; trouble speaking or understanding speech; visual disturbances; loss of balance, dizziness, difficulty walking; or sudden severe headache. Evaluation for week 1, 2 and 3 mong nursing care after kidney transplantation (immediate, mediated, late), the material studied has as main findings to control hemodynamic status, blood pressure, respiratory function and capillary glucose levels; monitor the hydration situation; perform volume replacement, diuresis control every hour; fasting weigh Promote sodium and fluid restriction as indicated.
Restriction of salt and fluid becomes crucial in the management of oliguric kidney failure, wherein the kidneys do not adequately excrete either toxins or fluids (Workeneh & Bfvfv fvfverfwew aswef
Evaluation serves two main purposes: accountability and learning. Development agencies have tended to prioritize the first, and given responsibility for that to centralized units. But evaluation for learning is the area where observers find the greatest need today and tomorrow. A learning approach to evaluation looks to designing evaluation with learning in mind.
Organizational Capacity-Building Series - Session 6: Program EvaluationINGENAES
This session describes different kinds of program evaluations, and key evaluation considerations. These presentations are are part of a workshop series that was implemented in Nepal and 2016 as part of the INGENAES initiative.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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2. Introduction of Evaluation
Evaluation is a systematic and purposeful undertaking carried out by internal or
external evaluators to appraise the relevance, efficiency, effectiveness of, as well
as the impacts and sustainability generated by the plans, policies, programmes
and projects under implementation.
The main objective of evaluation is;
• to draw lessons from the strengths and weaknesses experienced in the
implementation of plans, policies, programmes and projects so as to improve
their design and implementation in the future as well as to hold the officials
and agencies involved in the process accountable for its implementation and
results.
3. Why do we need evaluation?
• We need to have confidence that what we are doing is of value and to learn
how to do it better
• Evaluation has shown us that some of our ‘good ideas’ for interventions
don’t work or are counter productive
• Evidence of effectiveness is becoming increasingly important for getting new
interventions accepted and resources allocated to them
• Evaluation is crucial if we are to advance the services we provide for
survivors and to convince policy makers and funders of the value of our work
4. Monitoring and evaluation during Project Period
Ex-ante
evaluation
Baseline
Survey
Selection Stage Implementation Stage Operation Stage
Mid-term
Evaluation
Terminal
Evaluation
Ex-Post
Evaluation
Continuous Monitoring Sustainability Monitoring
Flow of
benefits
5. What needs to be evaluated?
• We need to understand the value and effectiveness of all of the current
components of health status
• We need to evaluate / have evaluated new interventions
• What is a new intervention? – Changes to policy, training programmes,
advocacy/education programmes, information leaflets, changes in staffing,
counselling approaches, treatments such as post-exposure prophylaxis etc.
6. Using evaluation to develop an evidence base
• Evaluations can be thought of as falling into two classes: formative
and summative
• Formative evaluation is a method for judging the worth of a program
while the program activities are forming (in progress). They can be
conducted during any phase. This part of the evaluation focuses on
the process
• Summative evaluation is a method of judging the worth of a program
at the end of the program activities (summation). The focus is on the
outcome.
7. Formative evaluation
• This will usually involve multiple iterations of testing and often the use of a
range of methods
• Successful interventions, whether behavioural or biomedical, always have
theoretical bases and are built on previous research
• This needs to be articulated and a mapping exercise should be undertaken
to address the question ‘what do I need to know in order to do this well?’
• If the knowledge base has gaps it may be important to conduct more basic
research before developing interventions
• Sometimes we won’t know everything when we develop interventions, but
it is very helpful to have mapped out gaps as we may be able to addressing
then the course of the formative research or in parallel studies
8. Formative evaluation
• Qualitative research is particularly valuable in the first stages of
formative evaluation because it enables to learn the unexpected
• Very often we initially test information and behavioural type of
interventions by exposing a small group of people to them and then
gathering feelings, reactions, responses, initial feedback etc using
qualitative methods
• Usually this qualitative information can be collected by skilled note
taking, processed rapidly and used to inform a next draft of the
intervention
9. Types and Uses of Evaluation
Evaluation Types When to use What it shows Why it is useful
Formative Evaluation
Assessment Needs
Assessment
• During the development of
a new program.
• When an existing program is
being modified or is being
used in a new setting or with a
new population.
• Whether the proposed program
elements are likely to be needed,
understood, and accepted by the
population we want to reach.
• The extent to which an
evaluation is possible, based on
the goals and objectives.
• It allows for modifications to
be made to the plan before full
implementation begins.
• Maximizes the likelihood that
the program will succeed.
Process Evaluation
Program Monitoring
• As soon as program
implementation begins.
• During operation of an
existing program.
How well the program is working.
• The extent to which the program
is being implemented as designed.
• Whether the program is
accessible an acceptable to its
target population.
• Provides an early warning for
any problems that may occur.
• Allows programs to monitor
how well their program plans
and activities are working.
Outcome Evaluation
Objectives-Based
Evaluation
• After the program has
made contact with at least
one person or group in the
target population
• The degree to which the program
is having an effect on the target
population’s behaviors.
• Tells whether the program is
being effective in meeting it’s
objectives.
10. Types and Uses of Evaluation
Evaluation Types When to use What it shows Why it is useful
Economic Evaluation:
Cost Analysis, Cost-
Effectiveness
Evaluation, Cost-
Benefit Analysis,
Cost-Utility Analysis
• At the beginning of a
program.
• During the operation of an
existing program.
What resources are being used in a
program and their costs (direct and
indirect) compared to outcomes.
• Provides program managers
and funders a way to assess cost
relative to effects.
Impact Evaluation • During the operation of an
existing program at
appropriate intervals.
• At the end of a program.
• The degree to which the program
meets its ultimate goal on an
overall rate of the program
intervention/ disease transmission
• Provides evidence for use in
policy and funding decisions
11. Different Approaches of Evaluation
Appreciative Inquiry: A strengths-based approach designed to support ongoing
learning and adaptation by identifying and investigating outlier examples of good
practice and ways of increasing their frequency.
Beneficiary Assessment: An approach that focuses on assessing the value of an
intervention as perceived by the (intended) beneficiaries, thereby aiming to give
voice to their priorities and concerns.
Case study: A research design that focuses on understanding a unit (person, site or
project) in its context, which can use a combination of qualitative and quantitative
data.
Causal Link Monitoring: An approach designed to support ongoing learning and
adaptation, which identifies the processes required to achieve desired results, and
then observes whether those processes take place, and how.
Collaborative Outcomes Reporting: An impact evaluation approach based on
contribution analysis, with the addition of processes for expert review and
community review of evidence and conclusions.
12. Different Approaches of Evaluation
Contribution Analysis: An impact evaluation approach that iteratively maps available
evidence against a theory of change, then identifies and addresses challenges to causal
inference.
Democratic Evaluation: Various ways of doing evaluation in ways that support
democratic decision making, accountability and/or capacity.
Developmental Evaluation: An approach designed to support ongoing learning and
adaptation, through iterative, embedded evaluation.
Empowerment Evaluation: A participatory approach designed to provide groups with
the tools and knowledge so they can monitor and evaluate their own performance.
Horizontal Evaluation: An approach to learning and improvement that combines self-
assessment by local participants and external review by peers
13. Different Approaches of Evaluation
Innovation History: A particular type of case study used to jointly develop an agreed
narrative of how an innovation was developed, including key contributors and
processes, to inform future innovation efforts.
Institutional Histories: A particular type of case study used to create a narrative of
how institutional arrangements have evolved over time and have created and
contributed to more effective ways to achieve project or program goals.
Most Significant Change: Approach primarily intended to clarify differences in values
among stakeholders by collecting and collectively analyzing personal accounts of
change.
Outcome Harvesting: An impact evaluation approach suitable for retrospectively
identifying emergent impacts by collecting evidence of what has changed and, then,
working backwards, determining whether and how an intervention has contributed to
these changes.
14. Different Approaches of Evaluation
Outcome Mapping: An impact evaluation approach which unpacks an initiative’s
theory of change, provides a framework to collect data on immediate, basic changes
that lead to longer, more transformative change, and allows for the plausible
assessment of the initiative’s contribution to results via ‘boundary partners’.
Participatory Evaluation: A range of approaches that engage stakeholders (especially
intended beneficiaries) in conducting the evaluation and/or making decisions about
the evaluation.
Participatory Rural Appraisal (PRA) / Participatory Learning for Action (PLA): A
participatory approach which enables people to analyze their own health status,
develop a common perspective on health care delivery units and benefits of health
programs like vaccination, deworming etc
Positive Deviance: A strengths-based approach to learning and improvement that
involves intended evaluation users in identifying ‘outliers’ – those with exceptionally
good outcomes - and understanding how they have achieved these.
15. Different Approaches of Evaluation
Qualitative Impact Assessment Protocol (QUIP): An impact evaluation approach without a control
group that uses narrative causal statements elicited directly from intended project beneficiaries.
Randomised Controlled Trials (RCT): An impact evaluation approach that compares results between a
randomly assigned control group and experimental group or groups to produce an estimate of the
mean net impact of an intervention.
Realist Evaluation: An approach especially to impact evaluation which examines what works for
whom in what circumstances through what causal mechanisms, including changes in the reasoning
and resources of participants.
Social Return on Investment (SROI): An participatory approach to value-for-money evaluation that
identifies a broad range of social outcomes, not only the direct outcomes for the intended
beneficiaries of an intervention.
Success Case Method: An impact evaluation approach based on identifying and investigating the most
successful cases and seeing if their results can justify the cost of the intervention (such as a training
course)
Utilization-Focused Evaluation: Uses the intended uses of the evaluation by its primary intended
users to guide decisions about how an evaluation should be conducted.
16. Evaluation of Medical Technology
With respect to the evaluation of medical technologies (medicines,
vaccines, etc), there is a general consensus that RCTs are the gold
reference standard; however, this consensus is commonly extrapolated
to the idea that, just as medical interventions, public health ones not
submitted to randomized trials are unworthy of consideration as such,
and it is recommended: “to reject the scientific double standard of
what constitutes acceptable evidence of efficacy for clinical versus
public health interventions”
17.
18. Efficacy, Effectiveness and Efficiency
• Health Services are evaluated by efficacy, effectiveness and efficiency
Efficacy: The ability to produce a desired or intended result is efficacy. Efficacy
is a measure in a situation in which all conditions are controlled to maximize
the effect of the agent.
Effectiveness: The degree to which something is successful in producing a
desired result; success is effectiveness. For example; the effectiveness of the
treatment, Effectiveness of vaccine etc
Efficiency: the ratio of the useful work performed by an agent or
medicine/vaccine is efficiency. For example; treatment of an specific disease by
a medicine with less side effects in cheaper price within less duration/dose
19. Characteristics of good evaluation
Good evaluation is inclusive.
• It ensures that diverse viewpoints are taken into account and that results are as complete
and unbiased as possible.
Good evaluation is honest.
• Evaluation results are likely to suggest that the program has strengths as well as
limitations.
Good evaluation is replicable and its methods are as rigorous as circumstances allow.
• A good evaluation is one that is likely to be replicable, meaning that someone else should
be able to conduct the same evaluation and get the same results. The higher the quality
of evaluation design, its data collection methods and its data analysis, the more accurate
its conclusions and the more confident others will be in its findings.
21. Different between Monitoring and Evaluation
Monitoring Evaluation
Monitoring is the systematic and routine collection of
information about the programs/projects activities
Evaluation is the periodic assessment of the
programs/projects activities
It is ongoing process which is done to see if things/activities
are going on track or not i.e. it regularly tracks the program
It is done on a periodic basis to measure the success against
the objective i.e. it is an in-depth assessment of the program
Monitoring is to be done starting from the initial stage of the
projects
Evaluation is to be done after certain point of time of the
project, usually at the mid of the project, completion of the
project or while moving from one stage to another stage of
the projects/programs
Monitoring is done usually by the internal members of the
team
Evaluation is mainly done by the external members. However,
sometimes it may be also done by internal members of the
team or by both internal and external members in a
combined way
Monitoring provides information about the current status
and thus helps to take immediate remedial actions, if
necessary
Evaluation provides recommendations, information for long
term planning and lessons for organizational growth and
success
22. Different Between Research and Evaluation
Research Evaluation
Produces generalizable
knowledge
Judges merit or worth
Scientific inquiry based on
intellectual curiosity
Policy and program interests
of stakeholders paramount
Advances broad knowledge
and theory
Provides information for
decision-making on specific
program
Controlled setting Conducted within settings of
changing actors, priorities,
resources and timelines
23. Health Program evaluation bodies in Nepal
• National Planning Commisison_Apex body
• Nepal Health Research Council –Scientific research and evaluation of
the program and project
• Ministry of Health and population/ Policy, Planning and Monitoring
Division
• Department of Health Services-Health Management Information
System (HMIS)
• Provincial and local governments
24. Health program monitoring and evaluation tools in Nepal
• Health Management Information System (HMIS)-monthly monitoring
and end-year evaluation of the health program
• Nepal Demographic and Health Survey (NDHS)-every five years
• Census- every ten years
• Program specific survey and research