Developing a logic model is an essential first step in program evaluation. Our experience has been that there is little guidance to teach students how to develop a logic model that is true to its intended purpose of providing a clear visual representation of the underlying rationale that is not shrouded by including the elements of evaluation. We have developed a three-step approach that begins with developing the visual representation of the underlying rationale, central to which is the identification of Antecedent conditions. Step 2 ensures that program activities Target antecedent conditions, while Step 3 focuses on Measurement issues, depicting indicators and objectives for outcomes being included in the evaluation plan. We have coined this method of teaching the ATM approach. We hope that teachers of evaluation will find the ATM approach useful in the form presented here or at least stimulate thought as to how to adapt the approach to meet individual teaching needs.
Objectives-To determine prevalence and incidence of carpal tunnel syndrome (CTS) in a modern meat packing plant. The secondary objective was to explore the relation between ethnicity and CTS. Methods-Six hundred and sixty five workers were interviewed and examined to find the prevalence of CTS. Subsequently, 421 workers without CTS were followed up and examined at a median interval of 253 days; of those, 333 remained without CTS and were again examined at a median interval of 148 days. Results-The prevalence and incidence of CTS was 21% and 11/100 person-years, respectively. The incidence for Asian mixed, white, and other ethnicities was 12.0, 12.2, and 7.2 cases/100 person-years, respectively. The observed incidence for men and women was 9.7 and 18.4 cases/100 person-years, respectively. This difference was not quite significant (p=0.068) with an estimated relative risk (women v men) of 1.9 (95% confidence interval (95% CI) 0.9 to 3.8). The interaction between sex and use of tools was significant (p=0.04), however, although the relative risk for CTS in women who used tools was 4.2 the numbers were small and not significant. The relative risk for men who used tools was 0.64 and not significant. The percentage of incident cases with comorbid disease was only 6.3% (3/47). Conclusions-The prevalence and incidence of CTS in this workforce were higher than in the general population. However, the prevalence of CTS in this modern, mechanised plant was not significantly diVerent from that reported in older plants. No relation was found between ethnicity, age, body mass index, and CTS for either prevalence or incidence. Comorbid disease among the cases of CTS is significantly less than that found in other industry. (Occup Environ Med 1999;56:417-422) Keywords: carpal tunnel syndrome; meat packing plant; ethnicity Carpal tunnel syndrome (CTS) is defined as a complex of symptoms resulting from compression of the median nerve at the carpal tunnel.
Reflective case narratives are a practical mechanism for conveying lessons learned for practice improvement. Their ability to transform experience into knowledge in a colloquial, narrative style positions reflective case narratives as a powerful learning tool with pedagogical benefits for the evaluation community. However, one criticism of reflective case narratives is they suffer from loose guidelines and lengthy discussions that obscure lessons learned. Through the use of adult learning theory, a restructuring of reflective case narratives are presented to facilitate learning. The restructuring consists of five sections to increase the likelihood of reflective case narratives as a resource for transferring knowledge, sharing ideas, and keeping a pulse on the dynamic and fluid process of evaluation.
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