Comparing and Contrasting a Program versus System Approach to Evaluation: The Example of a Cardiac Care System

This paper focuses on the application of systems thinking concepts to evaluate systems.  The terms systems and systems thinking concepts are first defined.  The use of systems thinking concepts in program and system evaluation are then highlighted.  It is noted that while there are methods available to assist evaluation practitioners in applying systems thinking concepts to program evaluation, there is a need for similar guidance in applying systems thinking concepts to evaluating systems.  System Evaluation Theory (SET) is then reviewed as one evaluation theory designed to apply systems thinking concepts to evaluating systems. A case illustration is presented to help teach practitioners how to apply SET’s three steps.  The discussion focuses on comparing the differences between evaluation questions answered by applying systems thinking concepts versus those using program logic models

Transient CDK4/6 inhibition protects hematopoietic stem cells from chemotherapy-induced exhaustion

Conventional cytotoxic chemotherapy is highly effective in certain cancers, but causes dose-limiting damage to normal proliferating cells, especially hematopoietic stem and progenitor cells (HSPCs). Serial exposure to cytotoxics causes a long-term hematopoietic compromise (‘exhaustion’), which limits the use of chemotherapy and success of cancer therapy. Here, we show that the co-administration of G1T28 (trilaciclib), a small-molecule inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), contemporaneously with cytotoxic chemotherapy protects murine hematopoietic stem cells (HSCs) from chemotherapy-induced exhaustion in a serial 5-fluorouracil (5FU) treatment model. Consistent with a cell intrinsic effect, we show directly preserved HSC function resulting in a more rapid recovery of peripheral blood counts, enhanced serial transplantation capacity and reduced myeloid skewing. When administered to healthy human volunteers, G1T28 demonstrated excellent in vivo pharmacology and transiently inhibited bone marrow (BM) HSPC proliferation. These findings suggest that the combination of CDK4/6 inhibitors (CDK4/6i) with cytotoxic chemotherapy should provide a means to attenuate therapy-induced BM exhaustion in patients with cancer

MECHANISMS OF THINKING AND GOAL SETTING

The ability to set and reach goals effectively is an adaptive and necessary part of everyday life. Certain types of goals (i.e. those that are extrinsically oriented/avoidance focused) have been correlated with mental health constructs such as depression and anxiety. This study sought to examine if individuals with higher levels of trait anxiety set different types of goals which impeded their ability to achieve their goals. A novel experience sampling approach was used to analyze the daily thoughts of those with anxious tendencies to analyze whether thought content also impacts goal achievement. It was found that individuals with higher trait anxiety set more avoidance focused goals but contrary to predictions also set more intrinsic goals and did not report a lower level of goal attainment. It was also found that the thoughts of more anxious individuals tended to be more negative, less controlled and associated with being in a more negative mood than those with lesser levels of anxiety. Across all participants, the greatest predictor of goal achievement were thoughts characterized as less negative while off-task. This may be an indirect marker for anxiety and future studies should further examine the relationship between anxiety levels and goal achievement

Comparing and Contrasting a Program versus System Approach to Evaluation: The Example of a Cardiac Care System

This paper focuses on the application of systems thinking concepts to evaluate systems. The terms systems and systems thinking concepts are first defined. The use of systems thinking concepts in program and system evaluation are then highlighted. It is noted that while there are methods available to assist evaluation practitioners in applying systems thinking concepts to program evaluation, there is a need for similar guidance in applying systems thinking concepts to evaluating systems. System Evaluation Theory (SET) is then reviewed as one evaluation theory designed to apply systems thinking concepts to evaluating systems. A case illustration is presented to help teach practitioners how to apply SET’s three steps. The discussion focuses on comparing the differences between evaluation questions answered by applying systems thinking concepts versus those using program logic models

Lessons learned in evaluating the infrastructure of a Centre for Translational Research

This article shares lessons learned while evaluating the implementation of a Clinical and Translational Research Centre (CTR). To meet its overarching goals, the CTR consists of numerous research support units (e.g., biostatistics, community engagement, professional development) that are intended to work together collaboratively. It is then argued that an evaluation approach grounded in system thinking was the best fit to evaluate this key CTR design feature. The rationale for selecting systems evaluation theory (SET) as the evaluation framework best suited to evaluate the CTR infrastructure is then presented. The application of SET and the lessons learned are then shared. This article concludes that there are many similarly structured programmes worldwide to which the lessons learned can be applied and upfront investments in using a system approach are rewarded by providing meaningful and useful evaluation recommendations for system change