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The interactive Outcomes and Evidence Framework supports humanitarian and development professionals to design effective programs. It delivers key information on outcomes related to health, safety, education, economic wellbeing, and power through theories of change, provides evidence for interventions that work or don't work to achieve the outcomes, and includes guidance on how to measure progress.

OVERVIEW

The interactive Outcomes and Evidence Framework is a set of tools developed by the International Rescue Committee (IRC) to guide practitioners in designing the most effective programs using the best available research evidence.

The Outcomes and Evidence Framework toolkit comprises:

In addition, indicators and guidance notes contained within the toolkit help us measure our progress against the selected outcomes.

Using the Outcomes and Evidence Framework tools can help ensure program are designed to be as effective as possible.

OUTCOME AREAS OUTCOMES

Most of us would agree that defining success by outcomes rather than outputs leads to more effective programming. This means focusing on positive change in people's lives rather than the number goods we distrubute or services we provide.

When we commit to achieving an outcome, the Outcomes and Evidence Framework can help us find the best way to achieve it rather than defaulting to past programming. Commitment to an outcome rather than an output also encourages more careful analysis of the problem, the available evidence, the context, client views, and other types of information.

The IRC has defined five outcome areas–health, safety, education, economic wellbeing, and power–that within them contain 32 outcomes. Twenty-six of the 32 outcomes have full theories of change and indicators; the remaining six outcomes are crosscutting, with five related to gender and one to marginialized groups, and all six focused on achieving equal access, opportunities, and norms (to learn more about how to use the gender equality outcomes in your work, see this document ). While the outcome areas and outcomes are based on IRC program priorities, the five outcome areas cover general humanitarian programming sectors and are relevant to a wide range of emergency response and development actors.

The Outcome Areas page also includes a crosscutting section focused on a theory of change that defines the pathways necessary to achieve effective program service delivery across outcome areas. Outcomes with a service delivery component, notably many health and education outcomes, will make specific reference to this theory of change.

THEORIES OF CHANGE

Theories of change help us understand the pathways to achieve outcomes. Each theory of change contains sub-outcomes that are the steps that build toward the outcome. Each sub-outcome within a causual pathway is important for the final outcome to be achieved.

Within the Interactive Outcome and Evidence Framework, each box below the outcome in the theory of change corresponds to a sub-outcome. Clicking on a sub-outcome or outcome will allow us to see more specific information about related research evidence indicators.

Each theory of change reflects specific constraints and opportunities for women and girls to achieve the outcomes. They describe our hypothese–based on the best available evidence–about how the specific outcome is most likely achieved. Because women and girls face different constrains and opportunities depending on the outcome, the pathways for women and girls show up in different ways across the outcomes.

Evidence helps clarify what we know about the effectiveness of different humanitarian and development interventions in different contexts.

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Your doctor should go over in detail what exact pouch procedure you are having. It may be overwhelming at first, but knowing what procedure you are having and how it works will help you understand your surgery and how your digestive system will work afterward.

(J-Pouch, S-Pouch, W-Pouch)

Your medical team may recommend that you have your pouch surgery in a few different steps. Everyone's body is different and the amount of surgeries needed is based off of the patient's overall health and condition and what type of pouch they will have. (The gold standard at Cleveland Clinic is a J-Pouch.)

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

The one stage procedure involves removal of the colon and rectum, with the formation of a J-Pouch with ileal pouch anal anastomosis, with no ileostomy. Considered in patients with FAP and select patients who have ulcerative colitis.

To ensure the healing of all suture lines, patients may undergo a two-stage procedure. The two-stage procedure involves removal of the colon and rectum, with the formation of a J-Pouch with ileal pouch anastomosis and loop ileostomy. The loop ileostomy closure is done approximately three to six months later following radiologic imaging to confirm everything has healed.

In patients that are acutely ill (anemia, weight loss), have a high body mass index (BMI), on high doses of steroids (Prednisone), taking immuno-modulators (Imuran, 6MP) and/or biologic agents (Remicade, Humira, Cimzia, Sumponi), or who require surgery to be performed emergently, it may be safer to treat the colorectal disease in three stages. Patients taking steroids, immune-modulators, and/or biologic agents may have a higher incidence of wound infection and may have a higher complication rate.

The first phase consists of removing the colon, leaving the rectum behind, and giving the patient an end ileostomy for approximately six months. (Most patients report feeling considerably better after this surgery.)

The second phase consists of removing the remnant of rectum, creating a J-Pouch, doing an ileal anal anastomosis, with diverting loop ileostomy. The patient will have the diverting loop ileostomy for approximately three months as long as everything has healed. The third phase consists of closing the stoma. This should be a simpler procedure than stage one and two with a shorter duration and faster recovery.

This procedure involves removing the colon and rectum, closing the anus, and giving the patient a permanent/lifelong ileostomy. This may be considered for elderly patients, patients with poor anal sphincters (the muscles in the anus), or patients that don’t want a J-Pouch and/or don’t mind having an ostomy (stoma).

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Networking, also known as computer networking, is the practice of transporting and exchanging data between nodes over a shared medium in an information system. Networking comprises not only the design, construction and use of a network, but also the management, maintenance and operation of the network infrastructure, software and policies.

The virtualized network poses challenges to network management systems -- and as more hardware components become virtualized, that challenge becomes even greater. This handbook discusses the steps IT must take to both build and corral their virtualized infrastructure.

Computer networking enables devices and endpoints to be connected to each other on a local area network () or to a larger network, such as the internet or a private wide area network (). This is an essential function for service providers, businesses and consumers worldwide to share resources, use or offer services, and communicate. Networking facilitates everything from telephone calls to text messaging to streaming video to the internet of things ().

The level of skill required to operate a network directly correlates to the complexity of a given network. For example, a large enterprise may have thousands of nodes and rigorous security requirements, such as end-to-end encryption , requiring specialized network administrators to oversee the network.

At the other end of the spectrum, a layperson may set up and perform basic troubleshooting for a home Wi-Fi network with a short instruction manual. Both examples constitute computer networking.

There are two primary types of computer networking: wired networking and wireless networking.

Wired networking requires the use of a physical medium for transport between nodes. Copper-based Ethernet cabling, popular due to its low cost and durability, is commonly used for digital communications in businesses and homes. Alternatively, optical fiber is used to transport data over greater distances and at faster speeds, but it has several tradeoffs, including higher costs and more fragile components.

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