Sample records for acetazolamide challenge assessed

  1. 21 CFR 522.44 - Sterile sodium acetazolamide.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Sterile sodium acetazolamide. 522.44 Section 522....44 Sterile sodium acetazolamide. (a) Specifications. Sterile sodium acetazolamide contains acetazolamide sodium complying with United States Pharmacopeia as a sterile powder with directions for...

  2. 21 CFR 522.44 - Sterile sodium acetazolamide.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Sterile sodium acetazolamide. 522.44 Section 522....44 Sterile sodium acetazolamide. (a) Specifications. Sterile sodium acetazolamide contains acetazolamide sodium complying with United States Pharmacopeia as a sterile powder with directions for...

  3. 21 CFR 522.44 - Sterile sodium acetazolamide.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Sterile sodium acetazolamide. 522.44 Section 522....44 Sterile sodium acetazolamide. (a) Specifications. Sterile sodium acetazolamide contains acetazolamide sodium complying with United States Pharmacopeia as a sterile powder with directions for...

  4. 21 CFR 522.44 - Sterile sodium acetazolamide.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Sterile sodium acetazolamide. 522.44 Section 522....44 Sterile sodium acetazolamide. (a) Specifications. Sterile sodium acetazolamide contains acetazolamide sodium complying with United States Pharmacopeia as a sterile powder with directions for...

  5. Acetazolamide: A New Treatment for Visual Vertigo.

    PubMed

    Sluch, Ilya M; Elliott, Michael S; Dvorak, Justin; Ding, Kai; Farris, Bradley K

    2017-12-01

    Visual vertigo is a disorder characterised by symptoms of dizziness, vertigo, unsteadiness, disorientation, and general discomfort induced by visual triggers. It is currently treated with vestibular rehabilitation therapy, with no effective pharmacotherapy available for treatment-resistant cases. The objective of this study was to evaluate the efficacy of oral acetazolamide in improving symptoms of visual vertigo. A comparative case series of adult patients clinically diagnosed with visual vertigo was conducted from January 1992 to May 2015. Patients without a full neurologic or otorhinolaryngologic work-up, negative magnetic resonance imaging (MRI), and an organic cause for their symptoms were excluded. The identified patients were then contacted by phone to complete a voluntary symptom survey. Main outcome was the subjective reported percentage in symptom improvement. Secondary outcomes were subjective improvement by symptom triggers. The participants were retrospectively divided into three groups based on their treatment with acetazolamide: currently on acetazolamide, terminated acetazolamide, or never initiated acetazolamide. Fifty-seven patients met the inclusion criteria and were willing to complete the phone survey (19 currently on acetazolamide, 27 terminated acetazolamide, and 11 never initiated therapy). Overall symptomatic improvement was reported by 18 (94.7%) patients currently on acetazolamide, 18 (66.7 %) who terminated acetazolamide, and 5 (45.5%) who never initiated therapy, varying significantly by group ( p = 0.0061). Greatest improvement was reported in symptoms triggered by being a passenger in a car. These results show that acetazolamide has a positive association with improvement of symptoms of visual vertigo.

  6. A highly selective and sensitive Tb3+-acetylacetone photo probe for the assessment of acetazolamide in pharmaceutical and serum samples

    NASA Astrophysics Data System (ADS)

    Youssef, A. O.

    2018-04-01

    A novel, simple, sensitive and selective spectrofluorimetric method was developed for the determination of Acetazolamide in pharmaceutical tablets and serum samples using photo probe Tb3+-ACAC. The Acetazolamide can remarkably quench the luminescence intensity of Tb3+-ACAC complex in DMSO at pH 6.8 and λex = 350 nm. The quenching of luminescence intensity of Tb3+-ACAC complex especially the electrical band at λem = 545 nm is used for the assessment of Acetazolamide in the pharmaceutical tablet and serum samples. The dynamic range found for the determination of Acetazolamide concentration is 4.49 × 10-9-1.28 × 10-7 mol L-1, and the limit of detection (LOD) and limit of quantification (LOQ) are (4.0 × 10-9 and 1.21 × 10-8) mol L-1, respectively.

  7. 21 CFR 520.44 - Acetazolamide sodium soluble powder.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Acetazolamide sodium soluble powder. 520.44... Acetazolamide sodium soluble powder. (a) Specifications. The drug is in a powder form containing acetazolamide sodium, USP equivalent to 25 percent acetazolamide activity. (b) Sponsor. See No. 053501 in § 510.600(c...

  8. 21 CFR 520.44 - Acetazolamide sodium soluble powder.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Acetazolamide sodium soluble powder. 520.44... Acetazolamide sodium soluble powder. (a) Specifications. The drug is in a powder form containing acetazolamide sodium, USP equivalent to 25 percent acetazolamide activity. (b) Sponsor. See No. 053501 in § 510.600(c...

  9. 21 CFR 520.44 - Acetazolamide sodium soluble powder.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Acetazolamide sodium soluble powder. 520.44... Acetazolamide sodium soluble powder. (a) Specifications. The drug is in a powder form containing acetazolamide sodium, USP equivalent to 25 percent acetazolamide activity. (b) Sponsor. See No. 053501 in § 510.600(c...

  10. Rapid resolution of retinoschisis with acetazolamide.

    PubMed

    Zhang, Lijuan; Reyes, Roberto; Lee, Winston; Chen, Ching-Lung; Chan, Lawrence; Sujirakul, Tharikarn; Chang, Stanley; Tsang, Stephen H

    2015-08-01

    To report the results of an acetazolamide (Diamox(®)) treatment regimen in a genetically confirmed case of X-linked juvenile retinoschisis (XLRS). A patient with XLRS was prescribed acetazolamide (Diamox(®)) at a dose of 500 mg/day, then discontinued the treatment due to non-compliance for 4 days, and finally resumed the course of treatment. Best-corrected visual acuity, retinal structure, and function were monitored with autofluorescence, spectral domain-optical coherence tomography (SD-OCT), adaptive optics scanning laser ophthalmoscopy (AOSLO), and full-field electroretinogram (ERG). Full-field ERG was performed using DTL recording electrodes and Ganzfeld stimulation according to ISCEV standards. Serial monitoring of the cysts by SD-OCT revealed a strong association between the effects of acetazolamide administration and the size of the schisis. A reduction in foveal cyst size was significant in as rapid as 6 days after acetazolamide initiation. AOSLO data revealed that the resolution of cone cell images improves as the foveal schisis decreases in size. Efficacy of acetazolamide in patients with XLRS can be apparent in as rapid as a week of therapy. AOSLO can be a good method to evaluate the cone cells after acetazolamide treatment in the early stages of XLRS.

  11. Use of acetazolamide in lithium-induced nephrogenic diabetes insipidus: a case report.

    PubMed

    Macau, Ricardo A; da Silva, Tiago Nunes; Silva, Joana Rego; Ferreira, Ana Gonçalves; Bravo, Pedro

    2018-01-01

    Lithium-induced nephrogenic diabetes insipidus (Li-NDI) is a rare and difficult-to-treat condition. A study in mice and two recent papers describe the use of acetazolamide in Li-NDI in 7 patients (a case report and a 6 patient series). We describe the case of a 63-year-old woman with bipolar disorder treated with lithium and no previous history of diabetes insipidus. She was hospitalized due to a bowel obstruction and developed severe dehydration after surgery when she was water deprived. After desmopressin administration and unsuccessful thiazide and amiloride treatment, acetazolamide was administrated to control polyuria and hydroelectrolytic disorders without significant side effects. To our knowledge, this is the third publication on acetazolamide use in Li-NDI patients. Treatment of lithium-induced nephrogenic diabetes insipidus might be challenging.Vasopressin, amiloride and thiazide diuretics have been used in lithium-induced nephrogenic diabetes insipidus treatment.Acetazolamide might be an option to treat lithium-induced nephrogenic diabetes insipidus patients who fail to respond to standard treatment.The use of acetazolamide in lithium-induced nephrogenic diabetes insipidus must be monitored, including its effects on glomerular filtration rate.

  12. Clinical trial of acetazolamide in SCA6, with assessment using the Ataxia Rating Scale and body stabilometry.

    PubMed

    Yabe, I; Sasaki, H; Yamashita, I; Takei, A; Tashiro, K

    2001-07-01

    To investigate the effect of acetazolamide on spinocerebellar ataxia type 6 (SCA6). Acetazolamide (250-500 mg/day) was administered orally for 88 weeks to 6 patients with SCA6, and its effect was quantitatively monitored using the Ataxia Rating Scale (ARS) and body sway analysis by stabilometry. During administration of acetazolamide, the ARS score and the amplitude of body sway were significantly reduced compared with before administration. However, the response became weaker after 1 year of treatment. Although this was an open trial, the results suggested that acetazolamide can temporarily reduce the severity of symptoms during the progression of SCA6.

  13. Acetazolamide Attenuates Lithium–Induced Nephrogenic Diabetes Insipidus

    PubMed Central

    de Groot, Theun; Sinke, Anne P.; Kortenoeven, Marleen L.A.; Alsady, Mohammad; Baumgarten, Ruben; Devuyst, Olivier; Loffing, Johannes; Wetzels, Jack F.

    2016-01-01

    To reduce lithium–induced nephrogenic diabetes insipidus (lithium-NDI), patients with bipolar disorder are treated with thiazide and amiloride, which are thought to induce antidiuresis by a compensatory increase in prourine uptake in proximal tubules. However, thiazides induced antidiuresis and alkalinized the urine in lithium-NDI mice lacking the sodium-chloride cotransporter, suggesting that inhibition of carbonic anhydrases (CAs) confers the beneficial thiazide effect. Therefore, we tested the effect of the CA–specific blocker acetazolamide in lithium-NDI. In collecting duct (mpkCCD) cells, acetazolamide reduced the cellular lithium content and attenuated lithium-induced downregulation of aquaporin-2 through a mechanism different from that of amiloride. Treatment of lithium-NDI mice with acetazolamide or thiazide/amiloride induced similar antidiuresis and increased urine osmolality and aquaporin-2 abundance. Thiazide/amiloride-treated mice showed hyponatremia, hyperkalemia, hypercalcemia, metabolic acidosis, and increased serum lithium concentrations, adverse effects previously observed in patients but not in acetazolamide-treated mice in this study. Furthermore, acetazolamide treatment reduced inulin clearance and cortical expression of sodium/hydrogen exchanger 3 and attenuated the increased expression of urinary PGE2 observed in lithium-NDI mice. These results show that the antidiuresis with acetazolamide was partially caused by a tubular-glomerular feedback response and reduced GFR. The tubular-glomerular feedback response and/or direct effect on collecting duct principal or intercalated cells may underlie the reduced urinary PGE2 levels with acetazolamide, thereby contributing to the attenuation of lithium-NDI. In conclusion, CA activity contributes to lithium-NDI development, and acetazolamide attenuates lithium-NDI development in mice similar to thiazide/amiloride but with fewer adverse effects. PMID:26574046

  14. Acetazolamide Attenuates Lithium-Induced Nephrogenic Diabetes Insipidus.

    PubMed

    de Groot, Theun; Sinke, Anne P; Kortenoeven, Marleen L A; Alsady, Mohammad; Baumgarten, Ruben; Devuyst, Olivier; Loffing, Johannes; Wetzels, Jack F; Deen, Peter M T

    2016-07-01

    To reduce lithium-induced nephrogenic diabetes insipidus (lithium-NDI), patients with bipolar disorder are treated with thiazide and amiloride, which are thought to induce antidiuresis by a compensatory increase in prourine uptake in proximal tubules. However, thiazides induced antidiuresis and alkalinized the urine in lithium-NDI mice lacking the sodium-chloride cotransporter, suggesting that inhibition of carbonic anhydrases (CAs) confers the beneficial thiazide effect. Therefore, we tested the effect of the CA-specific blocker acetazolamide in lithium-NDI. In collecting duct (mpkCCD) cells, acetazolamide reduced the cellular lithium content and attenuated lithium-induced downregulation of aquaporin-2 through a mechanism different from that of amiloride. Treatment of lithium-NDI mice with acetazolamide or thiazide/amiloride induced similar antidiuresis and increased urine osmolality and aquaporin-2 abundance. Thiazide/amiloride-treated mice showed hyponatremia, hyperkalemia, hypercalcemia, metabolic acidosis, and increased serum lithium concentrations, adverse effects previously observed in patients but not in acetazolamide-treated mice in this study. Furthermore, acetazolamide treatment reduced inulin clearance and cortical expression of sodium/hydrogen exchanger 3 and attenuated the increased expression of urinary PGE2 observed in lithium-NDI mice. These results show that the antidiuresis with acetazolamide was partially caused by a tubular-glomerular feedback response and reduced GFR. The tubular-glomerular feedback response and/or direct effect on collecting duct principal or intercalated cells may underlie the reduced urinary PGE2 levels with acetazolamide, thereby contributing to the attenuation of lithium-NDI. In conclusion, CA activity contributes to lithium-NDI development, and acetazolamide attenuates lithium-NDI development in mice similar to thiazide/amiloride but with fewer adverse effects. Copyright © 2016 by the American Society of Nephrology.

  15. [Contact dermatitis caused by acetazolamide under occlusion].

    PubMed

    Daveluy, Amélie; Vial, Thierry; Marty, Laurine; Miremont-Salamé, Ghada; Moore, Nicholas; Haramburu, Françoise

    2007-12-01

    Acetazolamide is a carbonic anhydrase inhibitor used topically for local secondary treatment of posttraumatic or postoperative edema. Two women had contact dermatitis, secondarily extensive, after local cutaneous use of acetazolamide under a compression panty after liposuction. The eruption disappeared after acetazolamide was stopped and local treatment administered. Cutaneous tests were positive for acetazolamide. Local allergic reactions are mentioned in the monograph on topical acetazolamide. Cases of contact dermatitis from this drug have not so far been published, but French adverse drug reaction reporting data include 10 other cases of eczema or rash at the application site. In one of these, a positive reaction was observed on readministration, and in 2 cases allergy skin tests were positive. The application of the drug under occlusion, which is contraindicated, may have contributed to spreading the lesions. Cases have also been described with another carbonic anhydrase inhibitor, dorzolamide, used in ophthalmology.

  16. Assessing the effects of ketorolac and acetazolamide on macular thickness by optical coherence tomography following cataract surgery.

    PubMed

    Turan-Vural, Ece; Halili, Elvin; Serin, Didem

    2014-06-01

    We aimed to evaluate the efficacy of topical ketorolac 0.5 % solution and oral acetazolamide 250 mg/day delivery during the first month after uneventful phacoemulsification surgery by measuring the macular thickness using optical coherence tomography. Our nonmasked randomized prospective study comprised 87 eyes of 80 patients. Complete follow-up was achieved on 84 eyes of 77 eligible patients. Postoperatively, the patients were divided into three groups. One group received ketorolac 0.5 %, the other group received acetazolamide 250 mg/day, and the control group was given no agent. Macular thickness and volume were measured at 1 week and 1 month after surgery by optical coherence tomography. Foveal thickness, parafoveal thickness, and perifoveal thickness were determined to be significantly elevated at postoperative 1 week and 1 month in the control group. Foveal, perifoveal, and parafoveal volumes were also significantly high at postoperative week 1 and month 1 in the control group. There was no significant difference between the ketorolac and acetazolamide groups. The correlation analysis between best-corrected visual acuity, and volume and thickness revealed a negative correlation in the acetazolamide group. Use of acetazolamide after cataract surgery is as effective as ketorolac on macular thickness and volume.

  17. Rapid Resolution of Retinoschisis with Acetazolamide

    PubMed Central

    Zhang, Lijuan; Reyes, Roberto; Lee, Winston; Chen, Ching-Lung; Chan, Lawrence; Sujirakul, Tharikarn; Chang, Stanley; Tsang, Stephen H.

    2015-01-01

    Purpose To report the results of an azetazolamide (Diamox®) treatment regimen in a genetically confirmed case of X-linked Juvenile Retinoschisis (XLRS). Methods A patient with XLRS was prescribed azetazolamide (Diamox®) at a dose of 500 mg/day, then discontinued the treatment due to non-compliance for 4 days, and finally resumed the course of treatment. Best-corrected visual acuity, retinal structure, and function were monitored with autofluorescence (AF), spectral domain-optical coherence tomography (SD-OCT), adaptive optics scanning laser ophthalmoloscopy (AOSLO), and full-field electroretinogram (ERG). Full-field ERG was performed using DTL recording electrodes and Ganzfeld stimulation according to ISCEV standards. Results Serial monitoring of the cysts by SD-OCT revealed a strong association between the effects of acetazolamide administration and the size of the schisis. A reduction in foveal cyst size was significant in as rapid as 6 days after acetazolamide initiation. AOSLO data revealed that the resolution of cone cell images improves as the foveal schisis decreases in size. Conclusions Efficacy of acetazolamide in patients with XLRS can be apparent in as rapid as a week of therapy. AOSLO can be a good method to evaluate the cone cells after acetazolamide treatment in the early stages of XLRS. PMID:25796216

  18. Acetazolamide-related life-threatening hypophosphatemia in a glaucoma patient.

    PubMed

    Hu, Ching-Yun; Lee, Bor-Jen; Cheng, Hsiang-Fan; Wang, Chen-Yu

    2015-01-01

    Acetazolamide-related hypophosphatemia leading to cardiac arrest is extremely rare. Herein we report a 78-year-old female glaucoma patient who developed general weakness and acute respiratory failure, followed by cardiac arrest 1 day after taking acetazolamide. The patient was successfully weaned from the ventilator after correction of hypophosphatemia and fully recovered. As acetazolamide was shown to have the potential to cause a lethal side effect in stable glaucoma, the risk of hypophosphatemia should be kept in mind by ophthalmologists. An examination of serum metabolic panels may be indicated in patients at risk of hypophosphatemia.

  19. Acetazolamide Therapy for Metabolic Alkalosis in Pediatric Intensive Care Patients.

    PubMed

    López, Carolina; Alcaraz, Andrés José; Toledo, Blanca; Cortejoso, Lucía; Gil-Ruiz, Maite Augusta

    2016-12-01

    Patients in PICUs frequently present hypochloremic metabolic alkalosis secondary to loop diuretic treatment, especially those undergoing cardiac surgery. This study evaluates the effectiveness of acetazolamide therapy for metabolic alkalosis in PICU patients. Retrospective, observational study. A tertiary care children's hospital PICU. Children receiving at least a 2-day course of enteral acetazolamide. None. Demographic variables, diuretic treatment and doses of acetazolamide, urine output, serum electrolytes, urea and creatinine, acid-base excess, pH, and use of mechanical ventilation during treatment were collected. Patients were studied according to their pathology (postoperative cardiac surgery, decompensated heart failure, or respiratory disease). A total of 78 episodes in 58 patients were identified: 48 were carried out in cardiac postoperative patients, 22 in decompensated heart failure, and eight in respiratory patients. All patients received loop diuretics. A decrease in pH and PCO2 in the first 72 hours, a decrease in serum HCO3 (mean, 4.65 ± 4.83; p < 0.001), and an increase in anion gap values were observed. Urine output increased in cardiac postoperative patients (4.5 ± 2.2 vs 5.1 ± 2.0; p = 0.020), whereas diuretic treatment was reduced in cardiac patients. There was no significant difference in serum electrolytes, blood urea, creatinine, nor chloride after the administration of acetazolamide from baseline. Acetazolamide treatment was well tolerated in all patients. Acetazolamide decreases serum HCO3 and PCO2 in PICU cardiac patients with metabolic alkalosis secondary to diuretic therapy. Cardiac postoperative patients present a significant increase in urine output after acetazolamide treatment.

  20. [A clinical trial of acetazolamide for SCA6].

    PubMed

    Yabe, I; Sasaki, H; Yamashita, I; Takei, A; Fukazawa, T; Hamada, T; Tashiro, K

    1999-08-01

    Spinocerebellar ataxia type 6 (SCA 6) is an allelic disorder of episodic ataxia type 2 (EA 2) and is caused by a small CAG repeat expansion in the gene encoding the alpha 1A-voltage-dependent-Ca channel subunit (CACNA 1 A) on chromosome 19p13.1. The disorder starts at adulthood with progressive cerebellar ataxia, and the symptoms often fluctuate at early stage. These clinical features overlap with those of EA 2, which has been known as acetazolamide-responsive ataxia. On this background, we studied the clinical effectiveness of acetazolamide for SCA 6 in 9 consecutive patients. Their clinical severity was serially evaluated by ARS (ataxia rating scale) and gravimetric test, over 32 weeks of oral administration of acetazolamide (250-500 mg/day). Consequently, a significant improvement was observed in ARS and postural sway. Our results indicate that acetazolamide is temporally effective for ameliorating the symptoms of SCA 6. However, its effects for the disease progression need to be examined in more large scales in number and duration.

  1. Acetazolamide during acute hypoxia improves tissue oxygenation in the human brain.

    PubMed

    Wang, Kang; Smith, Zachary M; Buxton, Richard B; Swenson, Erik R; Dubowitz, David J

    2015-12-15

    Low doses of the carbonic anhydrase inhibitor acetazolamide provides accelerated acclimatization to high-altitude hypoxia and prevention of cerebral and other symptoms of acute mountain sickness. We previously observed increases in cerebral O2 metabolism (CMRO2 ) during hypoxia. In this study, we investigate whether low-dose oral acetazolamide (250 mg) reduces this elevated CMRO2 and in turn might improve cerebral tissue oxygenation (PtiO2 ) during acute hypoxia. Six normal human subjects were exposed to 6 h of normobaric hypoxia with and without acetazolamide prophylaxis. We determined CMRO2 and cerebral PtiO2 from MRI measurements of cerebral blood flow (CBF) and cerebral venous O2 saturation. During normoxia, low-dose acetazolamide resulted in no significant change in CBF, CMRO2 , or PtiO2 . During hypoxia, we observed increases in CBF [48.5 (SD 12.4) (normoxia) to 65.5 (20.4) ml·100 ml(-1)·min(-1) (hypoxia), P < 0.05] and CMRO2 [1.54 (0.19) to 1.79 (0.25) μmol·ml(-1)·min(-1), P < 0.05] and a dramatic decline in PtiO2 [25.0 to 11.4 (2.7) mmHg, P < 0.05]. Acetazolamide prophylaxis mitigated these rises in CBF [53.7 (20.7) ml·100 ml(-1)·min(-1) (hypoxia + acetazolamide)] and CMRO2 [1.41 (0.09) μmol·ml(-1)·min(-1) (hypoxia + acetazolamide)] associated with acute hypoxia but also reduced O2 delivery [6.92 (1.45) (hypoxia) to 5.60 (1.14) mmol/min (hypoxia + acetazolamide), P < 0.05]. The net effect was improved cerebral tissue PtiO2 during acute hypoxia [11.4 (2.7) (hypoxia) to 16.5 (3.0) mmHg (hypoxia + acetazolamide), P < 0.05]. In addition to its renal effect, low-dose acetazolamide is effective at the capillary endothelium, and we hypothesize that local interruption in cerebral CO2 excretion accounts for the improvements in CMRO2 and ultimately in cerebral tissue oxygenation during hypoxia. This study suggests a potentially pivotal role of cerebral CO2 and pH in modulating CMRO2 and PtiO2 during acute hypoxia. Copyright © 2015 the American

  2. Lithium-induced NDI: acetazolamide reduces polyuria but does not improve urine concentrating ability.

    PubMed

    de Groot, Theun; Doornebal, Joan; Christensen, Birgitte M; Cockx, Simone; Sinke, Anne P; Baumgarten, Ruben; Bedford, Jennifer J; Walker, Robert J; Wetzels, Jack F M; Deen, Peter M T

    2017-09-01

    Lithium is the mainstay treatment for patients with bipolar disorder, but it generally causes nephrogenic diabetes insipidus (NDI), a disorder in which the renal urine concentrating ability has become vasopressin insensitive. Li-NDI is caused by lithium uptake by collecting duct principal cells and downregulation of aquaporin-2 (AQP2) water channels, which are essential for water uptake from tubular urine. Recently, we found that the prophylactic administration of acetazolamide to mice effectively attenuated Li-NDI. To evaluate whether acetazolamide might benefit lithium-treated patients, we administered acetazolamide to mice with established Li-NDI and six patients with a lithium-induced urinary concentrating defect. In mice, acetazolamide partially reversed lithium-induced polyuria and increased urine osmolality, which, however, did not coincide with increased AQP2 abundances. In patients, acetazolamide led to the withdrawal of two patients from the study due to side effects. In the four remaining patients acetazolamide did not lead to clinically relevant changes in maximal urine osmolality. Urine output was also not affected, although none of these patients demonstrated overt lithium-induced polyuria. In three out of four patients, acetazolamide treatment increased serum creatinine levels, indicating a decreased glomerular filtration rate (GFR). Strikingly, these three patients also showed a decrease in systemic blood pressure. All together, our data reveal that acetazolamide does not improve the urinary concentrating defect caused by lithium, but it lowers the GFR, likely explaining the reduced urine output in our mice and in a recently reported patient with lithium-induced polyuria. The reduced GFR in patients prone to chronic kidney disease development, however, warrants against application of acetazolamide in Li-NDI patients without long-term (pre)clinical studies. Copyright © 2017 the American Physiological Society.

  3. Acetazolamide or dexamethasone use versus placebo to prevent acute mountain sickness on Mount Rainier.

    PubMed

    Ellsworth, A J; Meyer, E F; Larson, E B

    1991-03-01

    Eighteen climbers actively ascended Mount Rainier (elevation 4,392 m) twice during a randomized, double-blind, concurrent, placebo-controlled, crossover trial comparing the use of acetazolamide, 250 mg, dexamethasone, 4 mg, and placebo every 8 hours as prophylaxis for acute mountain sickness. Each subject was randomly assigned to receive placebo during one ascent and one of the active medications during the other ascent. Assessment of acute mountain sickness was performed using the Environmental Symptoms Questionnaire and a clinical interview. At the summit or high point attained above base camp, the use of dexamethasone significantly reduced the incidence of acute mountain sickness and the severity of symptoms. Cerebral and respiratory symptom severity scores for subjects receiving dexamethasone (0.26 +/- 0.16 and 0.20 +/- 0.19, respectively) were significantly lower than similar scores for both acetazolamide (0.80 +/- 0.80 and 1.20 +/- 1.05; P = 0.25) and placebo (1.11 +/- 1.02 and 1.45 +/- 1.27; P = .025). Neither the use of dexamethasone nor that of acetazolamide measurably affected other physical or mental aspects. Compared with placebo, dexamethasone appears to be effective for prophylaxis of symptoms associated with acute mountain sickness accompanying rapid ascent. The precise role of dexamethasone for the prophylaxis of acute mountain sickness is not known, but it can be considered for persons without contraindications who are intolerant of acetazolamide, for whom acetazolamide is ineffective, or who must make forced, rapid ascent to high altitude for a short period of time with a guaranteed retreat route.

  4. Acetazolamide or dexamethasone use versus placebo to prevent acute mountain sickness on Mount Rainier.

    PubMed Central

    Ellsworth, A. J.; Meyer, E. F.; Larson, E. B.

    1991-01-01

    Eighteen climbers actively ascended Mount Rainier (elevation 4,392 m) twice during a randomized, double-blind, concurrent, placebo-controlled, crossover trial comparing the use of acetazolamide, 250 mg, dexamethasone, 4 mg, and placebo every 8 hours as prophylaxis for acute mountain sickness. Each subject was randomly assigned to receive placebo during one ascent and one of the active medications during the other ascent. Assessment of acute mountain sickness was performed using the Environmental Symptoms Questionnaire and a clinical interview. At the summit or high point attained above base camp, the use of dexamethasone significantly reduced the incidence of acute mountain sickness and the severity of symptoms. Cerebral and respiratory symptom severity scores for subjects receiving dexamethasone (0.26 +/- 0.16 and 0.20 +/- 0.19, respectively) were significantly lower than similar scores for both acetazolamide (0.80 +/- 0.80 and 1.20 +/- 1.05; P = 0.25) and placebo (1.11 +/- 1.02 and 1.45 +/- 1.27; P = .025). Neither the use of dexamethasone nor that of acetazolamide measurably affected other physical or mental aspects. Compared with placebo, dexamethasone appears to be effective for prophylaxis of symptoms associated with acute mountain sickness accompanying rapid ascent. The precise role of dexamethasone for the prophylaxis of acute mountain sickness is not known, but it can be considered for persons without contraindications who are intolerant of acetazolamide, for whom acetazolamide is ineffective, or who must make forced, rapid ascent to high altitude for a short period of time with a guaranteed retreat route. PMID:2028586

  5. Calcium phosphate stones during long-term acetazolamide treatment for epilepsy

    PubMed Central

    Paisley, K; Tomson, C

    1999-01-01

    We report a case of recurrent renal calculi containing calcium phosphate associated with long-term acetazolamide treatment for epilepsy. Unfortunately, the cause of stone formation was not recognised for many years, by which time irreversible renal damage had occurred.


Keywords: calcium phosphate renal calculi; renal failure; acetazolamide; adverse drug reaction PMID:10474731

  6. Population pharmacodynamic model of bicarbonate response to acetazolamide in mechanically ventilated chronic obstructive pulmonary disease patients

    PubMed Central

    2011-01-01

    Introduction Acetazolamide is commonly given to chronic obstructive pulmonary disease (COPD) patients with metabolic alkalosis. Little is known of the pharmacodynamics of acetazolamide in the critically ill. We undertook the pharmacodynamic modeling of bicarbonate response to acetazolamide in COPD patients under mechanical ventilation. Methods This observational, retrospective study included 68 invasively ventilated COPD patients who received one or multiple doses of 250 or 500 mg of acetazolamide during the weaning period. Among the 68 investigated patients, 207 time-serum bicarbonate observations were available for analysis. Population pharmacodynamics was modeled using a nonlinear mixedeffect model. The main covariates of interest were baseline demographic data, Simplified Acute Physiology Score II (SAPS II) at ICU admission, cause of respiratory failure, co-prescription of drugs interfering with the acid-base equilibrium, and serum concentrations of protein, creatinin, potassium and chloride. The effect of acetazolamide on serum bicarbonate levels at different doses and in different clinical conditions was subsequently simulated in silico. Results The main covariates interacting with acetazolamide pharmacodynamics were SAPS II at ICU admission (P = 0.01), serum chloride (P < 0.001) and concomitant administration of corticosteroids (P = 0.02). Co-administration of furosemide significantly decreased bicarbonate elimination. Acetazolamide induced a decrease in serum bicarbonate with a dose-response relationship. The amount of acetazolamide inducing 50% of the putative maximum effect was 117 ± 21 mg. According to our model, an acetazolamide dosage > 500 mg twice daily is required to reduce serum bicarbonate concentrations > 5 mmol/L in the presence of high serum chloride levels or coadministration of systemic corticosteroids or furosemide. Conclusions This study identified several covariates that influenced acetazolamide pharmacodynamics and could allow a better

  7. A randomized trial of dexamethasone and acetazolamide for acute mountain sickness prophylaxis.

    PubMed

    Ellsworth, A J; Larson, E B; Strickland, D

    1987-12-01

    Forty-seven climbers participated in a double-blind, randomized trial comparing acetazolamide 250 mg, dexamethasone 4 mg, and placebo every eight hours as prophylaxis for acute mountain sickness during rapid, active ascent of Mount Rainier (elevation 4,392 m). Forty-two subjects (89.4 percent) achieved the summit in an average of 34.5 hours after leaving sea level. At the summit or high point attained above base camp, the group taking dexamethasone reported less headache, tiredness, dizziness, nausea, clumsiness, and a greater sense of feeling refreshed (p less than or equal to 0.05). In addition, they reported fewer problems of runny nose and feeling cold, symptoms unrelated to acute mountain sickness. The acetazolamide group differed significantly (p less than or equal to 0.05) from other groups at low elevations (1,300 to 1,600 m), in that they experienced more feelings of nausea and tiredness, and they were less refreshed. These drug side effects probably obscured the previously established prophylactic effects of acetazolamide for acute mountain sickness. Separate analysis of an acetazolamide subgroup that did not experience side effects at low elevations revealed a prophylactic effect of acetazolamide similar in magnitude to the dexamethasone effect but lacking the euphoric effects of dexamethasone. This study demonstrates that prophylaxis with dexamethasone can reduce the symptoms associated with acute mountain sickness during active ascent and that acetazolamide can cause side effects that may limit its effectiveness as prophylaxis against the disease.

  8. Acetazolamide for the management of chronic metabolic alkalosis in neonates and infants.

    PubMed

    Tam, Bonnie; Chhay, Annie; Yen, Lilly; Tesoriero, Linda; Ramanathan, Rangasamy; Seri, Istvan; Friedlich, Philippe S

    2014-01-01

    In this study, we evaluated the efficacy and safety of acetazolamide in the management of chronic metabolic alkalosis in neonates and infants with chronic respiratory insufficiency. A retrospective chart review of 90 patients treated with acetazolamide between 2006 and 2007 admitted to the neonatal intensive care unit was performed. Blood gases and electrolytes obtained at baseline and by 24 hours after acetazolamide administration were compared. Compared with baseline and after 24 hours of acetazolamide, mean measured serum bicarbonate (29.5±3.7 vs. 26.9±3.8 mEq/L, P<0.001) and base excess (10.0±3.4 vs. 4.8±4.0 mEq/L, P<0.001) were significantly lower. No significant differences in other electrolytes, blood urea nitrogen, and urine output were noted, except for an increased serum chloride and creatinine. Uncompensated respiratory acidosis developed in 4 (3.1%) treatment courses. Acetazolamide may be effective in decreasing serum bicarbonate in carefully selected patients. Its use and safety as an adjunctive therapy for chronic metabolic alkalosis in neonates and infants with chronic respiratory insufficiency needs further study.

  9. [Reduction of omalgia in laparoscopic cholecystectomy: clinical randomized trial ketorolac vs ketorolac and acetazolamide].

    PubMed

    Figueroa-Balderas, Lorena; Franco-López, Francisco; Flores-Álvarez, Efrén; López-Rodríguez, Jorge Luis; Vázquez-García, José Antonio; Barba-Valadez, Claudia Teresa

    2013-01-01

    Laparoscopy cholecystectomy for the surgical treatment of cholelithiasis has been considered the gold standard. The referred pain to the shoulder (omalgia) may be present to 63% of the patients and limits outpatient management. The study was to evaluate the usefulness of acetazolamide associated with ketorolac for reduction of the omalgia to minimally invasive treatment. We performed a clinical trial, randomized, double blind in patients undergoing laparoscopic cholecystectomy to assess the reduction of post-operative omalgia comparing ketorolac and ketorolaco+acetazolamida. 31 patients in each group were studied. The study group: 250 mg of acetazolamide before anesthetic induction and 30 mg of ketorolac in the immediate postoperative period. one tablet of placebo prior to the anesthetic induction and 30 mg of ketorolac in the immediate postoperative. The presence of omalgia was assessed using the analog visual scale. The variables recorded included: age, sex, flow of carbon dioxide intra-abdominal pressure, surgical time, urgent or elective surgery, omalgia, severity of pain evaluated by analog visual scale, addition analgesia. Both groups were homogeneous and statistical analysis showed no differences in the variables studied. The omalgia in the study group was presented at 9.67% and in the group control was the 58.06% (p < 0.001). 250 mg oral acetazolamide associated 30 mg of ketorolac reduces significantly the development of omalgia in patients undergoing laparoscopic cholecystectomy.

  10. Antioxidants reverse depression of the hypoxic ventilatory response by acetazolamide in man.

    PubMed

    Teppema, Luc J; Bijl, Hans; Romberg, Raymonda R; Dahan, Albert

    2006-05-01

    The carbonic anhydrase inhibitor acetazolamide may have both inhibitory and stimulatory effects on breathing. In this placebo-controlled double-blind study we measured the effect of an intravenous dose (4 mg kg(-1)) of this agent on the acute isocapnic hypoxic ventilatory response in 16 healthy volunteers (haemoglobin oxygen saturation 83-85%) and examined whether its inhibitory effects on this response could be reversed by antioxidants (1 g ascorbic acid i.v. and 200 mg alpha-tocopherol p.o.). The subjects were randomly divided into an antioxidant (Aox) and placebo group. In the Aox group, acetazolamide reduced the mean normocapnic and hypercapnic hypoxic responses by 37% (P < 0.01) and 55% (P < 0.01), respectively, and abolished the O2-CO2 interaction, i.e. the increase in O2 sensitivity with rising Pco2. Antioxidants completely reversed this inhibiting effect on the normocapnic hypoxic response, while in hypercapnia the reversal was partial. In the placebo group, acetazolamide reduced the normo- and hypercapnic hypoxic responses by 33 and 47%, respectively (P < 0.01 versus control in both cases), and also abolished the O2-CO2 interaction. Placebo failed to reverse these inhibitory effects of acetazolamide in this group. We hypothesize that either an isoform of carbonic anhydrase may be involved in the regulation of the redox state in the carotid bodies or that acetazolamide and antioxidants exert independent effects on oxygen-sensing cells, in which both carbonic anhydrase and potassium channels may be involved. The novel findings of this study may have clinical implications, for example with regard to a combined use of acetazolamide and antioxidants at high altitude.

  11. Antioxidants reverse depression of the hypoxic ventilatory response by acetazolamide in man

    PubMed Central

    Teppema, Luc J; Bijl, Hans; Romberg, Raymonda R; Dahan, Albert

    2006-01-01

    The carbonic anhydrase inhibitor acetazolamide may have both inhibitory and stimulatory effects on breathing. In this placebo-controlled double-blind study we measured the effect of an intravenous dose (4 mg kg−1) of this agent on the acute isocapnic hypoxic ventilatory response in 16 healthy volunteers (haemoglobin oxygen saturation 83–85%) and examined whether its inhibitory effects on this response could be reversed by antioxidants (1 g ascorbic acid i.v. and 200 mg α-tocopherol p.o.). The subjects were randomly divided into an antioxidant (Aox) and placebo group. In the Aox group, acetazolamide reduced the mean normocapnic and hypercapnic hypoxic responses by 37% (P < 0.01) and 55% (P < 0.01), respectively, and abolished the O2–CO2 interaction, i.e. the increase in O2 sensitivity with rising PCO2. Antioxidants completely reversed this inhibiting effect on the normocapnic hypoxic response, while in hypercapnia the reversal was partial. In the placebo group, acetazolamide reduced the normo- and hypercapnic hypoxic responses by 33 and 47%, respectively (P < 0.01 versus control in both cases), and also abolished the O2–CO2 interaction. Placebo failed to reverse these inhibitory effects of acetazolamide in this group. We hypothesize that either an isoform of carbonic anhydrase may be involved in the regulation of the redox state in the carotid bodies or that acetazolamide and antioxidants exert independent effects on oxygen-sensing cells, in which both carbonic anhydrase and potassium channels may be involved. The novel findings of this study may have clinical implications, for example with regard to a combined use of acetazolamide and antioxidants at high altitude. PMID:16439432

  12. Development of a topical niosomal preparation of acetazolamide: preparation and evaluation.

    PubMed

    Aggarwal, Deepika; Garg, Alka; Kaur, Indu P

    2004-12-01

    Orally administered acetazolamide has a limited use in glaucoma due to the systemic side effects associated with its use. No topical formulation of acetazolamide is available, mainly because of it having a limited aqueous solubility and poor corneal permeation. To enhance the bioavailability of acetazolamide by the topical route and to improve the corneal permeability of the drug, niosomes of acetazolamide were prepared (employing span 60 and cholesterol) by different methods. Transmission electron microscopy (TEM) of the selected formulation was carried out to study the morphology. Niosomes were also prepared in the presence of dicetyl phosphate and stearylamine to obtain negatively and positively charged vesicles, respectively. It was found that the reverse-phase evaporation method (REV) gave the maximum drug entrapment efficiency (43.75%) as compared with ether injection (39.62%) and film hydration (31.43%) techniques. Drug entrapment efficiency varied with the charge and the percent entrapment efficiency for the REV method was 43.75, 51.23 and 36.26% for neutral, positively charged and negatively charged niosomes, respectively. Corneal permeability studies, however, showed that the percent permeation and the apparent permeability coefficient for the charged niosomes were less than for the neutral ones. A bioadhesive niosomal formulation of acetazolamide was also prepared and compared with the positively charged formulation, considering that both of them would have a prolonged stay in the cul-de-sac because of their expected interactions with mucin. The formulations were also compared based on their intraocular pressure (IOP)-lowering capacity. The positively charged niosomes (REV2), although showing good corneal permeability and pharmacodynamics, were however found to be inappropriate in terms of the corneal cell toxicity. The bioadhesive coated formulation (REV1bio) compared well with REV2 and also showed a much lesser toxicity. Further, the IOP

  13. Acetazolamide improves oxygenation in patients with respiratory failure and metabolic alkalosis.

    PubMed

    Gulsvik, Ragnhild; Skjørten, Ingunn; Undhjem, Kenneth; Holø, Lars; Frostad, Anne; Saure, Eirunn Waatevik; Lejlic, Vasvija; Humerfelt, Sjur; Hansen, Gunnar; Bruun Wyller, Torgeir

    2013-10-01

    Coexistent respiratory failure and metabolic alkalosis is a common finding. Acidotic diuretics cause a fall in pH that may stimulate respiration. The purpose of the study was to evaluate the effectiveness of short-term treatment with acetazolamide for combined respiratory failure and metabolic alkalosis. A randomised, placebo-controlled and double-blind parallel group trial where oral acetazolamide 250 mg three times a day for 5 days were administered to patients hospitalised for respiratory failure because of a pulmonary disease (Pa O2 ≤ 8 kPa and/or Pa CO2 ≥ 7 kPa) who had concurrent metabolic alkalosis [base excess (BE) ≥ 8 mmol/L]. Pa O2 after 5 days was the primary effect variable. Secondary effect variables were Pa CO2 , BE and pH on day 5, and the total number of days in hospital. Of 70 patients enrolled (35 in each group), data from 54 were analysed per protocol, while last observation carried forward was used for the remaining 16. During the 5-day treatment, Pa O2 increased on average 0.81 kPa in the placebo group and 1.41 kPa in the acetazolamide group. After adjustment for baseline skewness, the difference was statistically significant (adjusted mean difference 0.55 kPa, 95% confidence interval 0.03-1.06). Pa CO2 decreased in both groups, but the difference was not statistically significant. As expected, pH and BE decreased markedly in the acetazolamide group. Acetazolamide may constitute a useful adjuvant treatment mainly to be considered in selected patients with respiratory failure combined with prominent metabolic alkalosis or where non-invasive ventilation is insufficient or infeasible. © 2013 John Wiley & Sons Ltd.

  14. Effect of acetazolamide on blood gases and 2,3 DPG during ascent and acclimatization to high altitude.

    PubMed Central

    Milles, J. J.; Chesner, I. M.; Oldfield, S.; Bradwell, A. R.

    1987-01-01

    Blood gases and red cell 2,3 DPG concentrations were measured during ascent and a stay for 6 days at 4846 m in 20 subjects. Acetazolamide improved Pa,O2 and reduced pH and Pa,CO2. 2,3 DPG concentrations were lower in the acetazolamide group during ascent and at high altitude. However, 2,3 DPG concentrations were significantly greater at high altitude in both the acetazolamide and placebo groups compared with low altitude. The acetazolamide group remained different from the placebo group during the stay at high altitude with higher Pa,O2, lower PaCO2, lower pH and lower 2,3 DPG concentrations. PMID:3118349

  15. Acetazolamide in the treatment of metabolic alkalosis in critically ill patients.

    PubMed

    Marik, P E; Kussman, B D; Lipman, J; Kraus, P

    1991-09-01

    Metabolic alkalosis is a common acid-base disturbance in critically ill patients. In many patients correction of fluid and electrolyte status does not fully correct the metabolic derangement. In this study we examined the effect of 500 mg of intravenous acetazolamide, after correcting for fluid and electrolyte abnormalities, on the acid-base status of 30 ventilated patients. In all patients studied there was a fall of total serum bicarbonate; the mean reduction at 24 hours was 6.4 mmol/L, with a normalization of the base excess and pH. The onset of action was rapid (within 2 hours), and the maximal effect occurred at a mean of 15.5 hours, although there was wide variation. The effect of acetazolamide was still apparent at 48 hours. No adverse effects were noted. We conclude that in patients with metabolic alkalosis, once fluid and electrolyte abnormalities have been corrected, acetazolamide is an effective and safe form of therapy with a quick onset and long duration of action.

  16. Assessment of cerebral blood perfusion reserve with acetazolamide using 3D spiral ASL MRI: Preliminary experience in pediatric patients.

    PubMed

    Hu, Houchun H; Li, Zhiqiang; Pokorney, Amber L; Chia, Jonathan M; Stefani, Niccolo; Pipe, James G; Miller, Jeffrey H

    2017-01-01

    To demonstrate the clinical feasibility of a new non-Cartesian cylindrically-distributed spiral 3D pseudo-continuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI) pulse sequence in pediatric patients in quantifying cerebral blood flow (CBF) response to an acetazolamide (ACZ) vasodilator challenge. MRI exams were performed on two 3 Tesla Philips Ingenia systems using 32 channel head coil arrays. After local institutional review board approval, the 3D spiral-based pCASL technique was added to a standard brain MRI exam and evaluated in 13 pediatric patients (average age: 11.7±6.4years, range: 1.4-22.2years). All patients were administered ACZ for clinically indicated reasons. Quantitative whole-brain CBF measurements were computed pre- and post-ACZ to assess cerebrovascular reserve. 3D spiral pCASL data were successfully reconstructed in all 13 cases. In 11 patients, CBF increased 2.8% to 93.2% after administration of ACZ. In the two remaining patients, CBF decreased by 2.4 to 6.0% after ACZ. The group average change in CBF due to ACZ was approximately 25.0% and individual changes were statistically significant (p<0.01) in all patients using a paired t-test analysis. CBF perfusion data were diagnostically useful in supporting conventional MR angiography and clinical findings. 3D cylindrically-distributed spiral pCASL MRI provides a robust approach to assess cerebral blood flow and reserve in pediatric patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit?

    PubMed Central

    2012-01-01

    Patients with chronic obstructive pulmonary disease (COPD) are affected by episodes of respiratory exacerbations, some of which can be severe and may necessitate respiratory support. Prolonged invasive mechanical ventilation is associated with increased mortality rates. Persistent failure to discontinue invasive mechanical ventilation is a major issue in patients with COPD. Pure or mixed metabolic alkalosis is a common finding in the intensive care unit (ICU) and is associated with a worse outcome. In patients with COPD, the condition is called post-hypercapnic alkalosis and is a complication of mechanical ventilation. Reversal of metabolic alkalosis may facilitate weaning from mechanical ventilation of patients with COPD. Acetazolamide, a non-specific carbonic anhydrase inhibitor, is one of the drugs employed in the ICU to reverse metabolic alkalosis. The drug is relatively safe, undesirable effects being rare. The compartmentalization of the different isoforms of the carbonic anhydrase enzyme may, in part, explain the lack of evidence of the efficacy of acetazolamide as a respiratory stimulant. Recent findings suggest that the usually employed doses of acetazolamide in the ICU may be insufficient to significantly improve respiratory parameters in mechanically ventilated patients with COPD. Randomized controlled trials using adequate doses of acetazolamide are required to address this issue. PMID:22866939

  18. Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit?

    PubMed

    Heming, Nicholas; Urien, Saïk; Faisy, Christophe

    2012-08-07

    Patients with chronic obstructive pulmonary disease (COPD) are affected by episodes of respiratory exacerbations, some of which can be severe and may necessitate respiratory support. Prolonged invasive mechanical ventilation is associated with increased mortality rates. Persistent failure to discontinue invasive mechanical ventilation is a major issue in patients with COPD. Pure or mixed metabolic alkalosis is a common finding in the intensive care unit (ICU) and is associated with a worse outcome. In patients with COPD, the condition is called post-hypercapnic alkalosis and is a complication of mechanical ventilation. Reversal of metabolic alkalosis may facilitate weaning from mechanical ventilation of patients with COPD. Acetazolamide, a non-specific carbonic anhydrase inhibitor, is one of the drugs employed in the ICU to reverse metabolic alkalosis. The drug is relatively safe, undesirable effects being rare. The compartmentalization of the different isoforms of the carbonic anhydrase enzyme may, in part, explain the lack of evidence of the efficacy of acetazolamide as a respiratory stimulant. Recent findings suggest that the usually employed doses of acetazolamide in the ICU may be insufficient to significantly improve respiratory parameters in mechanically ventilated patients with COPD. Randomized controlled trials using adequate doses of acetazolamide are required to address this issue.

  19. Role of carbonic anhydrase in bone - Partial inhibition of disuse atrophy of bone by parenteral acetazolamide

    NASA Technical Reports Server (NTRS)

    Kenny, A. D.

    1985-01-01

    The effectiveness of orally and subcutaneously administered acetazolamide sodium in preventing denervation-induced bone loss in rats is examined. Male Sprague-Dawley rats were treated with acetazolamide either orally by incorporation of 0.2, 0.5, or 1.5 percent concentrations in their diet for 15 days, or subcutaneously by either injection of 0.5 ml/rat of a solution containing either 20 or 100 mg/ml of the drug twice daily for 15 days or by continuous infusion of 5, 50, 500, or 1000 mg/ml of acetazolamide sodium for 8 days using an osmotic minipump. The effects of acetazolamide on body weight, food consumption, and plasma calcium content are evaluated. It is observed that parenteral administration is equally effective as oral administration in partially preventing denervation-induced bone mass changes. The data reveal that approximately 50 percent protection occurs with daily doses of 1094, 129, and 8 mg/kg body weight for the oral, subcutaneous injection, and subcutaneous infusion methods, respectively.

  20. 21 CFR 520.44 - Acetazolamide sodium soluble powder.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Acetazolamide sodium soluble powder. 520.44 Section 520.44 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.44...

  1. 21 CFR 520.28 - Acetazolamide sodium soluble powder.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Acetazolamide sodium soluble powder. 520.28 Section 520.28 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.28...

  2. Intraocular pressure elevation after cataract surgery and its prevention by oral acetazolamide in eyes with pseudoexfoliation syndrome.

    PubMed

    Hayashi, Ken; Yoshida, Motoaki; Sato, Tatsuhiko; Manabe, Shin-Ichi; Yoshimura, Koichi

    2018-02-01

    To examine whether intraocular pressure (IOP) increases immediately after cataract surgery in eyes with pseudoexfoliation (PXF) syndrome and to assess whether orally administered acetazolamide can prevent the IOP elevation. Hayashi Eye Hospital, Fukuoka, Japan. Prospective case series. Patients with PXF syndrome scheduled for phacoemulsification were randomly assigned to 1 of 3 groups: (1) oral acetazolamide administered 1 hour preoperatively (preoperative administration group), (2) administered 3 hours postoperatively (postoperative administration group), and (3) not administered (no administration group). The IOP was measured using a rebound tonometer 1 hour preoperatively, upon completion of surgery, and at 1, 3, 5, 7, and 24 hours postoperatively. The study comprised 96 patients (96 eyes). The mean IOP increased at 3, 5, and 7 hours postoperatively in all groups. At 1 hour and 3 hours postoperatively, the IOP was significantly lower in the preoperative administration group than in the postoperative group and no administration group (P ≤ .001). At 5, 7, and 24 hours postoperatively, the IOP was significantly lower in the preoperative group and postoperative administration group than in the no administration group (P ≤. 045). An IOP spike higher than 25 mm Hg occurred less frequently in the preoperative administration group than in the postoperative administration group and the no administration group (P = .038). Intraocular pressure increased at 3, 5, and 7 hours after cataract surgery in eyes with PXF syndrome. Oral acetazolamide administered 1 hour preoperatively reduced the IOP elevation throughout the 24-hour follow-up; acetazolamide administered 3 hours postoperatively reduced the elevation at 5 hours postoperatively and thereafter. Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Treatment with acetazolamide of brain-stem and spinal paroxysmal disturbances in multiple sclerosis.

    PubMed Central

    Voiculescu, V; Pruskauer-Apostol, B; Alecu, C

    1975-01-01

    Nine cases of multiple sclerosis with paroxysmal disorders were treated with acetazolamide. In most cases a brain-stem origin of the seizures was suggested by their particular pattern: crossed syndromes (facial spasm associated with contralateral weakness of the arm and leg, paroxysmal paraesthesiae in one side of the face and weakness of the contralateral leg), paroxysmal dysarthria, and ataxia. One patient with a Brown-Sequard syndrome complained of paroxysmal paraesthesiae in the lower limbs, for which a spinal origin was admitted. In all patients the paroxysmal disorders were promptly suppressed or markedly reduced by acetazolamide. PMID:1151400

  4. Does preoperative measurement of cerebral blood flow with acetazolamide challenge in addition to preoperative measurement of cerebral blood flow at the resting state increase the predictive accuracy of development of cerebral hyperperfusion after carotid endarterectomy? Results from 500 cases with brain perfusion single-photon emission computed tomography study.

    PubMed

    Oshida, Sotaro; Ogasawara, Kuniaki; Saura, Hiroaki; Yoshida, Koji; Fujiwara, Shunro; Kojima, Daigo; Kobayashi, Masakazu; Yoshida, Kenji; Kubo, Yoshitaka; Ogawa, Akira

    2015-01-01

    The purpose of the present study was to determine whether preoperative measurement of cerebral blood flow (CBF) with acetazolamide in addition to preoperative measurement of CBF at the resting state increases the predictive accuracy of development of cerebral hyperperfusion after carotid endarterectomy (CEA). CBF at the resting state and cerebrovascular reactivity (CVR) to acetazolamide were quantitatively assessed using N-isopropyl-p-[(123)I]-iodoamphetamine (IMP)-autoradiography method with single-photon emission computed tomography (SPECT) before CEA in 500 patients with ipsilateral internal carotid artery stenosis (≥ 70%). CBF measurement using (123)I-IMP SPECT was also performed immediately and 3 days after CEA. A region of interest (ROI) was automatically placed in the middle cerebral artery territory in the affected cerebral hemisphere using a three-dimensional stereotactic ROI template. Preoperative decreases in CBF at the resting state [95% confidence intervals (CIs), 0.855 to 0.967; P = 0.0023] and preoperative decreases in CVR to acetazolamide (95% CIs, 0.844 to 0.912; P < 0.0001) were significant independent predictors of post-CEA hyperperfusion. The area under the receiver operating characteristic curve for prediction of the development of post-CEA hyperperfusion was significantly greater for CVR to acetazolamide than for CBF at the resting state (difference between areas, 0.173; P < 0.0001). Sensitivity, specificity, and positive- and negative-predictive values for the prediction of the development of post-CEA hyperperfusion were significantly greater for CVR to acetazolamide than for CBF at the resting state (P < 0.05, respectively). The present study demonstrated that preoperative measurement of CBF with acetazolamide in addition to preoperative measurement of CBF at the resting state increases the predictive accuracy of the development of post-CEA hyperperfusion.

  5. Rebound macular edema following oral acetazolamide therapy for juvenile X-linked retinoschisis in an Italian family.

    PubMed

    Galantuomo, Maria Silvana; Fossarello, Maurizio; Cuccu, Alberto; Farci, Roberta; Preising, Markus N; Lorenz, Birgit; Napoli, Pietro Emanuele

    2016-01-01

    Juvenile X-linked retinoschisis (RS1, OMIM: 312700) is a hereditary vitreoretinal dystrophy characterized by bilateral foveal schisis and, in half of the patients, splitting through the nerve fiber layer in the peripheral retina. In the first decade of life, patients usually develop a decrease in visual acuity. Long-term visual outcomes can be poor due to the limited number of known successful treatments. The purposes of this study were to present, for the first time, a p.Arg197Cys missense mutation in the RS1 gene (OMIM: 300839) in a four-generation Italian family with RS1 and to examine the clinical response to the treatment with acetazolamide tablets alone or in combination with dorzolamide eye drops as assessed by spectral-domain optical coherence tomography (SD-OCT). Eleven individuals, including two brothers with RS1 (patients 1 and 2), underwent a full medical history examination and a comprehensive ocular assessment that involved SD-OCT, fluorescein angiography, electroretinography and DNA analysis. Each RS1 patient received oral acetazolamide (375 mg daily) during the first three months. Thereafter, patient 1 continued only with dorzolamide eyedrops three times a day for a period of three months, while patient 2 spontaneously stopped both medications. Sequence analysis of the RS1 gene identified a hemizygous c.589C>T (p.Arg197Cys) missense mutation in exon 6, which has not been previously reported in an Italian family. A different response to the medical therapy was observed in the four eyes of the two affected brothers hemizygous for this abnormality. Of note, after acetazolamide interruption, a rebound effect on cystoid macular edema reduced the beneficial effects of the initial therapy for RS1 from p.Arg197Cys mutation. Indeed, a minimal rebound effect on cystoid macular edema, and an improvement in visual acuity, was observed in patient 1 during the six months of treatment. Conversely, in patient 2, an initial improvement in cystoid macular edema was

  6. Nanoemulsion-based electrolyte triggered in situ gel for ocular delivery of acetazolamide.

    PubMed

    Morsi, Nadia; Ibrahim, Magdy; Refai, Hanan; El Sorogy, Heba

    2017-06-15

    In the present work the antiglaucoma drug, acetazolamide, was formulated as an ion induced nanoemulsion-based in situ gel for ocular delivery aiming a sustained drug release and an improved therapeutic efficacy. Different acetazolamide loaded nanoemulsion formulations were prepared using peanut oil, tween 80 and/or cremophor EL as surfactant in addition to transcutol P or propylene glycol as cosurfactant. Based on physicochemical characterization, the nanoemulsion formulation containing mixed surfactants and transcutol P was selected to be incorporated into ion induced in situ gelling systems composed of gellan gum alone and in combination with xanthan gum, HPMC or carbopol. The nanoemulsion based in situ gels showed a significantly sustained drug release in comparison to the nanoemulsion. Gellan/xanthan and gellan/HPMC possessed good stability at all studied temperatures, but gellan/carbopol showed partial drug precipitation upon storage and was therefore excluded from the study. Gellan/xanthan and gellan/HPMC showed higher therapeutic efficacy and more prolonged intraocular pressure lowering effect relative to that of commercial eye drops and oral tablet. Gellan/xanthan showed superiority over gellan/HPMC in all studied parameters and is thus considered as a promising mucoadhesive nanoemulsion-based ion induced in situ gelling formula for topical administration of acetazolamide. Copyright © 2017. Published by Elsevier B.V.

  7. The effect of oral acetazolamide on cystoid macular edema in hydroxychloroquine retinopathy: a case report.

    PubMed

    Hong, Eun Hee; Ahn, Seong Joon; Lim, Han Woong; Lee, Byung Ro

    2017-07-12

    Hydroxychloroquine (HCQ) retinopathy can accompany other retinal complications such as cystoid macular edema (CME), which leads to central visual loss. We report a case of CME with HCQ retinopathy that improved with the use of oral acetazolamide, and discussed the possible mechanisms of CME in HCQ retinopathy using multimodal imaging modalities. A 62-year-old patient with systemic lupus erythematosus (SLE) and HCQ retinopathy developed bilateral CME with visual decline. Fluorescein angiography (FA) showed fluorescein leakage in the macular and midperipheral area. After treatment with oral acetazolamide (250 mg/day) for one month, CME was completely resolved, best corrected visual acuity (BCVA) improved from 20/50 to 20/25, and FA examination showed decreased dye leakage in the macular and midperipheral areas. In cases of vision loss in HCQ retinopathy, it is important to consider not only progression of maculopathy, but also development of CME, which can be effectively treated with oral acetazolamide.

  8. Preparation of acetazolamide composite microparticles by supercritical anti-solvent techniques.

    PubMed

    Duarte, Ana Rita C; Roy, Christelle; Vega-González, Arlette; Duarte, Catarina M M; Subra-Paternault, Pascale

    2007-03-06

    The possibility of preparation of ophthalmic drug delivery systems using compressed anti-solvent technology was evaluated. Eudragit RS 100 and RL 100 were used as drug carriers, acetazolamide was the model drug processed. Compressed anti-solvent experiments were carried out as a semi-continuous or a batch operation from a liquid solution of polymer(s)+solute dissolved in acetone. Both techniques allowed the recovery of composite particles, but the semi-continuous operation yielded smaller and less aggregated populations than the batch operation. The release behaviour of acetazolamide from the prepared microparticles was studied and most products exhibited a slower release than the single drug. Moreover, the release could be controlled to some extent by varying the ratio of the two Eudragit used in the formulation and by selecting one or the other anti-solvent technique. Simple diffusion models satisfactorily described the release profiles. Composites specifically produced by semi-continuous technique have a drug release rate controlled by a diffusion mechanism, whereas for composites produced by the batch operation, the polymer swelling also contributes to the overall transport mechanism.

  9. Effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial.

    PubMed

    Wall, Michael; McDermott, Michael P; Kieburtz, Karl D; Corbett, James J; Feldon, Steven E; Friedman, Deborah I; Katz, David M; Keltner, John L; Schron, Eleanor B; Kupersmith, Mark J

    Acetazolamide is commonly used to treat idiopathic intracranial hypertension (IIH), but there is insufficient information to establish an evidence base for its use. To determine whether acetazolamide is beneficial in improving vision when added to a low-sodium weight reduction diet in patients with IIH and mild visual loss. Multicenter, randomized, double-masked, placebo-controlled study of acetazolamide in 165 participants with IIH and mild visual loss who received a low-sodium weight-reduction diet. Participants were enrolled at 38 academic and private practice sites in North America from March 2010 to November 2012 and followed up for 6 months (last visit in June 2013). All participants met the modified Dandy criteria for IIH and had a perimetric mean deviation (PMD) between -2 dB and -7 dB. The mean age was 29 years and all but 4 participants were women. Low-sodium weight-reduction diet plus the maximally tolerated dosage of acetazolamide (up to 4 g/d) or matching placebo for 6 months. The planned primary outcome variable was the change in PMD from baseline to month 6 in the most affected eye, as measured by Humphrey Field Analyzer. Perimetric mean deviation is a measure of global visual field loss (mean deviation from age-corrected normal values), with a range of 2 to -32 dB; larger negative values indicate greater vision loss. Secondary outcome variables included changes in papilledema grade, quality of life (Visual Function Questionnaire 25 [VFQ-25] and 36-Item Short Form Health Survey), headache disability, and weight at month 6. The mean improvement in PMD was greater with acetazolamide (1.43 dB, from -3.53 dB at baseline to -2.10 dB at month 6; n = 86) than with placebo (0.71 dB, from -3.53 dB to -2.82 dB; n = 79); the difference was 0.71 dB (95% CI, 0 to 1.43 dB; P = .050). Mean improvements in papilledema grade (acetazolamide: -1.31, from 2.76 to 1.45; placebo: -0.61, from 2.76 to 2.15; treatment effect, -0.70; 95% CI, -0.99 to -0.41; P

  10. Patients with obstructive sleep apnea syndrome benefit from acetazolamide during an altitude sojourn: a randomized, placebo-controlled, double-blind trial.

    PubMed

    Nussbaumer-Ochsner, Yvonne; Latshang, Tsogyal D; Ulrich, Silvia; Kohler, Malcolm; Thurnheer, Robert; Bloch, Konrad E

    2012-01-01

    Many patients with obstructive sleep apnea syndrome (OSA) are unable or unwilling to use continuous positive airway pressure (CPAP) therapy when traveling to the mountains for work or recreation even though they risk pronounced hypoxemia and exacerbation of sleep apnea. Because the treatment of OSA at altitude has not been established, we tested the hypothesis that acetazolamide improves hypoxemia, sleep, and breathing disturbances in otherwise untreated patients with OSA at altitude. Forty-five patients with OSA on long-term CPAP, median age 64 years, living at < 600 m underwent a placebo-controlled, double-blind, crossover trial randomized for the sequence of drug and altitude exposure (490 m, 1,860 m, and 2,590 m). Patients spent two 3-day periods at altitude and a 2-week wash-out period at < 600 m. At altitude, patients discontinued CPAP and received acetazolamide 2 × 250 mg daily or placebo. Polysomnography, vigilance, and symptoms were evaluated. At 490 m, off CPAP, median nocturnal oxygen saturation was 93%, and the apnea/hypopnea index was 51.2/h. On placebo at 1,860 m and 2,590 m, the corresponding values were 89% and 85% and 63.6/h and 86.2/h, respectively (P < .01 vs 490 m, both instances). On acetazolamide at 1,860 m and 2,590 m, oxygen saturation was higher (91% and 88%) and apnea/hypopnea indices were lower (48.0/h and 61.4/h) than on placebo (P < .01 all instances). Acetazolamide reduced nocturnal transcutaneous Pco(2), improved sleep efficiency and subjective insomnia, and prevented excessive BP elevations at altitude. In patients with OSA discontinuing CPAP during an altitude sojourn, acetazolamide improves oxygenation, breathing disturbances, and sleep quality by stimulating ventilation. Therefore, patients with OSA may benefit from acetazolamide at altitude if CPAP therapy is not feasible. ClinicalTrials.gov; No.: NCT00714740; URL: www.clinicaltrials.gov.

  11. Cerebral fat embolism syndrome causing brain death after long-bone fractures and acetazolamide therapy.

    PubMed

    Walshe, Criona M; Cooper, James D; Kossmann, Thomas; Hayes, Ivan; Iles, Linda

    2007-06-01

    A 19-year-old woman with multiple fractures and mild brain injury developed severe cerebral fat embolism syndrome after "damage control" orthopaedic surgery. Acetazolamide therapy to manage ocular trauma, in association with hyperchloraemia, caused a profound metabolic acidosis with appropriate compensatory hypocapnia. During ventilator weaning, unexpected brainstem coning followed increased sedation and brief normalisation of arterial carbon dioxide concentration. Autopsy found severe cerebral fat embolism and brain oedema. In patients with multiple trauma, cerebral fat embolism syndrome is difficult to diagnose, and may be more common after delayed fixation of long-bone fractures. Acetazolamide should be used with caution, as sudden restoration of normocapnia during compensated metabolic acidosis in patients with raised intracranial pressure may precipitate coning.

  12. Effects of acetazolamide on infantile nystagmus syndrome waveforms: comparisons to contact lenses and convergence in a well-studied subject.

    PubMed

    Thurtell, M J; Dell'osso, L F; Leigh, R J; Matta, M; Jacobs, J B; Tomsak, R L

    2010-07-29

    To determine if acetazolamide, an effective treatment for certain inherited channelopathies, has therapeutic effects on infantile nystagmus syndrome (INS) in a well-studied subject, compare them to other therapies in the same subject and to tenotomy and reattachment (T&R) in other subjects. Eye-movement data were taken using a high-speed digital video recording system. Nystagmus waveforms were analyzed by applying an eXpanded Nystagmus Acuity Function (NAFX) at different gaze angles and determining the Longest Foveation Domain (LFD). Acetazolamide improved foveation by both a 59.7% increase in the peak value of the NAFX function (from 0.395 to 0.580) and a 70% broadening of the NAFX vs Gaze Angle curve (the LFD increased from 20° to 34°). The resulting U-shaped improvement in the percent NAFX vs Gaze Angle curve, varied from ~60% near the NAFX peak to over 1000% laterally. The therapeutic improvements in NAFX from acetazolamide (similar to T&R) were intermediate between those of soft contact lenses and convergence, the latter was best; for LFD improvements, acetazolamide and contact lenses were equivalent and less effective than convergence. Computer simulations suggested that damping the central oscillation driving INS was insufficient to produce the foveation improvements and increased NAFX values. Acetazolamide resulted in improved-foveation INS waveforms over a broadened range of gaze angles, probably acting at more than one site. This raises the question of whether hereditary INS involves an inherited channelopathy, and whether other agents with known effects on ion channels should be investigated as therapy for this condition.

  13. Acetazolamide on the ventral medulla of the cat increases phrenic output and delays the ventilatory response to CO2.

    PubMed Central

    Coates, E L; Li, A H; Nattie, E E

    1991-01-01

    1. Acetazolamide (0.1 mM) applied to the surface of the rostral ventrolateral medulla or microinjected beneath the medullary surface in chloralose-urethane-anaesthetized, vagotomized, carotid-denervated, paralysed, servo-ventilated cats produced a long-lasting increase in integrated phrenic nerve activity. 2. Extracellular pH measured beneath the rostral ventrolateral medulla exhibited a long-lasting decrease after surface acetazolamide but was not a good predictor, in each individual animal, of changes in phrenic activity. 3. Medullary carbonic anhydrase inhibition reduced the slope and the half-time of the phrenic response to rapid step CO2 increases. Conversely, acetazolamide did not affect the phrenic response to steady-state CO2 increases. 4. These data indicate that localized inhibition of medullary carbonic anhydrase causes a centrally mediated increase in ventilation that we attribute to medullary tissue hypercapnia and acidosis. In addition, these data indicate that medullary carbonic anhydrase may play a role in central CO2 chemotransduction. Images Fig. 8 PMID:1816381

  14. Binary and ternary cocrystals of sulfa drug acetazolamide with pyridine carboxamides and cyclic amides.

    PubMed

    Bolla, Geetha; Nangia, Ashwini

    2016-03-01

    A novel design strategy for cocrystals of a sulfonamide drug with pyridine carboxamides and cyclic amides is developed based on synthon identification as well as size and shape match of coformers. Binary adducts of acetazolamide (ACZ) with lactams (valerolactam and caprolactam, VLM, CPR), cyclic amides (2-pyridone, labeled as 2HP and its derivatives MeHP, OMeHP) and pyridine amides (nicotinamide and picolinamide, NAM, PAM) were obtained by manual grinding, and their single crystals by solution crystallization. The heterosynthons in the binary cocrystals of ACZ with these coformers suggested a ternary combination for ACZ with pyridone and nicotinamide. Novel supramolecular synthons of ACZ with lactams and pyridine carboxamides are reported together with binary and ternary cocrystals for a sulfonamide drug. This crystal engineering study resulted in the first ternary cocrystal of acetazolamide with amide coformers, ACZ-NAM-2HP (1:1:1).

  15. Retinal adhesive force in living rabbit, cat, and monkey eyes. Normative data and enhancement by mannitol and acetazolamide.

    PubMed

    Kita, M; Marmor, M F

    1992-05-01

    Small retinal detachments (blebs) were made in living eyes by injecting balanced salt solution into the subretinal space with a micropipette. A second micropipette, inserted into the same bleb, measured subretinal pressure using a resistance servonulling system. The adhesive force was calculated from the pressure difference across the retina according to Laplace's law. The retinal adhesive force in rabbit, cat, and monkey eyes averaged 1.0, 1.8, and 1.4 x 10(2) dyne/cm, respectively. In rabbit eyes, 2 hr after intravenous administration of 15 mg/kg acetazolamide, the retinal adhesive force was increased to 133%. In monkeys, this dose of acetazolamide increased retinal adhesion to 144% of control values. Mannitol (2 g/kg) increased retinal adhesion in the monkey to 153% of control values 90 min after intravenous injection (compared with an increase of 145% in previous experiments in the rabbit). Because both mannitol and acetazolamide enhance retinal adhesiveness in living primate eyes, it seems likely that they will have a similar effect in humans that they may be clinically useful.

  16. Changes in cerebral blood flow and vasoreactivity in response to acetazolamide in patients with transient global amnesia

    PubMed Central

    Sakashita, Y.; Kanai, M.; Sugimoto, T.; Taki, S.; Takamori, M.

    1997-01-01

    OBJECTIVE—Previous reports about changes in cerebral blood flow (CBF) in transient global amnesia disclosed decreased flow in some parts of the brain. However, CBF analyses in most reports were qualitative but not quantitative. The purpose of this study was to determine changes in CBF in transient global amnesia.
METHODS—The CBF was measured and the vasoreactive response to acetazolamide was evaluated in six patients with transient global amnesia using technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT). The CBF was measured during an attack in two patients and soon after an attack in the other four. About one month later, CBF was re-evaluated in each patient.
RESULTS—Two patients examined during an attack and one patient examined five hours after an attack had increased blood flow in the occipital cortex and cerebellum. Three patients examined at six to 10 hours after an attack had decreased blood flow in the thalamus, cerebellum, or putamen. These abnormalities of blood flow almost disappeared in all patients one month after onset. The vasodilatory response to acetazolamide, which was evaluated initially using SPECT, was poor in areas of increased blood flow. By the second evaluation of CBF with acetazolamide, the vasodilatory response had returned to normal.
CONCLUSIONS—In a patient with transient global amnesia, CBF increased in the vertebrobasilar territory during the attack and decreased afterwards. The vasodilatory response to acetazolamide may be impaired in the parts of the brain with increased blood flow. It is suggested that transient global amnesia is distinct from migraine but may share the same underlying mechanism.

 PMID:9408101

  17. Binary and ternary cocrystals of sulfa drug acetazolamide with pyridine carboxamides and cyclic amides

    PubMed Central

    Bolla, Geetha; Nangia, Ashwini

    2016-01-01

    A novel design strategy for cocrystals of a sulfonamide drug with pyridine carboxamides and cyclic amides is developed based on synthon identification as well as size and shape match of coformers. Binary adducts of acetazolamide (ACZ) with lactams (valerolactam and caprolactam, VLM, CPR), cyclic amides (2-pyridone, labeled as 2HP and its derivatives MeHP, OMeHP) and pyridine amides (nicotinamide and picolinamide, NAM, PAM) were obtained by manual grinding, and their single crystals by solution crystallization. The heterosynthons in the binary cocrystals of ACZ with these coformers suggested a ternary combination for ACZ with pyridone and nicotinamide. Novel supramolecular synthons of ACZ with lactams and pyridine carboxamides are reported together with binary and ternary cocrystals for a sulfonamide drug. This crystal engineering study resulted in the first ternary cocrystal of acetazolamide with amide coformers, ACZ–NAM–2HP (1:1:1). PMID:27006778

  18. Acetazolamide-mediated decrease in strong ion difference accounts for the correction of metabolic alkalosis in critically ill patients

    PubMed Central

    Moviat, Miriam; Pickkers, Peter; van der Voort, Peter HJ; van der Hoeven, Johannes G

    2006-01-01

    Introduction Metabolic alkalosis is a commonly encountered acid–base derangement in the intensive care unit. Treatment with the carbonic anhydrase inhibitor acetazolamide is indicated in selected cases. According to the quantitative approach described by Stewart, correction of serum pH due to carbonic anhydrase inhibition in the proximal tubule cannot be explained by excretion of bicarbonate. Using the Stewart approach, we studied the mechanism of action of acetazolamide in critically ill patients with a metabolic alkalosis. Methods Fifteen consecutive intensive care unit patients with metabolic alkalosis (pH ≥ 7.48 and HCO3- ≥ 28 mmol/l) were treated with a single administration of 500 mg acetazolamide intravenously. Serum levels of strong ions, creatinine, lactate, weak acids, pH and partial carbon dioxide tension were measured at 0, 12, 24, 48 and 72 hours. The main strong ions in urine and pH were measured at 0, 3, 6, 12, 24, 48 and 72 hours. Strong ion difference (SID), strong ion gap, sodium–chloride effect, and the urinary SID were calculated. Data (mean ± standard error were analyzed by comparing baseline variables and time dependent changes by one way analysis of variance for repeated measures. Results After a single administration of acetazolamide, correction of serum pH (from 7.49 ± 0.01 to 7.46 ± 0.01; P = 0.001) was maximal at 24 hours and sustained during the period of observation. The parallel decrease in partial carbon dioxide tension was not significant (from 5.7 ± 0.2 to 5.3 ± 0.2 kPa; P = 0.08) and there was no significant change in total concentration of weak acids. Serum SID decreased significantly (from 41.5 ± 1.3 to 38.0 ± 1.0 mEq/l; P = 0.03) due to an increase in serum chloride (from 105 ± 1.2 to 110 ± 1.2 mmol/l; P < 0.0001). The decrease in serum SID was explained by a significant increase in the urinary excretion of sodium without chloride during the first 24 hours (increase in urinary SID: from 48.4 ± 15.1 to 85.3 ± 7

  19. Effect of Acetazolamide vs Placebo on Duration of Invasive Mechanical Ventilation Among Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial.

    PubMed

    Faisy, Christophe; Meziani, Ferhat; Planquette, Benjamin; Clavel, Marc; Gacouin, Arnaud; Bornstain, Caroline; Schneider, Francis; Duguet, Alexandre; Gibot, Sébastien; Lerolle, Nicolas; Ricard, Jean-Damien; Sanchez, Olivier; Djibre, Michel; Ricome, Jean-Louis; Rabbat, Antoine; Heming, Nicholas; Urien, Saïk; Esvan, Maxime; Katsahian, Sandrine

    2016-02-02

    Acetazolamide has been used for decades as a respiratory stimulant for patients with chronic obstructive pulmonary disease (COPD) and metabolic alkalosis, but no large randomized placebo-controlled trial is available to confirm this approach. To determine whether acetazolamide reduces mechanical ventilation duration in critically ill patients with COPD and metabolic alkalosis. The DIABOLO study, a randomized, double-blind, multicenter trial, was conducted from October 2011 through July 2014 in 15 intensive care units (ICUs) in France. A total of 382 patients with COPD who were expected to receive mechanical ventilation for more 24 hours were randomized to the acetazolamide or placebo group and 380 were included in an intention-to treat analysis. Acetazolamide (500-1000 mg, twice daily) vs placebo administered intravenously in cases of pure or mixed metabolic alkalosis, initiated within 48 hours of ICU admission and continued during the ICU stay for a maximum of 28 days. The primary outcome was the duration of invasive mechanical ventilation via endotracheal intubation or tracheotomy. Secondary outcomes included changes in arterial blood gas and respiratory parameters, weaning duration, adverse events, use of noninvasive ventilation after extubation, successful weaning, the duration of ICU stay, and in-ICU mortality. Among 382 randomized patients, 380 (mean age, 69 years; 272 men [71.6%]; 379 [99.7%] with endotracheal intubation) completed the study. For the acetazolamide group (n = 187), compared with the placebo group (n = 193), no significant between-group differences were found for median duration of mechanical ventilation (-16.0 hours; 95% CI, -36.5 to 4.0 hours; P = .17), duration of weaning off mechanical ventilation (-0.9 hours; 95% CI, -4.3 to 1.3 hours; P = .36), daily changes of minute-ventilation (-0.0 L/min; 95% CI, -0.2 to 0.2 L/min; P = .72), or partial carbon-dioxide pressure in arterial blood (-0.3 mm Hg; 95% CI, -0.8 to 0.2 mm

  20. Spinocerebellar ataxia type 6 with positional vertigo and acetazolamide responsive episodic ataxia.

    PubMed

    Jen, J C; Yue, Q; Karrim, J; Nelson, S F; Baloh, R W

    1998-10-01

    The SCA6 mutation, a small expansion of a CAG repeat in a calcium channel gene CACNA1A, was identified in three pedigrees. Point mutations in other parts of the gene CACNA1A were excluded and new clinical features of SCA6 reported--namely, central positional nystagmus and episodic ataxia responsive to acetazolamide. The three allelic disorders, episodic ataxia type 2, familial hemiplegic migraine, and SCA6, have overlapping clinical features.

  1. Comparative study of acetazolamide and spironolactone on body fluid compartments on induction to high altitude

    NASA Astrophysics Data System (ADS)

    Singh, M. V.; Jain, S. C.; Rawal, S. B.; Divekar, H. M.; Parshad, Rajinder; Tyagi, A. K.; Sinha, K. C.

    1986-03-01

    Studies were conducted on 29 male healthy subjects having no previous experience of living at high altitude. These subjects were divided into three groups, i.e., subjects treated with placebo, acetazolamide and spironolactone. These subjects were first studied in Delhi. The drug schedule was started 24 hour prior to the airlift of these subjects to an altitude of 3,500 m and was continued for 48 hour after arrival at high altitude. Total body water, extra cellular water, plasma volume, blood electrolytes, pH, pO2, pCO2 and blood viscosity were determined on 3rd and 12th day of their stay at high altitude. Total body water, extra cellular water intracellular water and plasma volume decreased on high altitude exposure. There was a further slight decrease in these compartments with acetazolamide and spironolactone. It was also observed that spironolactone drives out more water from the extracellular compartment. Loss of plasma water was also confirmed by increased plasma osmolality. Increase in arterial blood pH was noticed on hypoxic exposure but the increase was found less in acetazolamide and spironolactone cases. This decrease in pH is expected to result in better oxygen delivery to the tissues at the low oxygen tension. It was also confirmed because blood pO2 increased in both the groups. No significant change in plasma electrolytes was observed in subjects of various groups. Blood viscosity slightly increased on exposure to high altitude. The degree of rise was found less in the group treated with spironolactone. This study suggests that both the drugs are likely to be beneficial in ameliorating/prevention of AMS syndrome.

  2. Stability of acetazolamide, allopurinol, azathioprine, clonazepam, and flucytosine in extemporaneously compounded oral liquids.

    PubMed

    Allen, L V; Erickson, M A

    1996-08-15

    The stability of drugs commonly prescribed for use in oral liquid dosage forms but not commercially available as such was studied. Acetazolamide 25 mg/mL, allopurinol 20 mg/mL, azathioprine 50 mg/mL, clonazepam 0.1 mg/mL, and flucytosine 10 mg/mL were prepared in 1:1 mixture of Ora-Sweet and Ora-Plus (Paddock Laboratories), a 1:1 mixture of Ora-Sweet SF and Ora-Plus (Paddock Laboratories), and cherry syrup and placed in polyethylene terephthalate bottles. The sources of the drugs were capsules and tablets. Six bottles were prepared per liquid; three were stored at 5 degrees C and three at 25 degrees C, all in the dark. A sample was removed from each bottle initially and at intervals up to 60 days and analyzed for drug concentration by stability-indicating high-performance liquid chromatography. At least 94% of the initial drug concentration was retained in all the oral liquids for up to 60 days. There were no substantial changes in the appearance or odor of the liquids, or in the pH. Acetazolamide 25 mg/mL, allopurinol 20 mg/mL, azathioprine 50 mg/mL, clonazepam 0.1 mg/mL, and flucytosine 10 mg/mL were stable for up to 60 days at 5 and 25 degrees C in three extemporaneously compounded oral liquids.

  3. Bicarbonate availability for vocal fold epithelial defense to acidic challenge.

    PubMed

    Durkes, Abigail; Sivasankar, M Preeti

    2014-01-01

    Bicarbonate is critical for acid-base tissue homeostasis. In this study we investigated the role of bicarbonate ion transport in vocal fold epithelial defense to acid challenges. Acidic insults to the larynx are common in gastric reflux, carcinogenesis and metastasis, and acute inflammation. Ion transport was measured in viable porcine vocal fold epithelium. First, 18 vocal folds were exposed to either the carbonic anhydrase antagonist acetazolamide or to vehicle. Second, 32 vocal folds were exposed to either a control buffer or a bicarbonate-free buffer on their luminal or basolateral surface or both. Third, 32 vocal folds were challenged with acid in the presence of bicarbonate-free or control buffer. The vocal fold transepithelial resistance was greater than 300 Ω*cm(2), suggesting robust barrier integrity. Ion transport did not change after exposure to acetazolamide (p > 0.05). Exposure to bicarbonate-free buffer did not compromise vocal fold ion transport (p > 0.05). Ion transport increased after acid challenge. This increase approached statistical significance and was the greatest for the control buffer and for the bicarbonate-free buffer applied to the basolateral surface. Bicarbonate secretion may contribute to vocal fold defense against acid challenge. Our data offer a potential novel role for bicarbonate as a therapeutic agent to reduce pH abnormalities in the larynx and prevent associated pathological changes.

  4. Bicarbonate Availability for Vocal Fold Epithelial Defense to Acidic Challenge

    PubMed Central

    Durkes, Abigail; Sivasankar, M. Preeti

    2014-01-01

    Objectives Bicarbonate is critical for acid-base tissue homeostasis. In this study we investigated the role of bicarbonate ion transport in vocal fold epithelial defense to acid challenges. Acidic insults to the larynx are common in gastric reflux, carcinogenesis and metastasis, and acute inflammation. Methods Ion transport was measured in viable, porcine vocal fold epithelium. First, 18 vocal folds were exposed to either the carbonic anhydrase antagonist acetazolamide or to vehicle. Second, 32 vocal folds were exposed to either a control buffer or a bicarbonate-free buffer on their luminal or basolateral surface or both. Third, vocal folds were challenged with acid in the presence of bicarbonate-free or control buffer. Results The vocal fold transepithelial resistance was greater than 300 Ω*cm2, suggesting robust barrier integrity. Ion transport did not change after exposure to acetazolamide (p > 0.05). Exposure to bicarbonate-free buffer did not compromise vocal fold ion transport (p > 0.05). Ion transport increased after acid challenge. This increase approached statistical significance and was the greatest for the control buffer and for the bicarbonate-free buffer applied to the basolateral surface. Conclusions Bicarbonate secretion may contribute to vocal fold defense against acid challenge. Our data offer a potential novel role for bicarbonate as a therapeutic agent to reduce pH abnormalities in the larynx and prevent associated pathological changes. PMID:24574427

  5. Arterial Spin Labeling Perfusion Magnetic Resonance Image with Dual Postlabeling Delay: A Correlative Study with Acetazolamide Loading (123)I-Iodoamphetamine Single-Photon Emission Computed Tomography.

    PubMed

    Haga, Sei; Morioka, Takato; Shimogawa, Takafumi; Akiyama, Tomoaki; Murao, Kei; Kanazawa, Yuka; Sayama, Tetsuro; Arakawa, Shuji

    2016-01-01

    Perfusion magnetic resonance image with arterial spin labeling (ASL) provides a completely noninvasive measurement of cerebral blood flow (CBF). However, arterial transient times can have a marked effect on the ASL signal. For example, a single postlabeling delay (PLD) of 1.5 seconds underestimates the slowly streaming collateral pathways that maintain the cerebrovascular reserve (CVR). To overcome this limitation, we developed a dual PLD method. A dual PLD method of 1.5  and 2.5 seconds was compared with (123)I-iodoamphetamine single-photon emission computed tomography with acetazolamide loading to assess CVR in 10 patients with steno-occlusive cerebrovascular disease. In 5 cases (Group A), dual PLD-ASL demonstrated low CBF with 1.5-second PLD in the target area, whereas CBF was improved with 2.5-second PLD. In the other 5 cases (Group B), dual PLD-ASL depicted low CBF with 1.5-second PLD, and no improvement in CBF with 2.5-second PLD in the target area was observed. On single-photon emission computed tomography, CVR was maintained in Group A but decreased in Group B. Although dual PLD methods may not be a completely alternative test for (123)I-iodoamphetamine single-photon emission computed tomography with acetazolamide loading, it is a feasible, simple, noninvasive, and repeatable technique for assessing CVR, even when employed in a routine clinical setting. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Acetazolamide-induced vasodilation does not inhibit the visually evoked flow response

    PubMed Central

    Yonai, Yaniv; Boms, Neta; Molnar, Sandor; Rosengarten, Bernhard; Bornstein, Natan M; Csiba, Laszlo; Olah, Laszlo

    2010-01-01

    Different methods are used to assess the vasodilator ability of cerebral blood vessels; however, the exact mechanism of cerebral vasodilation, induced by different stimuli, is not entirely known. Our aim was to investigate whether the potent vasodilator agent, acetazolamide (AZ), inhibits the neurovascular coupling, which also requires vasodilation. Therefore, visually evoked flow parameters were examined by transcranial Doppler in ten healthy subjects before and after AZ administration. Pulsatility index and peak systolic flow velocity changes, evoked by visual stimulus, were recorded in the posterior cerebral arteries before and after intravenous administration of 15 mg/kg AZ. Repeated-measures ANOVA did not show significant group main effect between the visually evoked relative flow velocity time courses before and after AZ provocation (P=0.43). Visual stimulation induced significant increase of relative flow velocity and decrease of pulsatility index not only before but also at the maximal effect of AZ. These results suggest that maximal cerebral vasodilation cannot be determined by the clinically accepted dose of AZ (15 mg/kg) and prove that neurovascular coupling remains preserved despite AZ-induced vasodilation. Our observation indicates independent regulation of vasodilation during neurovascular coupling, allowing the adaptation of cerebral blood flow according to neuronal activity even if other processes require significant vasodilation. PMID:19809468

  7. Effects of acetazolamide on the micro- and macro-vascular cerebral hemodynamics: a diffuse optical and transcranial doppler ultrasound study

    PubMed Central

    Zirak, Peyman; Delgado-Mederos, Raquel; Martí-Fàbregas, Joan; Durduran, Turgut

    2010-01-01

    Acetazolamide (ACZ) was used to stimulate the cerebral vasculature on ten healthy volunteers to assess the cerebral vasomotor reactivity (CVR). We have combined near infrared spectroscopy (NIRS), diffuse correlation spectroscopy (DCS) and transcranial Doppler (TCD) technologies to non-invasively assess CVR in real-time by measuring oxy- and deoxy-hemoglobin concentrations, using NIRS, local cerebral blood flow (CBF), using DCS, and blood flow velocity (CBFV) in the middle cerebral artery, using TCD. Robust and persistent increases in oxy-hemoglobin concentration, CBF and CBFV were observed. A significant agreement was found between macro-vascular (TCD) and micro-vascular (DCS) hemodynamics, between the NIRS and TCD data, and also within NIRS and DCS results. The relative cerebral metabolic rate of oxygen, rCMRO2, was also determined, and no significant change was observed. Our results showed that the combined diffuse optics-ultrasound technique is viable to follow (CVR) and rCMRO2 changes in adults, continuously, at the bed-side and in real time. PMID:21258561

  8. Effects of acetazolamide on the micro- and macro-vascular cerebral hemodynamics: a diffuse optical and transcranial doppler ultrasound study.

    PubMed

    Zirak, Peyman; Delgado-Mederos, Raquel; Martí-Fàbregas, Joan; Durduran, Turgut

    2010-11-19

    Acetazolamide (ACZ) was used to stimulate the cerebral vasculature on ten healthy volunteers to assess the cerebral vasomotor reactivity (CVR). We have combined near infrared spectroscopy (NIRS), diffuse correlation spectroscopy (DCS) and transcranial Doppler (TCD) technologies to non-invasively assess CVR in real-time by measuring oxy- and deoxy-hemoglobin concentrations, using NIRS, local cerebral blood flow (CBF), using DCS, and blood flow velocity (CBFV) in the middle cerebral artery, using TCD. Robust and persistent increases in oxy-hemoglobin concentration, CBF and CBFV were observed. A significant agreement was found between macro-vascular (TCD) and micro-vascular (DCS) hemodynamics, between the NIRS and TCD data, and also within NIRS and DCS results. The relative cerebral metabolic rate of oxygen, rCMRO(2), was also determined, and no significant change was observed. Our results showed that the combined diffuse optics-ultrasound technique is viable to follow (CVR) and rCMRO(2) changes in adults, continuously, at the bed-side and in real time.

  9. The effect of acetazolamide on different ocular vascular beds.

    PubMed

    Haustein, Michael; Spoerl, Eberhard; Boehm, Andreas G

    2013-05-01

    To assess the effect of acetazolamide (AZ) on different ocular vascular beds. In a prospective study, 32 healthy volunteers (16 male, 16 female) with a mean age of 23.9 ± 3.3 years (20-39 years) were included. Before and after intravenous administration of 1,000 mg AZ (single dose), ocular microcirculation parameters were measured every 20 min for 2 h. Retinal vessel diameters (VD) were measured by the retina vessel analyzer, blood flow (BF) in the neuroretinal rim by the laser doppler flowmeter according to Riva, and the parapapillary retinal BF by the scanning laser Doppler flowmeter. Additionally, the Langham ocular blood flow system was used to determine the ocular pulse amplitude (OPA) and the pulsatile ocular blood flow (pOBF). The measurements were correlated with systemic blood pressure (BP), ocular perfusion pressure (OPP), capillary base excess parameters and serum AZ levels. Arterial and venous VD were significantly increased by about 4-5% each. Papillary BF increased significantly about 40%. Parapapillary retinal flow dropped significantly about 19% (120 min). OPA and pOBF showed no statistically significant changes. BP showed no significant changes, and OPP was significantly increased. There were no correlations with pH or systemic perfusion parameters. AZ leads to a dilatation of retinal VD, to an increase of BF in the optic nerve head, and to a decrease of parapapillary retinal BF. The different BF changes in different vascular beds might be due to different regulatory mechanisms, steal effects, or different distributions of the carbonic anhydrase.

  10. [Acute confusional syndrome associated with obstructive sleep apnea aggravated by acidosis secondary to oral acetazolamide treatment].

    PubMed

    Miguel, E; Güell, R; Antón, A; Montiel, J A; Mayos, M

    2004-06-01

    Acute confusional syndrome, or delirium, is a transitory mental state characterized by the fluctuating alteration of awareness and attention levels. We present the case of a patient with acute confusional syndrome associated with obstructive sleep apnea syndrome (OSAS) aggravated by metabolic acidosis induced by oral acetazolamide treatment.A 70-year-old man with no history of neurological disease was referred with a clinical picture consistent with acute confusional syndrome presenting between midnight and dawn. During the admission examination infectious, toxic, and neurologic causes, or those related to metabolic or heart disease were ruled out. Arterial blood gases measured during one of the nighttime episodes of acute confusional syndrome showed mild hypoxia and hypercapnia with mixed acidosis. Signs and symptoms suggestive of OSAS had been developing over the months prior to admission, with snoring, sleep apnea, and moderate daytime drowsiness. Polysomnography demonstrated severe OSAS with an apnea-hypopnea index of 38. Mean arterial oxygen saturation was 83%; time oxygen saturation remained below 90% was 44%. The attending physician ordered the withdrawal of oral acetazolamide, which was considered the cause of the metabolic component of acidosis. Treatment with continuous positive airway pressure was initiated at 9 cm H2O, after a titration polysomnographic study. The patient continued to improve.OSAS, for which very effective treatment is available, should be included among diseases that may trigger acute confusional syndrome.

  11. Effect of acetazolamide and autoCPAP therapy on breathing disturbances among patients with obstructive sleep apnea syndrome who travel to altitude: a randomized controlled trial.

    PubMed

    Latshang, Tsogyal D; Nussbaumer-Ochsner, Yvonne; Henn, Rahel M; Ulrich, Silvia; Lo Cascio, Christian M; Ledergerber, Bruno; Kohler, Malcolm; Bloch, Konrad E

    2012-12-12

    Many patients with obstructive sleep apnea syndrome (OSA) living near sea level travel to altitude, but this may expose them to hypoxemia and exacerbation of sleep apnea. The treatment in this setting is not established. To evaluate whether acetazolamide and autoadjusted continuous positive airway pressure (autoCPAP) control breathing disturbances in OSA patients at altitude. Randomized, placebo-controlled, double-blind, crossover trial involving 51 patients with OSA living below an altitude of 800 m and receiving CPAP therapy who underwent studies at a university hospital at 490 m and resorts in Swiss mountain villages at 1630 m and 2590 m in summer 2009. Patients were studied during 2 sojourns of 3 days each in mountain villages, 2 days at 1630 m, 1 day at 2590 m, separated by a 2-week washout period at less than 800 m. At altitude, patients either took acetazolamide (750 mg/d) or placebo in addition to autoCPAP. Primary outcomes were nocturnal oxygen saturation and the apnea/hypopnea index; secondary outcomes were sleep structure, vigilance, symptoms, adverse effects, and exercise performance. Acetazolamide and autoCPAP treatment was associated with higher nocturnal oxygen saturation at 1630 m and 2590 m than placebo and autoCPAP: medians, 94% (interquartile range [IQR], 93%-95%) and 91% (IQR, 90%-92%) vs 93% (IQR, 92%-94%) and 89% (IQR, 87%-91%), respectively. Median increases were 1.0% (95% CI, 0.3%-1.0%) and 2.0% (95% CI, 2.0%-2.0). Median night-time spent with oxygen saturation less than 90% at 2590 m was 13% (IQR, 2%-38%) vs 57% (IQR, 28%-82%; P < .001). Acetazolamide and autoCPAP resulted in better control of sleep apnea at 1630 m and 2590 m than placebo and autoCPAP: median apnea/hypopnea index was 5.8 events per hour (5.8/h) (IQR, 3.0/h-10.1/h) and 6.8/h (IQR, 3.5/h-10.1/h) vs 10.7/h (IQR, 5.1/h-17.7/h) and 19.3/h (IQR, 9.3/h-29.0/h), respectively; median reduction was 3.2/h (95% CI, 1.3/h-7.5/h) and 9.2 (95% CI, 5.1/h-14.6/h). Among patients with OSA

  12. Paradoxical reduction of cerebral blood flow after acetazolamide loading: a hemodynamic and metabolic study with (15)O PET.

    PubMed

    Watabe, Tadashi; Shimosegawa, Eku; Kato, Hiroki; Isohashi, Kayako; Ishibashi, Mana; Tatsumi, Mitsuaki; Kitagawa, Kazuo; Fujinaka, Toshiyuki; Yoshimine, Toshiki; Hatazawa, Jun

    2014-10-01

    Paradoxical reduction of cerebral blood flow (CBF) after administration of the vasodilator acetazolamide is the most severe stage of cerebrovascular reactivity failure and is often associated with an increased oxygen extraction fraction (OEF). In this study, we aimed to reveal the mechanism underlying this phenomenon by focusing on the ratio of CBF to cerebral blood volume (CBV) as a marker of regional cerebral perfusion pressure (CPP). In 37 patients with unilateral internal carotid or middle cerebral arterial (MCA) steno-occlusive disease and 8 normal controls, the baseline CBF (CBF(b)), CBV, OEF, cerebral oxygen metabolic rate (CMRO2), and CBF after acetazolamide loading in the anterior and posterior MCA territories were measured by (15)O positron emission tomography. Paradoxical CBF reduction was found in 28 of 74 regions (18 of 37 patients) in the ipsilateral hemisphere. High CBF(b) (> 47.6 mL/100 mL/min, n = 7) was associated with normal CBF(b)/CBV, increased CBV, decreased OEF, and normal CMRO2. Low CBF(b) (< 31.8 mL/100 mL/min, n = 9) was associated with decreased CBF(b)/CBV, increased CBV, increased OEF, and decreased CMRO2. These findings demonstrated that paradoxical CBF reduction is not always associated with reduction of CPP, but partly includes high-CBF(b) regions with normal CPP, which has not been described in previous studies.

  13. Short-term intraocular pressure trends following intravitreal ranibizumab injections for neovascular age-related macular degeneration-the role of oral acetazolamide in protecting glaucoma patients.

    PubMed

    Murray, C D; Wood, D; Allgar, V; Walters, G; Gale, R P

    2014-10-01

    To determine the effect of oral acetazolamide on lowering the peak and duration of intraocular pressure (IOP) rise in glaucoma and glaucoma suspect patients, following intravitreal injection of ranibizumab for neovascular age-related macular degeneration. The study was an open-label, parallel, randomised, controlled trial (EudraCT Number: 2010-023037-35). Twenty-four glaucoma or glaucoma suspect patients received either 500 mg acetazolamide or no treatment 60-90 min before 0.5 mg ranibizumab. The primary outcome measure was the difference in IOP immediately after injection (T0) and 5, 10, and 30 min following injection. ANCOVA was used to compare groups, adjusting for baseline IOP. The study was powered to detect a 9-mm Hg difference at T0. The IOP at T0 was 2.3 mm Hg higher in the non-treated group (mean 44.5 mm Hg, range (19-86 mm Hg)) compared with the treated group (mean 42.2 mm Hg, range (25-58 mm Hg)), but was not statistically significant after adjusting for baseline IOP (P=0.440). At 30 min, IOP was 4.9 mm Hg higher in the non-treated group (mean 20.6 mm Hg, range (11-46 mm Hg)) compared with the treated group (mean 15.7 mm Hg, range (8-21 mm Hg)). This was statistically significant after adjusting for baseline IOP (P=0.013). Although the primary end points were not reached, 500 mg oral acetazolamide, 60-90 min before intravitreal injection, results in a statistically significant reduction in IOP at 3O min post injection. Prophylactic treatment may be considered as an option to minimise neuro-retinal rim damage in high-risk glaucoma patients who are most vulnerable to IOP spikes and undergoing repeated intravitreal injections of ranibizumab.

  14. Microwave assisted synthesis of novel acridine-acetazolamide conjugates and investigation of their inhibition effects on human carbonic anhydrase isoforms hCA I, II, IV and VII.

    PubMed

    Ulus, Ramazan; Aday, Burak; Tanç, Muhammet; Supuran, Claudiu T; Kaya, Muharrem

    2016-08-15

    4-Amino-N-(5-sulfamoyl-1,3,4-thiadiazol-2-yl)benzamide was condensed with cyclic-1,3-diketones (dimedone and cyclohexane-1,3-dione) and aromatic aldehydes under microwave irradiation, leading to a series of acridine-acetazolamide conjugates. The new compounds were investigated as inhibitors of carbonic anhydrases (CA, EC 4.2.1.1), and more precisely cytosolic isoforms hCA I, II, VII and membrane-bound one hCA IV. All investigated isoforms were inhibited in low micromolar and nanomolar range by the new compounds. hCA IV and VII were inhibited with KIs in the range of 29.7-708.8nM (hCA IV), and of 1.3-90.7nM (hCA VII). For hCA I and II the KIs were in the range of 6.7-335.2nM (hCA I) and of 0.5-55.4nM (hCA II). The structure-activity relationships (SAR) for the inhibition of these isoforms with the acridine-acetazolamide conjugates reported here were delineated. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Proficiency in science: assessment challenges and opportunities.

    PubMed

    Pellegrino, James W

    2013-04-19

    Proficiency in science is being defined through performance expectations that intertwine science practices, cross-cutting concepts, and core content knowledge. These descriptions of what it means to know and do science pose challenges for assessment design and use, whether at the classroom instructional level or the system level for monitoring the progress of science education. There are systematic ways to approach assessment development that can address design challenges, as well as examples of the application of such principles in science assessment. This Review considers challenges and opportunities that exist for design and use of assessments that can support science teaching and learning consistent with a contemporary view of what it means to be proficient in science.

  16. Challenges and perspectives of nanoparticle exposure assessment.

    PubMed

    Lee, Ji Hyun; Moon, Min Chaul; Lee, Joon Yeob; Yu, Il Je

    2010-06-01

    Nanoparticle exposure assessment presents a unique challenge in the field of occupational and environmental health. With the commercialization of nanotechnology, exposure usually starts from the workplace and then spreads to environment and consumer exposure. This report discusses the current trends of nanoparticle exposure assessment, including the definition of nanotechnology relevant terms, essential physicochemical properties for nanomaterial characterization, current international activities related nanomaterial safety, and exposure assessment standard development for nanotechnology. Further this report describes challenges of nanoparticle exposure assessment such as background measurement, metrics of nanoparticle exposure assessment and personal sampling.

  17. The Challenges of Assessing Media Literacy Education

    ERIC Educational Resources Information Center

    Schilder, Evelien; Lockee, Barbara; Saxon, D. Patrick

    2016-01-01

    In the media literacy literature, the challenges associated with assessment have, to a great extent, been ignored. The purpose of this mixed methods study was therefore to explore the views of media literacy scholars and professionals on assessment challenges through qualitative interviews (n = 10) with the intent of using this information to…

  18. Effects of sympathetic stimulation on cerebral and ocular blood flow. Modification by hypertension, hypercapnia, acetazolamide, PGI2 and papaverine.

    PubMed

    Beausang-Linder, M

    1982-02-01

    The effect of unilateral, electrical stimulation of the cervical sympathetic chain in rabbits anesthetized with pentobarbital sodium and vasodilated by hypercapnia, acetazolamide, papaverine or PGI2 was investigated to determine to what extent the sympathetic nerves to the brain and the eye cause vasoconstriction and prevent overperfusion in previously vasodilated animals. Evans blue was given as a tracer for protein leakage. Blood flow determinations were made with the labelled microsphere method during normotension and acute arterial hypertension. Hypertension was induced by ligation of the thoracic aorta and in some animals metaraminol or angiotensin was also used. Acetazolamide caused a two to threefold increase in cerebral blood flow (CBF) and hypercapnia resulted in a fivefold increase. CBF was not markedly affected by papaverine or PGI2. In the choroid plexus, the ciliary body and choroid, papaverine and hypercapnia caused significant blood flow increases on the control side. Sympathetic stimulation induced a 12% blood flow reduction in the brain in normotensive, hypercapnic animals. Marked effects of sympathetic stimulation at normotension were obtained under all conditions in the eye. In the hypertensive state the CBF reduction during sympathetic stimulation was moderate, but highly significant in hypercapnic or papaverine-treated animals as well as in controls. Leakage of Evans blue was more frequently seen on the nonstimulated side of the brain. In the eye there was leakage only on the control side except in PGI2-treated animals where 2 rabbits had bilateral leakage. The effect of sympathetic stimulation on the blood flow in the cerebrum and cerebellum in vasodilated animals seems to be small or absent if the blood pressure is normal. In the eye pronounced vasoconstriction occurs under these conditions. In acute arterial hypertension sympathetic stimulation protects both the cerebral and ocular barriers even under conditions of marked vasodilation.

  19. Current Challenges in Neurotoxicity Risk Assessment ...

    EPA Pesticide Factsheets

    Neurotoxicity risk assessment must continue to evolve in parallel with advances in basic research. Along with this evolution is an expansion in the scope of neurotoxicity assessments of environmental health risks. Examples of this expansion include an increasing emphasis on complex animal models that better replicate human behavior and a wider array of molecular and mechanistic data relevant to interpreting the underlying cause(s) of toxicity. However, modern neurotoxicology studies are often more nuanced and complicated than traditional studies, and they often vary considerably in evaluation methods from one study to the next, impeding comparisons. This can pose particular difficulties for risk assessors, especially given the recent demand for chemical risk assessments to be more systematic and transparent. This presentation will introduce and provide some examples of specific challenges in neurotoxicity assessments of environmental chemicals. Some of these challenges are relatively new to the field, such as the incorporation of data on neuron-supportive glial cells into hazard characterization, while other challenges have persisted for several decades, but only recently are studies being designed to evaluate them, including analyses of latent neurotoxicity. The examples provided illustrate some future research areas of interest for scientists and risk assessors examining human neurotoxicity risk. This abstract will be presented to internal U.S. Food and Drug A

  20. Stability of Acetazolamide, Baclofen, Dipyridamole, Mebeverine Hydrochloride, Propylthiouracil, Quinidine Sulfate, and Topiramate Oral Suspensions in SyrSpend SF PH4.

    PubMed

    Ferreira, Anderson de Oliveira; Polonini, Hudson; da Silva, Sharlene Loures; Aglio, Natália Cristina Buzinari; Abreu, Jordana; Fernandes, Brandão Marcos Antônio

    2017-01-01

    The objective of this study was to evaluate the stability of 7 commonly used active pharmaceutical ingredients compounded in oral suspensions using an internationally used suspending vehicle (SyrSpend SF PH4): acetazolamide 25.0 mg/mL, baclofen 10.0 mg/mL, dipyridamole 10.0 mg/mL, mebeverine hydrochloride 10.0 mg/mL, propylthiouracil 5.0 mg/mL, quinidine sulfate 10.0 mg/mL, and topiramate 5.0 mg/mL. All suspensions were stored both at controlled refrigerated (2°C to 8°C) and room temperature (20°C to 25°C). Stability was assessed by measuring the percentage recovery at varying time points throughout a 90-day period. Active pharmaceutical ingredient quantification was performed by ultraviolet (UV) high-performance liquid chromatography, via a stability-indicating method. Given the percentage of recovery of the active pharmaceutical ingredients within the suspensions, the beyond-use date of the final products (active pharmaceutical ingredient + vehicle) was at least 90 days for all suspensions with regards to both temperatures. This suggests that SyrSpend SF PH4 is suitable for compounding active pharmaceutical ingredients from different pharmacological classes. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  1. Neutron diffraction of acetazolamide-bound human carbonic anhydrase II reveals atomic details of drug binding

    PubMed Central

    Fisher, S. Zoë; Aggarwal, Mayank; Kovalevsky, Andrey Y.; Silverman, David N.; McKenna, Robert

    2012-01-01

    Carbonic anhydrases (CAs) catalyze the hydration of CO2 forming HCO3− and a proton, an important reaction for many physiological processes including respiration, fluid secretion, and pH regulation. As such, CA isoforms are prominent clinical targets for treating various diseases. The clinically used acetazolamide (AZM) is a sulfonamide that binds with high affinity to human CA isoform II (HCA II). There are several X-ray structures available of AZM bound to various CA isoforms, but these complexes do not show the charged state of AZM, or hydrogen (H) atom positions of the protein and solvent. Neutron diffraction is a useful technique for directly observing H atoms and the mapping of H-bonding networks that can greatly contribute to rational drug design. To this end the neutron structure of H/D exchanged HCA II crystals in complex with AZM was determined. The structure reveals the molecular details of AZM binding and the charged state of the bound drug. This represents the first determined neutron structure of a clinically used drug bound to its target. PMID:22928733

  2. Health technology assessment in Iran: challenges and views

    PubMed Central

    Olyaeemanesh, Alireza; Doaee, Shila; Mobinizadeh, Mohammadreza; Nedjati, Mina; Aboee, Parisa; Emami-Razavi, Seyed Hassan

    2014-01-01

    Background: Various decisions have been made on technology application at all levels of the health system in different countries around the world. Health technology assessment is considered as one of the best scientific tools at the service of policy- makers. This study attempts to investigate the current challenges of Iran’s health technology assessment and provide appropriate strategies to establish and institutionalize this program. Methods: This study was carried out in two independent phases. In the first, electronic databases such as Medline (via Pub Med) and Scientific Information Database (SID) were searched to provide a list of challenges of Iran’s health technology assessment. The views and opinions of the experts and practitioners on HTA challenges were studied through a questionnaire in the second phase which was then analyzed by SPSS Software version 16. This has been an observational and analytical study with a thematic analysis. Results: In the first phase, seven papers were retrieved; from which, twenty- two HTA challenges in Iran were extracted by the researchers; and they were used as the base for designing a structured questionnaire of the second phase. The views of the experts on the challenges of health technology assessment were categorized as follows: organizational culture, stewardship, stakeholders, health system management, infrastructures and external pressures which were mentioned in more than 60% of the cases and were also common in the views. Conclusion: The identification and prioritization of HTA challenges which were approved by those experts involved in the strategic planning of the Department of Health Technology Assessment will be a step forward in the promotion of an evidence- based policy- making and in the production of comprehensive scientific evidence. PMID:25695015

  3. Online Assessment and Measurement: Foundations and Challenges

    ERIC Educational Resources Information Center

    Hricko, Mary; Howell, Scott

    2006-01-01

    Online learning is one of the most important topics in distance learning, but practitioners and researchers have experienced difficulty in defining the process. "Online Assessment and Measurement: Foundations and Challenges" approaches the topic by finding a common ground to properly analyze online assessment and measurement. "Online Assessment…

  4. Formulation design of oral pediatric Acetazolamide suspension: dose uniformity and physico-chemical stability study.

    PubMed

    Santoveña, Ana; Suárez-González, Javier; Martín-Rodríguez, Cristina; Fariña, José B

    2017-03-01

    The formulation of an active pharmaceutical ingredient (API) as oral solution or suspension in pediatrics is a habitual practice, due to the non-existence of many commercialized medicines in pediatric doses. It is also the simplest way to prepare and administer them to this vulnerable population. The design of a formulation that assures the dose and the system stability depends on the physico-chemical properties of the API. In this study, we formulate a class IV API, Acetazolamide (AZM) as suspension for oral administration to pediatric population. The suspension must comply attributes of quality, safety and efficacy for this route of administration. We use simple compounding procedures, as well as fewer pure excipients, as recommended for children. Mass and uniformity content assays and physical and chemical stability studies were performed. To quantify the API an UPLC method was used. We verified the physico-chemical stability of the suspensions and that they passed the mass test of the European Pharmacopeia (EP), but not the dose uniformity test. This reveals that AZM must be formulated as liquid forms with a more complex system of excipients (not usually indicated in pediatrics), or otherwise solid forms capable of assuring uniformity of mass and dose for every dosage unit.

  5. The Challenge Course Experience Questionnaire: A Facilitator's Assessment Tool

    ERIC Educational Resources Information Center

    Schary, David P.; Waldron, Alexis L.

    2017-01-01

    Challenge course programs influence a variety of psychological, social, and educational outcomes. Yet, many challenges exist when measuring challenge course outcomes like logistical constraints and a lack of specific assessment tools. This study piloted and tested an assessment tool designed for facilitators to measure participant outcomes in…

  6. The effects of acetazolamide on arterial pressure variability during REM sleep in the rat.

    PubMed

    Sone, M; Sei, H; Morita, Y; Ogura, T; Sone, S

    1998-01-01

    During rapid eye movement (REM) sleep, the arterial pressure (AP) undergoes large fluctuations in the rat, cat, and other mammals, including humans, and it has been suggested that this effect originates in the forebrain. In addition, acetazolamide (ACTZ), a carbonic anhydrase inhibitor, is known to be effective in the treatment of central sleep apnea or epilepsy. The aim of the present study was to analyze the effects of ACTZ on EEG theta rhythm and AP variability during REM sleep in rats. Treatment consisted of intraperitoneal injection of 5 mg of ACTZ in 0.5 mL of saline (n = 6) or 0.5 mL of vehicle alone (n = 6). We then recorded and analyzed the mean AP (MAP) variations during different sleep phases, using a telemetric system. Our results show: 1) Significant decreases in the coefficient of variation of MAP, in the very-low frequency (0.025 - 0.225 Hz) component of the power spectral density of the AP and in theta frequency in the electroencephalogram, were seen in the ACTZ-treated group during REM sleep compared with controls, whereas no significant difference was found between the two groups in non-REM sleep. There was no significant difference in sleep duration, average MAP, and heart rate between the groups. Our data suggest that ACTZ may act as a stabilizing factor preventing AP fluctuations during REM sleep.

  7. Role of Multimodal Evaluation of Cerebral Hemodynamics in Selecting Patients with Symptomatic Carotid or Middle Cerebral Artery Steno-occlusive Disease for Revascularization

    PubMed Central

    Sharma, Vijay K; Tsivgoulis, Georgios; Ning, Chou; Teoh, Hock L; Bairaktaris, Chrisostomos; Chong, Vincent FH; Ong, Benjamin KC; Chan, Bernard PL; Sinha, Arvind K

    2008-01-01

    Background: The circle of Willis provides collateral pathways to perfuse the affected vascular territories in patients with severe stenoocclusive disease of major arteries. The collateral perfusion may become insufficient in certain physiological circumstances due to failed vasodilatory reserve and intracranial steal phenomenon, so-called ‘Reversed-Robinhood syndrome’. We evaluated cerebral hemodynamics and vasodilatory reserve in patients with symptomatic distal internal carotid (ICA) or middle cerebral artery (MCA) severe steno-occlusive disease. Methods: Diagnostic transcranial Doppler (TCD) and TCD-monitoring with voluntary breath-holding according to a standard scanning protocol were performed in patients with severe ICA or MCA steno-occlusive disease. The steal phenomenon was detected as transient, spontaneous, or vasodilatory stimuli-induced velocity reductions in affected arteries at the time of velocity increase in normal vessels. Patients with exhausted vasomotor reactivity and intracranial steal phenomenon during breath-holding were further evaluated by 99technetiumm-hexamethyl propylene amine oxime single photon emission computed tomography (HMPAO-SPECT) with acetazolamide challenge. Results: Sixteen patients (age 27–74 years, 11 men) fulfilled our TCD criteria for exhausted vasomotor reactivity and intracranial steal phenomenon during the standard vasomotor testing by breath holding. Acetazolamide-challenged HMPAO-SPECT demonstrated significant hypoperfusion in 12 patients in affected arterial territories, suggestive of failed vasodilatory reserve. A breath-holding index of ≤0.3 on TCD was associated with an abnormal HMPAO-SPECT with acetazolamide challenge. TCD findings of a breath holding index of ≤0.3 and intracranial steal during the procedure were determinants of a significant abnormality on HMPAO-SPECT with acetazolamide challenge. Conclusion: Multimodal evaluation of cerebral hemodynamics in symptomatic patients with severe steno

  8. Ventilatory oscillations at exercise: effects of hyperoxia, hypercapnia, and acetazolamide.

    PubMed

    Hermand, Eric; Lhuissier, François J; Larribaut, Julie; Pichon, Aurélien; Richalet, Jean-Paul

    2015-06-01

    Periodic breathing has been found in patients with heart failure and sleep apneas, and in healthy subjects in hypoxia, during sleep and wakefulness, at rest and, recently, at exercise. To unravel the cardiorespiratory parameters liable to modulate the amplitude and period of ventilatory oscillations, 26 healthy subjects were tested under physiological (exercise) and environmental (hypoxia, hyperoxia, hyperoxic hypercapnia) stresses, and under acetazolamide (ACZ) treatment. A fast Fourier transform spectral analysis of breath-by-breath ventilation (V˙E) evidenced an increase in V˙E peak power under hypercapnia (vs. normoxia and hyperoxia, P < 0.001) and a decrease under ACZ (vs. placebo, P < 0.001), whereas it was not modified in hyperoxia. V˙E period was shortened by exercise in all conditions (vs. rest, P < 0.01) and by hypercapnia (vs. normoxia, P < 0.05) but remained unchanged under ACZ (vs. placebo). V˙E peak power was positively related to cardiac output (Q˙c) and V˙E in hyperoxia (P < 0.01), in hypercapnia (P < 0.001) and under ACZ (P < 0.001). V˙E period was negatively related to Q˙c and V˙E in hyperoxia (P < 0.01 and P < 0.001, respectively), in hypercapnia (P < 0.05 and P < 0.01, respectively) and under ACZ (P < 0.05 and P < 0.01, respectively). Total respiratory cycle time was the main factor responsible for changes in V˙E period. In conclusion, exercise, hypoxia, and hypercapnia increase ventilatory oscillations by increasing Q˙c and V˙E, whereas ACZ decreases ventilatory instability in part by a contrasting action on O2 and CO2 sensing. An intrinsic oscillator might modulate ventilation through a complex system where peripheral chemoreflex would play a key role. © 2015 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  9. A Perkins Challenge: Assessing Technical Skills in CTE

    ERIC Educational Resources Information Center

    Stone, James R., III

    2009-01-01

    Federal law requires state to develop performance measures and data-collection systems for secondary and postsecondary technical-skill attainment. This poses many challenges, such as defining a technical skills, measurement and when to assess students. In this article, the author outlines various assessment models and looks at the challenges…

  10. Assessing species saturation: conceptual and methodological challenges.

    PubMed

    Olivares, Ingrid; Karger, Dirk N; Kessler, Michael

    2018-05-07

    Is there a maximum number of species that can coexist? Intuitively, we assume an upper limit to the number of species in a given assemblage, or that a lineage can produce, but defining and testing this limit has proven problematic. Herein, we first outline seven general challenges of studies on species saturation, most of which are independent of the actual method used to assess saturation. Among these are the challenge of defining saturation conceptually and operationally, the importance of setting an appropriate referential system, and the need to discriminate among patterns, processes and mechanisms. Second, we list and discuss the methodological approaches that have been used to study species saturation. These approaches vary in time and spatial scales, and in the variables and assumptions needed to assess saturation. We argue that assessing species saturation is possible, but that many studies conducted to date have conceptual and methodological flaws that prevent us from currently attaining a good idea of the occurrence of species saturation. © 2018 Cambridge Philosophical Society.

  11. The challenges and opportunities in cumulative effects assessment

    USGS Publications Warehouse

    Foley, Melissa M.; Mease, Lindley A; Martone, Rebecca G; Prahler, Erin E; Morrison, Tiffany H; Clarke Murray, Cathryn; Wojcik, Deborah

    2016-01-01

    The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmental assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.

  12. The challenges and opportunities in cumulative effects assessment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Foley, Melissa M., E-mail: mfoley@usgs.gov; Center for Ocean Solutions, Stanford University, 99 Pacific St., Monterey, CA 93940; Mease, Lindley A., E-mail: lamease@stanford.edu

    The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmentalmore » assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.« less

  13. A Direct Assessment of “Obesogenic” Built Environments: Challenges and Recommendations

    PubMed Central

    Gasevic, Danijela; Vukmirovich, Ina; Yusuf, Salim; Teo, Koon; Chow, Clara; Dagenais, Gilles; Lear, Scott A.

    2011-01-01

    This paper outlines the challenges faced during direct built environment (BE) assessments of 42 Canadian communities of various income and urbanization levels. In addition, we recommend options for overcoming such challenges during BE community assessments. Direct BE assessments were performed utilizing two distinct audit methods: (1) modified version of Irvine-Minnesota Inventory in which a paper version of an audit tool was used to assess BE features and (2) a Physical Activity and Nutrition Features audit tool, where the presence and positions of all environmental features of interest were recorded using a Global-Positioning-System (GPS) unit. This paper responds to the call for the need of creators and users of environmental audit tools to share experiences regarding the usability of tools for BE assessments. The outlined BE assessment challenges plus recommendations for overcoming them can help improve and refine the existing audit tools and aid researchers in future assessments of the BE. PMID:22174727

  14. Effect of acetazolamide on post-NIV metabolic alkalosis in acute exacerbated COPD patients.

    PubMed

    Fontana, V; Santinelli, S; Internullo, M; Marinelli, P; Sardo, L; Alessandrini, G; Borgognoni, L; Ferrazza, A M; Bonini, M; Palange, P

    2016-01-01

    Non-invasive ventilation (NIV) is an effective treatment in patients with acute exacerbation of COPD (AECOPD). However, it may induce post-hypercapnic metabolic alkalosis (MA). This study aims to evaluate the effect of acetazolamide (ACET) in AECOPD patients treated with NIV. Eleven AECOPD patients, with hypercapnic respiratory failure and MA following NIV, were treated with ACET 500 mg for two consecutive days and compared to a matched control group. Patients and controls were non invasively ventilated in a bilevel positive airway pressure (BiPAP) mode to a standard maximal pressure target of 15-20 cmH2O. ACET intra-group analysis showed a significant improvement for PaCO2 (63.9 ± 9.8 vs. 54.9 ± 8.3 mmHg), HCO3- (43.5 ± 5.9 vs. 36.1 ± 5.4 mmol/L) and both arterial pH (7.46 ± 0.06 vs. 7.41 ± 0.06) and urinary pH (6.94 ± 0.77 vs 5.80 ± 0.82), already at day 1. No significant changes in endpoints considered were observed in the control group at any time-point. Inter-group analysis showed significant differences between changes in PaCO2 and HCO3- (delta), both at day 1 and 2. Furthermore, the length of NIV treatment was significantly reduced in the ACET group compared to controls (6 ± 8 vs. 19 ± 19 days). No adverse events were recorded in the ACET and control groups. ACET appears to be effective and safe in AECOPD patients with post-NIV MA.

  15. Assessment of the Marine Transportation System (MTS) challenges : summary report

    DOT National Transportation Integrated Search

    2009-12-23

    The Volpe Center Report on the Assessment of the Marine Transportation System (MTS) : Challenges has been prepared in support of the Committee on MTS (CMTS) mission to : address critical MTS challenges through collaborative interagency efforts. The C...

  16. Challenges of Big Data in Educational Assessment

    ERIC Educational Resources Information Center

    Gibson, David C.; Webb, Mary; Ifenthaler, Dirk

    2015-01-01

    This paper briefly discusses four measurement challenges of data science or "big data" in educational assessments that are enabled by technology: 1. Dealing with change over time via time-based data. 2. How a digital performance space's relationships interact with learner actions, communications and products. 3. How layers of…

  17. Assessing nanoparticle risk poses prodigious challenges.

    PubMed

    MacPhail, Robert C; Grulke, Eric A; Yokel, Robert A

    2013-01-01

    Risk assessment is used both formally and informally to estimate the likelihood of an adverse event occurring, for example, as a consequence of exposure to a hazardous chemical, drug, or other agent. Formal risk assessments in government regulatory agencies have a long history of practice. The precision with which risk can be estimated is inevitably constrained, however, by uncertainties arising from the lack of pertinent data. Developing accurate risk assessments for nanoparticles and nanoparticle-containing products may present further challenges because of the unique properties of the particles, uncertainties about their composition and the populations exposed to them, and how these may change throughout the particle's life cycle. This review introduces the evolving practice of risk assessment followed by some of the uncertainties that need to be addressed to improve our understanding of nanoparticle risks. Given the clarion call for life-cycle assessments of nanoparticles, an unprecedented degree of national and international coordination between scientific organizations, regulatory agencies, and stakeholders will be required to achieve this goal. Copyright © 2013 Wiley Periodicals, Inc.

  18. Assessment in Open and Distance Learning System (ODL): A Challenge

    ERIC Educational Resources Information Center

    Chaudhary, S. V. S.; Dey, Niradhar

    2013-01-01

    Assessment is an integral part of the learning process. The traditional practice of assessment has changed to meet the need of the contemporary society. In this paper assessment strategies used in Open and Distance Education are discussed and constructive suggestions are given to meet the challenges of assessment. Recently we experience a paradigm…

  19. Challenges and Strategies for Assessing Specialised Knowledge for Teaching

    ERIC Educational Resources Information Center

    Orrill, Chandra Hawley; Kim, Ok-Kyeong; Peters, Susan A.; Lischka, Alyson E.; Jong, Cindy; Sanchez, Wendy B.; Eli, Jennifer A.

    2015-01-01

    Developing and writing assessment items that measure teachers' knowledge is an intricate and complex undertaking. In this paper, we begin with an overview of what is known about measuring teacher knowledge. We then highlight the challenges inherent in creating assessment items that focus specifically on measuring teachers' specialised knowledge…

  20. Rising to the Challenge: Meaningful Assessment of Student Learning

    ERIC Educational Resources Information Center

    Association of Public and Land-grant Universities, 2010

    2010-01-01

    "Rising to the Challenge: Meaningful Assessment of Student Learning" was envisioned in response to a 2007 request for proposals from the U.S. Department of Education's Fund for Improvement of Post Secondary Education (FIPSE). FIPSE called for national, consortial contributions to improving the knowledge and abilities to assess student…

  1. Personality disorder assessment: the challenge of construct validity.

    PubMed

    Clark, L A; Livesley, W J; Morey, L

    1997-01-01

    We begin with a review of the data that challenge the current categorical system for classifying personality disorder, focusing on the central assessment issues of convergent and discriminant validity. These data indicate that while there is room for improvement in assessment, even greater change is needed in conceptualization than in instrumentation. Accordingly, we then refocus the categorical-dimensional debate in assessment terms, and place it in the broader context of such issues as the hierarchical structure of personality, overlap and distinctions between normal and abnormal personality, sources of information in personality disorder assessment, and overlap and discrimination of trait and state assessment. We conclude that more complex conceptual models that can incorporate both biological and environmental influences on the development of adaptive and maladaptive personality are needed.

  2. Psychometric and Evidentiary Advances, Opportunities, and Challenges for Simulation-Based Assessment

    ERIC Educational Resources Information Center

    Levy, Roy

    2013-01-01

    This article characterizes the advances, opportunities, and challenges for psychometrics of simulation-based assessments through a lens that views assessment as evidentiary reasoning. Simulation-based tasks offer the prospect for student experiences that differ from traditional assessment. Such tasks may be used to support evidentiary arguments…

  3. Effectiveness of acetazolamide for reversal of metabolic alkalosis in weaning COPD patients from mechanical ventilation.

    PubMed

    Faisy, Christophe; Mokline, Amel; Sanchez, Olivier; Tadié, Jean-Marc; Fagon, Jean-Yves

    2010-05-01

    To evaluate the effects of a single daily dose of acetazolamide (ACET) on metabolic alkalosis and respiratory parameters in weaning chronic obstructive pulmonary disease (COPD) patients from invasive mechanical ventilation. Case-control study. An 18-bed intensive care unit (ICU) in a university hospital. Twenty-six intubated COPD patients with mixed metabolic alkalosis (serum bicarbonate >26 mmol/l and arterial pH >or=7.38) were compared with a historical control group (n = 26) matched for serum bicarbonate, arterial pH, age, and severity of illness at admission to ICU. ACET administration (500 mg intravenously) was monitored daily according to arterial blood gas analysis from readiness to wean until extubation. ACET was administered 4 (1-11) days throughout the weaning period. Patients with ACET treatment significantly decreased their serum bicarbonate (p = 0.01 versus baseline) and arterial blood pH (p < 0.0001), increased their PaO(2)/FiO(2) ratio (p = 0.04), but did not change their PaCO(2) (p = 0.71). Compared with matched controls, administration of ACET did not improve arterial blood gas and respiratory parameters except PaO(2)/FiO(2) ratio (p = 0.03). ACET patients and their matched controls had similar duration of weaning. Extubation success rate was not significantly different between groups, and causes of reintubation were comparable. ACET used at the dosage of 500 mg per day reduces metabolic alkalosis but has no benefit in terms of improving PaCO(2) or respiratory parameters in weaning COPD patients from mechanical ventilation.

  4. Towards a Rigorous Assessment of Systems Biology Models: The DREAM3 Challenges

    PubMed Central

    Prill, Robert J.; Marbach, Daniel; Saez-Rodriguez, Julio; Sorger, Peter K.; Alexopoulos, Leonidas G.; Xue, Xiaowei; Clarke, Neil D.; Altan-Bonnet, Gregoire; Stolovitzky, Gustavo

    2010-01-01

    Background Systems biology has embraced computational modeling in response to the quantitative nature and increasing scale of contemporary data sets. The onslaught of data is accelerating as molecular profiling technology evolves. The Dialogue for Reverse Engineering Assessments and Methods (DREAM) is a community effort to catalyze discussion about the design, application, and assessment of systems biology models through annual reverse-engineering challenges. Methodology and Principal Findings We describe our assessments of the four challenges associated with the third DREAM conference which came to be known as the DREAM3 challenges: signaling cascade identification, signaling response prediction, gene expression prediction, and the DREAM3 in silico network challenge. The challenges, based on anonymized data sets, tested participants in network inference and prediction of measurements. Forty teams submitted 413 predicted networks and measurement test sets. Overall, a handful of best-performer teams were identified, while a majority of teams made predictions that were equivalent to random. Counterintuitively, combining the predictions of multiple teams (including the weaker teams) can in some cases improve predictive power beyond that of any single method. Conclusions DREAM provides valuable feedback to practitioners of systems biology modeling. Lessons learned from the predictions of the community provide much-needed context for interpreting claims of efficacy of algorithms described in the scientific literature. PMID:20186320

  5. Use of new scientific developments in regulatory risk assessments: challenges and opportunities.

    PubMed

    Tarazona, Jose V

    2013-07-01

    Since the 1990s, science based ecological risk assessments constitute an essential tool for supporting decision making in the regulatory context. Using the European REACH Regulation as example, this article presents the challenges and opportunities for new scientific developments within the area of chemical control and environmental protection. These challenges can be sorted out in 3 main related topics (sets). In the short term, the challenges are directly associated with the regulatory requirements, required for facilitating a scientifically sound implementation of the different obligations for industry and authorities. It is important to mention that although the actual tools are different due to the regulatory requirements, the basic needs are still the same as those addressed in the early 1990s: understanding the ecological relevance of the predicted effects, including the uncertainty, and facilitating the link with the socio-economic assessment. The second set of challenges covers the opportunities for getting an added value from the regulatory efforts. The information compiled through REACH registration and notification processes is analyzed as source for new integrative developments for assessing the combined chemical risk at the regional level. Finally, the article discusses the challenge of inverting the process and developing risk assessment methods focusing on the receptor, the individual or ecosystem, instead of on the stressor or source. These approaches were limited in the past due to the lack of information, but the identification and dissemination of standard information, including uses, manufacturing sites, physical-chemical, environmental, ecotoxicological, and toxicological properties as well as operational conditions and risk management measures for thousands of chemicals, combined by the knowledge gathered through large scale monitoring programs and spatial information systems is generating new opportunities. The challenge is liking

  6. Assessing EDCs in the Field: Challenges and New Approaches

    EPA Science Inventory

    Assessing the occurrence and effects of EDCs in the environment can be challenging from a number of perspectives. For example, conventional analytical approaches and/or toxicity tests may not be appropriate to detecting very potent chemicals that impact specific pathways, and oft...

  7. Regional assessments of stream ecological condition: Scientific challenges associated with the USA's national Wadeable Stream Assessment

    EPA Science Inventory

    In this special issue of J-NABS, we have compiled a series of papers that describe some of the major scientific challenges that were encountered during the national Wadeable Streams Assessment (WSA) and some of the lessons learned subsequent to the assessment. Our goal in produc...

  8. Computer-assisted design and synthesis of molecularly imprinted polymers for selective extraction of acetazolamide from human plasma prior to its voltammetric determination.

    PubMed

    Khodadadian, Mehdi; Ahmadi, Farhad

    2010-06-15

    Molecularly imprinted polymers (MIPs) were computationally designed and synthesized for the selective extraction of a carbonic anhydrase inhibitor, i.e. acetazolamide (ACZ), from human plasma. Density functional theory (DFT) calculations were performed to study the intermolecular interactions in the pre-polymerization mixture and to find a suitable functional monomer in MIP preparation. The interaction energies were corrected for the basis set superposition error (BSSE) using the counterpoise (CP) correction. The polymerization solvent was simulated by means of polarizable continuum model (PCM). It was found that acrylamide (AAM) is the best candidate to prepare MIPs. To confirm the results of theoretical calculations, three MIPs were synthesized with different functional monomers and evaluated using Langmuir-Freundlich (LF) isotherm. The results indicated that the most homogeneous MIP with the highest number of binding sites is the MIP prepared by AAM. This polymer was then used as a selective adsorbent to develop a molecularly imprinted solid-phase extraction procedure followed by differential pulse voltammetry (MISPE-DPV) for clean-up and determination of ACZ in human plasma.

  9. Current developments and challenges in the assessment of negative symptoms.

    PubMed

    Lincoln, Tania M; Dollfus, Sonia; Lyne, John

    2017-08-01

    Reliable and valid assessment of negative symptoms is crucial to further develop etiological models and improve treatments. Our understanding of the concept of negative symptoms has undergone significant advances since the introduction of quantitative assessments of negative symptoms in the 1980s. These include the conceptualization of cognitive dysfunction as separate from negative symptoms and the distinction of two main negative symptom factors (avolition and diminished expression). In this review we provide an overview of existing negative symptom scales, focusing on both observer-rated and self-rated measurement of negative symptoms. We also distinguish between measures that assess negative symptoms as part of a broader assessment of schizophrenia symptoms, those specifically developed for negative symptoms and those that assess specific domains of negative symptoms within and beyond the context of psychotic disorders. We critically discuss strengths and limitations of these measures in the light of some existing challenges, i.e. observed and subjective symptom experiences, the challenge of distinguishing between primary and secondary negative symptoms, and the overlap between negative symptoms and related factors (e.g. personality traits and premorbid functioning). This review is aimed to inform the ongoing development of negative symptom scales. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Peer-Assessment in Higher Education--Twenty-First Century Practices, Challenges and the Way Forward

    ERIC Educational Resources Information Center

    Ashenafi, Michael Mogessie

    2017-01-01

    Peer assessment in higher education has been studied for decades. Despite the substantial amount of research carried out, peer assessment has yet to make significant advances. This review identifies themes of recent research and highlights the challenges that have hampered its advance. Most of these challenges arise from the manual nature of peer…

  11. Faculty and Career Advising: Challenges, Opportunities, and Outcome Assessment

    ERIC Educational Resources Information Center

    Vespia, Kristin M.; Freis, Stephanie D.; Arrowood, Rebecca M.

    2018-01-01

    Psychology prioritizes students' professional or career development by including it as one of the five undergraduate learning goals. Faculty advisors are critical to that development but likely feel less prepared for the role. Departments face challenges assessing associated student learning outcomes. We introduce an instrument programs can use to…

  12. Herbal hepatotoxicity: Challenges and pitfalls of causality assessment methods

    PubMed Central

    Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Eickhoff, Axel

    2013-01-01

    The diagnosis of herbal hepatotoxicity or herb induced liver injury (HILI) represents a particular clinical and regulatory challenge with major pitfalls for the causality evaluation. At the day HILI is suspected in a patient, physicians should start assessing the quality of the used herbal product, optimizing the clinical data for completeness, and applying the Council for International Organizations of Medical Sciences (CIOMS) scale for initial causality assessment. This scale is structured, quantitative, liver specific, and validated for hepatotoxicity cases. Its items provide individual scores, which together yield causality levels of highly probable, probable, possible, unlikely, and excluded. After completion by additional information including raw data, this scale with all items should be reported to regulatory agencies and manufacturers for further evaluation. The CIOMS scale is preferred as tool for assessing causality in hepatotoxicity cases, compared to numerous other causality assessment methods, which are inferior on various grounds. Among these disputed methods are the Maria and Victorino scale, an insufficiently qualified, shortened version of the CIOMS scale, as well as various liver unspecific methods such as the ad hoc causality approach, the Naranjo scale, the World Health Organization (WHO) method, and the Karch and Lasagna method. An expert panel is required for the Drug Induced Liver Injury Network method, the WHO method, and other approaches based on expert opinion, which provide retrospective analyses with a long delay and thereby prevent a timely assessment of the illness in question by the physician. In conclusion, HILI causality assessment is challenging and is best achieved by the liver specific CIOMS scale, avoiding pitfalls commonly observed with other approaches. PMID:23704820

  13. Assessment approaches in massive open online courses: Possibilities, challenges and future directions

    NASA Astrophysics Data System (ADS)

    Xiong, Yao; Suen, Hoi K.

    2018-03-01

    The development of massive open online courses (MOOCs) has launched an era of large-scale interactive participation in education. While massive open enrolment and the advances of learning technology are creating exciting potentials for lifelong learning in formal and informal ways, the implementation of efficient and effective assessment is still problematic. To ensure that genuine learning occurs, both assessments for learning (formative assessments), which evaluate students' current progress, and assessments of learning (summative assessments), which record students' cumulative progress, are needed. Providers' more recent shift towards the granting of certificates and digital badges for course accomplishments also indicates the need for proper, secure and accurate assessment results to ensure accountability. This article examines possible assessment approaches that fit open online education from formative and summative assessment perspectives. The authors discuss the importance of, and challenges to, implementing assessments of MOOC learners' progress for both purposes. Various formative and summative assessment approaches are then identified. The authors examine and analyse their respective advantages and disadvantages. They conclude that peer assessment is quite possibly the only universally applicable approach in massive open online education. They discuss the promises, practical and technical challenges, current developments in and recommendations for implementing peer assessment. They also suggest some possible future research directions.

  14. Fit for high altitude: are hypoxic challenge tests useful?

    PubMed

    Matthys, Heinrich

    2011-02-28

    Altitude travel results in acute variations of barometric pressure, which induce different degrees of hypoxia, changing the gas contents in body tissues and cavities. Non ventilated air containing cavities may induce barotraumas of the lung (pneumothorax), sinuses and middle ear, with pain, vertigo and hearing loss. Commercial air planes keep their cabin pressure at an equivalent altitude of about 2,500 m. This leads to an increased respiratory drive which may also result in symptoms of emotional hyperventilation. In patients with preexisting respiratory pathology due to lung, cardiovascular, pleural, thoracic neuromuscular or obesity-related diseases (i.e. obstructive sleep apnea) an additional hypoxic stress may induce respiratory pump and/or heart failure. Clinical pre-altitude assessment must be disease-specific and it includes spirometry, pulsoximetry, ECG, pulmonary and systemic hypertension assessment. In patients with abnormal values we need, in addition, measurements of hemoglobin, pH, base excess, PaO2, and PaCO2 to evaluate whether O2- and CO2-transport is sufficient.Instead of the hypoxia altitude simulation test (HAST), which is not without danger for patients with respiratory insufficiency, we prefer primarily a hyperoxic challenge. The supplementation of normobaric O2 gives us information on the acute reversibility of the arterial hypoxemia and the reduction of ventilation and pulmonary hypertension, as well as about the efficiency of the additional O2-flow needed during altitude exposure. For difficult judgements the performance of the test in a hypobaric chamber with and without supplemental O2-breathing remains the gold standard. The increasing numbers of drugs to treat acute pulmonary hypertension due to altitude exposure (acetazolamide, dexamethasone, nifedipine, sildenafil) or to other etiologies (anticoagulants, prostanoids, phosphodiesterase-5-inhibitors, endothelin receptor antagonists) including mechanical aids to reduce periodical or

  15. Psychophysiological Assessment in Pilots Performing Challenging Simulated and Real Flight Maneuvers.

    PubMed

    Johannes, Bernd; Rothe, Stefanie; Gens, André; Westphal, Soeren; Birkenfeld, Katja; Mulder, Edwin; Rittweger, Jörn; Ledderhos, Carla

    2017-09-01

    The objective assessment of psychophysiological arousal during challenging flight maneuvers is of great interest to aerospace medicine, but remains a challenging task. In the study presented here, a vector-methodological approach was used which integrates different psychophysiological variables, yielding an integral arousal index called the Psychophysiological Arousal Value (PAV). The arousal levels of 15 male pilots were assessed during predetermined, well-defined flight maneuvers performed under simulated and real flight conditions. The physiological data, as expected, revealed inter- and intra-individual differences for the various measurement conditions. As indicated by the PAV, air-to-air refueling (AAR) turned out to be the most challenging task. In general, arousal levels were comparable between simulator and real flight conditions. However, a distinct difference was observed when the pilots were divided by instructors into two groups based on their proficiency in AAR with AWACS (AAR-Novices vs. AAR-Professionals). AAR-Novices had on average more than 2000 flight hours on other aircrafts. They showed higher arousal reactions to AAR in real flight (contact: PAV score 8.4 ± 0.37) than under simulator conditions (7.1 ± 0.30), whereas AAR-Professionals did not (8.5 ± 0.46 vs. 8.8 ± 0.80). The psychophysiological arousal value assessment was tested in field measurements, yielding quantifiable arousal differences between proficiency groups of pilots during simulated and real flight conditions. The method used in this study allows an evaluation of the psychophysiological cost during a certain flying performance and thus is possibly a valuable tool for objectively evaluating the actual skill status of pilots.Johannes B, Rothe S, Gens A, Westphal S, Birkenfeld K, Mulder E, Rittweger J, Ledderhos C. Psychophysiological assessment in pilots performing challenging simulated and real flight maneuvers. Aerosp Med Hum Perform. 2017; 88(9):834-840.

  16. Regulatory forum opinion piece*: immunotoxicology assessments in nonhuman primates--challenges and opportunities.

    PubMed

    Lebrec, Hervé N

    2013-01-01

    The immune system has been recognized for decades as a potential "target organ" of toxicity. Immune system activation can result in cytokine release resulting in severe systemic toxicity. Immunosuppression can result in impaired host defense and an increase in opportunistic infection, reemergence of latent infection, poor responses to vaccination, or increased risk of certain cancers. Several regulatory documents have addressed various aspects of immunotoxicity assessments. Nonhuman primates (NHPs) and in particular macaques are often the only relevant species for biotechnology-derived investigational new drugs based on cross-reactivity with human and NHP targets. This article reviews the challenges and opportunities associated with monitoring immune function in NHPs in the context of regulatory expectations. The article emphasizes how a comprehensive assessment of immunotoxicity remains a challenge due to interanimal variability associated with certain parameters (e.g., T-dependent antibody response)and it identifies gaps, such as the stage of development of certain assays (e.g., cytotoxic T-cell function). Despite these challenges, a thorough assessment of target biology-driven theoretical risks, in combination with proper integration of all information from the standard toxicology studies, and the refinement of certain assays should enable proper risk assessment. To this effect, emphasis should be placed on leveraging predictive in vitro assays using human cells.

  17. Carbonic anhydrase activation enhances object recognition memory in mice through phosphorylation of the extracellular signal-regulated kinase in the cortex and the hippocampus.

    PubMed

    Canto de Souza, Lucas; Provensi, Gustavo; Vullo, Daniela; Carta, Fabrizio; Scozzafava, Andrea; Costa, Alessia; Schmidt, Scheila Daiane; Passani, Maria Beatrice; Supuran, Claudiu T; Blandina, Patrizio

    2017-05-15

    Rats injected with by d-phenylalanine, a carbonic anhydrase (CA) activator, enhanced spatial learning, whereas rats given acetazolamide, a CA inhibitor, exhibited impairments of fear memory consolidation. However, the related mechanisms are unclear. We investigated if CAs are involved in a non-spatial recognition memory task assessed using the object recognition test (ORT). Systemic administration of acetazolamide to male CD1 mice caused amnesia in the ORT and reduced CA activity in brain homogenates, while treatment with d-phenylalanine enhanced memory and increased CA activity. We provided also the first evidence that d-phenylalanine administration rapidly activated extracellular signal-regulated kinase (ERK) pathways, a critical step for memory formation, in the cortex and the hippocampus, two brain areas involved in memory processing. Effects elicited by d-phenylalanine were completely blunted by co-administration of acetazolamide, but not of 1-N-(4-sulfamoylphenyl-ethyl)-2,4,6-trimethylpyridinium perchlorate (C18), a CA inhibitor that, differently from acetazolamide, does not cross the blood brain barrier. Our results strongly suggest that brain but not peripheral CAs activation potentiates memory as a result of ERK pathway enhanced activation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Idiopathic intracranial hypertension: ongoing clinical challenges and future prospects

    PubMed Central

    Julayanont, Parunyou; Karukote, Amputch; Ruthirago, Doungporn; Panikkath, Deepa; Panikkath, Ragesh

    2016-01-01

    Idiopathic intracranial hypertension (IIH) is an uncommon disorder characterized by increased intracranial pressure without radiological or laboratory evidence of intracranial pathology except empty sella turcica, optic nerve sheath with filled out cerebrospinal fluid spaces, and smooth-walled nonflow-related venous sinus stenosis or collapse. This condition typically affects obese women. The incidence of IIH is increasing with the rising prevalence of obesity. Persistent headache is the most common symptom. Visual impairment is a serious complication that may not be recognized by the patients. This paper reviews clinical manifestations, diagnostic challenges, and current treatments of IIH in adults. Various imaging modalities have been studied on their validity for detection of IIH and papilledema. This review also includes new studies on medical, surgical, and interventional management of this condition. Acetazolamide and topiramate are the only two medications that have been studied in randomized controlled trials about their efficacy in treatment of IIH. In patients who have severe visual impairment or progressive visual deterioration despite medical management, surgical or interventional treatment may be considered. The efficacy and complications of cerebrospinal fluid diversion, optic nerve sheath fenestration, and endovascular venous stenting reported in the last 3 decades have been summarized in this review. Finally, the prospective aspects of biomarkers and treatments are proposed for future research. PMID:26929666

  19. Using a Sampling Strategy to Address Psychometric Challenges in Tutorial-Based Assessments

    ERIC Educational Resources Information Center

    Eva, Kevin W.; Solomon, Patty; Neville, Alan J.; Ladouceur, Michael; Kaufman, Karyn; Walsh, Allyn; Norman, Geoffrey R.

    2007-01-01

    Introduction: Tutorial-based assessment, despite providing a good match with the philosophy adopted by educational programmes that emphasize small group learning, remains one of the greatest challenges for educators working in this context. The current study was performed in an attempt to assess the psychometric characteristics of tutorial-based…

  20. Teaching Thinking Skills in Context-Based Learning: Teachers' Challenges and Assessment Knowledge

    NASA Astrophysics Data System (ADS)

    Avargil, Shirly; Herscovitz, Orit; Dori, Yehudit Judy

    2012-04-01

    For an educational reform to succeed, teachers need to adjust their perceptions to the reform's new curricula and strategies and cope with new content, as well as new teaching and assessment strategies. Developing students' scientific literacy through context-based chemistry and higher order thinking skills was the framework for establishing a new chemistry curriculum for Israeli high school students. As part of this endeavor, we developed the Taste of Chemistry module, which focuses on context-based chemistry, chemical understanding, and higher order thinking skills. Our research objectives were (a) to identify the challenges and difficulties chemistry teachers faced, as well as the advantages they found, while teaching and assessing the Taste of Chemistry module; and (b) to investigate how they coped with teaching and assessing thinking skills that include analyzing data from graphs and tables, transferring between multiple representations and, transferring between chemistry understanding levels. Research participants included eight teachers who taught the module. Research tools included interviews, classroom observations, teachers-designed students' assignments, and developers-designed students' assignments. We documented different challenges teachers had faced while teaching the module and found that the teachers developed different ways of coping with these challenges. Developing teachers' assessment knowledge (AK) was found to be the highest stage in teachers' professional growth, building on teachers' content knowledge (CK), pedagogy knowledge (PK), and pedagogical-content knowledge (PCK). We propose the use of assignments designed by teachers as an instrument for determining their professional growth.

  1. Assessing and Managing Natural Resource Damages: Continuing Challenges and Opportunities.

    PubMed

    Barnthouse, Lawrence W; Stahl, Ralph G

    2017-05-01

    In a 2002 paper, we discussed the technical challenges associated with quantifying natural resource injuries, service losses and damages, and suggested some actions that might help to overcome them. An important suggestion was to consider using some of the approaches in ecological risk assessment to help evaluate potential natural resource injuries, and ultimately in some cases to help translate those injuries into natural resource service loss. This was based on the observation that ecological risk assessment and natural resource damage assessments use much of the same types of data, but at that time the experience base with ecological risk assessment was greater than for natural resource damage assessments. We also discussed some of the issues in applying the then current Department of Interior natural resource damage assessments regulations. Since our 2002 publication the scientific literature, relevant regulations, the global context and more have changed. In the current paper we focus on the technical and regulatory changes in natural resource damage assessments practice since 2002, and use recent reports and publications to illustrate those changes and identify new directions in natural resource damage assessments.

  2. Assessing and Managing Natural Resource Damages: Continuing Challenges and Opportunities

    NASA Astrophysics Data System (ADS)

    Barnthouse, Lawrence W.; Stahl, Ralph G.

    2017-05-01

    In a 2002 paper, we discussed the technical challenges associated with quantifying natural resource injuries, service losses and damages, and suggested some actions that might help to overcome them. An important suggestion was to consider using some of the approaches in ecological risk assessment to help evaluate potential natural resource injuries, and ultimately in some cases to help translate those injuries into natural resource service loss. This was based on the observation that ecological risk assessment and natural resource damage assessments use much of the same types of data, but at that time the experience base with ecological risk assessment was greater than for natural resource damage assessments. We also discussed some of the issues in applying the then current Department of Interior natural resource damage assessments regulations. Since our 2002 publication the scientific literature, relevant regulations, the global context and more have changed. In the current paper we focus on the technical and regulatory changes in natural resource damage assessments practice since 2002, and use recent reports and publications to illustrate those changes and identify new directions in natural resource damage assessments.

  3. Response assessment challenges in clinical trials of gliomas.

    PubMed

    Wen, Patrick Y; Norden, Andrew D; Drappatz, Jan; Quant, Eudocia

    2010-01-01

    Accurate, reproducible criteria for determining tumor response and progression after therapy are critical for optimal patient care and effective evaluation of novel therapeutic agents. Currently, the most widely used criteria for determining treatment response in gliomas is based on two-dimensional tumor measurements using neuroimaging studies (Macdonald criteria). In recent years, the limitation of these criteria, which only address the contrast-enhancing component of the tumor, have become increasingly apparent. This review discusses challenges that have emerged in assessing response in patients with gliomas and approaches being introduced to address them.

  4. Challenges in assessing food environments in northern and remote communities in Canada.

    PubMed

    Skinner, Kelly; Burnett, Kristin; Williams, Patricia; Martin, Debbie; Stothart, Christopher; LeBlanc, Joseph; Veeraraghavan, Gigi; Sheedy, Amanda

    2016-06-09

    Effective tools for retail food environments in northern and remote communities are lacking. This paper examines the challenges of conducting food environment assessments in northern and remote communities in Canada encountered during our experience with a food costing project. One of the goals of the Paying for Nutrition in the North project is to develop guidelines to improve current food costing tools for northern Canada. Paying for Nutrition illustrates the complex context of measuring food environments in northern and remote communities. Through the development of a food costing methodology guide to assess northern food environments, several contextual issues emerged, including retail store oligopolies in communities; the importance of assessing food quality; informal social food economies; and the challenge of costing the acquisition and consumption of land- and water-based foods. Food environment measures designed for northern and remote communities need to reflect the geographic context in which they are being employed and must include input from local residents.

  5. The challenge of assessing social dimensions of avoided deforestation: Examples from Cambodia

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pasgaard, M., E-mail: mase@life.ku.dk

    Reduced Emissions from Deforestation and Forest Degradation in developing countries (REDD +) has moved to the central stage of the climate change debate by being promoted as a significant, cheap, and quick win-win strategy to reduce greenhouse gas emissions and thereby mitigate climate change. In order to be successful in reducing emissions while providing the projected social and environmental co-benefits, REDD + needs to overcome key challenges of insecure forest tenure and inequity in the distribution of benefits. Such challenges threaten to affect the livelihoods and well-being in the local communities and in turn the effectiveness of REDD+. While REDDmore » + programs will affect the participating communities, there is limited knowledge as to what social impacts these projects may bring to the local population. Similarly, assessment of these social dimensions has received little attention until recently, and is consequently out of sync with the realities of REDD + projects. The present paper aims to shed light on the methodological and contextual challenges in the assessment of the social dimensions of REDD+. Some of the main social concerns of REDD + are outlined with an emphasis on the uniqueness and complexity of REDD + interventions. Recently proposed approaches to assess social impacts in REDD + are critically assessed in terms of the diversity of frameworks proposed, choice of social indicators, and data collection requirements. Specifically, these methodological implications are further discussed in the light of the social dimensions and the prescribed regulations of REDD + in a Cambodian context. - Highlights: Black-Right-Pointing-Pointer Insecure tenure and inequitable benefit sharing are main social concerns in REDD +. Black-Right-Pointing-Pointer Two guides to social assessments in REDD + are critically reviewed. Black-Right-Pointing-Pointer Mismatch between social assessment requirements and the reality of REDD + is analyzed. Black

  6. Whither Risk Assessment: New Challenges and Opportunities a Third of a Century After the Red Book.

    PubMed

    Greenberg, Michael; Goldstein, Bernard D; Anderson, Elizabeth; Dourson, Michael; Landis, Wayne; North, D Warner

    2015-11-01

    Six multi-decade-long members of SRA reflect on the 1983 Red Book in order to examine the evolving relationship between risk assessment and risk management; the diffusion of risk assessment practice to risk areas such as homeland security and transportation; the quality of chemical risk databases; challenges from other groups to elements at the core of risk assessment practice; and our collective efforts to communicate risk assessment to a diverse set of critical groups that do not understand risk, risk assessment, or many other risk-related issues. The authors reflect on the 10 recommendations in the Red Book and present several pressing challenges for risk assessment practitioners. © 2015 Society for Risk Analysis.

  7. Assessment of immigrant certified nursing assistants' communication when responding to standardized care challenges.

    PubMed

    Massey, Meredith; Roter, Debra L

    2016-01-01

    Certified nursing assistants (CNAs) provide 80% of the hands-on care in US nursing homes; a significant portion of this work is performed by immigrants with limited English fluency. This study is designed to assess immigrant CNA's communication behavior in response to a series of virtual simulated care challenges. A convenience sample of 31 immigrant CNAs verbally responded to 9 care challenges embedded in an interactive computer platform. The responses were coded with the Roter Interaction Analysis System (RIAS), CNA instructors rated response quality and spoken English was rated. CNA communication behaviors varied across care challenges and a broad repertoire of communication was used; 69% of response content was characterized as psychosocial. Communication elements (both instrumental and psychosocial) were significant predictors of response quality for 5 of 9 scenarios. Overall these variables explained between 13% and 36% of the adjusted variance in quality ratings. Immigrant CNAs responded to common care challenges using a variety of communication strategies despite fluency deficits. Virtual simulation-based observation is a feasible, acceptable and low cost method of communication assessment with implications for supervision, training and evaluation of a para-professional workforce. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. "It Is Complicated!": Practices and Challenges of Generic Skills Assessment in Vietnamese Universities

    ERIC Educational Resources Information Center

    Nghia, Tran Le Huu

    2018-01-01

    Contributing to a lack of studies related to generic skills (GS) assessment, especially in non-Western university contexts, this article reports a study that explored practices and challenges of assessing students' GS in the Business Administration programmes in six Vietnamese universities. Content analysis of interviews with 41 teachers of skills…

  9. Developing School Heads as Instructional Leaders in School-Based Assessment: Challenges and Next Steps

    ERIC Educational Resources Information Center

    Lingam, Govinda Ishwar; Lingam, Narsamma

    2016-01-01

    The study explored challenges faced by school leaders in the Pacific nation of Solomon Islands in school-based assessment, and the adequacy of an assessment course to prepare them. A questionnaire including both open and closed-ended questions elicited relevant data from the school leaders. Modelling best practices in school-based assessment was…

  10. Reshaping Assessment Practices: Mathematics Assessment under Challenge. Proceedings from the National Conference on Assessment in the Mathematical Sciences (1st, Geelong, Victoria, Australia November 20-24, 1991).

    ERIC Educational Resources Information Center

    Stephens, Max, Ed.; Izard, John, Ed.

    The purpose of the Australian conference on mathematical assessment was to address the challenges to traditional methods of assessment that have resulted as part of the call for reform in the mathematics curriculum. The 28 papers presented were: "Who Assesses Whom and To What Purpose?" (Leone Burton; "Assessment of the Learned…

  11. Assessment of herbal medicinal products: Challenges, and opportunities to increase the knowledge base for safety assessment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jordan, Scott A., E-mail: scott.jordan@hc-sc.gc.c; Cunningham, David G.; Marles, Robin J.

    Although herbal medicinal products (HMP) have been perceived by the public as relatively low risk, there has been more recognition of the potential risks associated with this type of product as the use of HMPs increases. Potential harm can occur via inherent toxicity of herbs, as well as from contamination, adulteration, plant misidentification, and interactions with other herbal products or pharmaceutical drugs. Regulatory safety assessment for HMPs relies on both the assessment of cases of adverse reactions and the review of published toxicity information. However, the conduct of such an integrated investigation has many challenges in terms of the quantitymore » and quality of information. Adverse reactions are under-reported, product quality may be less than ideal, herbs have a complex composition and there is lack of information on the toxicity of medicinal herbs or their constituents. Nevertheless, opportunities exist to capitalise on newer information to increase the current body of scientific evidence. Novel sources of information are reviewed, such as the use of poison control data to augment adverse reaction information from national pharmacovigilance databases, and the use of more recent toxicological assessment techniques such as predictive toxicology and omics. The integration of all available information can reduce the uncertainty in decision making with respect to herbal medicinal products. The example of Aristolochia and aristolochic acids is used to highlight the challenges related to safety assessment, and the opportunities that exist to more accurately elucidate the toxicity of herbal medicines.« less

  12. Assessing Curriculum Planning for Humanities Inquiry: The Challenges and Opportunities of Poster Presentation

    ERIC Educational Resources Information Center

    Wallace, Heather D.; Preston, Lou; Harvie, Kate M.

    2016-01-01

    Authentic assessment has been promoted in teacher education as a means of addressing the challenge that pre-service teachers often face in translating theory into practice. In this article, we outline one approach to authentic assessment that utilises a poster format to present a humanities inquiry sequence. Drawing on a practice-based research…

  13. Nanopharmaceuticals: Tiny challenges for the environmental risk assessment of pharmaceuticals.

    PubMed

    Berkner, Silvia; Schwirn, Kathrin; Voelker, Doris

    2016-04-01

    Many new developments and innovations in health care are based on nanotechnology. The field of nanopharmaceuticals is diverse and not as new as one might think; indeed, nanopharmaceuticals have been marketed for many years, and the future is likely to bring more nanosized compounds to the market. Therefore, it is time to examine whether the environmental risk assessment for human pharmaceuticals is prepared to assess the exposure, fate, and effects of nanopharmaceuticals in an adequate way. Challenges include the different definitions for nanomaterials and nanopharmaceuticals, different regulatory frameworks, the diversity of nanopharmaceuticals, the scope of current regulatory guidelines, and the applicability of test protocols. Based on the current environmental risk assessment for human medicinal products in the European Union, necessary adaptations for the assessment procedures and underlying study protocols are discussed and emerging solutions identified. © 2015 The Authors. Environmental Toxicology & Chemistry published by Wiley Periodicals, Inc. on behalf of SETAC.

  14. Challenges of assessing fire and burn severity using field measures, remote sensing and modelling

    Treesearch

    Penelope Morgan; Robert E. Keane; Gregory K. Dillon; Theresa B. Jain; Andrew T. Hudak; Eva C. Karau; Pamela G. Sikkink; Zachery A. Holden; Eva K. Strand

    2014-01-01

    Comprehensive assessment of ecological change after fires have burned forests and rangelands is important if we are to understand, predict and measure fire effects. We highlight the challenges in effective assessment of fire and burn severity in the field and using both remote sensing and simulation models. We draw on diverse recent research for guidance on assessing...

  15. Health impact assessment in Mongolia: current situation, directions, and challenges.

    PubMed

    Spickett, Jeff; Batmunkh, Tsetsegsaikhan; Jones, Sarah

    2015-03-01

    Many developing countries have limited capacity to adequately assess and manage health impacts associated with environmental change. In Mongolia, methodologies to introduce health impact assessment (HIA) as part of the environmental impact assessment (EIA) process have been investigated, and a mechanism to incorporate HIA into the current EIA process is proposed. Some challenges to the implementation of HIA are discussed. The country is now in a position to incorporate HIA as part of the approvals process for development projects. Given the recent growth in population, industrial development, and urbanization together with the interest from international mining companies in the resources of the country, it is important for Mongolia to have such tools in place in order to take advantage of economic growth while improving health and well-being outcomes for the population. © 2012 APJPH.

  16. Progress and Challenges in Assessing NOAA Data Management

    NASA Astrophysics Data System (ADS)

    de la Beaujardiere, J.

    2016-12-01

    The US National Oceanic and Atmospheric Administration (NOAA) produces large volumes of environmental data from a great variety of observing systems including satellites, radars, aircraft, ships, buoys, and other platforms. These data are irreplaceable assets that must be properly managed to ensure they are discoverable, accessible, usable, and preserved. A policy framework has been established which informs data producers of their responsibilities and which supports White House-level mandates such as the Executive Order on Open Data and the OSTP Memorandum on Increasing Access to the Results of Federally Funded Scientific Research. However, assessing the current state and progress toward completion for the many NOAA datasets is a challenge. This presentation will discuss work toward establishing assessment methodologies and dashboard-style displays. Ideally, metrics would be gathered though software and be automatically updated whenever an individual improvement was made. In practice, however, some level of manual information collection is required. Differing approaches to dataset granularity in different branches of NOAA yield additional complexity.

  17. Assessing Biobehavioural Self-Regulation and Coregulation in Early Childhood: The Parent-Child Challenge Task

    PubMed Central

    Lunkenheimer, Erika; Kemp, Christine J.; Lucas-Thompson, Rachel G.; Cole, Pamela M.; Albrecht, Erin C.

    2016-01-01

    Researchers have argued for more dynamic and contextually relevant measures of regulatory processes in interpersonal interactions. In response, we introduce and examine the effectiveness of a new task, the Parent-Child Challenge Task, designed to assess the self-regulation and coregulation of affect, goal-directed behavior, and physiology in parents and their preschoolers in response to an experimental perturbation. Concurrent and predictive validity was examined via relations with children’s externalizing behaviors. Mothers used only their words to guide their 3-year-old children to complete increasingly difficult puzzles in order to win a prize (N = 96). A challenge condition was initiated mid-way through the task with a newly introduced time limit. The challenge produced decreases in parental teaching and dyadic behavioral variability and increases in child negative affect and dyadic affective variability, measured by dynamic systems-based methods. Children rated lower on externalizing showed respiratory sinus arrhythmia (RSA) suppression in response to challenge, whereas those rated higher on externalizing showed RSA augmentation. Additionally, select task changes in affect, behavior, and physiology predicted teacher-rated externalizing behaviors four months later. Findings indicate the Parent-Child Challenge Task was effective in producing regulatory changes and suggest its utility in assessing biobehavioral self-regulation and coregulation in parents and their preschoolers. PMID:28458616

  18. Assessing Biobehavioural Self-Regulation and Coregulation in Early Childhood: The Parent-Child Challenge Task.

    PubMed

    Lunkenheimer, Erika; Kemp, Christine J; Lucas-Thompson, Rachel G; Cole, Pamela M; Albrecht, Erin C

    2017-01-01

    Researchers have argued for more dynamic and contextually relevant measures of regulatory processes in interpersonal interactions. In response, we introduce and examine the effectiveness of a new task, the Parent-Child Challenge Task, designed to assess the self-regulation and coregulation of affect, goal-directed behavior, and physiology in parents and their preschoolers in response to an experimental perturbation. Concurrent and predictive validity was examined via relations with children's externalizing behaviors. Mothers used only their words to guide their 3-year-old children to complete increasingly difficult puzzles in order to win a prize ( N = 96). A challenge condition was initiated mid-way through the task with a newly introduced time limit. The challenge produced decreases in parental teaching and dyadic behavioral variability and increases in child negative affect and dyadic affective variability, measured by dynamic systems-based methods. Children rated lower on externalizing showed respiratory sinus arrhythmia (RSA) suppression in response to challenge, whereas those rated higher on externalizing showed RSA augmentation. Additionally, select task changes in affect, behavior, and physiology predicted teacher-rated externalizing behaviors four months later. Findings indicate the Parent-Child Challenge Task was effective in producing regulatory changes and suggest its utility in assessing biobehavioral self-regulation and coregulation in parents and their preschoolers.

  19. Assessing the Impact of Psychotropic Medication Changes on Challenging Behavior of Individuals with Intellectual Disabilities

    PubMed Central

    Valdovinos, Maria G.; Henninger-McMahon, Meara; Schieber, Elizabeth; Beard, Lisa; Conley, Brenna; Haas, Annette

    2016-01-01

    Objective The use of psychotropic medication to address challenging behavior in individuals diagnosed with intellectual disabilities is common practice; however, very few studies have examined how multiple medication use (or combination treatment) impacts the behaviors these medications are prescribed to treat. Method The current study followed eight individuals over a two-year period as they experienced changes in their psychotropic medication regimens. During that time, data from functional analyses and indirect assessments of challenging behavior were collected. Results The results suggest that changes in psychotropic medication regimens can produce changes in functional assessment outcomes, suggesting a need for continued behavioral assessment to better inform medication practices and behavioral treatment. Of the eight participants in the study, five participants’ behaviors varied in rate of responding in FAs across all medication changes. Additionally, three participants’ FAs produced changes in outcomes; however, those changes were not consistent across all medication changes, that is, not every medication change yielded different outcomes from previous assessments. Conclusion This study demonstrates how the outcome of an FA can be used to monitor the effects of psychotropic medication changes, specifically when medications are combined, on challenging behavior in individuals with intellectual and developmental disabilities. PMID:27429750

  20. Aquatic Ecosystems, Water Quality, and Global Change: Challenges of Conducting Multi-Stressor Vulnerability Assessments (Final Report)

    EPA Science Inventory

    EPA announced the availability of the final report, Aquatic Ecosystems and Global Change: The Challenges of conducting Multi-Stressor Global Change Vulnerability Assessments. This report investigates the issues and challenges associated with identifying, calculating, and ...

  1. Assessing the consequences of unrealistic optimism: Challenges and recommendations.

    PubMed

    Shepperd, James A; Pogge, Gabrielle; Howell, Jennifer L

    2017-04-01

    Of the hundreds of studies published on unrealistic optimism (i.e., expecting a better personal future than is reasonably likely), most have focused on demonstrating the phenomenon, examining boundary conditions, or documenting causes. Few studies have examined the consequences of unrealistic optimism. In this article, we provide an overview of the measurement of unrealistic optimism, review possible consequences, and identify numerous challenges confronting investigators attempting to understand the consequences. Assessing the consequences of unrealistic optimism is tricky, and ultimately probably impossible when researchers assess unrealistic optimism at the group level (which reveals if a group of people is displaying unrealistic optimism on average) rather than the individual level (which reveals whether a specific individual displays unrealistic optimism). We offer recommendations to researchers who wish to examine the consequences of unrealistic optimism. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. The challenge of assessing infant vaccine responses in resource-poor settings

    PubMed Central

    Flanagan, Katie L; Burl, Sarah; Lohman-Payne, Barbara L; Plebanski, Magdalena

    2010-01-01

    Newborns and infants are highly susceptible to infectious diseases, resulting in high mortality and morbidity, particularly in resource-poor settings. Many vaccines require several booster doses, resulting in an extensive vaccine schedule, and yet there is still inadequate protection from some of these diseases. This is partly due to the immaturity of the neonate and infant immune system. Little is known about the specific modifications to immunological assessment protocols in early life but increasing knowledge of infant immunology has helped provide better recommendations for assessing these responses. Since most new vaccines will eventually be deployed in low-income settings such as Africa, the logistics and resources of assessing immunity in such settings also need to be understood. In this article, we will review immunity to vaccines in early life, discuss the many challenges associated with assessing immunogenicity and provide practical tips. PMID:20518720

  3. Information and Communications Technology (ICT) in Nigeria Educational Assessment System--Emerging Challenges

    ERIC Educational Resources Information Center

    Aworanti, Olatunde Awotokun

    2016-01-01

    This paper examines Information and Communications Technology (ICT) in Nigeria educational assessment system with its emerging challenges. This is inevitable following the globalisation trend which has brought drastic changes in the world of technology. The essence of the paper is to describe the present status of ICT in the Nigeria educational…

  4. The benefits and challenges of using computer-assisted symptom assessments in oncology clinics: results of a qualitative assessment.

    PubMed

    Mark, Tami L; Johnson, Gina; Fortner, Barry; Ryan, Katheryn

    2008-10-01

    Developed for clinical use in oncology settings, the Patient Assessment, Care & Education (PACE) System is a computer technology tool designed to address the under-identification and treatment of chemotherapy-related symptoms. This system includes general core questions together with the Patient Care Monitor (PCM), a validated questionnaire that assesses patient-reported problems, six symptom burden indices, and one global quality of life index. The system automatically scores the PCM and generates a written report. The objective of this study was to assess the manner in which clinicians use this system and identify the benefits and challenges that oncology clinics may face when adopting this system. The study was part of a larger evaluation of the system that included standardized surveys and chart review. Sixteen providers (physicians, nurses, and physician assistants) at 13 community oncology clinics participated in a 30-minute interview. Responses were coded according to common phrases or concepts. Clinicians indicated that they use the system mainly for symptom assessment or review of systems. The most common benefits identified included the improved ability to identify under-reported symptoms, enhanced communication with patients; increased efficiency; and its ability to highlight patients' most bothersome symptoms. Challenges included patient burden from the frequent need to answer the questionnaires, issues with the wording and formatting of the screening questionnaire, and technical difficulties. In sum, these interviews suggest that electronic symptom assessments offer potential advantages in terms improving the integration of routine assessment of patients' symptoms and health-related quality of life into the daily flow of an oncology clinic. The approach should receive additional research and development attention.

  5. Acetazolamide

    MedlinePlus

    ... edema (excess fluid retention) and to help control seizures in certain types of epilepsy.This medication is ... painful urination yellowing of the skin or eyes seizures sore throat unusual bleeding or bruising If you ...

  6. Challenges and Developments in the Assessment of (Mal)adaptive Personality and Pathological States in Older Adults.

    PubMed

    Rossi, Gina; Videler, Arjan; van Alphen, S P J

    2018-04-01

    Since older adults often show an atypical presentation of (mal)adaptive personality traits and pathological states, the articles in this special issue will concisely discuss some perennial issues in clinical assessment in older adults and thus outline the main challenges this domain faces. By bringing empirical work and meta-analytic studies from leading scholars in the field of geropsychology, the articles will also address these challenges by reporting the latest developments in the field. This way, we hope to reshape the way clinicians and researchers assess (mal)adaptive personality and pathological states in older adults into a more reliable and valid assessment method that integrates the specific biopsychosocial context of older age.

  7. The Problem Behaviour Checklist: short scale to assess challenging behaviours

    PubMed Central

    Nagar, Jessica; Evans, Rosie; Oliver, Patricia; Bassett, Paul; Liedtka, Natalie; Tarabi, Aris

    2016-01-01

    Background Challenging behaviour, especially in intellectual disability, covers a wide range that is in need of further evaluation. Aims To develop a short but comprehensive instrument for all aspects of challenging behaviour. Method In the first part of a two-stage enquiry, a 28-item scale was constructed to examine the components of challenging behaviour. Following a simple factor analysis this was developed further to create a new short scale, the Problem Behaviour Checklist (PBCL). The scale was subsequently used in a randomised controlled trial and tested for interrater reliability. Scores were also compared with a standard scale, the Modified Overt Aggression Scale (MOAS). Results Seven identified factors – personal violence, violence against property, self-harm, sexually inappropriate, contrary, demanding and disappearing behaviour – were scored on a 5-point scale. A subsequent factor analysis with the second population showed demanding, violent and contrary behaviour to account for most of the variance. Interrater reliability using weighted kappa showed good agreement (0.91; 95% CI 0.83–0.99). Good agreement was also shown with scores on the MOAS and a score of 1 on the PBCL showed high sensitivity (97%) and specificity (85%) for a threshold MOASscore of 4. Conclusions The PBCL appears to be a suitable and practical scale for assessing all aspects of challenging behaviour. Declaration of interest None. Copyright and usage © 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703753

  8. Cultural challenges to implementation of formative assessment in Saudi Arabia: an exploratory study.

    PubMed

    Al-Wassia, Rolina; Hamed, Omayma; Al-Wassia, Heidi; Alafari, Reem; Jamjoom, Reda

    2015-04-01

    This study investigates challenges that students and faculty face to implement assessment for learning; and the activities, capabilities, enablers, and indicators which could impact performance. The study is a mixed methods research, cross-sectional, exploratory study. The study was organized through two phases of data collection and analysis (QUAL → quan). Based on qualitative focus group discussions (FGD), we first gathered data through field notes. Later, we engaged in analysis using techniques drawn from qualitative data including categorization, theme identification, and connection to existing literature. Based on this analysis, we developed a questionnaire that could provide quantitative measures based on the qualitative FGD. We then administered the questionnaire, and the quantitative data were analyzed to quantitatively test the qualitative findings. Twenty-four faculty and 142 students from the 4th and 5th clinical years participated voluntarily. Their perception of FA and the cultural challenges that hinder its adoption were evaluated through a FGD and a questionnaire. The mean score of understanding FA concept was equal in faculty and students (p = 0.08). The general challenge that scored highest was the need to balance work and academic load in faculty and the need to balance study load and training and mental anxiety in students. There was no difference between faculty and students in perceiving "learning is teacher-centered" (p = 0.481); and "past learning and assessment experience" (p = 0.322). There was a significant difference between them regarding interaction with opposite gender (p <0.001). Students showed higher value as regards the "gap between learning theories and assessment practice", "grade as a priority", and "discrimination by same faculty gender". The authors suggested a "Framework of Innovation in Endorsing Assessment for Learning". It emphasizes a holisitic approach through all levels of the System: Government

  9. [HTA-Perspective: Challenges in the early assessment of new oncological drugs].

    PubMed

    Wild, Claudia; Nachtnebel, Anna

    2013-01-01

    Oncologic drug therapies have gained wide attention in the context of health policy priority setting for serious and socially significant diseases with high human and monetary costs. Due to uncertainties and scepticism about the actual therapeutic importance of newly approved oncology products, an early assessment programme was already established in Austria in 2007. The assessment of new oncology products is thereby faced with special challenges, since study populations are frequently not representative or the study design is laid out in such a manner that a definitive assessment of patient-relevant endpoints is not possible (cross-overs after interim assessments, surrogate parameters as primary endpoints, uncontrolled studies or those with unrealistic comparators, invalidated post-hoc identified biomarkers). On account of these major uncertainties, even the European Medicines Agency (EMA) is already contemplating multi-stage, "adaptive" approvals, and national reimbursement institutions are increasingly working with outcome-oriented, conditional reimbursement. (As supplied by publisher). Copyright © 2013. Published by Elsevier GmbH.

  10. Conceptual and methodological challenges to integrating SEA and cumulative effects assessment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gunn, Jill, E-mail: jill.gunn@usask.c; Noble, Bram F.

    The constraints to assessing and managing cumulative environmental effects in the context of project-based environmental assessment are well documented, and the potential benefits of a more strategic approach to cumulative effects assessment (CEA) are well argued; however, such benefits have yet to be clearly demonstrated in practice. While it is widely assumed that cumulative effects are best addressed in a strategic context, there has been little investigation as to whether CEA and strategic environmental assessment (SEA) are a 'good fit' - conceptually or methodologically. This paper identifies a number of conceptual and methodological challenges to the integration of CEA andmore » SEA. Based on results of interviews with international experts and practitioners, this paper demonstrates that: definitions and conceptualizations of CEA are typically weak in practice; approaches to effects aggregation vary widely; a systems perspective lacks in both SEA and CEA; the multifarious nature of SEA complicates CEA; tiering arrangements between SEA and project-based assessment are limited to non-existing; and the relationship of SEA to regional planning remains unclear.« less

  11. Challenges Experienced by History Learners during Assessment Using the Medium of English

    ERIC Educational Resources Information Center

    Rapetsoa, J. M.; Singh, R. J.

    2012-01-01

    This study investigated the challenges that history learners in rural black schools are faced with during assessments when using English as the language of learning and teaching. The aim of the study was to investigate whether English, which is used as a language of learning and teaching in schools, is a barrier to the learning and teaching of…

  12. Assessment of anorexia nervosa: an overview of universal issues and contextual challenges

    PubMed Central

    2013-01-01

    Aim Anorexia Nervosa (AN) is a complex and clinically challenging syndrome. Intended for specialist audiences, this narrative review aims to summarise the available literature related to assessment in the adult patient context, synthesising both research evidence and clinical consensus guidelines. Method We provide a review of the available literature on specialist assessment of AN focusing on common trajectories into assessment, obstacles accessing assessment, common presenting issues and barriers to the assessment process, the necessary scope of assessment, and tools and techniques. It describes the further step of synthesising assessment information in ways that can inform resultant care plans. Results In addition to assessment of core behaviours and diagnostic skills, considerations for the expert assessor include the functions of primary care, systemic and personal barriers, knowledge of current assessment tools and research pertaining to comorbid pathology in AN, assessing severity of illness, role of family at assessment, as well as medical, nutritional and compulsory elements of assessment. Conclusion Comprehensive assessment of AN in the current healthcare context still remains largely the remit of the specialist ED clinician. Assessment should remain an on-going process, paying particular attention to available empirical evidence, thereby reducing the gap between research and practice. PMID:24999408

  13. Assessing Species Diversity Using Metavirome Data: Methods and Challenges.

    PubMed

    Herath, Damayanthi; Jayasundara, Duleepa; Ackland, David; Saeed, Isaam; Tang, Sen-Lin; Halgamuge, Saman

    2017-01-01

    Assessing biodiversity is an important step in the study of microbial ecology associated with a given environment. Multiple indices have been used to quantify species diversity, which is a key biodiversity measure. Measuring species diversity of viruses in different environments remains a challenge relative to measuring the diversity of other microbial communities. Metagenomics has played an important role in elucidating viral diversity by conducting metavirome studies; however, metavirome data are of high complexity requiring robust data preprocessing and analysis methods. In this review, existing bioinformatics methods for measuring species diversity using metavirome data are categorised broadly as either sequence similarity-dependent methods or sequence similarity-independent methods. The former includes a comparison of DNA fragments or assemblies generated in the experiment against reference databases for quantifying species diversity, whereas estimates from the latter are independent of the knowledge of existing sequence data. Current methods and tools are discussed in detail, including their applications and limitations. Drawbacks of the state-of-the-art method are demonstrated through results from a simulation. In addition, alternative approaches are proposed to overcome the challenges in estimating species diversity measures using metavirome data.

  14. Acetazolamide Inhibits the Level of Tyrosinase and Melanin: An Enzyme Kinetic, In Vitro, In Vivo, and In Silico Studies.

    PubMed

    Abbas, Qamar; Raza, Hussain; Hassan, Mubashir; Phull, Abdul Rehman; Kim, Song Ja; Seo, Sung-Yum

    2017-09-01

    Melanin is the major factor that determines skin color and protects from ultraviolet radiation. In present study we evaluated the anti-melanogenesis effect of acetazolamide (ACZ) using four different approaches: enzyme kinetic, in vitro, in vivo and in silico. ACZ demonstrated significant inhibitory activity (IC 50 7.895 ± 0.24 μm) against tyrosinase as compared to the standard drug kojic acid (IC 50 16.84 ± 0.64 μm) and kinetic analyses showed that ACZ is a non-competitive inhibitor without cytotoxic effect. In in vitro experiments, A375 human melanoma cells were treated with 20 or 40 μm of ACZ with or without 50 μm of l-DOPA. Western blot results showed that ACZ significantly (P < 0.05) decreased the expression level of tyrosinase at 40 μm. Zebrafish embryos were treated with 10, 20 or 40 μm of ACZ and of positive control kojic acid. At 72 h of treatment with ACZ and kojic acid, ACZ significantly (P < 0.001) decreased the embryos pigmentation to 40.8% of untreated embryos at the dose of 40 μm of ACZ while kojic acid decreased only 25.0% of pigmentation at the same dose of kojic acid. In silico docking were performed against tyrosinase using PyRx tool. Docking studies suggested that His244, Asn260 and His85 are the major interacting residues in the binding site of the protein. In conclusion, our results suggest that ACZ is a good candidate for the inhibition of melanin and it could be used as a lead for developing the drugs for hyperpigmentary disorders and skin whitening. © 2017 Wiley-VHCA AG, Zurich, Switzerland.

  15. The Challenge of Differing Perspectives Surrounding Grades in the Assessment Education of Pre-Service Teachers

    ERIC Educational Resources Information Center

    Mitton-Kukner, Jennifer; Munroe, Elizabeth; Graham, Deborah

    2015-01-01

    In this paper we describe the challenges we experience teaching an assessment course to pre-service teachers, as part of their studies in a bachelor of education program. As we teach the course, our intent is to explicitly model assessment practices that reflect a philosophy of "success for all," rather than "sort and rank."…

  16. Methods and challenges for the health impact assessment of vaccination programs in Latin America.

    PubMed

    Sartori, Ana Marli Christovam; Nascimento, Andréia de Fátima; Yuba, Tânia Yuka; Soárez, Patrícia Coelho de; Novaes, Hillegonda Maria Dutilh

    2015-01-01

    To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

  17. The changing face of nanomaterials: Risk assessment challenges along the value chain.

    PubMed

    Mattsson, Mats-Olof; Simkó, Myrtill

    2017-03-01

    Risk assessment (RA) of manufactured nanomaterials (MNM) is essential for regulatory purposes and risk management activities. Similar to RA of "classical" chemicals, MNM RA requires knowledge about exposure as well as of hazard potential and dose response relationships. What makes MNM RA especially challenging is the multitude of materials (which is expected to increase substantially in the future), the complexity of MNM value chains and life cycles, the accompanying possible changes in material properties over time and in contact with various environmental and organismal milieus, and the difficulties to obtain proper exposure data and to consider the proper dose metric. This article discusses these challenges and also critically overviews the current state of the art regarding MNM RA approaches. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Implementation of a Standardized Clinical Assessment and Management Plan (SCAMP) for Food Challenges.

    PubMed

    Simberloff, Tander; Parambi, Ron; Bartnikas, Lisa M; Broyles, Ana Dioun; Hamel, Victoria; Timmons, Karol G; Miller, D Marlowe; Graham, Dionne A; Schneider, Lynda C; MacGinnitie, Andrew J

    Oral food challenges (OFCs) are routinely used to confirm ongoing food allergy. Serum-specific IgE (sIgE) and skin prick testing (SPT) are imperfect predictors of which patients will pass OFCs. The objective of this study was to describe the design and implementation of a Standardized Clinical Assessment and Management Plan (SCAMP) to study and iteratively improve sIgE and SPT thresholds to determine when and where to conduct OFCs for patients. Allergists consulted recommended sIgE and SPT thresholds when ordering challenges although diversions were permitted. Criteria were iteratively improved after periodic analyses of challenge outcome and diversions. Over 3 years, allergists ordered 2368 food challenges for 1580 patients with histories of IgE-mediated reactions to food: 1386 in an outpatient clinic and 945 in a higher resource infusion center. Reactions to challenge were observed in 13% of clinic and 23% of infusion center challenges. Six patients challenged in clinic required treatment with epinephrine compared with 22 in the infusion center. The need for epinephrine was more common in patients with asthma-5% of asthmatic patients required epinephrine compared with 1% of nonasthmatic patients (P < .01). Recommended sIgE and SPT thresholds were incrementally changed and, using the control chart methodology, a significant decrease was noted in the proportion of challenges ordered in the higher resource location. By setting and continually refining sIgE and SPT recommendations using the SCAMP method, allergists can better determine the risk of severe reaction and triage patients to the appropriate setting for an OFC. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. The Implementations and Challenges of Continuous Assessment in Public Universities of Eastern Ethiopia

    ERIC Educational Resources Information Center

    Abera, Gemechu; Kedir, Muhammed; Beyabeyin, Maeregu

    2017-01-01

    The study was aimed to investigate the implementations and challenges of continuous assessment in selected Public Universities of Eastern Ethiopia. Descriptive survey research design was employed to carry out this study because it is used to describe the characteristics of a given population in a systematic and accurate fashion. Stratified random…

  20. Integrated modeling systems to assess exposure and toxicity of chemicals in support of aquatic ecological risk assessment of methodologically challenging chemicals

    EPA Science Inventory

    From an exposure assessment perspective, persistent, bioaccumulative and toxic chemicals (PBTs) are some of the most challenging chemicals facing environmental decision makers today. Due to their general physico-chemical properties [e.g., high octanol-water partition coefficien...

  1. Engineering Risk Assessment of Space Thruster Challenge Problem

    NASA Technical Reports Server (NTRS)

    Mathias, Donovan L.; Mattenberger, Christopher J.; Go, Susie

    2014-01-01

    The Engineering Risk Assessment (ERA) team at NASA Ames Research Center utilizes dynamic models with linked physics-of-failure analyses to produce quantitative risk assessments of space exploration missions. This paper applies the ERA approach to the baseline and extended versions of the PSAM Space Thruster Challenge Problem, which investigates mission risk for a deep space ion propulsion system with time-varying thruster requirements and operations schedules. The dynamic mission is modeled using a combination of discrete and continuous-time reliability elements within the commercially available GoldSim software. Loss-of-mission (LOM) probability results are generated via Monte Carlo sampling performed by the integrated model. Model convergence studies are presented to illustrate the sensitivity of integrated LOM results to the number of Monte Carlo trials. A deterministic risk model was also built for the three baseline and extended missions using the Ames Reliability Tool (ART), and results are compared to the simulation results to evaluate the relative importance of mission dynamics. The ART model did a reasonable job of matching the simulation models for the baseline case, while a hybrid approach using offline dynamic models was required for the extended missions. This study highlighted that state-of-the-art techniques can adequately adapt to a range of dynamic problems.

  2. Uses of NHANES Biomarker Data for Chemical Risk Assessment: Trends, Challenges, and Opportunities

    PubMed Central

    DeWoskin, Robert S.; Tan, Yu-Mei; Pleil, Joachim D.; Phillips, Martin Blake; George, Barbara Jane; Christensen, Krista; Schreinemachers, Dina M.; Williams, Marc A.; Hubal, Elaine A. Cohen; Edwards, Stephen W.

    2015-01-01

    Background Each year, the U.S. NHANES measures hundreds of chemical biomarkers in samples from thousands of study participants. These biomarker measurements are used to establish population reference ranges, track exposure trends, identify population subsets with elevated exposures, and prioritize research needs. There is now interest in further utilizing the NHANES data to inform chemical risk assessments. Objectives This article highlights a) the extent to which U.S. NHANES chemical biomarker data have been evaluated, b) groups of chemicals that have been studied, c) data analysis approaches and challenges, and d) opportunities for using these data to inform risk assessments. Methods A literature search (1999–2013) was performed to identify publications in which U.S. NHANES data were reported. Manual curation identified only the subset of publications that clearly utilized chemical biomarker data. This subset was evaluated for chemical groupings, data analysis approaches, and overall trends. Results A small percentage of the sampled NHANES-related publications reported on chemical biomarkers (8% yearly average). Of 11 chemical groups, metals/metalloids were most frequently evaluated (49%), followed by pesticides (9%) and environmental phenols (7%). Studies of multiple chemical groups were also common (8%). Publications linking chemical biomarkers to health metrics have increased dramatically in recent years. New studies are addressing challenges related to NHANES data interpretation in health risk contexts. Conclusions This article demonstrates growing use of NHANES chemical biomarker data in studies that can impact risk assessments. Best practices for analysis and interpretation must be defined and adopted to allow the full potential of NHANES to be realized. Citation Sobus JR, DeWoskin RS, Tan YM, Pleil JD, Phillips MB, George BJ, Christensen K, Schreinemachers DM, Williams MA, Cohen Hubal EA, Edwards SW. 2015. Uses of NHANES biomarker data for chemical risk

  3. Anti-glaucoma potential of Heliotropium indicum Linn in experimentally-induced glaucoma.

    PubMed

    Kyei, Samuel; Koffuor, George Asumeng; Ramkissoon, Paul; Owusu-Afriyie, Osei

    2015-01-01

    Heliotropium indicum is used as a traditional remedy for hypertension in Ghana. The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H. indicum to manage experimentally-induced glaucoma. The percentage change in intraocular pressure (IOP), after inducing acute glaucoma (15 mLkg(-1) of 5 % dextrose, i.v.), in New Zealand White rabbits pretreated with Heliotropium indicum aqueous extract (HIE) (30-300 mgkg(-1)), acetazolamide (5 mgkg(-1)), and normal saline (10 mLkg(-1)) per os were measured. IOPs were also monitored in chronic glaucoma in rabbits (induced by 1 % prednisolone acetate drops, 12 hourly for 21 days) after treatments with the same doses of HIE, acetazolamide, and normal saline for 2 weeks. The anti-oxidant property of the extract was assessed by assaying for glutathione levels in the aqueous humour. Glutamate concentration in the vitreous humour was also determined using ELISA technique. Histopathological assessment of the ciliary bodies was made. The extract significantly reduced intraocular pressure (p ≤ 0.05-0.001) in acute and chronic glaucoma, preserved glutathione levels and glutamate concentration (p ≤ 0.01-0.001). Histological assessment of the ciliary body showed a decrease in inflammatory infiltration in the extract and acetazolamide-treated group compared with the normal saline-treated group. The aqueous whole plant extract of Heliotropium indicum has ocular hypotensive, anti-oxidant and possible neuro-protective effects, which therefore underscore its plausible utility as an anti-glaucoma drug with further investigation.

  4. Opportunities and challenges of integrating ecological restoration into assessment and management of contaminated ecosystems.

    PubMed

    Hull, Ruth N; Luoma, Samuel N; Bayne, Bruce A; Iliff, John; Larkin, Daniel J; Paschke, Mark W; Victor, Sasha L; Ward, Sara E

    2016-04-01

    Ecosystem restoration planning near the beginning of the site assessment and management process ("early integration") involves consideration of restoration goals from the outset in developing solutions for contaminated ecosystems. There are limitations to integration that stem from institutional barriers, few successful precedents, and limited availability of guidance. Challenges occur in integrating expertise from various disciplines and multiple, sometimes divergent interests and goals. The more complex process can result in timing, capacity, communication, and collaboration challenges. On the other hand, integrating the 2 approaches presents new and creative opportunities. For example, integration allows early planning for expanding ecosystem services on or near contaminated lands or waters that might otherwise have been unaddressed by remediation alone. Integrated plans can explicitly pursue ecosystem services that have market value, which can add to funds for long-term monitoring and management. Early integration presents opportunities for improved and productive collaboration and coordination between ecosystem restoration and contaminant assessment and management. Examples exist where early integration facilitates liability resolution and generates positive public relations. Restoration planning and implementation before the completion of the contaminated site assessment, remediation, or management process ("early restoration") can facilitate coordination with offsite restoration options and a regional approach to restoration of contaminated environments. Integration of performance monitoring, for both remedial and restoration actions, can save resources and expand the interpretive power of results. Early integration may aid experimentation, which may be more feasible on contaminated lands than in many other situations. The potential application of concepts and tools from adaptive management is discussed as a way of avoiding pitfalls and achieving benefits in

  5. ASSESSING PARENTING IN THE CONTEXT OF REUNIFICATION OF INFANTS/TODDLERS AND THEIR FAMILIES: HOW TO FACE THE CHALLENGES?

    PubMed

    Vischer, Anne-Fleur W K; Grietens, Hans; Knorth, Erik J; Mulder, Hans

    2017-05-01

    Since a substantial portion of infants and toddlers reenter care after reunification, the question of whether family reunification is feasible needs to be answered very cautiously. How parenting is assessed is of major importance in answering this question, but the quality of these assessments is often poor. With an eye to improving current practice, we conducted an integrative review, in which we analyzed the challenges related to the assessment of parenting vis-à-vis reunification and linked relevant knowledge from research with significant know-how from practice. The challenges appear to be embedded in the struggle to define (especially good enough) parenting and the complex context of child protection. As an answer to the challenges, the integrative review resulted in a framework of four key components required for sufficient parenting-assessment practice: (a) the use and development of expertise; and (b) providing families aiming for reunification with an intervention that is intensive, (c) flexible, and (d) organized as teamwork. Providing families with such an intervention gives them the opportunity to make substantial changes in their parenting and helps professionals assess the capacity of parents to grow to an acceptable level of caretaking for their child. Further implications for research and practice are discussed. © 2017 Michigan Association for Infant Mental Health.

  6. Influence of acetazolamide loading on the (in vitro) performances of non-phospholipid-based cationic nanosized emulsion in comparison with phospholipid-based anionic and neutral-charged nanosized emulsions.

    PubMed

    Tamilvanan, Shunmugaperumal; Kumar, Balakrishnan Ajith

    2011-09-01

    Acetazolamide (ACZM)-loaded anionic, cationic, and neutral-charged oil-in-water nanosized emulsions were prepared and compared with their mean droplet diameter, surface charge, entrapment efficiency, freeze-thaw cycling stability, in vitro drug release, and transcorneal permeation. The present study aims to determine the influence of ACZM loading on the performances of non-phospholipid-based cationic nanosized emulsion in comparison with phospholipid-based anionic and neutral-charged nanosized emulsions. Regardless of charges, all of these emulsions exhibited a nanometer range mean particle diameter (240-443 nm) following autoclave sterilization. While the anionic and cationic emulsions did show high negative (-36.9 mV) and positive zeta potential (+41.4 mV) values, the neutral-charged emulsion did not. Presence of cryoprotectants (5% w/w sucrose + 5% w/w sorbitol) improved the stability of cationic emulsion to droplet aggregation during freeze-thaw cycling. The in vitro release kinetic behavior of drug exchange with physiological anions present in the simulated tear solution appears to be complex and difficult to characterize using mathematical fitting model equations. Augmentation in drug permeation through goat cornea, in vitro, was noticed for cationic emulsion. ACZM-loaded cationic nanosized emulsion could be suitable for topical application into eye to elicit better therapeutic effect in comparison with its anionic and neutral-charged emulsions.

  7. Nanomaterials: a challenge for toxicological risk assessment?

    PubMed

    Haase, Andrea; Tentschert, Jutta; Luch, Andreas

    2012-01-01

    Nanotechnology has emerged as one of the central technologies in the twenty-first century. This judgment becomes apparent by considering the increasing numbers of people employed in this area; the numbers of patents, of scientific publications, of products on the market; and the amounts of money invested in R&D. Prospects originating from different fields of nanoapplication seem unlimited. However, nanotechnology certainly will not be able to meet all of the ambitious expectations communicated, yet has high potential to heavily affect our daily life in the years to come. This might occur in particular in the field of consumer products, for example, by introducing nanomaterials in cosmetics, textiles, or food contact materials. Another promising area is the application of nanotechnology in medicine fueling hopes to significantly improve diagnosis and treatment of all kinds of diseases. In addition, novel technologies applying nanomaterials are expected to be instrumental in waste remediation and in the production of efficient energy storage devices and thus may help to overcome world's energy problems or to revolutionize computer and data storage technologies. In this chapter, we will focus on nanomaterials. After a brief historic and general overview, current proposals of how to define nanomaterials will be summarized. Due to general limitations, there is still no single, internationally accepted definition of the term "nanomaterial." After elaborating on the status quo and the scope of nanoanalytics and its shortcomings, the current thinking about possible hazards resulting from nanoparticulate exposures, there will be an emphasis on the requirements to be fulfilled for appropriate health risk assessment and regulation of nanomaterials. With regard to reliable risk assessments, until now there is still the remaining issue to be resolved of whether or not specific challenges and unique features exist on the nanoscale that have to be tackled and distinctively

  8. Advantages and challenges associated with implementing an ecosystem services approach to ecological risk assessment for chemicals.

    PubMed

    Maltby, Lorraine; van den Brink, Paul J; Faber, Jack H; Marshall, Stuart

    2018-04-15

    The ecosystem services (ES) approach is gaining broad interest in regulatory and policy arenas for use in landscape management and ecological risk assessment. It has the potential to bring greater ecological relevance to the setting of environmental protection goals and to the assessment of the ecological risk posed by chemicals. A workshop, organised under the auspices of the Society of Environmental Toxicology and Chemistry Europe, brought together scientific experts from European regulatory authorities, the chemical industry and academia to discuss and evaluate the challenges associated with implementing an ES approach to chemical ecological risk assessment (ERA). Clear advantages of using an ES approach in prospective and retrospective ERA were identified, including: making ERA spatially explicit and of relevance to management decisions (i.e. indicating what ES to protect and where); improving transparency in communicating risks and trade-offs; integrating across multiple stressors, scales, habitats and policies. A number of challenges were also identified including: the potential for increased complexity in assessments; greater data requirements; limitations in linking endpoints derived from current ecotoxicity tests to impacts on ES. In principle, the approach was applicable to all chemical sectors, but the scale of the challenge of applying an ES approach to general chemicals with widespread and dispersive uses leading to broad environmental exposure, was highlighted. There was agreement that ES-based risk assessment should be based on the magnitude of impact rather than on toxicity thresholds. The need for more bioassays/tests with functional endpoints was recognized, as was the role of modelling and the need for ecological production functions to link measurement endpoints to assessment endpoints. Finally, the value of developing environmental scenarios that can be combined with spatial information on exposure, ES delivery and service provider

  9. Challenges of assessing the clinical efficacy of asexual blood-stage Plasmodium falciparum malaria vaccines.

    PubMed

    Sheehy, Susanne H; Douglas, Alexander D; Draper, Simon J

    2013-09-01

    In the absence of any highly effective vaccine candidate against Plasmodium falciparum malaria, it remains imperative for the field to pursue all avenues that may lead to the successful development of such a formulation. The development of a subunit vaccine targeting the asexual blood-stage of Plasmodium falciparum malaria infection has proven particularly challenging with only limited success to date in clinical trials. However, only a fraction of potential blood-stage vaccine antigens have been evaluated as targets, and a number of new promising candidate antigen formulations and delivery platforms are approaching clinical development. It is therefore essential that reliable and sensitive methods of detecting, or ruling out, even modest efficacy of blood-stage vaccines in small clinical trials be established. In this article we evaluate the challenges facing blood-stage vaccine developers, assess the appropriateness and limitations of various in vivo approaches for efficacy assessment and suggest future directions for the field.

  10. Assessment of nurse retention challenges and strategies in Lebanese hospitals: the perspective of nursing directors.

    PubMed

    El-Jardali, Fadi; Merhi, Mirvat; Jamal, Diana; Dumit, Nuhad; Mouro, Gladys

    2009-05-01

    Assess nurse retention challenges and strategies as perceived by nursing directors in Lebanese hospitals. The Kampala Health Workforce Declaration stressed the importance of retaining an effective, responsive and equitably distributed health workforce, particularly nurses. Little is known about nurse retention challenges and strategies in Lebanon. Nursing directors of 76 hospitals participated and were sent a two-page survey on perceived retention challenges and hospital-based retention strategies. Retention challenges included unsatisfactory salary, unsuitable shifts and working hours, as well as better opportunities in other areas within or outside Lebanon. Retention strategies included implementing financial rewards and benefits, a salary scale, staff development, praise and improving work environment. Nursing directors did not address all perceived challenges in their strategies. To better manage the nursing workforce, nursing directors should regularly measure and monitor nurse turnover rates and also their causes and predictors. Nursing directors should develop, implement and evaluate retention strategies. More information is needed on the management and leadership capacities of nursing directors in addition to their span of control. Nursing directors are facing challenges in retaining their nurses. If these problems are not addressed, Lebanon will continue to lose competent and skilled nurses.

  11. A Bibliometric Assessment of Global Ice Bucket Challenge (Amyotrophic Lateral Sclerosis) Research.

    PubMed

    Ram, Shri

    2016-10-01

    This study is a quantitative and qualitative assessment of the global research trends on amyotrophic lateral sclerosis (ALS) (popularly known as Ice Bucket Challenge), through related literatures retrieved from SCOPUS multidisciplinary database for the period 1974-2013. This study is aimed at analyzing the literature on ALS in terms of document type, language, annual growth, productive country, journal, authors, subject, and most cited articles. The bibliographic data for this study was retrieved from the SCOPUS database using keywords 'amyotrophic lateral sclerosis', 'motor neurone disease', 'Charcot disease', 'Lou Gehrig's disease', 'Ice Bucket Challenge' available in title, abstract, and keyword fields of Scopus database from 1974 to 2013. The literature analysis included 21,750 articles during the period from 1974 to 2013 in different areas of ALS. USA was the most productive country in terms of literature produced, while Neurology was the most productive journal. An intensive awareness created by 'Ice Bucket Challenge' has attracted masses, and an intensive growth of literature is pertinent on ALS. The results of this study are expressed in terms of growth of literature, output of individual countries, and authors, and will be helpful in collaborative research in future.

  12. Challenges in the assessment of total fluid intake in children and adolescents: a discussion paper.

    PubMed

    Warren, Janet; Guelinckx, Isabelle; Livingstone, Barbara; Potischman, Nancy; Nelson, Michael; Foster, Emma; Holmes, Bridget

    2018-06-01

    In recent years, evidence has emerged about the importance of healthy fluid intake in children for physical and mental performance and health, and in the prevention of obesity. Accurate data on water intake are needed to inform researchers and policymakers and for setting dietary reference values. However, to date, there are few published data on fluid or water intakes in children. This is due partly to the fact that drinking water is not always reported in dietary surveys. The aim of this paper is to review the current status of the literature and highlight the challenges of assessing total fluid intake in children and adolescents. From the dietary assessment literature it is apparent that children present unique challenges to assessing intake due to ongoing cognitive capacity development, limited literacy skills, difficulties in estimating portion sizes and multiple caregivers during any 1 day making it difficult to track intakes. As such, many issues should be considered when assessing total fluid intakes in children or adolescents. Various methods to assess fluid intakes exist, each with its own strengths and weaknesses; the ultimate choice of method depends on the research question and resources available. Based on the literature review, it is apparent that if the research focus is to assess only fluid intake, a fluid-specific method, such as a diary or record, appears to be a feasible approach to provide an accurate estimate of intakes.

  13. Multidimensional assessment of challenging behaviors in advanced stages of dementia in nursing homes-The insideDEM framework.

    PubMed

    Teipel, Stefan; Heine, Christina; Hein, Albert; Krüger, Frank; Kutschke, Andreas; Kernebeck, Sven; Halek, Margareta; Bader, Sebastian; Kirste, Thomas

    2017-01-01

    Assessment of challenging behaviors in dementia is important for intervention selection. Here, we describe the technical and experimental setup and the feasibility of long-term multidimensional behavior assessment of people with dementia living in nursing homes. We conducted 4 weeks of multimodal sensor assessment together with real-time observation of 17 residents with moderate to very severe dementia in two nursing care units. Nursing staff received extensive training on device handling and measurement procedures. Behavior of a subsample of eight participants was further recorded by videotaping during 4 weeks during day hours. Sensors were mounted on the participants' wrist and ankle and measured motion, rotation, as well as surrounding loudness level, light level, and air pressure. Participants were in moderate to severe stages of dementia. Almost 100% of participants exhibited relevant levels of challenging behaviors. Automated quality control detected 155 potential issues. But only 11% of the recordings have been influenced by noncompliance of the participants. Qualitative debriefing of staff members suggested that implementation of the technology and observation platform in the routine procedures of the nursing home units was feasible and identified a range of user- and hardware-related implementation and handling challenges. Our results indicate that high-quality behavior data from real-world environments can be made available for the development of intelligent assistive systems and that the problem of noncompliance seems to be manageable. Currently, we train machine-learning algorithms to detect episodes of challenging behaviors in the recorded sensor data.

  14. A Pilot Study of the Challenges and Prospects of Continuous Assessment Implementation in Nigeria

    ERIC Educational Resources Information Center

    Owolabi, Henry O.; Onuka, Adams O. U.

    2010-01-01

    This study obtained basic information from teachers and students on the challenges and prospects of implementing continuous assessment (CA) in the Nigerian school system. Secondary Schools in Ilorin, the capital city of Kwara State, located in the central region of Nigeria were sampled for use in the study. It employed survey research design…

  15. Assessment of Challenges and Opportunity of Basketball Developments in Some Selected Regions in Ethiopia

    ERIC Educational Resources Information Center

    Tufa, Gemechu Beker

    2015-01-01

    The intent of this study is to assess the challenges and Opportunity of Basketball development of in Some Selected Regions Ethiopia. The research made Addis Ababa, Oromia, Gambella and South Nation Nationality and People Regional States as the sites of this study. Both qualitative and quantitative approaches particularly a descriptive survey were…

  16. Designing trials for pressure ulcer risk assessment research: methodological challenges.

    PubMed

    Balzer, K; Köpke, S; Lühmann, D; Haastert, B; Kottner, J; Meyer, G

    2013-08-01

    For decades various pressure ulcer risk assessment scales (PURAS) have been developed and implemented into nursing practice despite uncertainty whether use of these tools helps to prevent pressure ulcers. According to current methodological standards, randomised controlled trials (RCTs) are required to conclusively determine the clinical efficacy and safety of this risk assessment strategy. In these trials, PURAS-aided risk assessment has to be compared to nurses' clinical judgment alone in terms of its impact on pressure ulcer incidence and adverse outcomes. However, RCTs evaluating diagnostic procedures are prone to specific risks of bias and threats to the statistical power which may challenge their validity and feasibility. This discussion paper critically reflects on the rigour and feasibility of experimental research needed to substantiate the clinical efficacy of PURAS-aided risk assessment. Based on reflections of the methodological literature, a critical appraisal of available trials on this subject and an analysis of a protocol developed for a methodologically robust cluster-RCT, this paper arrives at the following conclusions: First, available trials do not provide reliable estimates of the impact of PURAS-aided risk assessment on pressure ulcer incidence compared to nurses' clinical judgement alone due to serious risks of bias and insufficient sample size. Second, it seems infeasible to assess this impact by means of rigorous experimental studies since sample size would become extremely high if likely threats to validity and power are properly taken into account. Third, means of evidence linkages seem to currently be the most promising approaches for evaluating the clinical efficacy and safety of PURAS-aided risk assessment. With this kind of secondary research, the downstream effect of use of PURAS on pressure ulcer incidence could be modelled by combining best available evidence for single parts of this pathway. However, to yield reliable modelling

  17. A 6-month telephone-based weight loss intervention in overweight and obese subjects with idiopathic intracranial hypertension.

    PubMed

    Weil, Richard; Kovacs, Betty; Miller, Neil; McDermott, Michael P; Wall, Michael; Kupersmith, Mark; Pi-Sunyer, F Xavier

    2016-06-01

    The purpose of this paper is to measure the change in body weight after a 6-month telephone-based weight loss intervention in overweight and obese subjects with idiopathic intracranial hypertension (IIH) and mild visual loss randomized to receive either acetazolamide or placebo. One hundred sixty-five subjects with IIH, aged 29.1 ± 7.5 (mean ± SD) and BMI 39.9 + 8.3 kg/m 2 , enrolled at 38 academic and private practice sites in North America, participated in this trial. This was a randomized, double-masked, placebo-controlled trial of acetazolamide in subjects with IIH and mild visual loss. All participants received a reduced-sodium, weight-reduction diet and a 6-month telephone-based weight loss intervention. Six-month changes from baseline in body weight, perimetric mean deviation as assessed by automated perimetry and quality of life using the National Eye Institute Visual Function Questionnaire 25 and the 36-item Short Form Health Survey were measured. Mean percent weight change at 6 months was -5.9% ± 6.7% of initial body weight overall, -3.5% ± 5.9% in the placebo group and -7.8% ± 6.8% in the acetazolamide group. Weight change was not associated with changes in either mean deviation or quality of life scores. Patients with IIH and mild visual loss assigned to either acetazolamide or placebo, all of whom received a 6-month telephone-based weight loss intervention, lost an average of 5.9% of initial body weight, consistent with NHLBI guidelines of 5% to 10% of body weight loss for clinically significant health benefit.

  18. Use of Urine Biomarkers to Assess Sodium Intake: Challenges and Opportunities

    PubMed Central

    Maalouf, Joyce; Elliott, Paul; Loria, Catherine M.; Patel, Sheena; Bowman, Barbara A.

    2017-01-01

    This article summarizes current data and approaches to assess sodium intake in individuals and populations. A review of the literature on sodium excretion and intake estimation supports the continued use of 24-h urine collections for assessing population and individual sodium intake. Since 2000, 29 studies used urine biomarkers to estimate population sodium intake, primarily among adults. More than half used 24-h urine; the rest used a spot/casual, overnight, or 12-h specimen. Associations between individual sodium intake and health outcomes were investigated in 13 prospective cohort studies published since 2000. Only three included an indicator of long-term individual sodium intake, i.e., multiple 24-h urine specimens collected several days apart. Although not insurmountable, logistic challenges of 24-h urine collection remain a barrier for research on the relationship of sodium intake and chronic disease. Newer approaches, including modeling based on shorter collections, offer promise for estimating population sodium intake in some groups. PMID:25974702

  19. Evaluation of the cerebral vasodilatory capacity by the acetazolamide test before EC-IC bypass surgery in patients with occlusion of the internal carotid artery

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vorstrup, S.; Brun, B.; Lassen, N.A.

    1986-11-01

    Cerebral blood flow (CBF) was measured by xenon-133 inhalation tomography in 18 patients with cerebrovascular disease before and 4 months after extracranial-intracranial bypass surgery. Only patients who showed a reduced CBF in areas that were intact on the CT scan and relevant to the clinical and angiographical findings were operated. The majority of the patients had suffered a minor stroke with or without subsequent transient ischemic attacks. They were studied at least 6 weeks following the stroke. All patients had an occlusion of the relevant internal carotid artery. To identify preoperatively the patients with a compromised collateral circulation and hencemore » reduced CBF due to reduced perfusion pressure, a cerebral vasodilatory stress test was performed using acetazolamide (Diamox). In normal subjects, Diamox has been shown to increase tomographic CBF without change of the flow distribution. In the present series 9 patients showed a significant redistribution of flow in favor of the non-occluded side (positive Diamox test). Two of these 9 patients showed even a paradoxical decrease in focal CBF preoperatively, i.e., a steal effect. These 2 patients were the only patients who improved in focal CBF after shunting. The remaining 9 patients all showed uniform flow responses (negative Diamox test), and none of these increased in focal CBF postoperatively. The finding of an unchanged flow map postoperatively confirmed that the low flow areas were not due to restricted flow via collateral pathways. However, an increase in the regional vasodilatory capacity was observed postoperatively in the majority of patients.« less

  20. Challenges in assessing college students' conception of duality: the case of infinity

    NASA Astrophysics Data System (ADS)

    Babarinsa-Ochiedike, Grace Olutayo

    Interpreting students' views of infinity posits a challenge for researchers due to the dynamic nature of the conception. There is diversity and variation among students' process-object perceptions. The fluctuations between students' views however reveal an undeveloped duality conception. This study examined college students' conception of duality in understanding and representing infinity with the intent to design strategies that could guide researchers in categorizing students' views of infinity into different levels. Data for the study were collected from N=238 college students enrolled in Calculus sequence courses (Pre-Calculus, Calculus I through Calculus III) at one of the southwestern universities in the U.S. using self-report questionnaires and semi-structured individual task-based interviews. Data was triangulated using multiple measures analyzed by three independent experts using self-designed coding sheets to assess students' externalization of the duality conception of infinity. Results of this study reveal that college students' experiences in traditional Calculus sequence courses are not supportive of the development of duality conception. On the contrary, it strengthens the singularity perspective on fundamental ideas of mathematics such as infinity. The study also found that coding and assessing college students' conception of duality is a challenging and complex process due to the dynamic nature of the conception that is task-dependent and context-dependent. Practical significance of the study is that it helps to recognize misconceptions and starts addressing them so students will have a more comprehensive view of fundamental mathematical ideas as they progress through the Calculus coursework sequence. The developed duality concept development framework called Action-Process-Object-Duality (APOD) adapted from the APOS theory could guide educators and researchers as they engage in assessing students' conception of duality. The results of this study

  1. Flight assessment in patients with respiratory disease: hypoxic challenge testing vs. predictive equations.

    PubMed

    Martin, S E; Bradley, J M; Buick, J B; Bradbury, I; Elborn, J S

    2007-06-01

    Predictive equations have been proposed as a simpler alternative to hypoxic challenge testing (HCT) for determining the risk of in-flight hypoxia. To assess agreement between hypoxic challenge testing (HCT) and predictive equations for assessment of in-flight hypoxia. Retrospective study. Patients with chronic obstructive pulmonary disease (COPD) (n = 15), interstitial lung disease (ILD) (n = 15) and cystic fibrosis (CF) (n = 15) were studied. Spirometry was recorded prior to hypoxic inhalation and oxygen saturations (SpO2) were recorded before, after and during hypoxic inhalation. Blood gases were analysed before and after hypoxic inhalation and when SpO2 = 85%. An HCT was performed using the Ventimask method. The PaO2 at altitude was estimated for each group using four published predictive equations, which use values of PaO2 (ground) and lung function measurements to predict altitude PaO2. Results were interpreted using the BTS recommendations for prescription of in-flight oxygen post HCT. The Stuart Maxwell test of overall homogeneity was used to assess agreement between HCT results and each of the predictive equations. Ground PaO2 was significantly greater in patients with CF than either ILD or COPD (p < 0.05). PaO2 in all three groups significantly decreased following HCT. With the exception of equation 3, significantly fewer patients in each group would require in-flight O2 if prescription was based on HCT, compared to predictive equations (p < 0.05). Predictive equations considerably overestimate the need for in-flight O2, compared to HCT.

  2. Assessing macroinvertebrate biodiversity in freshwater ecosystems: Advances and challenges in dna-based approaches

    USGS Publications Warehouse

    Pfrender, M.E.; Ferrington, L.C.; Hawkins, C.P.; Hartzell, P.L.; Bagley, M.; Jackson, S.; Courtney, G.W.; Larsen, D.P.; Creutzburg, B.R.; Levesque, C.A.; Epler, J.H.; Morse, J.C.; Fend, S.; Petersen, M.J.; Ruiter, D.; Schindel, D.; Whiting, M.

    2010-01-01

    Assessing the biodiversity of macroinvertebrate fauna in freshwater ecosystems is an essential component of both basic ecological inquiry and applied ecological assessments. Aspects of taxonomic diversity and composition in freshwater communities are widely used to quantify water quality and measure the efficacy of remediation and restoration efforts. The accuracy and precision of biodiversity assessments based on standard morphological identifications are often limited by taxonomic resolution and sample size. Morphologically based identifications are laborious and costly, significantly constraining the sample sizes that can be processed. We suggest that the development of an assay platform based on DNA signatures will increase the precision and ease of quantifying biodiversity in freshwater ecosystems. Advances in this area will be particularly relevant for benthic and planktonic invertebrates, which are often monitored by regulatory agencies. Adopting a genetic assessment platform will alleviate some of the current limitations to biodiversity assessment strategies. We discuss the benefits and challenges associated with DNA-based assessments and the methods that are currently available. As recent advances in microarray and next-generation sequencing technologies will facilitate a transition to DNA-based assessment approaches, future research efforts should focus on methods for data collection, assay platform development, establishing linkages between DNA signatures and well-resolved taxonomies, and bioinformatics. ?? 2010 by The University of Chicago Press.

  3. Challenges and Opportunities for Integrating Social Science Perspectives into Climate and Global Change Assessments

    NASA Astrophysics Data System (ADS)

    Larson, E. K.; Li, J.; Zycherman, A.

    2017-12-01

    Integration of social science into climate and global change assessments is fundamental for improving understanding of the drivers, impacts and vulnerability of climate change, and the social, cultural and behavioral challenges related to climate change responses. This requires disciplinary and interdisciplinary knowledge as well as integrational and translational tools for linking this knowledge with the natural and physical sciences. The USGCRP's Social Science Coordinating Committee (SSCC) is tasked with this challenge and is working to integrate relevant social, economic and behavioral knowledge into processes like sustained assessments. This presentation will discuss outcomes from a recent SSCC workshop, "Social Science Perspectives on Climate Change" and their applications to sustained assessments. The workshop brought academic social scientists from four disciplines - anthropology, sociology, geography and archaeology - together with federal scientists and program managers to discuss three major research areas relevant to the USGCRP and climate assessments: (1) innovative tools, methods, and analyses to clarify the interactions of human and natural systems under climate change, (2) understanding of factors contributing to differences in social vulnerability between and within communities under climate change, and (3) social science perspectives on drivers of global climate change. These disciplines, collectively, emphasize the need to consider socio-cultural, political, economic, geographic, and historic factors, and their dynamic interactions, to understand climate change drivers, social vulnerability, and mitigation and adaptation responses. They also highlight the importance of mixed quantitative and qualitative methods to explain impacts, vulnerability, and responses at different time and spatial scales. This presentation will focus on major contributions of the social sciences to climate and global change research. We will discuss future directions for

  4. Academic Challenges: Student Outcomes Assessment.

    ERIC Educational Resources Information Center

    California State Univ., Long Beach. Office of the Chancellor.

    A "meta-assessment" was done of 13 pilot projects on student outcomes assessment in a variety of disciplines at 11 campuses in the California State University (CSU) system. These projects had developed both quantitative and qualitative strategies for collecting data on student learning outcomes. The meta-assessment was designed to…

  5. A 6‐month telephone‐based weight loss intervention in overweight and obese subjects with idiopathic intracranial hypertension

    PubMed Central

    Kovacs, Betty; Miller, Neil; McDermott, Michael P.; Wall, Michael; Kupersmith, Mark; Pi‐Sunyer, F. Xavier

    2016-01-01

    Summary Objectives The purpose of this paper is to measure the change in body weight after a 6‐month telephone‐based weight loss intervention in overweight and obese subjects with idiopathic intracranial hypertension (IIH) and mild visual loss randomized to receive either acetazolamide or placebo. Methods One hundred sixty‐five subjects with IIH, aged 29.1 ± 7.5 (mean ± SD) and BMI 39.9 + 8.3 kg/m2, enrolled at 38 academic and private practice sites in North America, participated in this trial. This was a randomized, double‐masked, placebo‐controlled trial of acetazolamide in subjects with IIH and mild visual loss. All participants received a reduced‐sodium, weight‐reduction diet and a 6‐month telephone‐based weight loss intervention. Six‐month changes from baseline in body weight, perimetric mean deviation as assessed by automated perimetry and quality of life using the National Eye Institute Visual Function Questionnaire 25 and the 36‐item Short Form Health Survey were measured. Results Mean percent weight change at 6 months was −5.9% ± 6.7% of initial body weight overall, −3.5% ± 5.9% in the placebo group and −7.8% ± 6.8% in the acetazolamide group. Weight change was not associated with changes in either mean deviation or quality of life scores. Conclusion Patients with IIH and mild visual loss assigned to either acetazolamide or placebo, all of whom received a 6‐month telephone‐based weight loss intervention, lost an average of 5.9% of initial body weight, consistent with NHLBI guidelines of 5% to 10% of body weight loss for clinically significant health benefit. PMID:29071096

  6. Clinical Implication of Temporary Hypointense Lesion on Diffusion-Weighted Imaging After Extracranial-Intracranial Bypass Surgery.

    PubMed

    Kimura, Hidehito; Taniguchi, Masaaki; Mori, Tatsuya; Hosoda, Kohkichi; Kohmura, Eiji

    2017-01-01

    Postoperative hyperperfusion syndrome after extracranial-to-intracranial bypass causing temporary neurologic deterioration has been reported rarely as isosignal intensity on diffusion-weighted imaging (DWI) with hyperintense lesion on T2-weighted image and fluid-attenuated inversion recovery (FLAIR) imaging as an expression of vasogenic edema. We present a rare case of a patient suffering from temporary aphasia after an extracranial-to-intracranial bypass surgery, which was shown as a transient hypointense lesion on DWI with increased apparent diffusion coefficient value, evidence of postoperative hyperperfusion. By the preoperative single-photon emission computed tomography study analyzed retrospectively, preoperative cerebral blood flow (CBF) was compared between the lesions in which the hypointensity emerged and the lesions in which its signal remained unchanged in the hyperperfusion area. We found CBF after an acetazolamide challenge was much smaller and the percentage increase of CBF after an acetazolamide challenge was much less than zero in the temporal hypointense lesion on DWI. An abrupt increase of CBF after bypass installation to the brain with no vascular response and complete disruption of the blood-brain barrier would cause a remarkable increase of extracellular fluid and excessive water molecule diffusion, resulting in excessive vasogenic edema. This was a plausible mechanism for the transient hypointense lesion on DWI with increased apparent diffusion coefficient value. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. "I Just Do as Expected". Teachers' Implementation of Continuous Assessment and Challenges to Curriculum Literacy

    ERIC Educational Resources Information Center

    Nsibande, Rejoice N.; Modiba, Maropeng M.

    2012-01-01

    This paper reports on a study that clarifies the nature and scope of the challenges experienced by primary school teachers in Swaziland when using Continuous Assessment (CA) as a tool to improve teaching and learning. Through the use of classroom observations and stimulated recall interviews, we sought to understand the significance of the choices…

  8. Assessing climate risks across different business sectors and industries: an investigation of methodological challenges at national scale for the UK

    NASA Astrophysics Data System (ADS)

    Surminski, Swenja; Di Mauro, Manuela; Baglee, J. Alastair R.; Connell, Richenda K.; Hankinson, Joel; Haworth, Anna R.; Ingirige, Bingunath; Proverbs, David

    2018-06-01

    Climate change poses severe risks for businesses, which companies as well as governments need to understand in order to take appropriate steps to manage those. This, however, represents a significant challenge as climate change risk assessment is itself a complex, dynamic and geographically diverse process. A wide range of factors including the nature of production processes and value chains, the location of business sites as well as relationships and interdependencies with customers and suppliers play a role in determining if and how companies are impacted by climate risks. This research explores the methodological challenges for a national-scale assessment of climate risks through the lens of the UK Climate Change Risk Assessment (UKCCRA) process and compares the approaches adopted in the first and second UKCCRA (2011, 2016), while also reflecting on international experiences elsewhere. A review of these issues is presented, drawing on a wide body of contemporary evidence from a range of sources including the research disciplines, grey literature and government policy. The study reveals the methodological challenges and highlights six broad themes, namely scale, evidence base, adaptation responses, scope, interdependencies and public policy. The paper concludes by identifying suitable lessons for future national climate risk assessments, which should guide the next phase of research in preparation for UKCCRA3 and those of national-level risk assessments elsewhere. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

  9. Assessing climate risks across different business sectors and industries: an investigation of methodological challenges at national scale for the UK.

    PubMed

    Surminski, Swenja; Di Mauro, Manuela; Baglee, J Alastair R; Connell, Richenda K; Hankinson, Joel; Haworth, Anna R; Ingirige, Bingunath; Proverbs, David

    2018-06-13

    Climate change poses severe risks for businesses, which companies as well as governments need to understand in order to take appropriate steps to manage those. This, however, represents a significant challenge as climate change risk assessment is itself a complex, dynamic and geographically diverse process. A wide range of factors including the nature of production processes and value chains, the location of business sites as well as relationships and interdependencies with customers and suppliers play a role in determining if and how companies are impacted by climate risks. This research explores the methodological challenges for a national-scale assessment of climate risks through the lens of the UK Climate Change Risk Assessment (UKCCRA) process and compares the approaches adopted in the first and second UKCCRA (2011, 2016), while also reflecting on international experiences elsewhere. A review of these issues is presented, drawing on a wide body of contemporary evidence from a range of sources including the research disciplines, grey literature and government policy. The study reveals the methodological challenges and highlights six broad themes, namely scale, evidence base, adaptation responses, scope, interdependencies and public policy. The paper concludes by identifying suitable lessons for future national climate risk assessments, which should guide the next phase of research in preparation for UKCCRA3 and those of national-level risk assessments elsewhere.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'. © 2018 The Author(s).

  10. Internet-Based Self-Help Career Assessments and Interventions: Challenges and Implications for Evidence-Based Career Counseling

    ERIC Educational Resources Information Center

    Gati, Itamar; Asulin-Peretz, Lisa

    2011-01-01

    A major characteristic of the 21st century with significant implications on career decision making is the growing prevalence of Information and Communication Technologies (ICTs). Challenges involving ICT-based self-assessment and self-help interventions aimed at facilitating career decision making are discussed. Specifically, this article focuses…

  11. Genome Assembly Forensics: Metrics for Assessing Assembly Correctness (Metagenomics Informatics Challenges Workshop: 10K Genomes at a Time)

    ScienceCinema

    Pop, Mihai

    2018-04-27

    University of Maryland's Mihai Pop on Genome Assembly Forensics: Metrics for Assessing Assembly Correctness at the Metagenomics Informatics Challenges Workshop held at the DOE JGI on October 12-13, 2011.

  12. Challenges for PISA

    ERIC Educational Resources Information Center

    Schleicher, Andreas

    2016-01-01

    The OECD Programme for International Student Assessment (PISA) provides a framework in which over 80 countries collaborate to build advanced global metrics to assess the knowledge, skills and character attributes of the students. The design of assessments poses major conceptual and technical challenges, as successful learning. Beyond a sound…

  13. Scientific Challenges in the Risk Assessment of Food Contact Materials.

    PubMed

    Muncke, Jane; Backhaus, Thomas; Geueke, Birgit; Maffini, Maricel V; Martin, Olwenn Viviane; Myers, John Peterson; Soto, Ana M; Trasande, Leonardo; Trier, Xenia; Scheringer, Martin

    2017-09-11

    Food contact articles (FCAs) are manufactured from food contact materials (FCMs) that include plastics, paper, metal, glass, and printing inks. Chemicals can migrate from FCAs into food during storage, processing, and transportation. Food contact materials' safety is evaluated using chemical risk assessment (RA). Several challenges to the RA of FCAs exist. We review regulatory requirements for RA of FCMs in the United States and Europe, identify gaps in RA, and highlight opportunities for improving the protection of public health. We intend to initiate a discussion in the wider scientific community to enhance the safety of food contact articles. Based on our evaluation of the evidence, we conclude that current regulations are insufficient for addressing chemical exposures from FCAs. RA currently focuses on monomers and additives used in the manufacture of products, but it does not cover all substances formed in the production processes. Several factors hamper effective RA for many FCMs, including a lack of information on chemical identity, inadequate assessment of hazardous properties, and missing exposure data. Companies make decisions about the safety of some food contact chemicals (FCCs) without review by public authorities. Some chemical migration limits cannot be enforced because analytical standards are unavailable. We think that exposures to hazardous substances migrating from FCAs require more attention. We recommend a ) limiting the number and types of chemicals authorized for manufacture and b ) developing novel approaches for assessing the safety of chemicals in FCAs, including unidentified chemicals that form during or after production. https://doi.org/10.1289/EHP644.

  14. Scientific Challenges in the Risk Assessment of Food Contact Materials

    PubMed Central

    Backhaus, Thomas; Geueke, Birgit; Maffini, Maricel V.; Martin, Olwenn Viviane; Myers, John Peterson; Soto, Ana M.; Trasande, Leonardo; Trier, Xenia; Scheringer, Martin

    2017-01-01

    Background: Food contact articles (FCAs) are manufactured from food contact materials (FCMs) that include plastics, paper, metal, glass, and printing inks. Chemicals can migrate from FCAs into food during storage, processing, and transportation. Food contact materials’ safety is evaluated using chemical risk assessment (RA). Several challenges to the RA of FCAs exist. Objectives: We review regulatory requirements for RA of FCMs in the United States and Europe, identify gaps in RA, and highlight opportunities for improving the protection of public health. We intend to initiate a discussion in the wider scientific community to enhance the safety of food contact articles. Discussion: Based on our evaluation of the evidence, we conclude that current regulations are insufficient for addressing chemical exposures from FCAs. RA currently focuses on monomers and additives used in the manufacture of products, but it does not cover all substances formed in the production processes. Several factors hamper effective RA for many FCMs, including a lack of information on chemical identity, inadequate assessment of hazardous properties, and missing exposure data. Companies make decisions about the safety of some food contact chemicals (FCCs) without review by public authorities. Some chemical migration limits cannot be enforced because analytical standards are unavailable. Conclusion: We think that exposures to hazardous substances migrating from FCAs require more attention. We recommend a) limiting the number and types of chemicals authorized for manufacture and b) developing novel approaches for assessing the safety of chemicals in FCAs, including unidentified chemicals that form during or after production. https://doi.org/10.1289/EHP644 PMID:28893723

  15. Effects of Coaching on the Implementation of Functional Assessment-Based Parent Intervention in Reducing Challenging Behaviors

    ERIC Educational Resources Information Center

    Fettig, Angel; Schultz, Tia R.; Sreckovic, Melissa A.

    2015-01-01

    This study examined the effects of coaching on the implementation of functional assessment--based parent intervention in reducing children's challenging behaviors. A multiple baseline across participants design was used with three parent-child dyads with children between the ages of 2 and 5 years. The intervention consisted of training and delayed…

  16. Assessing atrophy measurement techniques in dementia: Results from the MIRIAD atrophy challenge.

    PubMed

    Cash, David M; Frost, Chris; Iheme, Leonardo O; Ünay, Devrim; Kandemir, Melek; Fripp, Jurgen; Salvado, Olivier; Bourgeat, Pierrick; Reuter, Martin; Fischl, Bruce; Lorenzi, Marco; Frisoni, Giovanni B; Pennec, Xavier; Pierson, Ronald K; Gunter, Jeffrey L; Senjem, Matthew L; Jack, Clifford R; Guizard, Nicolas; Fonov, Vladimir S; Collins, D Louis; Modat, Marc; Cardoso, M Jorge; Leung, Kelvin K; Wang, Hongzhi; Das, Sandhitsu R; Yushkevich, Paul A; Malone, Ian B; Fox, Nick C; Schott, Jonathan M; Ourselin, Sebastien

    2015-12-01

    Structural MRI is widely used for investigating brain atrophy in many neurodegenerative disorders, with several research groups developing and publishing techniques to provide quantitative assessments of this longitudinal change. Often techniques are compared through computation of required sample size estimates for future clinical trials. However interpretation of such comparisons is rendered complex because, despite using the same publicly available cohorts, the various techniques have been assessed with different data exclusions and different statistical analysis models. We created the MIRIAD atrophy challenge in order to test various capabilities of atrophy measurement techniques. The data consisted of 69 subjects (46 Alzheimer's disease, 23 control) who were scanned multiple (up to twelve) times at nine visits over a follow-up period of one to two years, resulting in 708 total image sets. Nine participating groups from 6 countries completed the challenge by providing volumetric measurements of key structures (whole brain, lateral ventricle, left and right hippocampi) for each dataset and atrophy measurements of these structures for each time point pair (both forward and backward) of a given subject. From these results, we formally compared techniques using exactly the same dataset. First, we assessed the repeatability of each technique using rates obtained from short intervals where no measurable atrophy is expected. For those measures that provided direct measures of atrophy between pairs of images, we also assessed symmetry and transitivity. Then, we performed a statistical analysis in a consistent manner using linear mixed effect models. The models, one for repeated measures of volume made at multiple time-points and a second for repeated "direct" measures of change in brain volume, appropriately allowed for the correlation between measures made on the same subject and were shown to fit the data well. From these models, we obtained estimates of the

  17. Students with Reading and Writing Challenges: Using Informal Assessment to Assist in Planning for the Transition to Adult Life

    ERIC Educational Resources Information Center

    Sitlington, Patricia L.

    2008-01-01

    The transition to adult life for students with reading and writing challenges is an area that is not often addressed. The purpose of this article is to relate the informal assessment process to the broader context of high stakes assessment, high school exit exams, diploma options, and transition planning; identify the competencies needed for a…

  18. RESPONSIVENESS, LANGUAGE, AND ALIGNMENT: REFLECTIONS ON SOME CHALLENGES FOR HEALTH TECHNOLOGY ASSESSMENT.

    PubMed

    Dillon, Andrew

    2015-01-01

    Health systems around the world cope with the challenge of difficult economic times, and the value of health technology assessment (HTA) is increasing. Making the right choices, with limited resources, in the face of increasingly complex technologies requires decisions informed by data and analyses that help us to manage the risks involved. Those who undertake and use HTA can play a greater role in helping decision makers meet these challenges; they need to think how to define innovation and respond to it, how to communicate their analyses, and, critically, how to align their work with the ambitions of their health systems. HTA can become a key health system enabler without compromising its objectivity or independence. It can say that it is too early to determine the value of a new technology when the data simply will not support a safe decision. However, it can also be bold and recommend the managed introduction of new technologies, even when the when the data is immature, provided that the health system understands the risks and there is a plausible case for believing that further research will support the value proposition. The goal for HTA is to be able confidently to do both.

  19. Assessing Academic Challenges for Their Contribution to Cognitive Development.

    ERIC Educational Resources Information Center

    McCormick, David F.; Whittington, M. Susie

    2000-01-01

    Challenges (assignments, activities, tests) incorporated into agriculture classes were evaluated using Bloom's Taxonomy. The cognitive level varied by course and type of activity. Effectiveness depended on selecting challenges appropriate for the material, requiring higher-order thinking, and rewarding students for work at higher cognitive levels.…

  20. A study to assess whether fixed-width beam walking provides sufficient challenge to assess balance ability across lower limb prosthesis users.

    PubMed

    Sawers, Andrew; Hafner, Brian J

    2018-04-01

    To evaluate the feasibility of fixed-width beam walking for assessing balance in lower limb prosthesis users. Cross-sectional. Laboratory. Lower limb prosthesis users. Participants attempted 10 walking trials on three fixed-width beams (18.6, 8.60, and 4.01 wide; 5.5 m long; 3.8 cm high). Beam-walking performance was quantified using the distance walked to balance failure. Heuristic rules applied to each participant's beam-walking distance to classify each beam as "too easy," "too hard," or "appropriately challenging" and determine whether any single beam provided an appropriate challenge to all participants. The number of trials needed to achieve stable beam-walking performance was quantified for appropriately challenging beams by identifying the last inflection point in the slope of each participant's trial-by-trial cumulative performance record. In all, 30 unilateral lower limb prosthesis users participated in the study. Each of the fixed-width beams was either too easy or too hard for at least 33% of the sample. Thus, no single beam was appropriately challenging for all participants. Beam-walking performance was stable by trial 8 for all participants and by trial 6 for 90% of participants. There was no significant difference in the number of trials needed to achieve stable performance among beams ( P = 0.74). Results suggest that a clinical beam-walking test would require multiple beams to evaluate balance across a range of lower limb prosthesis users, emphasizing the need for adaptive or progressively challenging balance tests. While the administrative burden of a multiple-beam balance test may limit clinical feasibility, alternatives to ease this administrative burden are proposed.

  1. Conclusion: challenges for the future.

    PubMed

    North, D W

    1993-12-01

    The title "Challenges for the Future" implies the challenge to summarize a very complex meeting. Of necessity, I will present a personal impression. My interest is in risk assessment, which I define as a process for summarizing science in support of decision making. Risk assessment is sometimes regarded as arcane numerology, a rigid process of computing risk numbers in which much available science is unused. I am a strong advocate for the broader definition of risk assessment. It is encouraging to learn how much science is becoming available for use in risk assessment for gasoline, its components, and alternative fuels.

  2. Conclusion: challenges for the future

    PubMed Central

    North, D. Warner

    1993-01-01

    The title “Challenges for the Future” implies the challenge to summarize a very complex meeting. Of necessity, I will present a personal impression. My interest is in risk assessment, which I define as a process for summarizing science in support of decision making. Risk assessment is sometimes regarded as arcane numerology, a rigid process of computing risk numbers in which much available science is unused. I am a strong advocate for the broader definition of risk assessment. It is encouraging to learn how much science is becoming available for use in risk assessment for gasoline, its components, and alternative fuels. PMID:17539103

  3. Assessment of Teacher Competencies in Handling Physically Challenged Pupils in Public Primary Schools in Kericho County

    ERIC Educational Resources Information Center

    Maiwa, Jeniffer Chepkoech; Ngeno, Godfrey

    2017-01-01

    The process of having inclusive education in Kenya has been very slow for children with special needs yet many of these children are still at home and have attained school going age. The purpose of this study was to assess teacher competencies in handling physically challenged pupils in public primary schools in Kericho County. The study was…

  4. The Challenge of Assessing Creative Problem Solving in Client-Based Marketing Development Projects: A SOLO Taxonomy Approach

    ERIC Educational Resources Information Center

    Jaskari, Minna-Maarit

    2013-01-01

    Creativity and marketing imagination are essential core competencies for marketers. Therefore, higher marketing education emphasizes creativity in several ways. However, assessing creativity and creative problem solving is challenging and tools for this purpose have not been developed in the context of marketing education. To address this gap, we…

  5. Applications and Challenges in Dynamic Assessment.

    ERIC Educational Resources Information Center

    Haywood, H. Carl; Tzuriel, David

    2002-01-01

    Reviews what is known about dynamic assessment, offering examples of its utility as a tool for research and clinical work in psychopathology, neuropsychology, education, the study of cultural differences, and developmental research. After discussing the use of dynamic assessment in assessing outcomes of cognitive education programs, the paper…

  6. Herbicide-related signaling in plants reveals novel insights for herbicide use strategies, environmental risk assessment and global change assessment challenges.

    PubMed

    Alberto, Diana; Serra, Anne-Antonella; Sulmon, Cécile; Gouesbet, Gwenola; Couée, Ivan

    2016-11-01

    Herbicide impact is usually assessed as the result of a unilinear mode of action on a specific biochemical target with a typical dose-response dynamics. Recent developments in plant molecular signaling and crosstalk between nutritional, hormonal and environmental stress cues are however revealing a more complex picture of inclusive toxicity. Herbicides induce large-scale metabolic and gene-expression effects that go far beyond the expected consequences of unilinear herbicide-target-damage mechanisms. Moreover, groundbreaking studies have revealed that herbicide action and responses strongly interact with hormone signaling pathways, with numerous regulatory protein-kinases and -phosphatases, with metabolic and circadian clock regulators and with oxidative stress signaling pathways. These interactions are likely to result in mechanisms of adjustment that can determine the level of sensitivity or tolerance to a given herbicide or to a mixture of herbicides depending on the environmental and developmental status of the plant. Such regulations can be described as rheostatic and their importance is discussed in relation with herbicide use strategies, environmental risk assessment and global change assessment challenges. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Effects of competitive red blood cell binding and reduced hematocrit on the blood and plasma levels of (/sup 14/C)Indapamide in the rat

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lettieri, J.T.; Portelli, S.T.

    1983-02-01

    The effects of chlorthalidone and acetazolamide on the red blood cell binding of indapamide were investigated. Both drugs caused a substantial decrease in the amount of indapamide bound to the erythrocytes in vitro. This effect was demonstrated by a change in the indapamide blood/plasma ratio from approximately 6 in control samples, to a value of 1 when either of the displacing agents was added. Coadministration of acetazolamide with /sup 14/C-labeled indapamide to rats, resulted in a 5-fold drop in the blood levels of total radioactivity, relative to rats dosed with (/sup 14/C)indapamide alone. Concomitantly, there was a 2-fold increase inmore » the plasma levels of total radioactivity after acetazolamide coadministration. In rats whose hematocrits had been reduced by extensive bleeding, there were only minor alterations in the blood/plasma partitioning of (/sup 14/C)indapamide. Thus, chlorthalidone and acetazolamide were able to displace indapamide from erythrocytes in vitro and in vivo, possibly by competition at a carbonic anhydrase binding site. The pharmacokinetics of drugs which are extensively bound to erythrocytes may be significantly altered by the presence of other agents capable of competitive binding.« less

  8. Visual Field Outcomes for the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT).

    PubMed

    Wall, Michael; Johnson, Chris A; Cello, Kimberly E; Zamba, K D; McDermott, Michael P; Keltner, John L

    2016-03-01

    The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) showed that acetazolamide provided a modest, significant improvement in mean deviation (MD). Here, we further analyze visual field changes over the 6-month study period. Of 165 subjects with mild visual loss in the IIHTT, 125 had perimetry at baseline and 6 months. We evaluated pointwise linear regression of visual sensitivity versus time to classify test locations in the worst MD (study) eye as improving or not; pointwise changes from baseline to month 6 in decibels; and clinical consensus of change from baseline to 6 months. The average study eye had 36 of 52 test locations with improving sensitivity over 6 months using pointwise linear regression, but differences between the acetazolamide and placebo groups were not significant. Pointwise results mostly improved in both treatment groups with the magnitude of the mean change within groups greatest and statistically significant around the blind spot and the nasal area, especially in the acetazolamide group. The consensus classification of visual field change from baseline to 6 months in the study eye yielded percentages (acetazolamide, placebo) of 7.2% and 17.5% worse, 35.1% and 31.7% with no change, and 56.1% and 50.8% improved; group differences were not statistically significant. In the IIHTT, compared to the placebo group, the acetazolamide group had a significant pointwise improvement in visual field function, particularly in the nasal and pericecal areas; the latter is likely due to reduction in blind spot size related to improvement in papilledema. (ClinicalTrials.gov number, NCT01003639.).

  9. Caring for people with dementia and challenging behaviors in nursing homes: A needs assessment geriatric nursing.

    PubMed

    Daly, Jeanette M; Bay, Camden P; Levy, Barcey T; Carnahan, Ryan M

    2015-01-01

    An estimated 50% of nursing home residents have a dementia diagnosis. The purpose of this research was to conduct a needs assessment of directors of nursing (DON) in Iowa nursing homes in relation to caring for patients with Behavioral and Psychological Symptoms of Dementia. DON responses were linked to Online Survey Certification and Reporting/Certification and Survey Provider Enhanced Reporting (OSCAR/CASPER) data to examine how facility characteristics may be associated with use of and confidence in non-drug management strategies. From 431 questionnaires mailed to DONs, 160 (37%) were returned. Regression analysis showed that those who were more confident in managing challenging behavior were more likely to have satisfaction with current training on managing challenging behaviors and had a psychiatrist available to visit the facility. Facilities with a larger proportion of patients with challenging behaviors being treated with non-drug approaches instead of antipsychotics had DONs who were more likely to be confident in non-drug management strategies and have knowledge about the FDA antipsychotic medications risks. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Assessing atrophy measurement techniques in dementia: Results from the MIRIAD atrophy challenge

    PubMed Central

    Cash, David M.; Frost, Chris; Iheme, Leonardo O.; Ünay, Devrim; Kandemir, Melek; Fripp, Jurgen; Salvado, Olivier; Bourgeat, Pierrick; Reuter, Martin; Fischl, Bruce; Lorenzi, Marco; Frisoni, Giovanni B.; Pennec, Xavier; Pierson, Ronald K.; Gunter, Jeffrey L.; Senjem, Matthew L.; Jack, Clifford R.; Guizard, Nicolas; Fonov, Vladimir S.; Collins, D. Louis; Modat, Marc; Cardoso, M. Jorge; Leung, Kelvin K.; Wang, Hongzhi; Das, Sandhitsu R.; Yushkevich, Paul A.; Malone, Ian B.; Fox, Nick C.; Schott, Jonathan M.; Ourselin, Sebastien

    2015-01-01

    Structural MRI is widely used for investigating brain atrophy in many neurodegenerative disorders, with several research groups developing and publishing techniques to provide quantitative assessments of this longitudinal change. Often techniques are compared through computation of required sample size estimates for future clinical trials. However interpretation of such comparisons is rendered complex because, despite using the same publicly available cohorts, the various techniques have been assessed with different data exclusions and different statistical analysis models. We created the MIRIAD atrophy challenge in order to test various capabilities of atrophy measurement techniques. The data consisted of 69 subjects (46 Alzheimer's disease, 23 control) who were scanned multiple (up to twelve) times at nine visits over a follow-up period of one to two years, resulting in 708 total image sets. Nine participating groups from 6 countries completed the challenge by providing volumetric measurements of key structures (whole brain, lateral ventricle, left and right hippocampi) for each dataset and atrophy measurements of these structures for each time point pair (both forward and backward) of a given subject. From these results, we formally compared techniques using exactly the same dataset. First, we assessed the repeatability of each technique using rates obtained from short intervals where no measurable atrophy is expected. For those measures that provided direct measures of atrophy between pairs of images, we also assessed symmetry and transitivity. Then, we performed a statistical analysis in a consistent manner using linear mixed effect models. The models, one for repeated measures of volume made at multiple time-points and a second for repeated “direct” measures of change in brain volume, appropriately allowed for the correlation between measures made on the same subject and were shown to fit the data well. From these models, we obtained estimates of the

  11. From chemical risk assessment to environmental quality management: the challenge for soil protection.

    PubMed

    Bone, James; Head, Martin; Jones, David T; Barraclough, Declan; Archer, Michael; Scheib, Catherine; Flight, Dee; Eggleton, Paul; Voulvoulis, Nikolaos

    2011-01-01

    The 40 years that have passed since the beginning of the 'environmental revolution' has seen a large increase in development of policies for the protection of environmental media and a recognition by the public of the importance of environmental quality. There has been a shift from policy in reaction to high profile events, then to control of releases to single environmental media, and to the present position of moving toward integrated management of all environmental media at present. This development has moved away from classical chemical risk assessment toward environmental holism, including recognition of the ecological value of these media. This work details how policy developments have taken place for air and water, with examples from the USA and EU, in order to compare this with policy development regarding soil. Soil, with quite different policy frameworks and distinct uses, understanding, and threats compared to other environmental media, is currently attracting attention regarding the need for its protection independent of use. Challenges for soil policy are identified and evaluated, and recommendations on how these challenges can be overcome are discussed with relevance to water and air protection policy.

  12. Addressing challenging behaviour in children with Down syndrome: the use of applied behaviour analysis for assessment and intervention.

    PubMed

    Feeley, Kathleen M; Jones, Emily A

    2006-09-01

    Children with Down syndrome are at an increased risk for engaging in challenging behaviour that may be part of a behavioural phenotype characteristic of Down syndrome. The methodology of applied behaviour analysis has been demonstrated effective with a wide range of challenging behaviours, across various disabilities. Applications to children with Down syndrome and the examination of behaviourally based strategies to specifically address the unique characteristics of children with Down syndrome are limited. However, there are several studies in which a subset of the participants did have Down syndrome. A handful of these studies are reviewed within the context of functional behaviour assessment and Positive Behavioural Supports. Drawing from these studies and the behavioural literature, as well as the authors' clinical experience and research, suggestions regarding early intervention for challenging behaviour with children with Down syndrome are provided.

  13. Communicative Alternatives to Challenging Behavior: Integrating Functional Assessment and Intervention Strategies. Volume 3. Communication and Language Intervention Series.

    ERIC Educational Resources Information Center

    Reichle, Joe, Ed.; Wacker, David P., Ed.

    Emphasizing the use of communication training as the foundation for effective behavioral programming, this book explains how challenging behavior can be redirected into socially acceptable behavior through functional communication intervention. The book offers hands-on assessment and intervention strategies that can be used in school, home, work,…

  14. Post-Challenger evaluation of space shuttle risk assessment and management

    NASA Technical Reports Server (NTRS)

    1988-01-01

    As the shock of the Space Shuttle Challenger accident began to subside, NASA initiated a wide range of actions designed to ensure greater safety in various aspects of the Shuttle system and an improved focus on safety throughout the National Space Transportation System (NSTS) Program. Certain specific features of the NASA safety process are examined: the Critical Items List (CIL) and the NASA review of the Shuttle primary and backup units whose failure might result in the loss of life, the Shuttle vehicle, or the mission; the failure modes and effects analyses (FMEA); and the hazard analysis and their review. The conception of modern risk management, including the essential element of objective risk assessment is described and it is contrasted with NASA's safety process in general terms. The discussion, findings, and recommendations regarding particular aspects of the NASA STS safety assurance process are reported. The 11 subsections each deal with a different aspect of the process. The main lessons learned by SCRHAAC in the course of the audit are summarized.

  15. The development of a questionnaire to assess the perceptions of care staff towards people with intellectual disabilities who display challenging behaviour.

    PubMed

    Williams, Ruth J; Rose, John L

    2007-06-01

    The perceptions of staff about challenging behaviour may be a key factor in designing successful behavioural interventions. There is a lack of robust psychometric instruments designed to assess staff attributions towards incidents of challenging behaviour. The aim of this research was to develop a scale based upon the self-regulation theory of illness behaviour. Two staff focus groups identified and clarified relevant constructs to be included in the Challenging Behaviour Perception Questionnaire (CBPQ), which was then completed by 51 staff. Some correlations between the CBPQ and the Attributional Style Questionnaire were found. A significant amount of the variance in the perception of challenging behaviour was explained by the subscales of the new questionnaire. In particular, episodic timeline would seem to be a promising area for further investigation.

  16. Different Methods for Long-term Systematic Assessment of Challenging Behaviors in People with Severe Intellectual Disability

    PubMed Central

    Delgado, Candida; Gonzalez-Gordon, Rodrigo G.; Aragón, Estívaliz; Navarro, Jose I.

    2017-01-01

    The aim of this study was to compare the advantages and disadvantages of different behavioral assessment procedures with the purpose of design a long-term assessment procedure that brings together the benefits observed. The study involved four adults with severe and profound intellectual disabilities and severe behavioral problems. A behavioral assessment has been carried out with Scatter Plot, Antecedent-Behavior-Consequence record sheets and, finally, The Observer XT. We conducted a comprehensive assessment of challenging behavior of each participant, by reviewing bio-psychosocial records, interviewing family and direct caregiver staff, as well as direct observation. A large inter-subject behavior variability and instability of intra-subject behavior were found, raising questions about the election of the period to evaluate. The first evaluation level highlighted information about stability of behavior, the second level stand out the context in which it occurs and the third level detailed the different topographies of each behavioral category. The results suggest the desirability of a continuous assessment by combining these three levels for adjusting to the specific characteristics of behavior. We suggest the need of designing a single behavioral assessment procedure that includes the benefits observed in each of the instruments used. PMID:28154543

  17. Different Methods for Long-term Systematic Assessment of Challenging Behaviors in People with Severe Intellectual Disability.

    PubMed

    Delgado, Candida; Gonzalez-Gordon, Rodrigo G; Aragón, Estívaliz; Navarro, Jose I

    2017-01-01

    The aim of this study was to compare the advantages and disadvantages of different behavioral assessment procedures with the purpose of design a long-term assessment procedure that brings together the benefits observed. The study involved four adults with severe and profound intellectual disabilities and severe behavioral problems. A behavioral assessment has been carried out with Scatter Plot, Antecedent-Behavior-Consequence record sheets and, finally, The Observer XT. We conducted a comprehensive assessment of challenging behavior of each participant, by reviewing bio-psychosocial records, interviewing family and direct caregiver staff, as well as direct observation. A large inter-subject behavior variability and instability of intra-subject behavior were found, raising questions about the election of the period to evaluate. The first evaluation level highlighted information about stability of behavior, the second level stand out the context in which it occurs and the third level detailed the different topographies of each behavioral category. The results suggest the desirability of a continuous assessment by combining these three levels for adjusting to the specific characteristics of behavior. We suggest the need of designing a single behavioral assessment procedure that includes the benefits observed in each of the instruments used.

  18. Assessing nanoparticle risk poses prodigious challenges

    EPA Science Inventory

    Risk assessment is used both formally and informally to estimate the likelihood of an adverse event occurring, for example, as a consequence of exposure to a hazardous chemical, drug or other agent. Formal risk assessments in government regulatory agencies have a long history of ...

  19. Assessing Cognitive Function in Bipolar Disorder: Challenges and Recommendations for Clinical Trial Design

    PubMed Central

    Burdick, Katherine E.; Ketter, Terence A.; Goldberg, Joseph F.; Calabrese, Joseph R.

    2015-01-01

    provided here as a preliminary guide for future trial design. Recommendations comprise exclusion of certain syndromal level comorbid diagnoses and current affective instability, restrictions on numbers and types of medications, and use of pre-screening assessment to ensure enrollment of subjects with adequate objective evidence of baseline cognitive impairment. CONCLUSIONS Clinical trials to address cognitive deficits in bipolar disorder face distinctive design challenges. As such trials move from proof-of-concept to confirmation of clinical efficacy, it will be important to incorporate distinctive design modifications to adequately address these challenges and increase the likelihood of demonstrating cognitive remediation effects. The field is now primed to address these challenges and a comprehensive effort to formalize best practice guidelines will be a critically important next step. PMID:25830456

  20. Validation of the Chinese Challenging Behaviour Scale: clinical correlates of challenging behaviours in nursing home residents with dementia.

    PubMed

    Lam, Chi Leung; Chan, W C; Mok, Cycbie C M; Li, S W; Lam, Linda C W

    2006-08-01

    Behavioural and psychological symptoms of dementia (BPSD) are associated with considerable burden to patients with dementia and their caregivers. Formal caregivers in residential care settings face different challenges when delivering care. This study aimed at assessing the clinical correlates of challenging BPSD using the Chinese version of the Challenging Behaviour Scale (CCBS) designed for residential care settings. One hundred and twenty-five participants were recruited from three care-and-attention homes in Hong Kong. The CCBS was administered together with the Cantonese version of Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Disability Assessment for Dementia (DAD) and Neuropsychiatric Inventory (NPI) to explore the relationships between challenging behaviour and important clinical correlates. The CCBS had good internal consistency (alpha = 0.86), inter-rater (ICC = 0.79) and test-retest reliability (ICC = 0.98). A four-factor structure is demonstrated by factor analysis: hyperactivity behaviours, hypoactivity behaviours, verbally aggressive and aberrant behaviours. Challenging behaviours were associated with male gender, cognitive impairment, functional disability, neuropsychiatric symptoms, and higher caregiver's workload. The CCBS is a valid and reliable measure to assess BPSD in residential care settings in local Chinese community. It is useful in evaluating the challenges faced by formal caregivers during daily care of the dementia patients.

  1. Challenges in Assessing for Postsecondary Readiness

    ERIC Educational Resources Information Center

    Mellard, Daryl F.; Anderson, Gretchen

    2007-01-01

    Adult secondary education learners approach the goal of college-level postsecondary education through three assessment gateways: (a) measures of adult education program learning gains, (b) a high-school equivalency exam, and (c) college placement tests. On the surface, the assessments in this sequence might appear to work in concert and point…

  2. Assessment of tumor response to oxygen challenge using quantitative diffusion MRI in an animal model.

    PubMed

    Zhang, Zhongwei; Yuan, Qing; Zhou, Heling; Zhao, Dawen; Li, Li; Gerberich, Jenifer L; Mason, Ralph P

    2015-11-01

    To assess tumor response to oxygen challenge using quantitative diffusion magnetic resonance imaging (MRI). A well-characterized Dunning R3327-AT1 rat prostate cancer line was implanted subcutaneously in the right thigh of male Copenhagen rats (n = 8). Diffusion-weighted images (DWI) with multiple b values (0, 25, 50, 100, 150, 200, 300, 500, 1000, 1500 s/mm(2) ) in three orthogonal directions were obtained using a multishot FSE-based Stejskal-Tanner DWI sequence (FSE-DWI) at 4.7T, while rats breathed medical air (21% oxygen) and with 100% oxygen challenge. Stretched-exponential and intravoxel incoherent motion (IVIM) models were used to calculate and compare quantitative diffusion parameters: diffusion heterogeneity index (α), intravoxel distribution of diffusion coefficients (DDC), tissue diffusivity (Dt), pseudo-diffusivity (Dp), and perfusion fraction (f) on a voxel-by-voxel basis. A significant increase of α (73.9 ± 4.7% in air vs. 78.1 ± 4.5% in oxygen, P = 0.0198) and a significant decrease of f (13.4 ± 3.7% in air vs. 10.4 ± 2.7% in oxygen, P = 0.0201) were observed to accompany oxygen challenge. Correlations between f and α during both air and oxygen breathing were found; the correlation coefficients (r) were -0.90 and -0.96, respectively. Positive correlations between Dt and DDC with oxygen breathing (r = 0.95, P = 0.0003), f and DDC with air breathing were also observed (r = 0.95, P = 0.0004). Quantitative diffusion MRI demonstrated changes in tumor perfusion in response to oxygen challenge. © 2015 Wiley Periodicals, Inc.

  3. Installing a System of Performance Standards for National Assessments in the Republic of Trinidad and Tobago: Issues and Challenges

    ERIC Educational Resources Information Center

    De Lisle, Jerome

    2015-01-01

    This article explores the challenge of setting performance standards in a non-Western context. The study is centered on standard-setting practice in the national learning assessments of Trinidad and Tobago. Quantitative and qualitative data from annual evaluations between 2005 and 2009 were compiled, analyzed, and deconstructed. In the mixed…

  4. Assessment of Institutional and Personnel-Related Challenges Facing Educational Programme for the Mentally Challenged Persons at Kaimosi Special School, Kenya

    ERIC Educational Resources Information Center

    Mmbwanga, Daniel M.; Matemba, Collins K.; Bota, Kennedy N.

    2015-01-01

    The mentally challenged child (MC) can achieve a lot if the right environment and curriculum are designed for him/her. However, the realization of the desirable outcomes faces many challenges. The objective of the study was to examine institutional and personnel-related challenges facing education programs for the MC persons at Kaimosi Special…

  5. Assessing Accomplished Teaching: Good Strides, Great Challenges

    ERIC Educational Resources Information Center

    Norman, Antony D.

    2010-01-01

    This article surveys efforts at the national and international level to define and assess accomplished teaching with particular attention devoted to how assessments of accomplished teaching connect to student learning. The author finds that most assessments are based on aspects of teaching that, presumably, come together as accomplished teaching.…

  6. Professional development for teachers of students who are deaf or hard of hearing: facing the assessment challenge.

    PubMed

    Cawthon, Stephanie

    2009-01-01

    Teachers of students with low-incidence disabilities, such as students who are deaf or hard of hearing, face unique challenges in putting education policy into practice. The present article presents professional development findings from the Third Annual National Survey of Accommodations and Assessment for Students Who Are Deaf or Hard of Hearing (Cawthon, Hersh, Kim, & Online Research Lab, in press). A total of 391 participants described professional development they had experienced related to assessment of students who are deaf or hard of hearing. Teachers reported greater exposure to topics in school/district sessions and discussion with their colleagues than in their preparation programs. Teaching at a school for the deaf or teaching students in high school were significant predictors of an increased prevalence of professional development opportunities on assessment-related topics for students who are deaf or hard of hearing.

  7. The Neurovestibular Challenges of Astronauts and Balance Patients: Some Past Countermeasures and Two Alternative Approaches to Elicitation, Assessment and Mitigation.

    PubMed

    Lawson, Ben D; Rupert, Angus H; McGrath, Braden J

    2016-01-01

    Astronauts and vestibular patients face analogous challenges to orientation function due to adaptive exogenous (weightlessness-induced) or endogenous (pathology-induced) alterations in the processing of acceleration stimuli. Given some neurovestibular similarities between these challenges, both affected groups may benefit from shared research approaches and adaptation measurement/improvement strategies. This article reviews various past strategies and introduces two plausible ground-based approaches, the first of which is a method for eliciting and assessing vestibular adaptation-induced imbalance. Second, we review a strategy for mitigating imbalance associated with vestibular pathology and fostering readaptation. In discussing the first strategy (for imbalance assessment), we review a pilot study wherein imbalance was elicited (among healthy subjects) via an adaptive challenge that caused a temporary/reversible disruption. The surrogate vestibular deficit was caused by a brief period of movement-induced adaptation to an altered (rotating) gravitoinertial frame of reference. This elicited adaptation and caused imbalance when head movements were made after reentry into the normal (non-rotating) frame of reference. We also review a strategy for fall mitigation, viz., a prototype tactile sway feedback device for aiding balance/recovery after disruptions caused by vestibular pathology. We introduce the device and review a preliminary exploration of its effectiveness in aiding clinical balance rehabilitation (discussing the implications for healthy astronauts). Both strategies reviewed in this article represent cross-disciplinary research spin-offs: the ground-based vestibular challenge and tactile cueing display were derived from aeromedical research to benefit military aviators suffering from flight simulator-relevant aftereffects or inflight spatial disorientation, respectively. These strategies merit further evaluation using clinical and astronaut populations.

  8. Nano-TiO₂--feasibility and challenges for human health risk assessment based on open literature.

    PubMed

    Christensen, Frans M; Johnston, Helinor J; Stone, Vicki; Aitken, Robert J; Hankin, Steve; Peters, Sheona; Aschberger, Karin

    2011-06-01

    This study aims at investigating feasibility and challenges associated with conducting a human health risk assessment for nano-titanium-dioxide (nano-TiO₂) based on the open literature by following an approach similar to a classical regulatory risk assessment. Gaps in the available data set, both in relation to exposures and hazard, do not allow reaching any definite conclusions that could be used for regulatory decision-making. Results show that repeated inhalation in the workplace and possibly consumer inhalation may cause risks. Also short-term inhalation following spray applications may cause risks. Main future work should focus on generating occupational and consumer inhalation exposure data, as well as toxicity data on absorption following inhalation, repeated dermal contact, and contact with damaged skin. Also relevant seems further information on possible neurotoxicity and genotoxicity/carcinogenicity, as well as establishing a No Observed Adverse Effect Level (NOAEL) for acute inhalation of nano-TiO₂.

  9. Assessment Challenges for Business Education in Changing Times

    ERIC Educational Resources Information Center

    Hazari, Sunil; Gaytan, Jorge; North, Alexa

    2008-01-01

    In addition to the difficult task of identifying teaching methods that ensure student learning, the American educational system is facing significant challenges. Schools are struggling to maintain standards for high-quality teaching while trying to address the learning needs of students with Limited English Proficiency (LEP). The same struggle is…

  10. A retrospective study of acute mountain sickness on Mt. Kilimanjaro using trekking company data.

    PubMed

    Eigenberger, Paul; Faino, Anna; Maltzahn, Joanne; Lisk, Christina; Frank, Eddie; Frank, Amy; Loomis, Zoe; Schroeder, Thies; Strand, Matthew; Irwin, David

    2014-11-01

    High altitude illnesses (HAI) are a risk factor for any individual who is exposed to a significant increase in altitude. To learn more about the epidemiology of HAI, we sought to determine if health records from a commercial trekking company could provide novel data on the prevalence of HAI, as well as efficacy data regarding common HAI therapeutics. Health parameters from 917 tourists ascending Mt. Kilimanjaro over a 10-yr period were analyzed for meaningful data. Of all subjects, 70% experienced at least one instance of a symptom related to HAI (headache, nausea, vomiting, diarrhea, or loss of appetite) during the trek. Acetazolamide was used at least once by 90% of subjects and, of those who used acetazolamide, 92% began taking it on day 1 of the ascent. Acetazolamide was found to improve oxygen saturation 1.2% above 9842.5 ft (3000 m). Dexamethasone use 12 h prior to ascending above 18,996 ft (5790 m) decreased the probability of a subject exhibiting at least one AMS symptom at that altitude. The prevalence of AMS symptoms was not reduced by taking 2 extra days to reach the summit of Mt. Kilimanjaro. Prophylactic acetazolamide modestly improved oxygen saturation; however, it did not reduce symptoms. Therapeutic dexamethasone, especially at higher altitudes, was effective at reducing symptoms. We conclude that meaningful high altitude physiological data can be obtained from private trekking companies.

  11. Frequent behavioural challenges in children with fetal alcohol spectrum disorder: a needs-based assessment reported by caregivers and clinicians.

    PubMed

    Green, Courtney R; Roane, Jessica; Hewitt, Amy; Muhajarine, Nazeem; Mushquash, Christopher; Sourander, Andre; Lingley-Pottie, Patricia; McGrath, Patrick; Reynolds, James N

    2014-01-01

    Despite substantial research characterizing the brain injury, a significant gap still exists in providing timely and effective care for children with Fetal Alcohol Spectrum Disorder (FASD). The objective of this study was to conduct a needs assessment that could help inform intervention programs and appropriate strategies to manage challenging behaviours targeted to families impacted by FASD. Sixty caregivers and 26 clinicians from across Canada completed a semi-structured telephone interview. Caregivers reported that the most challenging behaviour categories were "Externalizing Behaviours", "Cognitive Difficulties", and "Social Difficulties/Maladjustment", whereas the most successful parenting strategies were "Parental Reflection", "Routine/Structure/Consistency", and "Environmental Modification". Clinicians reported that "Insufficient Support/Knowledge from Health and Social Professionals and Agencies" and "Behavioural Difficulties/Challenges" were the most common concerns from caregivers of children with FASD. The number and extent of challenges reported make it evident that there are many unmet needs that compromise the quality of life for these caregivers, their children, and their families. These data will be used to inform the development of an intervention program that will provide a family-centered approach to training, education, and support for children with FASD and their families.

  12. Challenges in coupling LTER with environmental assessments: An insight from potential and reality of the Chinese Ecological Research Network in servicing environment assessments.

    PubMed

    Xia, Shaoxia; Liu, Yu; Yu, Xiubo; Fu, Bojie

    2018-08-15

    Environmental assessments estimate, evaluate and predict the consequences of natural processes and human activities on the environment. Long-term ecosystem observation and research networks (LTERs) are potentially valuable infrastructure to support environmental assessments. However, very few environmental assessments have successfully incorporated them. In this study, we try to reveal the current status of coupling LTERs with environmental assessments and look at the challenges involved in improving this coupling through exploring the role that Chinese Ecological Research Network (CERN), the LTER of China, currently plays in regional environment assessments. A review of official protocols and standards, regional assessments and CERN researches related to ecosystems and environment shows that there is great potential for coupling CERN with environment assessments. However in practice, CERN does not currently play the expected role. Remote sensing and irregular inventory data are still the main data sources currently used in regional assessments. Several causes led to the present situation: (1) insufficient cross-site research and failure to scale up site-level variables to the regional scale; (2) data barriers resulting from incompatible protocols and low data usability due to lack of data assimilation and scaling; and (3) absence of indicators relevant to human activities in existing monitoring protocols. For these reasons, enhancing cross-site monitoring and research, data assimilation and scaling up are critical steps required to improve coupling of LTER with environmental assessments. Site-focused long-term monitoring should be combined with wide-scale ground surveys and remote sensing to establish an effective connection between different environmental monitoring platforms for regional assessments. It is also necessary to revise the current monitoring protocols to include human activities and their impacts on the ecosystem, or change the LTERs into Long

  13. The Neurovestibular Challenges of Astronauts and Balance Patients: Some Past Countermeasures and Two Alternative Approaches to Elicitation, Assessment and Mitigation

    PubMed Central

    Lawson, Ben D.; Rupert, Angus H.; McGrath, Braden J.

    2016-01-01

    Astronauts and vestibular patients face analogous challenges to orientation function due to adaptive exogenous (weightlessness-induced) or endogenous (pathology-induced) alterations in the processing of acceleration stimuli. Given some neurovestibular similarities between these challenges, both affected groups may benefit from shared research approaches and adaptation measurement/improvement strategies. This article reviews various past strategies and introduces two plausible ground-based approaches, the first of which is a method for eliciting and assessing vestibular adaptation-induced imbalance. Second, we review a strategy for mitigating imbalance associated with vestibular pathology and fostering readaptation. In discussing the first strategy (for imbalance assessment), we review a pilot study wherein imbalance was elicited (among healthy subjects) via an adaptive challenge that caused a temporary/reversible disruption. The surrogate vestibular deficit was caused by a brief period of movement-induced adaptation to an altered (rotating) gravitoinertial frame of reference. This elicited adaptation and caused imbalance when head movements were made after reentry into the normal (non-rotating) frame of reference. We also review a strategy for fall mitigation, viz., a prototype tactile sway feedback device for aiding balance/recovery after disruptions caused by vestibular pathology. We introduce the device and review a preliminary exploration of its effectiveness in aiding clinical balance rehabilitation (discussing the implications for healthy astronauts). Both strategies reviewed in this article represent cross-disciplinary research spin-offs: the ground-based vestibular challenge and tactile cueing display were derived from aeromedical research to benefit military aviators suffering from flight simulator-relevant aftereffects or inflight spatial disorientation, respectively. These strategies merit further evaluation using clinical and astronaut populations. PMID

  14. Methodological challenges in assessing the environmental status of a marine ecosystem: case study of the Baltic Sea.

    PubMed

    Ojaveer, Henn; Eero, Margit

    2011-04-29

    Assessments of the environmental status of marine ecosystems are increasingly needed to inform management decisions and regulate human pressures to meet the objectives of environmental policies. This paper addresses some generic methodological challenges and related uncertainties involved in marine ecosystem assessment, using the central Baltic Sea as a case study. The objectives of good environmental status of the Baltic Sea are largely focusing on biodiversity, eutrophication and hazardous substances. In this paper, we conduct comparative evaluations of the status of these three segments, by applying different methodological approaches. Our analyses indicate that the assessment results are sensitive to a selection of indicators for ecological quality objectives that are affected by a broad spectrum of human activities and natural processes (biodiversity), less so for objectives that are influenced by a relatively narrow array of drivers (eutrophications, hazardous substances). The choice of indicator aggregation rule appeared to be of essential importance for assessment results for all three segments, whereas the hierarchical structure of indicators had only a minor influence. Trend-based assessment was shown to be a useful supplement to reference-based evaluation, being independent of the problems related to defining reference values and indicator aggregation methodologies. Results of this study will help in setting priorities for future efforts to improve environmental assessments in the Baltic Sea and elsewhere, and to ensure the transparency of the assessment procedure.

  15. Carbonic anhydrase activity in developing sea urchin embryos with special reference to calcification of spicules.

    PubMed

    Mitsunaga, K; Akasaka, K; Shimada, H; Fujino, Y; Yasumasu, I; Numanoi, H

    1986-06-01

    Eggs and embryos of the sea urchins Anthocidaris crassispina and Hemicentrotus pulcherrimus did not exhibit significant changes in carbonic anhydrase activity during early development. Acetazolamide inhibited enzyme activity in homogenates of embryos and inhibited the formation of calcified spicules in a culture of micromeres at concentrations between 40 and 100 microM. Acetazolamide allowed intact embryos to develop to quasi-normal plutei but inhibited calcium deposition in the spicules. It is suggested that carbonic anhydrase contributes to CaCO3 deposition in the spicule.

  16. Meeting challenges related to the dietary assessment of ethnic minority populations.

    PubMed

    Garduño-Diaz, S D; Husain, W; Ashkanani, F; Khokhar, S

    2014-08-01

    Migrants from the Indian subcontinent comprise the largest minority group in the UK. With the process of migration come alterations in lifestyle and eating habits. The present study aimed to disseminate the valuable information, experiences and challenges faced by researchers who conduct studies with ethnic minority groups in the area of diet and nutritional surveys, with an emphasis on migrant South Asians. The findings reported are the result of research carried out during 2008-2012, involving 1100 face-to-face dietary recalls conducted in the UK among South Asian children (aged 1.5-11 years; n = 300) and adults (≥30 years; n = 100). Factors to consider when planning and carrying out diet and nutrition survey studies among migrant South Asians were identified and include the employment of culture-specific tools, visual aid reinforcement and the involvement of key community members and translators to facilitate recruitment and data collection. One of the best practices found when working with minority groups was the use of incentives and tangible benefits to reward study participants. It was also found that constant communication and follow-up of the study participants improved the quality of the data and the likelihood of maintaining links with community members for future studies. From the results of in-house studies and a revision of practices reported in earlier literature, two 24-h face-to-face dietary recalls are recommended as the optimal method for the dietary assessment of migrant South Asians. To complement this assessment, ethnic-specific food frequency questionnaires such as that developed and successfully implemented among South Asians in the present study must be employed. © 2013 The British Dietetic Association Ltd.

  17. Standardizing assessment practices of undergraduate medical competencies across medical schools: challenges, opportunities and lessons learned from a consortium of medical schools in Uganda.

    PubMed

    Mubuuke, Aloysius Gonzaga; Mwesigwa, Catherine; Maling, Samuel; Rukundo, Godfrey; Kagawa, Mike; Kitara, David Lagoro; Kiguli, Sarah

    2014-01-01

    Health professions education is gradually moving away from the more traditional approaches to new innovative ways of training aimed at producing professionals with the necessary competencies to address the community health needs. In response to these emerging trends, Medical Education for Equitable Services to All Ugandans (MESAU), a consortium of Ugandan medical schools developed key competencies desirable of graduates and successfully implemented Competency Based Education (CBE) for undergraduate medical students. To examine the current situation and establish whether assessment methods of the competencies are standardized across MESAU schools as well as establish the challenges, opportunities and lessons learned from the MESAU consortium. It was a cross-sectional descriptive study involving faculty of the medical schools in Uganda. Data was collected using focus group discussions and document reviews. Findings were presented in form of themes. Although the MESAU schools have implemented the developed competencies within their curricular, the assessment methods are still not standardized with each institution having its own assessment procedures. Lack of knowledge and skills regarding assessment of the competencies was evident amongst the faculty. The fear for change amongst lecturers was also noted as a major challenge. However, the institutional collaboration created while developing competencies was identified as key strength. Findings demonstrated that despite having common competencies, there is no standardized assessment blue print applicable to all MESAU schools. Continued collaboration and faculty development in assessment is strongly recommended.

  18. [Productivity and academic assessment in the Brazilian public health field: challenges for Human and Social Sciences research].

    PubMed

    Bosi, Maria Lúcia Magalhães

    2012-12-01

    This article analyzes some challenges for knowledge output in the human and social sciences in the public health field, under the current academic assessment model in Brazil. The article focuses on the qualitative research approach in human and social sciences, analyzing its status in comparison to the other traditions vying for hegemony in the public health field, conjugating the dialogue with the literature, especially the propositions pertaining to the social fields present in the work of Pierre Bourdieu, with elements concerning the field's dynamics, including some empirical data. Challenges identified in the article include hurdles to interdisciplinary dialogue and equity in the production of knowledge, based on recognition of the founding place of human and social sciences in the public health field. The article discusses strategies to reshape the current correlation of forces among centers of knowledge in public health, especially those capable of impacting the committees and agendas that define the accumulation of symbolic and economic capital in the field.

  19. Classroom Challenge: A 3D Snapshot of Student Learning in Mathematics

    ERIC Educational Resources Information Center

    Wilder, Sandra

    2015-01-01

    This article aims to describe a type of formative assessment, MAP Classroom Challenge, which has been introduced in mathematics classrooms in recent years. MAP, or the Mathematics Assessment Project Classroom Challenges (formerly known as Formative Assessment Lessons), are developed by teams of math educators from the Shell Centre for Mathematical…

  20. Ukrainian prisoners and community reentry challenges: implications for transitional care

    PubMed Central

    Morozova, Olga; Azbel, Lyuba; Grishaev, Yevgeny; Dvoryak, Sergii; Wickersham, Jeffrey A.; Altice, Frederick L.

    2013-01-01

    Purpose The study aims to assess reentry challenges faced by Ukrainian prisoners and to determine the factors associated with having a greater number of challenges in order to suggest pre- and post-release interventions with the aim of facilitating community reintegration. Design/methodology/approach A representative national cross-sectional study with a sample size of 402 prisoners was conducted among imprisoned adults within six months of release. The study consisted of interviews and biological testing for infectious diseases. Anticipated reentry challenges were assessed using a structured questionnaire. Findings The most difficult and relatively important challenges identified were finding a job or a stable source of income and staying out of prison following release. Risk-specific challenges pertinent to drug users and HIV-infected individuals were assessed as difficult, but generally less important. Similarly, challenges associated with reducing drug relapse were ranked as less important, with only 0.6 percent identifying opioid substitution therapy as a helpful measure. In the multivariate analysis, having a greater number of challenges is associated with previous incarcerations, drug use immediately before incarceration and lower levels of social support. Practical implications To facilitate community re-integration, it is vital to design interventions aimed at reducing recidivism and improvement of social support through comprehensive case management as well as to improve understanding about and address drug dependence issues among inmates by implementing evidence-based treatment both within prisons and after release. Originality/value This is the first comprehensive assessment of community reentry challenges by prisoners in the former Soviet Union. PMID:25152767

  1. Effects of early administration of acetazolamide on the duration of mechanical ventilation in patients with chronic obstructive pulmonary disease or obesity-hypoventilation syndrome with metabolic alkalosis. A randomized trial.

    PubMed

    Rialp Cervera, G; Raurich Puigdevall, J M; Morán Chorro, I; Martín Delgado, M C; Heras la Calle, G; Mas Serra, A; Vallverdú Perapoch, I

    2017-06-01

    Metabolic alkalosis (MA) inhibits respiratory drive and may delay weaning from mechanical ventilation (MV). MA is common in CO 2 -retainer patients that need MV. Acetazolamide (ACTZ) decreases serum bicarbonate concentration and stimulates respiratory drive. This study evaluated the effects of ACTZ on the duration of MV in patients with MA and COPD or obesity hypoventilation syndrome (OHS) intubated with acute respiratory failure. Multicenter, randomized, controlled, double-blind study, with COPD or OHS patients with MV < 72 h and initial bicarbonate >28 mmol/L and pH > 7.35. Test-treatment, ACTZ 500 mg or placebo, was daily administered if pH > 7.35 and bicarbonate >26 mmol/L. Clinical, respiratory and laboratory parameters were recorded. 47 patients (36 men) were randomized. There were no significant differences between groups in comorbidities, baseline characteristics or arterial blood gases at inclusion. The mean difference in the duration of MV between placebo and ACTZ group was 1.3 days (95%CI, -2.1-4.8; p = 0.44). Kaplan-Meier curves showed no differences in the duration of MV (Log-Rank p = 0.41). Between-group comparison of estimated marginal means (CI 95%) during MV were, respectively: PaCO 2 55 (51-59) vs 48 (47-50) mm Hg, p = 0.002; bicarbonate concentration 34 (32-35) vs 29 (28-30) mmol/L, p < 0.0001; and minute volume 9.7 (8.9-10.4) vs 10.6 (9.2-12.0) L/min, p = 0.26. There were no severe adverse effects with ACTZ administration. Among patients with MA and COPD or OHS, early treatment with ACTZ did not shorten significantly the duration of MV compared with placebo. clinical.trials.gov; NCT01499485; URL:.www.clinicaltrials.gov. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Assessing the criminal capacity of children: a challenge to the capacity of mental health professionals.

    PubMed

    Pillay, Anthony L; Willows, Clive

    2015-01-01

    With increasing numbers of juveniles accused of serious crimes international concern is growing around the procedural consequences for affected individuals within the context of the law and criminal justice. Issues of culpability in children and adolescents are often raised, with much deliberation and insufficient agreement among legal and child development experts. Exactly when and to what extent juveniles can be held responsible for their action is a matter requiring careful consideration to avoid substantial erring in either direction. Although some international guiding standards and principles have been established, these are rather broad and unable to provide specific prescriptions. In addition, the assessment of criminal capacity in juveniles is a complex task, and one that is not wholly without reliability and validity problems. As in the case of South Africa and a few other countries, mental health specialists are often tasked with conducting developmental assessments to provide courts with expert evidence regarding criminal capacity. This paper examines the concept of criminal capacity in the context of the theory, controversies and challenges that affect this area of psychological focus.

  3. Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa

    PubMed Central

    2012-01-01

    Background Mobile phone technology has demonstrated the potential to improve health service delivery, but there is little guidance to inform decisions about acquiring and implementing mHealth technology at scale in health systems. Using the case of community-based health services (CBS) in South Africa, we apply a framework to appraise the opportunities and challenges to effective implementation of mHealth at scale in health systems. Methods A qualitative study reviewed the benefits and challenges of mHealth in community-based services in South Africa, through a combination of key informant interviews, site visits to local projects and document reviews. Using a framework adapted from three approaches to reviewing sustainable information and communication technology (ICT), the lessons from local experience and elsewhere formed the basis of a wider consideration of scale up challenges in South Africa. Results Four key system dimensions were identified and assessed: government stewardship and the organisational, technological and financial systems. In South Africa, the opportunities for successful implementation of mHealth include the high prevalence of mobile phones, a supportive policy environment for eHealth, successful use of mHealth for CBS in a number of projects and a well-developed ICT industry. However there are weaknesses in other key health systems areas such as organisational culture and capacity for using health information for management, and the poor availability and use of ICT in primary health care. The technological challenges include the complexity of ensuring interoperability and integration of information systems and securing privacy of information. Finally, there are the challenges of sustainable financing required for large scale use of mobile phone technology in resource limited settings. Conclusion Against a background of a health system with a weak ICT environment and limited implementation capacity, it remains uncertain that the potential

  4. Integrated Basin-Scale Modelling and Assessment: Lessons and Challenges in Linking Biophysical and Socioeconomic Sciences for Enhancing Sustainability Outcomes

    NASA Astrophysics Data System (ADS)

    Jakeman, A. J.; Croke, B. F.; Letcher, R. A.; Newham, L. T.; Norton, J. P.

    2004-12-01

    Integrated Assessment (IA) and Integrated Scenario Modelling (ISM) are being increasingly used to assess sustainability options and, in particular, the effects of policy changes, land use management, climate forcing and other uncontrollable drivers on a wide range of river basin outcomes. IA and ISM are processes that invoke the necessary range of biophysical and socioeconomic disciplines and embrace stakeholder involvement as an essential ingredient. The authors report on their IA studies in Australian and Asian river basins. They illustrate a range of modelling frameworks and tools that were used to perform the assessments, engage the relevant interest groups and promote systems understanding and social learning. The studies cover a range of issues and policies including poverty alleviation, industrial investments, infrastructure provision, erosion and sedimentation, water supply allocation, and ecological protection. The positive impacts of these studies are presented, as well as the lessons learnt and the challenges for modellers and disciplinary experts in advancing the reputation and performance of integrated assessment exercises.

  5. The Evolution of Integrated Assessment and Emerging Challenges in the Assessment of Human and Natural System Interactions

    NASA Astrophysics Data System (ADS)

    Clarke, L.

    2017-12-01

    Integrated assessment (IA) modeling and research has a long history, spanning over 30 years since its inception and addressing a wide range of contemporary issues along the way. Over the last decade, IA modeling and research has emerged as one of the primary analytical methods for understanding the complex interactions between human and natural systems, from the interactions between energy, water, and land/food systems to the interplay between health, climate, and air pollution. IA modeling and research is particularly well-suited for the analysis of these interactions because it is a discipline that strives to integrate representations of multiple systems into consistent computational platforms or frameworks. In doing so, it explicitly confronts the many tradeoffs that are frequently necessary to manage complexity and computational cost while still representing the most important interactions and overall, coupled system behavior. This talk explores the history of IA modeling and research as a means to better understand its role in the assessment of contemporary issues at the confluence of human and natural systems. It traces the evolution of IA modeling and research from initial exploration of long-term emissions pathways, to the role of technology in the global evolution of the energy system, to the key linkages between land and energy systems and, more recently, the linkages with water, air pollution, and other key systems and issues. It discusses the advances in modeling that have emerged over this evolution and the biggest challenges that still present themselves as we strive to better understand the most important interactions between human and natural systems and the implications of these interactions for human welfare and decision making.

  6. Characteristics and Hypothesized Functions of Challenging Behavior in a Community-Based Sample

    ERIC Educational Resources Information Center

    Petursdottir, Anna Ingeborg; Esch, John W.; Sautter, Rachael A.; Stewart, Kelise K.

    2010-01-01

    An archival study was conducted to document (a) types of challenging behavior, and (b) functional assessment outcomes, for a sample of persons with developmental disabilities who were referred to community-practicing behavior analysts for assessment and treatment of challenging behavior. Functional assessment reports, prepared by 17 behavior…

  7. Standardizing assessment practices of undergraduate medical competencies across medical schools: challenges, opportunities and lessons learned from a consortium of medical schools in Uganda

    PubMed Central

    Mubuuke, Aloysius Gonzaga; Mwesigwa, Catherine; Maling, Samuel; Rukundo, Godfrey; Kagawa, Mike; Kitara, David Lagoro; Kiguli, Sarah

    2014-01-01

    Introduction Health professions education is gradually moving away from the more traditional approaches to new innovative ways of training aimed at producing professionals with the necessary competencies to address the community health needs. In response to these emerging trends, Medical Education for Equitable Services to All Ugandans (MESAU), a consortium of Ugandan medical schools developed key competencies desirable of graduates and successfully implemented Competency Based Education (CBE) for undergraduate medical students. Objectives To examine the current situation and establish whether assessment methods of the competencies are standardized across MESAU schools as well as establish the challenges, opportunities and lessons learned from the MESAU consortium. Methods It was a cross-sectional descriptive study involving faculty of the medical schools in Uganda. Data was collected using focus group discussions and document reviews. Findings were presented in form of themes. Results Although the MESAU schools have implemented the developed competencies within their curricular, the assessment methods are still not standardized with each institution having its own assessment procedures. Lack of knowledge and skills regarding assessment of the competencies was evident amongst the faculty. The fear for change amongst lecturers was also noted as a major challenge. However, the institutional collaboration created while developing competencies was identified as key strength. Conclusion Findings demonstrated that despite having common competencies, there is no standardized assessment blue print applicable to all MESAU schools. Continued collaboration and faculty development in assessment is strongly recommended. PMID:25995778

  8. Baseline integrated behavioural and biological assessment among most at-risk populations in six high-prevalence states of India: design and implementation challenges.

    PubMed

    Saidel, Tobi; Adhikary, Rajatashuvra; Mainkar, Mandar; Dale, Jayesh; Loo, Virginia; Rahman, Motiur; Ramesh, Banadakoppa M; Paranjape, Ramesh S

    2008-12-01

    This paper presents key methodological approaches and challenges in implementing and analysing the first round of the integrated biobehavioural assessment of most-at-risk populations, conducted in conjunction with evaluation of Avahan, the India AIDS initiative. The survey collected data on HIV risk behaviours, sexually transmitted infections and HIV prevalence in 29 districts in six high-prevalence states of India. Groups included female sex workers and clients, men who have sex with men, injecting drug users and truck drivers. Strategies for overcoming some challenges of the large-scale surveys among vulnerable populations, including sampling hidden populations, involvement of the communities targeted by the survey, laboratory and quality control in remote, non-clinic field settings, and data analysis and data use are presented. Satisfying the need for protocols, guidelines and tools that allowed for sufficient standardization, while being tailored enough to fit diverse local situations on such a large scale, with so many implementing partners, emerged as a major management challenge. A major lesson from the first round is the vital importance of investing upfront time in tailoring the sampling methods, data collection instruments, and analysis plan to match measurement objectives. Despite the challenges, the integrated biobehavioural assessment was a huge achievement, and was largely successful in providing previously unavailable information about the HIV situation among populations that are critical to the curtailment of HIV spread in India. Lessons from the first round will be used to evolve the second round into an exercise with increased evaluative capability for Avahan.

  9. Implementing systematic review techniques in chemical risk assessment: challenges, opportunities and recommendations

    PubMed Central

    Whaley, Paul; Halsall, Crispin; Ågerstrand, Marlene; Benford, Diane; Aiassa, Elisa; Bilotta, Gary; Coggon, David; Dempsey, Ciara; Duarte-Davidson, Raquel; FitzGerald, Rex; Gee, David; Hoffmann, Sebastian; Lam, Juleen; Lassersson, Toby; Levy, Len; Lipworth, Steven; Ross, Sarah Mackenzie; Martin, Olwenn; Meads, Catherine; Meyer-Baron, Monika; Miller, James; Pease, Camilla; Rooney, Andrew; Sapiets, Alison; Stewart, Gavin; Taylor, David

    2016-01-01

    Systematic review (SR) is a rigorous, protocol-driven approach designed to minimise error and bias when summarising the body of research evidence relevant to a specific scientific question. Taking as a comparator the use of SR in synthesising research in healthcare, we argue that SR methods could also pave the way for a “step change” in the transparency, objectivity and communication of chemical risk assessments (CRA) in Europe and elsewhere. We suggest that current controversies around the safety of certain chemicals are partly due to limitations in current CRA procedures which have contributed to ambiguity about the health risks posed by these substances. We present an overview of how SR methods can be applied to the assessment of risks from chemicals, and indicate how challenges in adapting SR methods from healthcare research to the CRA context might be overcome. Regarding the latter, we report the outcomes from a workshop exploring how to increase uptake of SR methods, attended by experts representing a wide range of fields related to chemical toxicology, risk analysis and SR. Priorities which were identified include: the conduct of CRA-focused prototype SRs; the development of a recognised standard of reporting and conduct for SRs in toxicology and CRA; and establishing a network to facilitate research, communication and training in SR methods. We see this paper as a milestone in the creation of a research climate that fosters communication between experts in CRA and SR and facilitates wider uptake of SR methods into CRA. PMID:26687863

  10. Implementing systematic review techniques in chemical risk assessment: Challenges, opportunities and recommendations.

    PubMed

    Whaley, Paul; Halsall, Crispin; Ågerstrand, Marlene; Aiassa, Elisa; Benford, Diane; Bilotta, Gary; Coggon, David; Collins, Chris; Dempsey, Ciara; Duarte-Davidson, Raquel; FitzGerald, Rex; Galay-Burgos, Malyka; Gee, David; Hoffmann, Sebastian; Lam, Juleen; Lasserson, Toby; Levy, Len; Lipworth, Steven; Ross, Sarah Mackenzie; Martin, Olwenn; Meads, Catherine; Meyer-Baron, Monika; Miller, James; Pease, Camilla; Rooney, Andrew; Sapiets, Alison; Stewart, Gavin; Taylor, David

    2016-01-01

    Systematic review (SR) is a rigorous, protocol-driven approach designed to minimise error and bias when summarising the body of research evidence relevant to a specific scientific question. Taking as a comparator the use of SR in synthesising research in healthcare, we argue that SR methods could also pave the way for a "step change" in the transparency, objectivity and communication of chemical risk assessments (CRA) in Europe and elsewhere. We suggest that current controversies around the safety of certain chemicals are partly due to limitations in current CRA procedures which have contributed to ambiguity about the health risks posed by these substances. We present an overview of how SR methods can be applied to the assessment of risks from chemicals, and indicate how challenges in adapting SR methods from healthcare research to the CRA context might be overcome. Regarding the latter, we report the outcomes from a workshop exploring how to increase uptake of SR methods, attended by experts representing a wide range of fields related to chemical toxicology, risk analysis and SR. Priorities which were identified include: the conduct of CRA-focused prototype SRs; the development of a recognised standard of reporting and conduct for SRs in toxicology and CRA; and establishing a network to facilitate research, communication and training in SR methods. We see this paper as a milestone in the creation of a research climate that fosters communication between experts in CRA and SR and facilitates wider uptake of SR methods into CRA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Personalized Medicine and Genomics: Challenges and Opportunities in Assessing Effectiveness, Cost-Effectiveness, and Future Research Priorities

    PubMed Central

    Conti, Rena; Veenstra, David L.; Armstrong, Katrina; Lesko, Lawrence J.; Grosse, Scott D.

    2015-01-01

    Personalized medicine is health care that tailors interventions to individual variation in risk and treatment response. Although medicine has long strived to achieve this goal, advances in genomics promise to facilitate this process. Relevant to present-day practice is the use of genomic information to classify individuals according to disease susceptibility or expected responsiveness to a pharmacologic treatment and to provide targeted interventions. A symposium at the annual meeting of the Society for Medical Decision Making on 23 October 2007 highlighted the challenges and opportunities posed in translating advances in molecular medicine into clinical practice. A panel of US experts in medical practice, regulatory policy, technology assessment, and the financing and organization of medical innovation was asked to discuss the current state of practice and research on personalized medicine as it relates to their own field. This article reports on the issues raised, discusses potential approaches to meet these challenges, and proposes directions for future work. The case of genetic testing to inform dosing with warfarin, an anticoagulant, is used to illustrate differing perspectives on evidence and decision making for personalized medicine. PMID:20086232

  12. Operational challenges to community participation in post-disaster damage assessments: observations from Fiji.

    PubMed

    Méheux, Kirstie; Dominey-Howes, Dale; Lloyd, Kate

    2010-10-01

    Community participation is becoming increasingly popular within the field of disaster management. International disaster policies, frameworks and charters embrace the notion that communities should play an active role in initiatives to identify vulnerabilities and risks and to mitigate those dangers, and, in the event of a disaster, that they should play a proactive part in response and recovery (see, for example, UNISDR, 1994; The Sphere Project, 2004; United Nations, 2005). A number of studies have investigated the participation of communities in disaster preparedness and mitigation efforts (see, for instance, Scott-Villiers, 2000; Andharia, 2002; Godschalk, Brody and Burby, 2003), There is, however, limited reflection on the challenges to ensuring participation in the operational context of disaster response. This paper draws on a study of the policy and practice of participatory damage assessment in Fiji to identify and discuss the barriers to formal implementation of community participation in a post-disaster context. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

  13. VAST 2010 Challenge: Arms Dealings and Pandemics

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Grinstein, Georges; Konecni, Shawn; Plaisant, Catherine

    2010-10-23

    The 5th VAST Challenge consisted of three mini-challenges that involved both intelligence analysis and bioinformatics. Teams could solve one, two or all three mini-challenges and assess the overall situation to enter the Grand Challenge. Mini-challenge one involved text reports about people and events giving information about arms dealers, situations in various countries and linkages between different countries. Mini-challenge two involved hospital admission and death records from various countries providing information about the spread of a world wide pandemic. Mini-challenge three involved genetic data to be used to identify the origin of the pandemic and the most dangerous viral mutations. Themore » Grand Challenge was to determine how these various mini-challenges were connected. As always the goal was to analyze the data and provide novel interactive visualizations useful in the analytic process. We received 58 submissions in total and gave 15 awards.« less

  14. Role of carbonic anhydrase in bone resorption induced by prostaglandin E2 in vitro

    NASA Technical Reports Server (NTRS)

    Hall, G. E.; Kenny, A. D.

    1985-01-01

    The possible role of carbonic anhydrase in bone resorption induced by prostaglandin E2 (PGE2) was studied using an in vitro neonatal mouse calvarial culture system. PGE2 (10 to the -6th M) was effective in stimulating resorption, as assessed by calcium release into culture media. This enhanced resorption was accompanied by significant increases in calvarial carbonic anhydrase activity over control values at 48 and 96 h. At 48 h, bones treated with PGE2 had 20 percent more carbonic anhydrase activity than controls. By 96 h, treated bones contained 79 percent more carbonic anhydrase activity than controls. PGE2-induced bone resorption was inhibited by the carbonic anhydrase inhibitor acetazolamide in a dose-dependent fashion from 10 to the -5th to 10 to the -4th M with 77 percent inhibition observed at 10 to the -4th M. The acetazolamide analogue CL 13,850 (N-t-butylacetazolamide), which does not inhibit carbonic anhydrase, failed to inhibit PGE2-induced resorption. These results are consistent with the hypothesis that carbonic anhydrase is a necessary component of the osteoclastic bone resorptive mechanism.

  15. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Capacio, B.R.; Harris, L.W.; Anderson, D.R.

    The accelerating rotarod was used to assess motor performance decrement in rats after administration of candidate anticonvulsant compounds (acetazolamide, amitriptyline, chlordiazepoxide, diazepan, diazepam-lysine, lorazepam, loprazolam, midazolam, phenobarbital and scopolamine) against nerve agent poisoning. AH compounds were tested as the commercially available injectable preparation except for diazepam-lysine and loprazolam, which are not FDA approved. A peak effect time, as well as a dose to decrease performance time by 50% from control (PDD50), was determined. The calculated PDD50 (micrometer ol/kg) values and peak effect tunes were midazolam, 1.16 at 15 min; loprazolam, 1.17 at 15 min; diazepam-lysine, 4.17 at 30 min; lorazepwn,more » 4.98 at 15 min; diazepam, 5.27 at 15 min; phenobarbital, 101.49 at 45 min; chlordiazepoxide, 159.21 at 30 min; scopolamine, amitriptyline and acetazolamide did not demonstrate a performance decrement at any of the doses tested. The PDD50 values were compared with doses which have been utilized against nerve agent-induced convulsions or published ED50 values from standard anticonvulsant screening tests (maximal electroshock MES and subcutaneous pentylenetetrazol (scMET)). I serve agents, anticonvulsants, diazepam, accelerating rotarod, motor performance.« less

  16. Environmental fate and exposure models: advances and challenges in 21st century chemical risk assessment.

    PubMed

    Di Guardo, Antonio; Gouin, Todd; MacLeod, Matthew; Scheringer, Martin

    2018-01-24

    Environmental fate and exposure models are a powerful means to integrate information on chemicals, their partitioning and degradation behaviour, the environmental scenario and the emissions in order to compile a picture of chemical distribution and fluxes in the multimedia environment. A 1995 pioneering book, resulting from a series of workshops among model developers and users, reported the main advantages and identified needs for research in the field of multimedia fate models. Considerable efforts were devoted to their improvement in the past 25 years and many aspects were refined; notably the inclusion of nanomaterials among the modelled substances, the development of models at different spatial and temporal scales, the estimation of chemical properties and emission data, the incorporation of additional environmental media and processes, the integration of sensitivity and uncertainty analysis in the simulations. However, some challenging issues remain and require research efforts and attention: the need of methods to estimate partition coefficients for polar and ionizable chemical in the environment, a better description of bioavailability in different environments as well as the requirement of injecting more ecological realism in exposure predictions to account for the diversity of ecosystem structures and functions in risk assessment. Finally, to transfer new scientific developments into the realm of regulatory risk assessment, we propose the formation of expert groups that compare, discuss and recommend model modifications and updates and help develop practical tools for risk assessment.

  17. Challenges in Research and Health Technology Assessment of Rare Disease Technologies: Report of the ISPOR Rare Disease Special Interest Group.

    PubMed

    Nestler-Parr, Sandra; Korchagina, Daria; Toumi, Mondher; Pashos, Chris L; Blanchette, Christopher; Molsen, Elizabeth; Morel, Thomas; Simoens, Steven; Kaló, Zoltán; Gatermann, Ruediger; Redekop, William

    2018-05-01

    Successful development of new treatments for rare diseases (RDs) and their sustainable patient access require overcoming a series of challenges related to research and health technology assessment (HTA). These impediments, which may be unique to RDs or also apply to common diseases but are particularly pertinent in RDs, are diverse and interrelated. To develop for the first time a catalog of primary impediments to RD research and HTA, and to describe the cause and effect of individual challenges. Challenges were identified by an international 22-person expert working group and qualitative outreach to colleagues with relevant expertise. A broad range of stakeholder perspectives is represented. Draft results were presented at annual European and North American International Society for Pharmacoeconomics and Outcomes Research (ISPOR) congresses, and written comments were received by the 385-strong ISPOR Rare Disease Review Group from two rounds of review. Findings were refined and confirmed via targeted literature search. Research-related challenges linked to the low prevalence of RDs were categorized into those pertaining to disease recognition and diagnosis, evaluation of treatment effect, and patient recruitment for clinical research. HTA-related challenges were classified into issues relating to the lack of a tailored HTA method for RD treatments and uncertainty for HTA agencies and health care payers. Identifying and highlighting diverse, but interrelated, key challenges in RD research and HTA is an essential first step toward developing implementable and sustainable solutions. A collaborative multistakeholder effort is required to enable faster and less costly development of safe, efficacious, and appropriate new RD therapies that offer value for money. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. Geriatric gambling disorder: challenges in clinical assessment.

    PubMed

    Smith, Mara; Hategan, Ana; Bourgeois, James A

    2017-12-01

    To the Editor: The gaming industry is growing rapidly, as is the proportion of older adults aged 65 years or older who participate in gambling (Tse et al., 2012). With casinos tailoring their venues and providing incentives to attract older adults, and with the increasing popularity of "pleasure trips" to casinos organized by retirement homes, plus active promotion of government-operated lotteries in many countries, this trend is likely to continue. Gambling disorder (GD) or "pathological" or "problem" gambling presents a public health concern in the geriatric population. However, ascertainment of its prevalence and diagnostic accuracy have proven challenging. This is largely due to the absence of diagnostic criteria specific to the geriatric age and rating scales validated for use in this population.

  19. Assessment of antigenic difference of equine influenza virus strains by challenge study in horses.

    PubMed

    Yamanaka, Takashi; Nemoto, Manabu; Bannai, Hiroshi; Tsujimura, Koji; Kondo, Takashi; Matsumura, Tomio; Gildea, Sarah; Cullinane, Ann

    2016-11-01

    We previously reported that horse antiserum against the Japanese equine influenza vaccine virus, A/equine/La Plata/1993 (LP93) exhibited reduced cross-neutralization against some Florida sublineage Clade (Fc) 2 viruses, for example, A/equine/Carlow/2011 (CL11). As a result, Japanese vaccine manufacturers will replace LP93 with A/equine/Yokohama/aq13/2010 (Y10, Fc2). To assess the benefit of updating the vaccine, five horses vaccinated with inactivated Y10 vaccine and five vaccinated with inactivated LP93 were challenged by exposure to a nebulized aerosol of CL11. The durations of pyrexia (≥38.5°C) and other adverse clinical symptoms experienced by the Y10 group were significantly shorter than those of the LP93 group. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  20. Increasing clinical relevance in oral radiology: Benefits and challenges when implementing digital assessment.

    PubMed

    de Lange, T; Møystad, A; Torgersen, G R

    2018-02-13

    The aims of the study were to investigate benefits and challenges in implementing a digital examination and study the clinical relevance of the digital examination in relation to clinical training and practice. The study was based on semi-structured focus-group interviews from two distinct student populations (2016 and 2017) in a bachelor programme in dental hygiene. In addition, conversational data from a plenary discussion from the whole second student population (2017) were collected and analysed. The data were approached on basis of content analysis. A benefit experienced in the digital examination was the ease in typing and editing answers on the computer. This suggests an increased effectiveness in computer-based compared to analogue examinations. An additional advantage was the experienced relevance of the examination related to the clinic. This finding refers not only to the digital presentations of images, but also to the entire setting in the clinic and dental practice. The limitations reported by the students were non-optimal viewing conditions for presenting radiographic images and difficulties in obtaining an overview of the assignments compared to paper-based examinations due to the linear digital examination format. The last finding on lacking overview revealed an influence on student performances which should be taken seriously in designing digital examinations. In conclusion, the digital layout increases efficiency and clinical relevance of examinations to a certain extent. Obstacles were found in limitations related to image presentation and lack of overview of the examination. The latter challenge raises questions related to developing suitable assessment software. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Ecological Momentary Assessment in Behavioral Research: Addressing Technological and Human Participant Challenges

    PubMed Central

    Shiffman, Saul; Music, Edvin; Styn, Mindi A; Kriska, Andrea; Smailagic, Asim; Siewiorek, Daniel; Ewing, Linda J; Chasens, Eileen; French, Brian; Mancino, Juliet; Mendez, Dara; Strollo, Patrick; Rathbun, Stephen L

    2017-01-01

    the 12-month study interval, adherence to completing EMA surveys was high, with 88.3% (66,978/75,888) completion of random assessments and around 90% (23,411/25,929 and 23,343/26,010) completion of time-contingent assessments, despite the duration of EMA data collection and challenges with implementation. Conclusions This work informed us of the necessary preliminary steps to plan and prepare a longitudinal study using smartphone technology and the critical elements to ensure participant engagement in the potentially burdensome protocol, which spanned 12 months. While this was a technology-supported and -programmed study, it required close oversight to ensure all elements were functioning correctly, particularly once human participants became involved. PMID:28298264

  2. Assessing the educational needs of Canadian gastroenterologists and gastroenterology nurses: challenges to optimal care in Crohn's Disease.

    PubMed

    Dupuis, Martin; Marshall, John K; Hayes, Sean M; Cytryn, Kayla; Murray, Suzanne

    2009-12-01

    A national needs assessment of Canadian gastroenterologists and gastroenterology nurses was undertaken to determine the perceived and unperceived educational and performance barriers to caring for patients with Crohn's disease (CD). A triangulated, mixed-method approach (qualitative and quantitative) was used to determine the nature and extent of knowledge gaps and barriers in the care of patients with CD. Qualitative interviews were conducted with nine gastroenterologists, four gastroenterology nurses and nine patients with CD. Based on this exploratory research, a survey was designed and launched nationally (37 gastroenterologists, 36 gastroenterology nurses). Findings indicated that Canadian gastroenterologists and gastroenterology nurses lacked clarity regarding their roles and responsibilities across the continuum of CD care, and face communication gaps within the health care team, undermining their effectiveness. Gastroenterologists identified challenges in optimal diagnosis due to unclear testing and diagnostic criteria. They recognized knowledge gaps when treating patient subgroups and in prescribing biological therapies. Furthermore, gastroenterologists self-identified gaps in skill, knowledge, and confidence in monitoring disease progression and effectively assessing response to therapy. When managing patients with CD, gastroenterologists expressed challenges with patient issues outside their domain of medical expertise, particularly with the skills needed to facilitate effective patient communication and education that would enhance adherence to recommended treatments. Educational initiatives should address diagnostic and treatment guidelines, as well as enhancement of clinical performance gaps in health care team processes and the patient-professional therapeutic relationship. To impact care and patient outcomes, these initiatives must be relevant to clinical practice settings and applicable to the practice context.

  3. Hypoxic challenge flight assessments in patients with severe chest wall deformity or neuromuscular disease at risk for nocturnal hypoventilation.

    PubMed

    Mestry, N; Thirumaran, M; Tuggey, J M; Macdonald, W; Elliott, M W

    2009-06-01

    The British Thoracic Society (BTS) recommendations for patients with respiratory disease planning air travel suggest that an oxygen saturation (SaO(2)) >95% precludes the need for any further assessment of the need for supplemental oxygen during flight. A hypoxic challenge test (HCT) is recommended for patients with a resting SaO(2) between 92% and 95% with an additional risk factor, including kyphoscoliosis (KS) or neuromuscular disease (NMD). However, this recommendation was based on very few data. HCTs were performed on 19 adult patients with KS and/or NMD (age 22-73 years, forced expiratory volume in 1 s (FEV(1)) 0.76, forced vital capacity (FVC) 0.92, SaO(2) 95%, partial pressure of arterial CO(2) (PaCO(2)) 5.7 kPa) who were at risk for nocturnal hypoventilation. 15 were home ventilator users. Arterial blood gas measurements were made before and at the end of the hypoxic challenge. The results of HCTs show that the majority (15 of 19) of this cohort of patients met the criteria suggested by the BTS Standards of Care Committee for in-flight oxygen regardless of baseline SaO(2). This finding suggests that all patients with severe extrapulmonary restrictive lung disease should undergo assessment with HCT prior to air travel. The study confirms that even patients with a resting saturation of >95% can desaturate significantly during hypoxic challenge. This study does not address the question of whether desaturation at altitude has any adverse consequences for patients. A decision as to whether it is safe for a patient to fly should be made by an experienced clinician and based on a number of factors, which should include previous travel experience, the patient's overall condition and the results of an HCT.

  4. Capacities for the Risk Assessment of GMOs: Challenges to Build Sustainable Systems.

    PubMed

    Fernández Ríos, Danilo; Rubinstein, Clara; Vicién, Carmen

    2018-01-01

    The need for functional risk assessment bodies in general, and in the biosafety field in particular, demands continued efforts and commitment from regulatory agencies, if results that are sustainable in time are to be achieved. The lack of formal processes that ensure continuity in the application of state of the art scientific criteria, the high rotation in some cases or the lack of experienced professionals, in others, is a challenge to be addressed. Capacity building initiatives with different approaches and degrees of success have been implemented in many countries over the years, supported by diverse governmental and non-governmental organizations. This document summarizes some capacity building experiences in developing countries and concludes that risk assessors taking ownership and regulatory authorities fully committed to developing and retaining highly qualified bodies are a sine qua non to achieve sustainable systems. To this end, it is essential to implement "in-house" continuing education mechanisms supported by external experts and organizations, and inter-institutional cooperation. It has to be noted that these recommendations could only be realized if policy makers understand and appreciate the value of professional, independent regulatory bodies.

  5. The European flood risk directive: challenges for research

    NASA Astrophysics Data System (ADS)

    Mostert, E.; Junier, S. J.

    2009-07-01

    In recent years, flood management has shifted from protection against floods to managing the risks of floods. In Europe, this shift is reflected in the Flood risk directive of October 2007 (2007/60/EC; FRD). The FRD requires EU Member States to undertake a preliminary assessment of flood risks and, for areas with a significant flood risk, to prepare flood hazard and flood risk maps and flood risk management plans. The purpose of this paper is to introduce the FRD and discuss the challenges that the FRD poses to research. These challenges include the issue how to define and measure ''flood risk'', the selection of alternatives to be assessed, coping with uncertainty, risk communication, nurturing trust and promoting collaboration. These research challenges cannot be addressed properly within any single discipline and without involving the flood risk managers and other stakeholders. The paper therefore concludes that there is a large need for interdisciplinary and participatory research. This constitutes in fact the biggest research challenge.

  6. Assessment of physiological parameters in response to an endotoxin challenge in crossbred steer progeny sired by Brahman bulls that experienced prenatal transportation stress

    USDA-ARS?s Scientific Manuscript database

    The objective of this experiment was to assess physiological responses to an endotoxin challenge in crossbred male progeny whose Brahman sires experienced prenatal transportation stress (PS) in utero. Sixteen steers (PNS group) sired by 3 PS bulls (gestating dams were transported for 2 h at 60, 80, ...

  7. Challenges in the Assessment of Medical Devices: The MedtecHTA Project.

    PubMed

    Tarricone, Rosanna; Torbica, Aleksandra; Drummond, Michael

    2017-02-01

    Assessing medical devices (MDs) raises challenges which require us to reflect on whether current methods are adequate. Major features of devices are: (i) device-operator interaction can generate learning curve effects; (ii) incremental nature of innovation needs to be addressed by careful identification of the alternatives for comparative and incremental cost-effectiveness analysis; and (iii) broader organizational impact in terms of training and infrastructure, coupled with dynamic pricing, requires a more flexible approach to costing. The objective of the MedtecHTA project was to investigate improvements in HTA methods to allow for more comprehensive evaluation of MDs. It consisted of several work packages concerning (i) the available evidence on the currently adopted approaches for regulation and HTA of medical devices; (ii) the geographical variation in access to MDs; (iii) the development of methodological frameworks for conducting comparative effectiveness research and economic evaluation of MDs; and (iv) the organizational impact of MDs. This introductory paper summarizes the main results of the project and draws out the main overarching themes. This supplement represents a comprehensive report of all the main findings of the MedtecHTA project, and it is intended to be the main source for researchers and policy makers wanting information on the project. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd. © 2017 The Authors. Health Economics Published by John Wiley & Sons, Ltd.

  8. THE CHALLENGE OF ASSESSING CHILDREN'S EXPOSURE TO PESTICIDES

    EPA Science Inventory

    In implementing the Food Quality Protection Act (FQPA) the U.S. Environmental Protection Agency (USEPA) has adopted a policy that the exposure factors and models used to assess and predict exposure to pesticides should generally be conservative. Some elements of exposure assess...

  9. Assessing cost-effectiveness of HPV vaccines with decision analytic models: what are the distinct challenges of low- and middle-income countries? A protocol for a systematic review.

    PubMed

    Ekwunife, Obinna I; Grote, Andreas Gerber; Mosch, Christoph; O'Mahony, James F; Lhachimi, Stefan K

    2015-05-12

    Cervical cancer poses a huge health burden, both to developed and developing nations, making prevention and control strategies necessary. However, the challenges of designing and implementing prevention strategies differ for low- and middle-income countries (LMICs) as compared to countries with fully developed health care systems. Moreover, for many LMICs, much of the data needed for decision analytic modelling, such as prevalence, will most likely only be partly available or measured with much larger uncertainty. Lastly, imperfect implementation of human papillomavirus (HPV) vaccination may influence the effectiveness of cervical cancer prevention in unpredictable ways. This systematic review aims to assess how decision analytic modelling studies of HPV cost-effectiveness in LMICs accounted for the particular challenges faced in such countries. Specifically, the study will assess the following: (1) whether the existing literature on cost-effectiveness modelling of HPV vaccines acknowledges the distinct challenges of LMICs, (2) how these challenges were accommodated in the models, (3) whether certain parameters systemically exhibited large degrees of uncertainty due to lack of data and how influential were these parameters on model-based recommendations, and (4) whether the choice of modelling herd immunity influences model-based recommendations, especially when coverage of a HPV vaccination program is not optimal. We will conduct a systematic review to identify suitable studies from MEDLINE (via PubMed), EMBASE, NHS Economic Evaluation Database (NHS EED), EconLit, Web of Science, and CEA Registry. Searches will be conducted for studies of interest published since 2006. The searches will be supplemented by hand searching of the most relevant papers found in the search. Studies will be critically appraised using Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement checklist. We will undertake a descriptive, narrative, and interpretative

  10. Summative assessment of undergraduates' communication competence in challenging doctor-patient encounters. Evaluation of the Düsseldorf CoMeD-OSCE.

    PubMed

    Mortsiefer, Achim; Immecke, Janine; Rotthoff, Thomas; Karger, André; Schmelzer, Regine; Raski, Bianca; Schmitten, Jürgen In der; Altiner, Attila; Pentzek, Michael

    2014-06-01

    To evaluate the summative assessment (OSCE) of a communication training programme for dealing with challenging doctor-patient encounters in the 4th study year. Our OSCE consists of 4 stations (breaking bad news, guilt and shame, aggressive patients, shared decision making), using a 4-item global rating (GR) instrument. We calculated reliability coefficients for different levels, discriminability of single items and interrater reliability. Validity was estimated by gender differences and accordance between GR and a checklist. In a pooled sample of 456 students in 3 OSCEs over 3 terms, total reliability was α=0.64, reliability coefficients for single stations were >0.80, and discriminability in 3 of 4 stations was within the range of 0.4-0.7. Except for one station, interrater reliability was moderate to strong. Reliability on item level was poor and pointed to some problems with the use of the GR. The application of the GR on regular undergraduate medical education shows moderate reliability in need of improvement and some traits of validity. Ongoing development and evaluation is needed with particular regard to the training of the examiners. Our CoMeD-OSCE proved suitable for the summative assessment of communication skills in challenging doctor-patient encounters. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Ecological Momentary Assessment in Behavioral Research: Addressing Technological and Human Participant Challenges.

    PubMed

    Burke, Lora E; Shiffman, Saul; Music, Edvin; Styn, Mindi A; Kriska, Andrea; Smailagic, Asim; Siewiorek, Daniel; Ewing, Linda J; Chasens, Eileen; French, Brian; Mancino, Juliet; Mendez, Dara; Strollo, Patrick; Rathbun, Stephen L

    2017-03-15

    completing EMA surveys was high, with 88.3% (66,978/75,888) completion of random assessments and around 90% (23,411/25,929 and 23,343/26,010) completion of time-contingent assessments, despite the duration of EMA data collection and challenges with implementation. This work informed us of the necessary preliminary steps to plan and prepare a longitudinal study using smartphone technology and the critical elements to ensure participant engagement in the potentially burdensome protocol, which spanned 12 months. While this was a technology-supported and -programmed study, it required close oversight to ensure all elements were functioning correctly, particularly once human participants became involved. ©Lora E Burke, Saul Shiffman, Edvin Music, Mindi A Styn, Andrea Kriska, Asim Smailagic, Daniel Siewiorek, Linda J Ewing, Eileen Chasens, Brian French, Juliet Mancino, Dara Mendez, Patrick Strollo, Stephen L Rathbun. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 15.03.2017.

  12. Assessing mobile food vendors (a.k.a. street food vendors)—methods, challenges, and lessons learned for future food-environment research

    PubMed Central

    Lucan, Sean C.; Varona, Monica; Maroko, Andrew R.; Bumol, Joel; Torrens, Luis; Wylie-Rosett, Judith

    2013-01-01

    most comfort with languages other than English, and reluctance to interact with individuals gathering data are principal challenges to assessment. Strategies to address assessment challenges that emerged form this project may help make mobile-vendor assessments more routine in food-environment research. PMID:23891280

  13. The reproducibility of adenosine monophosphate bronchial challenges in mild, steroid-naive asthmatics

    PubMed Central

    Singh, Dave; Fairwood, Jennifer; Murdoch, Robert; Weeks, Amanda; Russell, Paul; Roy, Kay; Langley, Steve; Woodcock, Ashley

    2008-01-01

    WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Repeated adenosine monophosphate (AMP) challenges are used to assess drug effects in asthma clinical trials, but may be prone to tachyphylaxis when repeated at short intervals. Possible tachyphylaxis at 12- and 24-h intervals has not been studied. WHAT THIS STUDY ADDS Clinically relevant tachyphylaxis after repeated AMP challenges does not occur when repeated at 12- and 24-h intervals. AMP challenges at these intervals can be used to assess drug effects in clinical trials. AIMS Repeated adenosine monophosphate (AMP) challenges are used to assess drug efficacy in clinical trials of mild, steroid-naive asthmatics. Refractoriness has been reported after repeated challenges over short intervals. This study evaluated possible tachyphylaxis after repeated AMP challenges at 12 and 24 h in mild, steroid-naive asthmatics. METHODS This was an open, three-way crossover study. Twenty-six steroid-naive asthmatic subjects were randomized to the following AMP challenge regimens separated by 7–14 days: (A) challenge at 08.00 h, repeated 24 h later; (B) challenge at 08.00 h, repeated 12 and 24 h later; (C) challenge at 20.00 h, repeated 12 h later. Comparisons within day were assessed using 90% confidence intervals (CIs). Non-inferiority approach taken with 1 doubling concentration (DC) as a clinically relevant difference. RESULTS Regimen A: Significant increase in AMP reactivity at 24 h. Mean DC difference was 0.6 (90% CI 0.24, 0.96). Regimen B: No evidence of difference between AMP reactivity at 08.00 h and a repeated challenge 12 h later. Repeated challenge at 24 h caused a significant increase in provocation concentration (PC)20 compared with 12 h (mean DC difference 0.48, 90% CI 0.02, 0.95) and 0 h (mean DC difference 0.82, 90% CI 0.49, 1.14 – the upper CI exceeds the criteria of 1 DC). Challenge regimen C: No difference between challenges; mean DC difference of 0.28 (90% CI −0.2, 0.76). CONCLUSION The small decline in AMP

  14. Methodical Challenges Concerning the Draw-A-Scientist Test: A Critical View about the Assessment and Evaluation of Learners' Conceptions of Scientists

    ERIC Educational Resources Information Center

    Reinisch, Bianca; Krell, Moritz; Hergert, Susann; Gogolin, Sarah; Krüger, Dirk

    2017-01-01

    Students' and pre-service teachers' conceptions of scientists have been assessed in a variety of studies. One of the most commonly used instruments is the Draw-A-Scientist Test (DAST) which offers the advantage that no verbal skills are needed by the participants. In some studies, methodical challenges related to the DAST have been discussed; for…

  15. Next-generation sequencing (NGS) for assessment of microbial water quality: current progress, challenges, and future opportunities

    PubMed Central

    Tan, BoonFei; Ng, Charmaine; Nshimyimana, Jean Pierre; Loh, Lay Leng; Gin, Karina Y.-H.; Thompson, Janelle R.

    2015-01-01

    Water quality is an emergent property of a complex system comprised of interacting microbial populations and introduced microbial and chemical contaminants. Studies leveraging next-generation sequencing (NGS) technologies are providing new insights into the ecology of microbially mediated processes that influence fresh water quality such as algal blooms, contaminant biodegradation, and pathogen dissemination. In addition, sequencing methods targeting small subunit (SSU) rRNA hypervariable regions have allowed identification of signature microbial species that serve as bioindicators for sewage contamination in these environments. Beyond amplicon sequencing, metagenomic and metatranscriptomic analyses of microbial communities in fresh water environments reveal the genetic capabilities and interplay of waterborne microorganisms, shedding light on the mechanisms for production and biodegradation of toxins and other contaminants. This review discusses the challenges and benefits of applying NGS-based methods to water quality research and assessment. We will consider the suitability and biases inherent in the application of NGS as a screening tool for assessment of biological risks and discuss the potential and limitations for direct quantitative interpretation of NGS data. Secondly, we will examine case studies from recent literature where NGS based methods have been applied to topics in water quality assessment, including development of bioindicators for sewage pollution and microbial source tracking, characterizing the distribution of toxin and antibiotic resistance genes in water samples, and investigating mechanisms of biodegradation of harmful pollutants that threaten water quality. Finally, we provide a short review of emerging NGS platforms and their potential applications to the next generation of water quality assessment tools. PMID:26441948

  16. Assessing mobile food vendors (a.k.a. street food vendors)--methods, challenges, and lessons learned for future food-environment research.

    PubMed

    Lucan, S C; Varona, M; Maroko, A R; Bumol, J; Torrens, L; Wylie-Rosett, J

    2013-08-01

    to interact with individuals gathering data are principal challenges to assessment. Strategies to address assessment challenges that emerged form this project may help make mobile-vendor assessments more routine in food-environment research. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Common Core State Standards Assessments: Challenges and Opportunities

    ERIC Educational Resources Information Center

    Polikoff, Morgan S.

    2014-01-01

    The Common Core State Standards (CCSS) were created in response to the shortcomings of No Child Left Behind era standards and assessments. Among those failings were the poor quality of content standards and assessments and the variability in content expectations and proficiency targets across states, as well as concerns related to the economic…

  18. REGIONAL ASSESSMENT OF WETLAND ECOLOGICAL CONDITION -- ISSUES AND CHALLENGES

    EPA Science Inventory

    Most work on wetland assessment has focused on the development of methods, however, effective assessment involves more than having a method. In a 2004 review of rapid assessment methods, Fennessey et al. recommended key considerations when adopting existing methods or developing...

  19. On Learning and Assessment

    ERIC Educational Resources Information Center

    Schoenfeld, Alan H.

    2017-01-01

    The challenge of "educational" assessments--assessments that advance the purposes of learning and instruction--is to provide useful information regarding students' progress towards the goals of instruction in ways that are reliable and not idiosyncratic. In this commentary, the author indicates that the challenges are actually more…

  20. Assessing Induced Seismicity Risk at CO 2 Storage Projects: Recent Progress and Remaining Challenges

    DOE PAGES

    White, Joshua A.; Foxall, William

    2016-04-13

    It is well established that fluid injection has the potential to induce earthquakes—from microseismicity to magnitude 5+ events—by altering state-of-stress conditions in the subsurface. This paper reviews recent lessons learned regarding induced seismicity at carbon storage sites. While similar to other subsurface injection practices, CO 2 injection has distinctive features that should be included in a discussion of its seismic hazard. Induced events have been observed at CO 2 injection projects, though to date it has not been a major operational issue. Nevertheless, the hazard exists and experience with this issue will likely grow as new storage operations come online.more » This review paper focuses on specific technical difficulties that can limit the effectiveness of current risk assessment and risk management approaches, and highlights recent research aimed at overcoming them. Finally, these challenges form the heart of the induced seismicity problem, and novel solutions to them will advance our ability to responsibly deploy large-scale CO 2 storage.« less

  1. Human exposure to chemical mixtures: Challenges for the integration of toxicology with epidemiology data in risk assessment.

    PubMed

    Hernández, Antonio F; Tsatsakis, Aristidis M

    2017-05-01

    Little is known about the potential adverse effects from longterm exposure to complex mixtures at low doses, close to health-based reference values. Traditional chemical-specific risk assessment based on animal testing may be insufficient and the lack of toxicological studies on chemical mixtures remains a major regulatory challenge. Hence, new methodologies on cumulative risk assessment are being developed but still present major limitations. Evaluation of chemical mixture effects requires an integrated and systematic approach and close collaboration across different scientific fields, particularly toxicology, epidemiology, exposure science, risk assessment and statistics for a proper integration of data from all these disciplines. Well designed and conducted epidemiological studies can take advantage of this new paradigm and can provide insight to support the correlation between humans low-dose exposures and diseases, thus avoiding the uncertainty associated with extrapolation across species. In this regard, human epidemiology studies may play a significant role in the new vision of toxicity testing. However, this type of information has not been fully considered in risk assessment, mainly due to the inherent limitations of epidemiologic studies. An integrated approach of in vivo, in vitro and in silico data, together with systematic reviews or meta-analysis of high quality epidemiological studies will improve the robustness of risk assessment of chemical mixtures and will provide a stronger basis for regulatory decisions. The ultimate goal is that experimental and mechanistic data can lend support and biological plausibility to the human epidemiological observations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Tool for evaluating research implementation challenges: A sense-making protocol for addressing implementation challenges in complex research settings

    PubMed Central

    2013-01-01

    Background Many challenges arise in complex organizational interventions that threaten research integrity. This article describes a Tool for Evaluating Research Implementation Challenges (TECH), developed using a complexity science framework to assist research teams in assessing and managing these challenges. Methods During the implementation of a multi-site, randomized controlled trial (RCT) of organizational interventions to reduce resident falls in eight nursing homes, we inductively developed, and later codified the TECH. The TECH was developed through processes that emerged from interactions among research team members and nursing home staff participants, including a purposive use of complexity science principles. Results The TECH provided a structure to assess challenges systematically, consider their potential impact on intervention feasibility and fidelity, and determine actions to take. We codified the process into an algorithm that can be adopted or adapted for other research projects. We present selected examples of the use of the TECH that are relevant to many complex interventions. Conclusions Complexity theory provides a useful lens through which research procedures can be developed to address implementation challenges that emerge from complex organizations and research designs. Sense-making is a group process in which diverse members interpret challenges when available information is ambiguous; the groups’ interpretations provide cues for taking action. Sense-making facilitates the creation of safe environments for generating innovative solutions that balance research integrity and practical issues. The challenges encountered during implementation of complex interventions are often unpredictable; however, adoption of a systematic process will allow investigators to address them in a consistent yet flexible manner, protecting fidelity. Research integrity is also protected by allowing for appropriate adaptations to intervention protocols that

  3. Assessing the educational needs of Canadian gastroenterologists and gastroenterology nurses: Challenges to optimal care in Crohn’s disease

    PubMed Central

    Dupuis, Martin; Marshall, John K; Hayes, Sean M; Cytryn, Kayla; Murray, Suzanne

    2009-01-01

    OBJECTIVE: A national needs assessment of Canadian gastroenterologists and gastroenterology nurses was undertaken to determine the perceived and unperceived educational and performance barriers to caring for patients with Crohn’s disease (CD). METHODS: A triangulated, mixed-method approach (qualitative and quantitative) was used to determine the nature and extent of knowledge gaps and barriers in the care of patients with CD. RESULTS: Qualitative interviews were conducted with nine gastroenterologists, four gastroenterology nurses and nine patients with CD. Based on this exploratory research, a survey was designed and launched nationally (37 gastroenterologists, 36 gastroenterology nurses). Findings indicated that Canadian gastroenterologists and gastroenterology nurses lacked clarity regarding their roles and responsibilities across the continuum of CD care, and face communication gaps within the health care team, undermining their effectiveness. Gastroenterologists identified challenges in optimal diagnosis due to unclear testing and diagnostic criteria. They recognized knowledge gaps when treating patient subgroups and in prescribing biological therapies. Furthermore, gastroenterologists self-identified gaps in skill, knowledge, and confidence in monitoring disease progression and effectively assessing response to therapy. When managing patients with CD, gastroenterologists expressed challenges with patient issues outside their domain of medical expertise, particularly with the skills needed to facilitate effective patient communication and education that would enhance adherence to recommended treatments. CONCLUSIONS: Educational initiatives should address diagnostic and treatment guidelines, as well as enhancement of clinical performance gaps in health care team processes and the patient-professional therapeutic relationship. To impact care and patient outcomes, these initiatives must be relevant to clinical practice settings and applicable to the practice

  4. Function-Based Interventions for Children with Challenging Behavior

    ERIC Educational Resources Information Center

    Dunlap, Glen; Fox, Lise

    2011-01-01

    It is now axiomatic that challenging behaviors are defined more profitably by their functions (their motivations) than by their topographies (what they look like). The notion that challenging behaviors can be defined on the basis of their function has led in the past 30 years to a dramatically reconfigured approach to assessment and intervention.…

  5. Conceptual Questions and Challenge Problems

    NASA Astrophysics Data System (ADS)

    Nurrenbern, Susan C.; Robinson, William R.

    1998-11-01

    The JCE Internet Conceptual Question and Challenge Problem Web site is a source of questions and problems that can be used in teaching and assessing conceptual understanding and problem solving in chemistry. Here you can find a library of free-response and multiple-choice conceptual questions and challenge problems, tips for writing these questions and problems, and a discussion of types of conceptual questions. This site is intended to be a means of sharing conceptual questions and challenge problems among chemical educators. This is a living site that will grow as you share conceptual questions and challenge problems and as we find new sources of information. We would like to make this site as inclusive as possible. Please share your questions and problems with us and alert us to references or Web sites that could be included on the site. You can use email, fax, or regular mail. Email: nurrenbern@purdue.edu or wrrobin@purdue.edu Fax: 765/494-0239 Mailing address: Susan C. Nurrenbern or William R. Robinson; Department of Chemistry; Purdue University; 1393 Brown Building; West Lafayette, IN 47907-1393. The Conceptual Questions and Challenge Problems Web site can be found here.

  6. Assessing Students in the Margin: Challenges, Strategies, and Techniques

    ERIC Educational Resources Information Center

    Russell, Michael; Kavanaugh, Maureen

    2011-01-01

    The importance of student assessment, particularly for summative purposes, has increased greatly over the past thirty years. At the same time, emphasis on including all students in assessment programs has also increased. Assessment programs, whether they are large-scale, district-based, or teacher developed, have traditionally attempted to assess…

  7. Strategies for risk assessment and control in welding: challenges for developing countries.

    PubMed

    Hewitt, P J

    2001-06-01

    Metal arc welding ranges from primitive (manual) to increasingly complex automated welding processes. Welding occupies 1% of the labour force in some industrialised countries and increasing knowledge of health risks, necessitating improved assessment strategies and controls have been identified by the International Institute of Welding (IIW), ILO, WHO and other authoritative bodies. Challenges for developing countries need to be addressed. For small scale production and repair work, predominantly by manual metal arc on mild steel, the focus in developing economies has correctly been on control of obvious physical and acute health affects. Development introduces more sophisticated processes and hazards. Work pieces of stainless steel and consumables with chromium, nickel and manganese constituents are used with increasingly complex semi-manual or automated systems involving variety of fluxes or gasses. Uncritical adoption of new welding technologies by developing countries potentiates future health problems. Control should be integral at the design stage, otherwise substantive detriments and later costs can ensue. Developing countries need particular guidance on selection of the optimised welding consumables and processes to minimise such detriments. The role of the IIW and the MFRU are described. Applications of occupational hygiene principals of prevention and control of welding fume at source by process modification are presented.

  8. Biogas Production from Sugarcane Waste: Assessment on Kinetic Challenges for Process Designing

    PubMed Central

    Janke, Leandro; Leite, Athaydes; Nikolausz, Marcell; Schmidt, Thomas; Liebetrau, Jan; Nelles, Michael; Stinner, Walter

    2015-01-01

    Biogas production from sugarcane waste has large potential for energy generation, however, to enable the optimization of the anaerobic digestion (AD) process each substrate characteristic should be carefully evaluated. In this study, the kinetic challenges for biogas production from different types of sugarcane waste were assessed. Samples of vinasse, filter cake, bagasse, and straw were analyzed in terms of total and volatile solids, chemical oxygen demand, macronutrients, trace elements, and nutritional value. Biochemical methane potential assays were performed to evaluate the energy potential of the substrates according to different types of sugarcane plants. Methane yields varied considerably (5–181 Nm3·tonFM−1), mainly due to the different substrate characteristics and sugar and/or ethanol production processes. Therefore, for the optimization of AD on a large-scale, continuous stirred-tank reactor with long hydraulic retention times (>35 days) should be used for biogas production from bagasse and straw, coupled with pre-treatment process to enhance the degradation of the fibrous carbohydrates. Biomass immobilization systems are recommended in case vinasse is used as substrate, due to its low solid content, while filter cake could complement the biogas production from vinasse during the sugarcane offseason, providing a higher utilization of the biogas system during the entire year. PMID:26404248

  9. Biogas Production from Sugarcane Waste: Assessment on Kinetic Challenges for Process Designing.

    PubMed

    Janke, Leandro; Leite, Athaydes; Nikolausz, Marcell; Schmidt, Thomas; Liebetrau, Jan; Nelles, Michael; Stinner, Walter

    2015-08-31

    Biogas production from sugarcane waste has large potential for energy generation, however, to enable the optimization of the anaerobic digestion (AD) process each substrate characteristic should be carefully evaluated. In this study, the kinetic challenges for biogas production from different types of sugarcane waste were assessed. Samples of vinasse, filter cake, bagasse, and straw were analyzed in terms of total and volatile solids, chemical oxygen demand, macronutrients, trace elements, and nutritional value. Biochemical methane potential assays were performed to evaluate the energy potential of the substrates according to different types of sugarcane plants. Methane yields varied considerably (5-181 Nm³·tonFM(-1)), mainly due to the different substrate characteristics and sugar and/or ethanol production processes. Therefore, for the optimization of AD on a large-scale, continuous stirred-tank reactor with long hydraulic retention times (>35 days) should be used for biogas production from bagasse and straw, coupled with pre-treatment process to enhance the degradation of the fibrous carbohydrates. Biomass immobilization systems are recommended in case vinasse is used as substrate, due to its low solid content, while filter cake could complement the biogas production from vinasse during the sugarcane offseason, providing a higher utilization of the biogas system during the entire year.

  10. Assessing School Leadership Challenges in Ghana Using Leadership Practices Inventory

    ERIC Educational Resources Information Center

    Edwards, Alexander Kyei; Aboagye, Samuel Kwadwo

    2015-01-01

    The Ghana Education Service (GES) is facing challenges in school leadership and hence a lot of criticisms on basic school performances. The issue is whether school leadership relates to school performances and that there is the need for transformation leadership. The purpose of this study was to discuss self-reported leadership practices…

  11. Beyond the Family Geography Challenge.

    ERIC Educational Resources Information Center

    Keeler, Christy

    1997-01-01

    Describes a school-community program based on and extending the efforts of the Michigan Model Family Geography Challenge. The program includes inviting community members to participate in hands-on activities, as well as, shared activities between parents and students followed by dinner and socializing. Discusses materials, assessment, and…

  12. Monitoring challenges and innovative ideas

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    O'Neill, R.V.; Hunsaker, C.T.; Levine, D.A.

    1990-01-01

    Monitoring programs are difficult to design even when they focus on specific problems. Ecosystems are complex, and it is often impossible to predetermine what aspects of system structure or dynamics will respond to a specific insult. It is equally difficult to interpret whether a response is a stabilizing compensatory mechanism or a real loss of capacity to maintain the ecosystem. The problems are compounded in a broad monitoring program designed to assess ecosystem health'' at regional and continental scales. It is challenging in the extreme to monitor ecosystem response, at any scale, to past insults as well as an unknownmore » future array of impacts. The present paper will examine some of the fundamental issues and challenges raised by large-scale monitoring efforts. The challenges will serve as a framework and as an excuse to discuss several important topics in more detail. Following the discussion of challenges, we suggest some basic innovations that could be important across a range of monitoring programs. The innovations include integrative measures, innovative methodology, and creative interpretation. 59 refs., 1 tab.« less

  13. INTEGRATED SCIENCE FOR ECOSYSTEM CHALLENGES - ISEC

    EPA Science Inventory

    In support of the National Science and Technology Council's cross-Agency priority of Integrated Science for Ecological Challenges (ISEC) EPA is conducting research to improve capabilities in the area of regional vulnerability assessment and ecological forecasting. EPA's research...

  14. A pilot study investigating the feasibility of symptom assessment manager (SAM), a Web-based real-time tool for monitoring challenging behaviors.

    PubMed

    Loi, Samantha M; Wanasinghage, Sangeeth; Goh, Anita; Lautenschlager, Nicola T; Darby, David G; Velakoulis, Dennis

    2018-04-01

    Improving and minimizing challenging behaviors seen in psychiatric conditions, including behavioral and psychological symptoms of dementia are important in the care of people with these conditions. Yet there is a lack of systematic evaluation of these as a part of routine clinical care. The Neuropsychiatric Inventory is a validated and reliable tool for rating the severity and disruptiveness of challenging behaviors. We report on the evaluation of a Web-based symptom assessment manager (SAM), designed to address the limitation of previous tools using some of the Neuropsychiatric Inventory functions, to monitor behaviors by staff caring for people with dementia and other psychiatric conditions in inpatient and residential care settings. The SAM was piloted in an 8-bed inpatient neuropsychiatry unit over 5 months. Eleven nurses and 4 clinicians were trained in usage of SAM. Primary outcomes were usage of SAM and perceived usability, utility, and acceptance of SAM. Secondary outcomes were the frequencies of documented behavior. Usage data were analyzed using chi-square and logistic regression analyses. The SAM was used for all admitted patients regardless of diagnosis, with a usage rate of 64% for nurses regularly employed in the unit. Staff provided positive feedback regarding the utility of SAM. The SAM appeared to offer individualized behavior assessment by providing a quick, structured, and standardized platform for assessing behavior in a real-world setting. Further research would involve trialing SAM with more staff in alternative settings such as in home or residential care settings. Copyright © 2017 John Wiley & Sons, Ltd.

  15. A review of multi-risk methodologies for natural hazards: Consequences and challenges for a climate change impact assessment.

    PubMed

    Gallina, Valentina; Torresan, Silvia; Critto, Andrea; Sperotto, Anna; Glade, Thomas; Marcomini, Antonio

    2016-03-01

    This paper presents a review of existing multi-risk assessment concepts and tools applied by organisations and projects providing the basis for the development of a multi-risk methodology in a climate change perspective. Relevant initiatives were developed for the assessment of multiple natural hazards (e.g. floods, storm surges, droughts) affecting the same area in a defined timeframe (e.g. year, season, decade). Major research efforts were focused on the identification and aggregation of multiple hazard types (e.g. independent, correlated, cascading hazards) by means of quantitative and semi-quantitative approaches. Moreover, several methodologies aim to assess the vulnerability of multiple targets to specific natural hazards by means of vulnerability functions and indicators at the regional and local scale. The overall results of the review show that multi-risk approaches do not consider the effects of climate change and mostly rely on the analysis of static vulnerability (i.e. no time-dependent vulnerabilities, no changes among exposed elements). A relevant challenge is therefore to develop comprehensive formal approaches for the assessment of different climate-induced hazards and risks, including dynamic exposure and vulnerability. This requires the selection and aggregation of suitable hazard and vulnerability metrics to make a synthesis of information about multiple climate impacts, the spatial analysis and ranking of risks, including their visualization and communication to end-users. To face these issues, climate impact assessors should develop cross-sectorial collaborations among different expertise (e.g. modellers, natural scientists, economists) integrating information on climate change scenarios with sectorial climate impact assessment, towards the development of a comprehensive multi-risk assessment process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Getting People Involved: The Benefit of Intellectual Capital Management for Addressing HR Challenges

    ERIC Educational Resources Information Center

    Pook, Katja

    2011-01-01

    Purpose: This paper aims to explore the benefits of intellectual capital assessment for facing current challenges of human resources work and organizational development. Design/methodology/approach: The paper takes findings of studies on challenges in HR work and maps them with features of intellectual capital assessment methods. It is thus a…

  17. Challenges associated with the implementation of the nursing process: A systematic review.

    PubMed

    Zamanzadeh, Vahid; Valizadeh, Leila; Tabrizi, Faranak Jabbarzadeh; Behshid, Mojghan; Lotfi, Mojghan

    2015-01-01

    Nursing process is a scientific approach in the provision of qualified nursing cares. However, in practice, the implementation of this process is faced with numerous challenges. With the knowledge of the challenges associated with the implementation of the nursing process, the nursing processes can be developed appropriately. Due to the lack of comprehensive information on this subject, the current study was carried out to assess the key challenges associated with the implementation of the nursing process. To achieve and review related studies on this field, databases of Iran medix, SID, Magiran, PUBMED, Google scholar, and Proquest were assessed using the main keywords of nursing process and nursing process systematic review. The articles were retrieved in three steps including searching by keywords, review of the proceedings based on inclusion criteria, and final retrieval and assessment of available full texts. Systematic assessment of the articles showed different challenges in implementation of the nursing process. Intangible understanding of the concept of nursing process, different views of the process, lack of knowledge and awareness among nurses related to the execution of process, supports of managing systems, and problems related to recording the nursing process were the main challenges that were extracted from review of literature. On systematically reviewing the literature, intangible understanding of the concept of nursing process has been identified as the main challenge in nursing process. To achieve the best strategy to minimize the challenge, in addition to preparing facilitators for implementation of nursing process, intangible understanding of the concept of nursing process, different views of the process, and forming teams of experts in nursing education are recommended for internalizing the nursing process among nurses.

  18. The Advantages and Challenges of Unannounced Standardized Patients Methodology to Assess Healthcare Communication

    PubMed Central

    Siminoff, Laura A.; Rogers, Heather L.; Waller, Allison C.; Harris-Haywood, Sonja; Esptein, Ronald M.; Borrell Carrio, Francesc; Gliva-McConvey, Gayle; Longo, Daniel R.

    2011-01-01

    Objective This paper provides an overview of the implementation of using Unannounced Standardized Patients (USPs) to conduct health communication research in clinical settings. Methods Certain types of health communication situations are difficult to capture because of their rarity or unpredictable nature. In primary care the real reasons for a visit are frequently unknown until the consultation is well under way. Therefore, it is logistically difficult for communication studies to capture many real-time communications between patients and their physicians. Although the USP methodology is ideal for capturing these communication behaviors, challenges to using this method include developing collaborative relationships with clinical practices, logistical issues such as safeguarding the identity of the USP, training USPs and creating their identities, maintaining fidelity to the role, and analyzing the resultant data. Results This paper discusses the challenges and solutions to USP implementation. We provide an example of how to implement a USP study using an on-going study being conducted in primary care practices. Conclusion This paper explores the advantages and challenges as well as strategies to overcome obstacles to implementing a USP study. Practice Implications Despite the challenges, USP methodology can contribute much to our understanding of health communication and practice. PMID:21316182

  19. Challenges of assessment and treatment of ultra high risk for psychosis in an adolescent.

    PubMed

    Boričević Maršanić, Vlatka; Jukić, Josipa; Flander, Mia

    2018-06-01

    The onset of psychosis is typically preceded by a prodromal phase that is characterised by the emergence of "attenuated" psychotic symptoms. This phase is described as ultra-high risk (UHR) or at-risk mental state (ARMS) of psychosis. Criteria have been established for identifying these young people who are at clinical high risk. People at ultra-high risk (UHR) of psychosis have about 30% chance of developing the illness within two years. This category was introduced with the goal of developing treatments for prevention of psychotic disorders. Recent research suggests that early interventions appear to be effective in delaying and even preventing the onset of psychosis. These treatments include antipsychotic medication, nutritional supplements such as omega-3 fatty acids and psychological treatment. Cognitive behavioral therapy (CBT) has been tested as a potentially effective intervention in this group. Here we describe a case of a male adolescent with UHR psychotic symptoms with focus on challenges of assessing the UHR in adolescents and issues of providing effective age appropriate interventions.

  20. Report on the first round of the Mock LISA Data Challenges

    NASA Astrophysics Data System (ADS)

    Arnaud, K. A.; Auger, G.; Babak, S.; Baker, J. G.; Benacquista, M. J.; Bloomer, E.; Brown, D. A.; Camp, J. B.; Cannizzo, J. K.; Christensen, N.; Clark, J.; Cornish, N. J.; Crowder, J.; Cutler, C.; Finn, L. S.; Halloin, H.; Hayama, K.; Hendry, M.; Jeannin, O.; Królak, A.; Larson, S. L.; Mandel, I.; Messenger, C.; Meyer, R.; Mohanty, S.; Nayak, R.; Numata, K.; Petiteau, A.; Pitkin, M.; Plagnol, E.; Porter, E. K.; Prix, R.; Roever, C.; Stroeer, A.; Thirumalainambi, R.; Thompson, D. E.; Toher, J.; Umstaetter, R.; Vallisneri, M.; Vecchio, A.; Veitch, J.; Vinet, J.-Y.; Whelan, J. T.; Woan, G.

    2007-10-01

    The Mock LISA Data Challenges (MLDCs) have the dual purpose of fostering the development of LISA data analysis tools and capabilities, and demonstrating the technical readiness already achieved by the gravitational-wave community in distilling a rich science payoff from the LISA data output. The first round of MLDCs has just been completed: nine challenges consisting of data sets containing simulated gravitational-wave signals produced either by galactic binaries or massive black hole binaries embedded in simulated LISA instrumental noise were released in June 2006 with deadline for submission of results at the beginning of December 2006. Ten groups have participated in this first round of challenges. All of the challenges had at least one entry which successfully characterized the signal to better than 95% when assessed via a correlation with phasing ambiguities accounted for. Here, we describe the challenges, summarize the results and provide a first critical assessment of the entries.

  1. Lubrication of space systems: Challenges and potential solutions

    NASA Technical Reports Server (NTRS)

    Fusaro, Robert L.

    1992-01-01

    Future space missions will all require advanced mechanical moving components which will require wear protection and lubrication. The tribology practices used today are primarily based upon a technology base that is more than 20 years old. This paper will discuss NASA's future space missions and some of the mechanism tribology challenges that will be encountered. Potential solutions to these challenges using coatings technology will be assessed.

  2. Watershed challenges for the 21st Century: A global perspective for mountainous terrain

    Treesearch

    Roy C. Sidle

    2000-01-01

    Three global challenges for watershed researchers in the 21st century are examined in this paper. These challenges are obtaining better assessments of terrain stability; understanding hydrologic responses at different watershed scales; and developing better methods for analyzing and assessing cumulative watershed effects. These topics are only a subset of the pressing...

  3. Investigation of the Physiological Responses of Belugas to Stressors to Aid in Assessing the Impact of Environmental and Anthropogenic Challenges on Health

    DTIC Science & Technology

    2013-12-19

    Physiological Responses of Belugas to "Stressors" to Aid in Assessing the Impact of Environmental and Anthropogenic Challenges on Health 5a. CONTRACT...ANSI Std.Z39.18 " DISTRIBUTION STATEMENT A. Approved for public release: distribution is unlimited. Investigation of the Physiological Responses... physiological i.e. neuroimmunoendocrino logical responses of beluga whales to "Stressors". "Stressor events" will allow for a better understanding and

  4. Food safety systems in a small dairy factory: implementation, major challenges, and assessment of systems' performances.

    PubMed

    Cusato, Sueli; Gameiro, Augusto H; Corassin, Carlos H; Sant'ana, Anderson S; Cruz, Adriano G; Faria, José de Assis F; de Oliveira, Carlos Augusto F

    2013-01-01

    The present study describes the implementation of a food safety system in a dairy processing plant located in the State of São Paulo, Brazil, and the challenges found during the process. In addition, microbiological indicators have been used to assess system's implementation performance. The steps involved in the implementation of a food safety system included a diagnosis of the prerequisites, implementation of the good manufacturing practices (GMPs), sanitation standard operating procedures (SSOPs), training of the food handlers, and hazard analysis and critical control point (HACCP). In the initial diagnosis, conformity with 70.7% (n=106) of the items analyzed was observed. A total of 12 critical control points (CCPs) were identified: (1) reception of the raw milk, (2) storage of the raw milk, (3 and 4) reception of the ingredients and packaging, (5) milk pasteurization, (6 and 7) fermentation and cooling, (8) addition of ingredients, (9) filling, (10) storage of the finished product, (11) dispatching of the product, and (12) sanitization of the equipment. After implementation of the food safety system, a significant reduction in the yeast and mold count was observed (p<0.05). The main difficulties encountered for the implementation of food safety system were related to the implementation of actions established in the flow chart and to the need for constant training/adherence of the workers to the system. Despite this, the implementation of the food safety system was shown to be challenging, but feasible to be reached by small-scale food industries.

  5. Cognitive assessment: A challenge for occupational therapists in Brazil

    PubMed Central

    Conti, Juliana

    2017-01-01

    Cognitive impairment is a common dysfunction after neurological injury. Cognitive assessment tools can help the therapist understand how impairments are affecting functional status and quality of life. Objective The aim of the study was to identify instruments for cognitive assessment that Occupational Therapists (OT) can use in clinical practice. Methods The instruments published in English and Portuguese between 1999 and 2016 were systematically reviewed. Results The search identified 17 specific instruments for OT not validated in Brazilian Portuguese, 10 non-specific instruments for OT not validated in Brazilian Portuguese, and 25 instruments validated for Portuguese, only one of which was specific for OT (Lowenstein Occupational Therapy Cognitive Assessment). Conclusion There are few assessment cognitive tools validated for use in the Brazilian culture and language. The majority of the instruments appear not to be validated for use by OT in clinical practice. PMID:29213503

  6. Developmental Audits with Challenging Youth

    ERIC Educational Resources Information Center

    Brendtro, Larry K.; du Toit, Lesley; Bath, Howard; Van Bockern, Steve

    2006-01-01

    The Developmental Audit[R] is a new strength-based assessment model for youth who are in conflict in home, school, or community. Developmental Audits involve collaboration with young persons who are seen as experts on themselves. Discussing challenging life events provides a window to the young person's private logic and goals. The audit scans…

  7. Challenging Relativism: The Problem of Assessment Criteria

    ERIC Educational Resources Information Center

    Hammersley, Martyn

    2009-01-01

    This article raises serious questions about the relativist approach to assessing qualitative research that has been championed by John K. Smith and various colleagues. They reject not just empiricism but also what they refer to as "neorealism." Against both these positions, they advance an antirealist, anti-ontological argument to the effect that…

  8. Functional Assessment of Challenging Behavior: Toward a Strategy for Applied Settings

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Minshawi, Noha F.

    2007-01-01

    The development of experimental functional analysis and more recently functional analysis checklists have become common technologies for evaluating antecedent events and the consequences of problematic behaviors. Children and developmentally disabled persons across the life span with challenging behaviors have been the primary focus of this…

  9. Reference Structures: Stagnation, Progress, and Future Challenges.

    ERIC Educational Resources Information Center

    Greenberg, Jane

    1997-01-01

    Assesses the current state of reference structures in online public access catalogs (OPACs) in a framework defined by stagnation, progress, and future challenges. Outlines six areas for reference structure development. Twenty figures provide illustrations. (AEF)

  10. Preventing and managing challenging behaviour.

    PubMed

    Hallett, Nutmeg

    2018-02-21

    Patients exhibiting challenging behaviour, which includes any non-verbal, verbal or physical behaviour, is a significant issue in healthcare settings. Preventing such behaviour and the harm it can cause is important for healthcare organisations and individuals, and involves following a public health model comprised of three tiers: primary, secondary and tertiary prevention. Primary prevention aims to reduce the risk of challenging behaviour occurring in the first instance; secondary prevention involves reducing the risk associated with imminent challenging behaviour and its potential escalation; and tertiary prevention focuses on minimising the physical and emotional harm caused by challenging behaviours, during and after an event. De-escalation should be the first-line response to challenging behaviour, and healthcare staff should use a range of techniques - maintaining safety, self-regulation, effective communication, and assessment and actions - to reduce the incidence of challenging behaviour. In some situations, physical interventions may be required to protect the safety of the individual, healthcare staff and other individuals involved, and healthcare staff should be aware of local policies and procedures for this. Following a serious incident, where there was potential or actual harm to patients and healthcare staff, healthcare organisations should use post-incident reviews to learn from the situation, while healthcare staff should be offered the opportunity for debriefing. Positive responses to challenging behaviour at an organisational and individual level can lead to improved work environments for healthcare staff and optimal patient care and outcomes. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  11. Conceptualising Teachers' Assessment Literacies in an Era of Curriculum and Assessment Reform

    ERIC Educational Resources Information Center

    Willis, Jill; Adie, Lenore; Klenowski, Val

    2013-01-01

    Teacher assessment literacy is a phrase that is often used but rarely defined. Yet understanding teacher assessment literacy is important in an international curriculum and assessment reform context that continues to challenge teachers' assessment practices. In this article situated examples of classroom assessment literacies are analysed using…

  12. Challenges associated with the implementation of the nursing process: A systematic review

    PubMed Central

    Zamanzadeh, Vahid; Valizadeh, Leila; Tabrizi, Faranak Jabbarzadeh; Behshid, Mojghan; Lotfi, Mojghan

    2015-01-01

    Background: Nursing process is a scientific approach in the provision of qualified nursing cares. However, in practice, the implementation of this process is faced with numerous challenges. With the knowledge of the challenges associated with the implementation of the nursing process, the nursing processes can be developed appropriately. Due to the lack of comprehensive information on this subject, the current study was carried out to assess the key challenges associated with the implementation of the nursing process. Materials and Methods: To achieve and review related studies on this field, databases of Iran medix, SID, Magiran, PUBMED, Google scholar, and Proquest were assessed using the main keywords of nursing process and nursing process systematic review. The articles were retrieved in three steps including searching by keywords, review of the proceedings based on inclusion criteria, and final retrieval and assessment of available full texts. Results: Systematic assessment of the articles showed different challenges in implementation of the nursing process. Intangible understanding of the concept of nursing process, different views of the process, lack of knowledge and awareness among nurses related to the execution of process, supports of managing systems, and problems related to recording the nursing process were the main challenges that were extracted from review of literature. Conclusions: On systematically reviewing the literature, intangible understanding of the concept of nursing process has been identified as the main challenge in nursing process. To achieve the best strategy to minimize the challenge, in addition to preparing facilitators for implementation of nursing process, intangible understanding of the concept of nursing process, different views of the process, and forming teams of experts in nursing education are recommended for internalizing the nursing process among nurses. PMID:26257793

  13. Community-Based Research Assessments: Some Principles and Practices.

    ERIC Educational Resources Information Center

    Marullo, Sam; Cooke, Deanna; Willis, Jason; Rollins, Alexandra; Burke, Jacqueline; Bonilla, Paul; Waldref, Vanessa

    2003-01-01

    Examines benefits and challenges of undertaking assessments in community-based research (CBR). Such assessments are compared and contrasted to more traditional research processes. Further, the challenges of integrating CBR assessments into an ongoing social change initiative are analyzed. Five principles to guide CBR assessments are articulated. A…

  14. Assessing the challenges of multi-scope clinical research sites: an example from NIH HIV/AIDS clinical trials networks.

    PubMed

    Rosas, Scott R; Cope, Marie T; Villa, Christie; Motevalli, Mahnaz; Utech, Jill; Schouten, Jeffrey T

    2014-04-01

    Large-scale, multi-network clinical trials are seen as a means for efficient and effective utilization of resources with greater responsiveness to new discoveries. Formal structures instituted within the National Institutes of Health (NIH) HIV/AIDS Clinical Trials facilitate collaboration and coordination across networks and emphasize an integrated approach to HIV/AIDS vaccine, prevention and therapeutics clinical trials. This study examines the joint usage of clinical research sites as means of gaining efficiency, extending capacity, and adding scientific value to the networks. A semi-structured questionnaire covering eight clinical management domains was administered to 74 (62% of sites) clinical site coordinators at single- and multi-network sites to identify challenges and efficiencies related to clinical trials management activities and coordination with multi-network units. Overall, respondents at multi-network sites did not report more challenges than single-network sites, but did report unique challenges to overcome including in the areas of study prioritization, community engagement, staff education and training, and policies and procedures. The majority of multi-network sites reported that such affiliations do allow for the consolidation and cost-sharing of research functions. Suggestions for increasing the efficiency or performance of multi-network sites included streamlining standards and requirements, consolidating protocol activation methods, using a single cross-network coordinating centre, and creating common budget and payment mechanisms. The results of this assessment provide important information to consider in the design and management of multi-network configurations for the NIH HIV/AIDS Clinical Trials Networks, as well as others contemplating and promoting the concept of multi-network settings. © 2013 John Wiley & Sons Ltd.

  15. Role of carbonic anhydrase in basal and stimulated bicarbonate secretion by the guinea pig duodenum.

    PubMed

    Muallem, R; Reimer, R; Odes, H S; Schwenk, M; Beil, W; Sewing, K F

    1994-05-01

    The role of carbonic anhydrase in the process of proximal duodenal mucosal bicarbonate secretion was investigated in the guinea pig. In a series of experiments in vivo, the duodenum was perfused with 24 mmol/liter NaHCO3 solution (+ NaCl for isotonicity) to ensure that active duodenal HCO3- secretion against a concentration gradient was measured. Acetazolamide (80 mg/kg) was infused intravenously to examine the role of carbonic anhydrase on basal and agonist-stimulated HCO3- secretion. Acetazolamide abolished basal HCO3- secretion and significantly decreased HCO3- secretion after stimulation with dibutyryl 5'-cyclic adenosine monophosphate (dBcAMP, 10(-5) mol/kg), dibutyryl 5'-cyclic guanosine monophosphate (dBcGMP, 10(-5) mol/kg), prostaglandin E2 (PGE2, 10(-6) mol/kg), PGF2 alpha (10(-6) mol/kg), tetradecanoyl-phorbol-acetate (TPA, 10(-7) mol/kg), glucagon (10(-7) mol/kg), vasoactive intestinal polypeptide (VIP, 10(-8) mol/kg), and carbachol (10(-8) mol/kg). Utilizing a fluorescence technique, we could detect the enzyme carbonic anhydrase in equal amounts in villous and crypt cells of the proximal duodenal epithelium; no activity was demonstrated in tissues pretreated with acetazolamide. In conclusion, carbonic anhydrase is required for both basal and stimulated duodenal HCO3- secretion.

  16. Early-onset progressive ataxia associated with the first CACNA1A mutation identified within the I-II loop.

    PubMed

    Cricchi, F; Di Lorenzo, C; Grieco, G S; Rengo, C; Cardinale, A; Racaniello, M; Santorelli, F M; Nappi, G; Pierelli, F; Casali, C

    2007-03-15

    Familial hemiplegic migraine type 1, spinocerebellar ataxia type 6 (SCA6) and episodic ataxia type 2 (EA2) are allelic disorders associated with mutations in the CACNA1A gene, which encodes the alpha1 subunit of the P/Q-type calcium channel (Ca(V)2.1). SCA6 and EA2 share a number of clinical features, such as prominent cerebellar involvement and good response to acetazolamide therapy. However, while SCA6 develops as a late-onset, progressive ataxia, EA2 has an earlier, and episodic, onset. We report on two sisters with a heterogeneous clinical phenotype. The first developed progressive cerebellar ataxia after age 30, without noticeable episodes of vertigo or headache. A 1 year trial with acetazolamide did not produce significant results. The other reported episodes of vertigo, headache and gait imbalance since late childhood, with good response to acetazolamide, before developing moderate chronic cerebellar ataxia. Brain MRI showed cerebellar atrophy, especially in the vermis, in both patients. Direct sequencing of CACNA1A identified a heterozygous 1360G>A mutation in exon 11 resulting in the substitution of alanine for threonine at residue 454 (p.Ala454Thr). This is the first description of a change residing in the cytoplasmic I-II loop associated with a clinical phenotype.

  17. Challenges in evaluating surgical innovation.

    PubMed

    Ergina, Patrick L; Cook, Jonathan A; Blazeby, Jane M; Boutron, Isabelle; Clavien, Pierre-Alain; Reeves, Barnaby C; Seiler, Christoph M; Altman, Douglas G; Aronson, Jeffrey K; Barkun, Jeffrey S; Campbell, W Bruce; Cook, Jonathan A; Feldman, Liane S; Flum, David R; Glasziou, Paul; Maddern, Guy J; Marshall, John C; McCulloch, Peter; Nicholl, Jon; Strasberg, Steven M; Meakins, Jonathan L; Ashby, Deborah; Black, Nick; Bunker, John; Burton, Martin; Campbell, Marion; Chalkidou, Kalipso; Chalmers, Iain; de Leval, Marc; Deeks, Jon; Grant, Adrian; Gray, Muir; Greenhalgh, Roger; Jenicek, Milos; Kehoe, Sean; Lilford, Richard; Littlejohns, Peter; Loke, Yoon; Madhock, Rajan; McPherson, Kim; Rothwell, Peter; Summerskill, Bill; Taggart, David; Tekkis, Parris; Thompson, Matthew; Treasure, Tom; Trohler, Ulrich; Vandenbroucke, Jan

    2009-09-26

    Research on surgical interventions is associated with several methodological and practical challenges of which few, if any, apply only to surgery. However, surgical evaluation is especially demanding because many of these challenges coincide. In this report, the second of three on surgical innovation and evaluation, we discuss obstacles related to the study design of randomised controlled trials and non-randomised studies assessing surgical interventions. We also describe the issues related to the nature of surgical procedures-for example, their complexity, surgeon-related factors, and the range of outcomes. Although difficult, surgical evaluation is achievable and necessary. Solutions tailored to surgical research and a framework for generating evidence on which to base surgical practice are essential.

  18. Engineering Challenges for Floating Offshore Wind Turbines

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Butterfield, S.; Musial, W.; Jonkman, J.

    The major objective of this paper is to survey the technical challenges that must be overcome to develop deepwater offshore wind energy technologies and to provide a framework from which the first-order economics can be assessed.

  19. Productivity and Academic Assessment in Brazil: Challenges for Qualitative Health Research

    ERIC Educational Resources Information Center

    Bosi, Maria Lucia Magalhaes

    2012-01-01

    This paper discusses the challenges to the qualitative health research approach, under the regime of productivity that rules current academic evaluation in many countries. The analysis considers aspects common to several contexts, illustrating the discussion with the Brazilian context and, more specifically, within the dynamics of the collective…

  20. Vocational and Technical Education in Lebanon: Strategic Issues and Challenges

    ERIC Educational Resources Information Center

    Karam, Gebran

    2006-01-01

    The current status of the Lebanese vocational and technical education (VTE) system is assessed and the strategic issues and challenges facing it are identified. In addition to the economic and social challenges that are common to many developing countries, the Lebanese system suffers from idiosyncratic problems, which may require innovative and…

  1. Assessment of Children: Cognitive Applications. Fourth Edition.

    ERIC Educational Resources Information Center

    Sattler, Jerome M.

    This text is designed not only as a teaching text but also as a reference source for students and professionals on the assessment of the cognitive development of children. Chapters address: (1) process challenges of assessing children; (2) context challenges in assessing children; (3) ethical, legal, and professional applications of assessment…

  2. Healthcare-associated infections: challenges to public health in Brazil.

    PubMed

    Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco

    2014-12-01

    This study presents a critical evaluation of the scientific literature related to this subject, aiming to assess the policies and administrative issues regarding the prevention and magnitude of healthcare-associated infections and discuss the challenges for their prevention in Brazil. The topics discussed included historical and administrative issues, challenges imposed by the characteristics of the healthcare system and the territorial dimension, laboratorial support limitations, costs, institutional culture, professional qualification, and patient engagement. It is urgent to hold a nationwide discussion among government representatives, institutions, and healthcare workers and users to overcome these challenges.

  3. Healthcare-associated infections: challenges to public health in Brazil

    PubMed Central

    Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco

    2014-01-01

    This study presents a critical evaluation of the scientific literature related to this subject, aiming to assess the policies and administrative issues regarding the prevention and magnitude of healthcare-associated infections and discuss the challenges for their prevention in Brazil. The topics discussed included historical and administrative issues, challenges imposed by the characteristics of the healthcare system and the territorial dimension, laboratorial support limitations, costs, institutional culture, professional qualification, and patient engagement. It is urgent to hold a nationwide discussion among government representatives, institutions, and healthcare workers and users to overcome these challenges. PMID:26039403

  4. The Relationship of Challenging Behaviors to Severity and Symptoms of Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Wilkins, Jonathan; Macken, Jennifer

    2009-01-01

    Challenging behaviors were assessed in 313 children, and it was demonstrated that children with autism spectrum disorders (ASD) exhibited greater levels of challenging behavior than both normally developing controls and children with psychopathology or atypical development. Next, we examined the relation between challenging behaviors and symptoms…

  5. Comparative Evaluation of Two Venous Sampling Techniques for the Assessment of Pancreatic Insulin and Zinc Release upon Glucose Challenge.

    PubMed

    Pillai, Anil Kumar; Silvers, William; Christensen, Preston; Riegel, Matthew; Adams-Huet, Beverley; Lingvay, Ildiko; Sun, Xiankai; Öz, Orhan K

    2015-01-01

    Advances in noninvasive imaging modalities have provided opportunities to study β cell function through imaging zinc release from insulin secreting β cells. Understanding the temporal secretory pattern of insulin and zinc corelease after a glucose challenge is essential for proper timing of administration of zinc sensing probes. Portal venous sampling is an essential part of pharmacological and nutritional studies in animal models. The purpose of this study was to compare two different percutaneous image-guided techniques: transhepatic ultrasound guided portal vein access and transsplenic fluoroscopy guided splenic vein access for ease of access, safety, and evaluation of temporal kinetics of insulin and zinc release into the venous effluent from the pancreas. Both techniques were safe, reproducible, and easy to perform. The mean time required to obtain desired catheter position for venous sampling was 15 minutes shorter using the transsplenic technique. A clear biphasic insulin release profile was observed in both techniques. Statistically higher insulin concentration but similar zinc release after a glucose challenge was observed from splenic vein samples, as compared to the ones from the portal vein. To our knowledge, this is the first report of percutaneous methods to assess zinc release kinetics from the porcine pancreas.

  6. Rethinking Assessment in a Digital Age: Opportunities, Challenges and Risks

    ERIC Educational Resources Information Center

    Timmis, Sue; Broadfoot, Patricia; Sutherland, Rosamund; Oldfield, Alison

    2016-01-01

    While it is frequently argued that assessment sits at the heart of the learning process, in practice assessment often remains narrowly focused on qualifications and reporting achievements, driven by institutional and societal aspirations and tensions such as accountability and economic well being. Yet, the need for assessment to account for the…

  7. Assessing Assessment: In Pursuit of Meaningful Learning

    ERIC Educational Resources Information Center

    Rootman-le Grange, Ilse; Blackie, Margaret A. L.

    2018-01-01

    The challenge of supporting the development of meaningful learning is prevalent in chemistry education research. One of the core activities used in the learning process is assessments. The aim of this paper is to illustrate how the semantics dimension of Legitimation Code Theory can be a helpful tool to critique the quality of assessments and…

  8. Challenges in assessing seismic hazard in intraplate Europe

    NASA Astrophysics Data System (ADS)

    Brooks, Edward; Stein, Seth; Liu, Mian; Camelbeeck, Thierry; Merino, Miguel; Landgraf, Angela; Hintersberger, Esther; Kübler, Simon

    2016-04-01

    Intraplate seismicity is often characterized by episodic, clustered and migrating earth- quakes and extended after-shock sequences. Can these observations - primarily from North America, China and Australia - usefully be applied to seismic hazard assessment for intraplate Europe? Existing assessments are based on instrumental and historical seismicity of the past c. 1000 years, as well as some data for active faults. This time span probably fails to capture typical large-event recurrence intervals of the order of tens of thousands of years. Palaeoseismology helps to lengthen the observation window, but preferentially produces data in regions suspected to be seismically active. Thus the expected maximum magnitudes of future earthquakes are fairly uncertain, possibly underestimated, and earthquakes are likely to occur in unexpected locations. These issues particularly arise in considering the hazards posed by low-probability events to both heavily populated areas and critical facilities. For example, are the variations in seismicity (and thus assumed seismic hazard) along the Rhine Graben a result of short sampling or are they real? In addition to a better assessment of hazards with new data and models, it is important to recognize and communicate uncertainties in hazard estimates. The more users know about how much confidence to place in hazard maps, the more effectively the maps can be used.

  9. Computational fluid dynamics-habitat suitability index (CFD-HSI) modelling as an exploratory tool for assessing passability of riverine migratory challenge zones for fish

    USGS Publications Warehouse

    Haro, Alexander J.; Chelminski, Michael; Dudley, Robert W.

    2015-01-01

    We developed two-dimensional computational fluid hydraulics-habitat suitability index (CFD-HSI) models to identify and qualitatively assess potential zones of shallow water depth and high water velocity that may present passage challenges for five major anadromous fish species in a 2.63-km reach of the main stem Penobscot River, Maine, as a result of a dam removal downstream of the reach. Suitability parameters were based on distribution of fish lengths and body depths and transformed to cruising, maximum sustained and sprint swimming speeds. Zones of potential depth and velocity challenges were calculated based on the hydraulic models; ability of fish to pass a challenge zone was based on the percent of river channel that the contiguous zone spanned and its maximum along-current length. Three river flows (low: 99.1 m3 sec-1; normal: 344.9 m3 sec-1; and high: 792.9 m3 sec-1) were modelled to simulate existing hydraulic conditions and hydraulic conditions simulating removal of a dam at the downstream boundary of the reach. Potential depth challenge zones were nonexistent for all low-flow simulations of existing conditions for deeper-bodied fishes. Increasing flows for existing conditions and removal of the dam under all flow conditions increased the number and size of potential velocity challenge zones, with the effects of zones being more pronounced for smaller species. The two-dimensional CFD-HSI model has utility in demonstrating gross effects of flow and hydraulic alteration, but may not be as precise a predictive tool as a three-dimensional model. Passability of the potential challenge zones cannot be precisely quantified for two-dimensional or three-dimensional models due to untested assumptions and incomplete data on fish swimming performance and behaviours.

  10. The Gannett Foundation Literacy Challenge Grants Program 1987-1990. Assessment Report.

    ERIC Educational Resources Information Center

    Sibbison, Virginia Hayes

    This report describes how 20 states and Puerto Rico used $2.7 million awarded by the Gannett Foundation to build and expand adult literacy activities in a coordinated fashion statewide. Chapter 1 presents information on development of the Literacy Challenge grants program and brief descriptions of each project, including year funded, amount of…

  11. Assessment Moderation in an Australian Context: Processes, Practices, and Challenges

    ERIC Educational Resources Information Center

    Beutel, Denise; Adie, Lenore; Lloyd, Margaret

    2017-01-01

    Moderation is a quality assurance process that plays a central role in the teaching, learning, and assessment cycle in higher education. While there is a growing body of research globally on teaching, learning, and, to a lesser degree, assessment in higher education, the process of moderation of assessment has received even less attention. In a…

  12. Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

    PubMed

    Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

    2017-07-01

    To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

  13. Building Better Environmental Risk Assessments.

    PubMed

    Layton, Raymond; Smith, Joe; Macdonald, Phil; Letchumanan, Ramatha; Keese, Paul; Lema, Martin

    2015-01-01

    Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision-making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERAs) for genetically modified (GM) crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems - examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data), and adapting advances in risk analysis from other relevant disciplines.

  14. Building Better Environmental Risk Assessments

    PubMed Central

    Layton, Raymond; Smith, Joe; Macdonald, Phil; Letchumanan, Ramatha; Keese, Paul; Lema, Martin

    2015-01-01

    Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision-making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERAs) for genetically modified (GM) crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems – examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data), and adapting advances in risk analysis from other relevant disciplines. PMID:26301217

  15. Assessment and Challenges of Ligand Docking into Comparative Models of G-Protein Coupled Receptors

    PubMed Central

    Frimurer, Thomas M.; Meiler, Jens

    2013-01-01

    The rapidly increasing number of high-resolution X-ray structures of G-protein coupled receptors (GPCRs) creates a unique opportunity to employ comparative modeling and docking to provide valuable insight into the function and ligand binding determinants of novel receptors, to assist in virtual screening and to design and optimize drug candidates. However, low sequence identity between receptors, conformational flexibility, and chemical diversity of ligands present an enormous challenge to molecular modeling approaches. It is our hypothesis that rapid Monte-Carlo sampling of protein backbone and side-chain conformational space with Rosetta can be leveraged to meet this challenge. This study performs unbiased comparative modeling and docking methodologies using 14 distinct high-resolution GPCRs and proposes knowledge-based filtering methods for improvement of sampling performance and identification of correct ligand-receptor interactions. On average, top ranked receptor models built on template structures over 50% sequence identity are within 2.9 Å of the experimental structure, with an average root mean square deviation (RMSD) of 2.2 Å for the transmembrane region and 5 Å for the second extracellular loop. Furthermore, these models are consistently correlated with low Rosetta energy score. To predict their binding modes, ligand conformers of the 14 ligands co-crystalized with the GPCRs were docked against the top ranked comparative models. In contrast to the comparative models themselves, however, it remains difficult to unambiguously identify correct binding modes by score alone. On average, sampling performance was improved by 103 fold over random using knowledge-based and energy-based filters. In assessing the applicability of experimental constraints, we found that sampling performance is increased by one order of magnitude for every 10 residues known to contact the ligand. Additionally, in the case of DOR, knowledge of a single specific ligand

  16. An Assessment Framework for Inclusive Education: Integrating Assessment Approaches

    ERIC Educational Resources Information Center

    Bourke, Roseanna; Mentis, Mandia

    2014-01-01

    Teachers committed to inclusive education have the potential to revolutionise pedagogical and assessment practices within regular classrooms simply because students with high needs challenge traditional assumptions about what it means "to learn" and "to assess". This creates opportunities for teachers to find creative ways to…

  17. Assessment of iron status in settings of inflammation: challenges and potential approaches.

    PubMed

    Suchdev, Parminder S; Williams, Anne M; Mei, Zuguo; Flores-Ayala, Rafael; Pasricha, Sant-Rayn; Rogers, Lisa M; Namaste, Sorrel Ml

    2017-12-01

    The determination of iron status is challenging when concomitant infection and inflammation are present because of confounding effects of the acute-phase response on the interpretation of most iron indicators. This review summarizes the effects of inflammation on indicators of iron status and assesses the impact of a regression analysis to adjust for inflammation on estimates of iron deficiency (ID) in low- and high-infection-burden settings. We overviewed cross-sectional data from 16 surveys for preschool children (PSC) ( n = 29,765) and from 10 surveys for nonpregnant women of reproductive age (WRA) ( n = 25,731) from the Biomarkers Reflecting the Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Effects of C-reactive protein (CRP) and α1-acid glycoprotein (AGP) concentrations on estimates of ID according to serum ferritin (SF) (used generically to include plasma ferritin), soluble transferrin receptor (sTfR), and total body iron (TBI) were summarized in relation to infection burden (in the United States compared with other countries) and population group (PSC compared with WRA). Effects of the concentrations of CRP and AGP on SF, sTfR, and TBI were generally linear, especially in PSC. Overall, regression correction changed the estimated prevalence of ID in PSC by a median of +25 percentage points (pps) when SF concentrations were used, by -15 pps when sTfR concentrations were used, and by +14 pps when TBI was used; the estimated prevalence of ID in WRA changed by a median of +8 pps when SF concentrations were used, by -10 pps when sTfR concentrations were used, and by +3 pps when TBI was used. In the United States, inflammation correction was done only for CRP concentrations because AGP concentrations were not measured; regression correction for CRP concentrations increased the estimated prevalence of ID when SF concentrations were used by 3 pps in PSC and by 7 pps in WRA. The correction of iron-status indicators for inflammation with the

  18. Cross-species extrapolation of chemical effects: Challenges and new insights

    EPA Science Inventory

    One of the greatest uncertainties in chemical risk assessment is extrapolation of effects from tested to untested species. While this undoubtedly is a challenge in the human health arena, species extrapolation is a particularly daunting task in ecological assessments, where it is...

  19. Development and evaluation of the content validity, practicability and feasibility of the Innovative dementia-oriented Assessment system for challenging behaviour in residents with dementia.

    PubMed

    Halek, Margareta; Holle, Daniela; Bartholomeyczik, Sabine

    2017-08-14

    One of the most difficult issues for care staff is the manifestation of challenging behaviour among residents with dementia. The first step in managing this type of behaviour is analysing its triggers. A structured assessment instrument can facilitate this process and may improve carers' management of the situation. This paper describes the development of an instrument designed for this purpose and an evaluation of its content validity and its feasibility and practicability in nursing homes. The development process and evaluation of the content validity were based on Lynn's methodology (1998). A literature review (steps 1 + 2) provided the theoretical framework for the instrument and for item formation. Ten experts (step 3) evaluated the first version of the instrument (the Innovative dementia-oriented Assessment (IdA®)) regarding its relevance, clarity, meaningfulness and completeness; content validity indices at the scale-level (S-CVI) and item-level (I-CVI) were calculated. Health care workers (step 4) evaluated the second version in a workshop. Finally, the instrument was introduced to 17 units in 11 nursing homes in a field study (step 5), and 60 care staff members assessed its practicability and feasibility. The IdA® used the need-driven dementia-compromised behaviour (NDB) model as a theoretical framework. The literature review and expert-based panel supported the content validity of the IdA®. At the item level, 77% of the ratings had a CVI greater than or equal to 0.78. The majority of the question-ratings (84%, n = 154) and answer-ratings (69%, n = 122) showed valid results, with none below 0.50. The health care workers confirmed the understandability, completeness and plausibility of the IdA®. Steps 3 and 4 led to further item clarification. The carers in the study considered the instrument helpful for reflecting challenging behaviour and beneficial for the care of residents with dementia. Negative ratings referred to the time required and the

  20. Assessing submarine groundwater discharge (SGD) and nitrate fluxes in highly heterogeneous coastal karst aquifers: Challenges and solutions

    NASA Astrophysics Data System (ADS)

    Montiel, Daniel; Dimova, Natasha; Andreo, Bartolomé; Prieto, Jorge; García-Orellana, Jordi; Rodellas, Valentí

    2018-02-01

    Groundwater discharge in coastal karst aquifers worldwide represents a substantial part of the water budget and is a main pathway for nutrient transport to the sea. Groundwater discharge to the sea manifests under different forms, making its assessment very challenging particularly in highly heterogeneous coastal systems karst systems. In this study, we present a methodology approach to identify and quantify four forms of groundwater discharge in a mixed lithology system in southern Spain (Maro-Cerro Gordo) that includes an ecologically protected coastal area comprised of karstic marble. We found that groundwater discharge to the sea occurs via: (1) groundwater-fed creeks, (2) coastal springs, (3) diffuse groundwater seepage through seabed sediments, and (4) submarine springs. We used a multi-method approach combining tracer techniques (salinity, 224Ra, and 222Rn) and direct measurements (seepage meters and flowmeters) to evaluate the discharge. Groundwater discharge via submarine springs was the most difficult to assess due to their depth (up to 15 m) and extensive development of the springs conduits. We determined that the total groundwater discharge over the 16 km of shoreline of the study area was at least 11 ± 3 × 103 m3 d-1 for the four types of discharge assessed. Groundwater-derived nitrate (NO3-) fluxes to coastal waters over ∼3 km (or 20%) in a highly populated and farmed section of Maro-Cerro Gordo was 641 ± 166 mol d-1, or ∼75% of the total NO3- loading in the study area. We demonstrate in this study that a multi-method approach must be applied to assess all forms of SGD and derived nutrient fluxes to the sea in highly heterogeneous karst aquifer systems.

  1. Environmental decision support systems (EDSS) development - Challenges and best practices

    Treesearch

    B. S. McIntosh; J. C. Ascough II; S. Chen; J. Chew; S. Cuddy; A. Elmahdi; D. Haase; J. Harou; D. Hepting; A. J. Jakeman; A. Kassahun; S. Lautenbach; K. Matthews; W. Merritt; N. W. T. Quinn; I. Rodriguez-Roda; S. Sieber; M. Stavenga; A. Sulis; J. Ticehurst; M. J. Twery; M. Volk; M. Wrobel; H. van Delden; S. El-Sawah; A. Rizzoli; A. Voinov

    2011-01-01

    Despite the perceived value of DSS in informing environmental and natural resource management, DSS tools often fail to be adopted by intended end users. By drawing together the experience of a global group of EDSS developers, we have identified and assessed key challenges in EDSS development and offer recommendations to resolve them. Challenges related to engaging end...

  2. Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.

    PubMed

    Morris, Andrea M; Ricci, Karen A; Griffin, Anne R; Heslin, Kevin C; Dobalian, Aram

    2016-05-05

    Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns. Semi-structured interviews were conducted with individuals who filled key management roles in the United States Department of Veterans Affairs New York Harbor Healthcare System's response to Superstorm Sandy and during the facility's initial recovery phase. All interviews were audio recorded and transcribed. Three major themes were identified: 1) Barriers to reporting ("Barriers"), 2) Facilitators to reporting ("Facilitators"), and 3) Responses to staff needs and concerns ("Responses"). Atlas.ti 7.1.6 software program was used for the management and analysis of the transcripts. Results indicated that staff encountered several barriers that impeded their ability to report to work at mobile vans at the temporarily nonoperational Manhattan campus or at two other VA facilities in Brooklyn and the Bronx in the initial post-Sandy period including transportation problems, personal property damage, and communication issues. In addition, we found evidence of facilitators to reporting as expressed through descriptions of professional duty. Our findings also revealed that management was aware of the challenges that staff was facing and made efforts to reduce barriers and accommodate staff affected by the storm. During and after a disaster event, hospital staff is often confronted with challenges that affect decisions to report for work and perform effectively under potentially harsh conditions. This study examined barriers and facilitators that hospital staff

  3. Challenger Center's Window on the Universe

    NASA Astrophysics Data System (ADS)

    Livengood, T. A.; Goldstein, J. J.; Smith, S.; Bobrowsky, M.; Radnofsky, M.; Perelmuter, J.-M.; Jaggar, L.

    2001-11-01

    Challenger Center for Space Science Education's Window on the Universe program aims to create a network of under-served communities across the nation dedicated to sustained science, math, and technology education. Window communities presently include Broken Arrow, OK; Muncie, IN; Moscow, ID; Nogales, AZ; Tuskegee, AL; Marquette, MI; Altamont, KS; Washington, D.C.; and other emerging sites. Window uses themes of human space flight and the space sciences as interdisciplinary means to inspire entire communities. Practicing scientists and engineers engaged in these disciplines are invited to volunteer to become a part of these communities for a week, each visitor reaching roughly 2000 K-12 students through individual classroom visits and Family Science Night events during an intense Window on the Universe Week. In the same Window Week, Challenger Center scientists and educators present a workshop for local educators to provide training in the use of a K-12 educational module built around a particular space science and exploration theme. Window communities follow a 3-year development: Year 1, join the network, experience Window Week presented by Challenger Center and visiting researchers; Year 2, same as Year 1 plus workshop on partnering with local organizations to develop sources of visiting researchers and to enhance connections with local resources; Year 3 and subsequent, the community stages its own Window Week, with Challenger Center providing new education modules and training workshops for "master educators" from the Window community, after which the master educators return home to conduct training workshops of their own. Challenger Center remains a resource and clearinghouse for Window communities to acquire experience, technical information, and opportunities for distance collaboration with other Window communities. Window on the Universe is dedicated to assessing degree of success vs. failure in each program component and as a whole, using pre- and post-assessment

  4. Challenging Behaviors in Adults with Intellectual Disability: The Effects of Race and Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Horovitz, Max; Matson, Johnny L.; Hattier, Megan A.; Tureck, Kimberly; Bamburg, Jay W.

    2013-01-01

    Rates of challenging behaviors were assessed in 175 adults with intellectual disability (ID) or ID and a comorbid autism spectrum disorder (ASD). The relationship between ASD diagnosis, race, and challenging behaviors was assessed using the "Autism Spectrum Disorders-Behavior Problems for Adults (ASD-BPA)." Those with ASD and ID were…

  5. An Assessment of Information Exchange Practices, Challenges, and Opportunities to Support US Disease Surveillance in 3 States.

    PubMed

    Garcia, Macarena C; Garrett, Nedra Y; Singletary, Vivian; Brown, Sheereen; Hennessy-Burt, Tamara; Haney, Gillian; Link, Kimberly; Tripp, Jennifer; Mac Kenzie, William R; Yoon, Paula

    2017-12-07

    State and local public health agencies collect and use surveillance data to identify outbreaks, track cases, investigate causes, and implement measures to protect the public-s health through various surveillance systems and data exchange practices. The purpose of this assessment was to better understand current practices at state and local public health agencies for collecting, managing, processing, reporting, and exchanging notifiable disease surveillance information. Over an 18-month period (January 2014-June 2015), we evaluated the process of data exchange between surveillance systems, reporting burdens, and challenges within 3 states (California, Idaho, and Massachusetts) that were using 3 different reporting systems. All 3 states use a combination of paper-based and electronic information systems for managing and exchanging data on reportable conditions within the state. The flow of data from local jurisdictions to the state health departments varies considerably. When state and local information systems are not interoperable, manual duplicative data entry and other work-arounds are often required. The results of the assessment show the complexity of disease reporting at the state and local levels and the multiple systems, processes, and resources engaged in preparing, processing, and transmitting data that limit interoperability and decrease efficiency. Through this structured assessment, the Centers for Disease Control and Prevention (CDC) has a better understanding of the complexities for surveillance of using commercial off-the-shelf data systems (California and Massachusetts), and CDC-developed National Electronic Disease Surveillance System Base System. More efficient data exchange and use of data will help facilitate interoperability between National Notifiable Diseases Surveillance Systems.

  6. Applying Tandem Mass Spectral Libraries for Solving the Critical Assessment of Small Molecule Identification (CASMI) LC/MS Challenge 2012

    PubMed Central

    Oberacher, Herbert

    2013-01-01

    The “Critical Assessment of Small Molecule Identification” (CASMI) contest was aimed in testing strategies for small molecule identification that are currently available in the experimental and computational mass spectrometry community. We have applied tandem mass spectral library search to solve Category 2 of the CASMI Challenge 2012 (best identification for high resolution LC/MS data). More than 230,000 tandem mass spectra part of four well established libraries (MassBank, the collection of tandem mass spectra of the “NIST/NIH/EPA Mass Spectral Library 2012”, METLIN, and the ‘Wiley Registry of Tandem Mass Spectral Data, MSforID’) were searched. The sample spectra acquired in positive ion mode were processed. Seven out of 12 challenges did not produce putative positive matches, simply because reference spectra were not available for the compounds searched. This suggests that to some extent the limited coverage of chemical space with high-quality reference spectra is still a problem encountered in tandem mass spectral library search. Solutions were submitted for five challenges. Three compounds were correctly identified (kanamycin A, benzyldiphenylphosphine oxide, and 1-isopropyl-5-methyl-1H-indole-2,3-dione). In the absence of any reference spectrum, a false positive identification was obtained for 1-aminoanthraquinone by matching the corresponding sample spectrum to the structurally related compounds N-phenylphthalimide and 2-aminoanthraquinone. Another false positive result was submitted for 1H-benz[g]indole; for the 1H-benz[g]indole-specific sample spectra provided, carbazole was listed as the best matching compound. In this case, the quality of the available 1H-benz[g]indole-specific reference spectra was found to hamper unequivocal identification. PMID:24957994

  7. Community challenges in biomedical text mining over 10 years: success, failure and the future

    PubMed Central

    Huang, Chung-Chi

    2016-01-01

    One effective way to improve the state of the art is through competitions. Following the success of the Critical Assessment of protein Structure Prediction (CASP) in bioinformatics research, a number of challenge evaluations have been organized by the text-mining research community to assess and advance natural language processing (NLP) research for biomedicine. In this article, we review the different community challenge evaluations held from 2002 to 2014 and their respective tasks. Furthermore, we examine these challenge tasks through their targeted problems in NLP research and biomedical applications, respectively. Next, we describe the general workflow of organizing a Biomedical NLP (BioNLP) challenge and involved stakeholders (task organizers, task data producers, task participants and end users). Finally, we summarize the impact and contributions by taking into account different BioNLP challenges as a whole, followed by a discussion of their limitations and difficulties. We conclude with future trends in BioNLP challenge evaluations. PMID:25935162

  8. The exposome concept: a challenge and a potential driver for environmental health research.

    PubMed

    Siroux, Valérie; Agier, Lydiane; Slama, Rémy

    2016-06-01

    The exposome concept was defined in 2005 as encompassing all environmental exposures from conception onwards, as a new strategy to evidence environmental disease risk factors. Although very appealing, the exposome concept is challenging in many respects. In terms of assessment, several hundreds of time-varying exposures need to be considered, but increasing the number of exposures assessed should not be done at the cost of increased exposure misclassification. Accurately assessing the exposome currently requires numerous measurements, which rely on different technologies; resulting in an expensive set of protocols. In the future, high-throughput 'omics technologies may be a promising technique to integrate a wide range of exposures from a small numbers of biological matrices. Assessing the association between many exposures and health raises statistical challenges. Due to the correlation structure of the exposome, existing statistical methods cannot fully and efficiently untangle the exposures truly affecting the health outcome from correlated exposures. Other statistical challenges relate to accounting for exposure misclassification or identifying synergistic effects between exposures. On-going exposome projects are trying to overcome technical and statistical challenges. From a public health perspective, a better understanding of the environmental risk factors should open the way to improved prevention strategies. Copyright ©ERS 2016.

  9. Comparative Evaluation of Two Venous Sampling Techniques for the Assessment of Pancreatic Insulin and Zinc Release upon Glucose Challenge

    PubMed Central

    Pillai, Anil Kumar; Silvers, William; Christensen, Preston; Riegel, Matthew; Adams-Huet, Beverley; Lingvay, Ildiko; Sun, Xiankai; Öz, Orhan K.

    2015-01-01

    Advances in noninvasive imaging modalities have provided opportunities to study β cell function through imaging zinc release from insulin secreting β cells. Understanding the temporal secretory pattern of insulin and zinc corelease after a glucose challenge is essential for proper timing of administration of zinc sensing probes. Portal venous sampling is an essential part of pharmacological and nutritional studies in animal models. The purpose of this study was to compare two different percutaneous image-guided techniques: transhepatic ultrasound guided portal vein access and transsplenic fluoroscopy guided splenic vein access for ease of access, safety, and evaluation of temporal kinetics of insulin and zinc release into the venous effluent from the pancreas. Both techniques were safe, reproducible, and easy to perform. The mean time required to obtain desired catheter position for venous sampling was 15 minutes shorter using the transsplenic technique. A clear biphasic insulin release profile was observed in both techniques. Statistically higher insulin concentration but similar zinc release after a glucose challenge was observed from splenic vein samples, as compared to the ones from the portal vein. To our knowledge, this is the first report of percutaneous methods to assess zinc release kinetics from the porcine pancreas. PMID:26273676

  10. The challenges of training, support and assessment of healthcare support workers: A qualitative study of experiences in three English acute hospitals.

    PubMed

    Sarre, Sophie; Maben, Jill; Aldus, Clare; Schneider, Justine; Wharrad, Heather; Nicholson, Caroline; Arthur, Antony

    2018-03-01

    current and unprecedented policy focus on training, support and assessment of healthcare support workers, our study suggests improved training would be welcomed by them and their managers. Provision of training, support and assessment could be improved by organisational policy that promotes and protects healthcare support worker training; formalising the provision and availability of on-ward support; and training and IT support provided on a drop-in basis. Challenges in implementation are likely to be faced in all international settings where there is increased reliance on a support workforce. While recent policies in the UK offers scope to overcome some of these challenges there is a risk that some will be exacerbated. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. USGCRP assessments: Meeting the challenges of climate and global change

    NASA Astrophysics Data System (ADS)

    Dickinson, T.; Kuperberg, J. M.

    2016-12-01

    The United States Global Change Research Program (USGCRP) is a confederation of the research arms of 13 Federal departments and agencies. Its mission is to build a knowledge base that informs human responses to climate and global change through coordinated and integrated Federal programs of research, education, communication, and decision support. USGCRP has supported several initiatives to promote better understanding of climate change impacts on health, support responses, and build on the progress of the 2014 National Climate Assessment. Most recently, USGCRP released a new report, "The Impacts of Climate Change on Human Health: A Scientific Assessment". This presentation will provide an overview of USGCRP, highlight the importance of assessments, and introduce ways in which assessment findings and underlying data can be translated into critical tools to build resilience.

  12. The challenge of documenting water quality benefits of conservation practices: a review of USDA-ARS's conservation effects assessment project watershed studies.

    PubMed

    Tomer, M D; Locke, M A

    2011-01-01

    The Conservation Effects Assessment Project was established to quantify water quality benefits of conservation practices supported by the U.S. Department of Agriculture (USDA). In 2004, watershed assessment studies were begun in fourteen agricultural watersheds with varying cropping systems, landscapes, climate, and water quality concerns. This paper reviews USDA Agricultural Research Service 'Benchmark' watershed studies and the challenge of identifying water quality benefits in watersheds. Study goals included modeling and field research to assess practices, and evaluation of practice placement in watersheds. Not all goals were met within five years but important lessons were learned. While practices improved water quality, problems persisted in larger watersheds. This dissociation between practice-focused and watershed-scale assessments occurred because: (1) Conservation practices were not targeted at critical sources/pathways of contaminants; (2) Sediment in streams originated more from channel and bank erosion than from soil erosion; (3) Timing lags, historical legacies, and shifting climate combined to mask effects of practice implementation; and (4) Water quality management strategies addressed single contaminants with little regard for trade-offs among contaminants. These lessons could help improve conservation strategies and set water quality goals with realistic timelines. Continued research on agricultural water quality could better integrate modeling and monitoring capabilities, and address ecosystem services.

  13. Young persons with visual impairment: challenges of participation.

    PubMed

    Salminen, Anna-Liisa; Karhula, Maarit E

    2014-07-01

    To describe the challenges to activity and participation faced by young people with visual impairment within the framework of the International Classification of Functioning (ICF). 14 young persons (aged 16-22 years) with visual impairment and their parents (n = 22) participated in the study. The Canadian Occupational Performance Measure (COPM) was used to describe challenges of participation as perceived by the young persons themselves. Individual interviews with the young persons and their parents were used to investigate in more depth the challenges the young persons face with regard to participation. Young persons with visual impairment face challenges to participation most frequently with regard to mobility, domestic life, interpersonal interaction and relationships, major life areas, and leisure activities. The environment in which they live has a central role as a barrier or facilitator of participation. The challenges related to activities and participation that young persons with visual impairment face are diverse. It is important that these challenges are assessed individually and with the help of subjective measures. Serving as a broad framework for classifying the data, the ICF proved to be a useful tool, but used strictly at category level it may limit the coding of data and narrow interpretation.

  14. Sustainable Facility Development: Perceived Benefits and Challenges

    ERIC Educational Resources Information Center

    Stinnett, Brad; Gibson, Fred

    2016-01-01

    Purpose: The purpose of this paper is to assess the perceived benefits and challenges of implementing sustainable initiatives in collegiate recreational sports facilities. Additionally, this paper intends to contribute to the evolving field of facility sustainability in higher education. Design/methodology/approach The design included qualitative…

  15. Perspectives: Prior Learning Assessment Challenges the Status Quo

    ERIC Educational Resources Information Center

    Boilard, Steve D.

    2011-01-01

    Offering some relief from a raft of reports about declining education attainment and increasing college costs, Anya Kamenetz celebrates Prior Learning Assessment (PLA) for boosting higher education productivity, access, and affordability ("Change," September/October 2011). According to Kamenetz, PLA is transforming higher education by leveraging…

  16. Fostering sustained energy behavior change and increasing energy literacy in a student housing energy challenge

    NASA Astrophysics Data System (ADS)

    Brewer, Robert Stephen

    We designed the Kukui Cup challenge to foster energy conservation and increase energy literacy. Based on a review of the literature, the challenge combined a variety of elements into an overall game experience, including: real-time energy feedback, goals, commitments, competition, and prizes. We designed a software system called Makahiki to provide the online portion of the Kukui Cup challenge. Energy use was monitored by smart meters installed on each floor of the Hale Aloha residence halls on the University of Hawai'i at Manoa campus. In October 2011, we ran the UH Kukui Cup challenge for the over 1000 residents of the Hale Aloha towers. To evaluate the Kukui Cup challenge, I conducted three experiments: challenge participation, energy literacy, and energy use. Many residents participated in the challenge, as measured by points earned and actions completed through the challenge website. I measured the energy literacy of a random sample of Hale Aloha residents using an online energy literacy questionnaire administered before and after the challenge. I found that challenge participants' energy knowledge increased significantly compared to non-challenge participants. Positive self-reported energy behaviors increased after the challenge for both challenge participants and non-participants, leading to the possibility of passive participation by the non-challenge participants. I found that energy use varied substantially between and within lounges over time. Variations in energy use over time complicated the selection of a baseline of energy use to compare the levels during and after the challenge. The best team reduced its energy use during the challenge by 16%. However, team energy conservation did not appear to correlate to participation in the challenge, and there was no evidence of sustained energy conservation after the challenge. The problems inherent in assessing energy conservation using a baseline call into question this common practice. My research has

  17. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    Members of team Mountaineers pose with officials from the 2014 NASA Centennial Challenges Sample Return Robot Challenge on Saturday, June 14, 2014 at Worcester Polytechnic Institute (WPI) in Worcester, Mass. Team Mountaineer was the only team to complete the level one challenge this year. Team Mountaineer members, from left (in blue shirts) are: Ryan Watson, Marvin Cheng, Scott Harper, Jarred Strader, Lucas Behrens, Yu Gu, Tanmay Mandal, Alexander Hypes, and Nick Ohi Challenge judges and competition staff (in white and green polo shirts) from left are: Sam Ortega, NASA Centennial Challenge program manager; Ken Stafford, challenge technical advisor, WPI; Colleen Shaver, challenge event manager, WPI. During the competition, teams were required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge was to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  18. Pseudotumor cerebri syndrome

    MedlinePlus

    ... problems. Repeat lumbar punctures are helpful for pregnant women in order to delay surgery until after delivery. Other treatments may include: Fluid or salt restriction Medicines such as corticosteroids, acetazolamide, furosemide, and topiramate ...

  19. Assessment-Ready Preservice Teachers

    ERIC Educational Resources Information Center

    Kelting-Gibson, Lynn; Karsted, Kimberly; Weikert, Angela

    2013-01-01

    As teacher educators search for ways to prepare future educators for the challenges of assessment implementation, we suggest that authentic practice by preservice teachers in an informal learning environment promotes assessment implementation. The analysis of 28 volunteer assessment students' reflections revealed that practicing assessment…

  20. Floristic Quality Assessment Across the Nation: Status, Opportunities, and Challenges

    EPA Science Inventory

    Floristic Quality Assessment (FQA) will be considered in the USEPA National Wetland Condition Assessment (NWCA). FQA is a powerful tool to describe wetland ecological condition, and is based on Coefficients of Conservatism (CC) of individual native plant species. CCs rank sensiti...

  1. Assessment for All

    ERIC Educational Resources Information Center

    Science Scope, 2005

    2005-01-01

    There are many ways of assessing students and the work they do, and many ways of getting them ready for those assessments. Special needs students provide an extra challenge to educators because they have difficulty preparing for assessment and often more difficulty communicating what they know. It is not enough to be a thoughtful, lab-focused…

  2. Exploring challenges to telehealth communication by specialists in poison information.

    PubMed

    Rothwell, Erin; Ellington, Lee; Planalp, Sally; Crouch, Barbara

    2012-01-01

    The use of the telephone for providing health care is growing. A significant amount of social meaning is derived from visual information, and the absence of visual stimuli provides unique barriers to communication and increases the risks for misunderstandings and distractions. Understanding challenges to telephone communication can provide insight into training opportunities for overcoming these difficulties and improving patient care. The purpose of this research was to explore through focus groups the challenges of phone communication perceived by specialists in poison information. General types of challenges to effective phone communication included developing new communication skills to compensate for lack of visual information, difficulty assessing caller understanding, difficulty managing caller misunderstandings, maintaining distinctive assessments for routine calls, and managing the multifaceted aspects of job stress. The desire for training to enhance telehealth and cultural competency skills was also mentioned, and these findings might provide guidance for the development of training opportunities for telehealth professionals.

  3. Solving a methodological challenge in work stress evaluation with the Stress Assessment and Research Toolkit (StART): a study protocol.

    PubMed

    Guglielmi, Dina; Simbula, Silvia; Vignoli, Michela; Bruni, Ilaria; Depolo, Marco; Bonfiglioli, Roberta; Tabanelli, Maria Carla; Violante, Francesco Saverio

    2013-06-22

    Stress evaluation is a field of strong interest and challenging due to several methodological aspects in the evaluation process. The aim of this study is to propose a study protocol to test a new method (i.e., the Stress Assessment and Research Toolkit) to assess psychosocial risk factors at work. This method addresses several methodological issues (e.g., subjective vs. objective, qualitative vs quantitative data) by assessing work-related stressors using different kinds of data: i) organisational archival data (organisational indicators sheet); ii) qualitative data (focus group); iii) worker perception (questionnaire); and iv) observational data (observational checklist) using mixed methods research. In addition, it allows positive and negative aspects of work to be considered conjointly, using an approach that considers at the same time job demands and job resources. The integration of these sources of data can reduce the theoretical and methodological bias related to stress research in the work setting, allows researchers and professionals to obtain a reliable description of workers' stress, providing a more articulate vision of psychosocial risks, and allows a large amount of data to be collected. Finally, the implementation of the method ensures in the long term a primary prevention for psychosocial risk management in that it aims to reduce or modify the intensity, frequency or duration of organisational demands.

  4. Some Challenges in the Design of Human-Automation Interaction for Safety-Critical Systems

    NASA Technical Reports Server (NTRS)

    Feary, Michael S.; Roth, Emilie

    2014-01-01

    Increasing amounts of automation are being introduced to safety-critical domains. While the introduction of automation has led to an overall increase in reliability and improved safety, it has also introduced a class of failure modes, and new challenges in risk assessment for the new systems, particularly in the assessment of rare events resulting from complex inter-related factors. Designing successful human-automation systems is challenging, and the challenges go beyond good interface development (e.g., Roth, Malin, & Schreckenghost 1997; Christoffersen & Woods, 2002). Human-automation design is particularly challenging when the underlying automation technology generates behavior that is difficult for the user to anticipate or understand. These challenges have been recognized in several safety-critical domains, and have resulted in increased efforts to develop training, procedures, regulations and guidance material (CAST, 2008, IAEA, 2001, FAA, 2013, ICAO, 2012). This paper points to the continuing need for new methods to describe and characterize the operational environment within which new automation concepts are being presented. We will describe challenges to the successful development and evaluation of human-automation systems in safety-critical domains, and describe some approaches that could be used to address these challenges. We will draw from experience with the aviation, spaceflight and nuclear power domains.

  5. From the teachers' eyes: An ethnographic-case study on developing models of Informal Formative Assessments (IFA) and understanding the challenges to effective implementation in science classrooms

    NASA Astrophysics Data System (ADS)

    Sezen, Asli

    The emphasis on socio-cultural theories of learning has required the understanding of multi-dimensional, dynamic and social nature of acquiring the scientific knowledge and practices. Recent policy documents suggest a focus on formative and dynamic assessment practices that will help understand and improve the complex nature of scientific learning in classrooms. This study focuses on teachers' use of "Informal Formative Assessments (IFA)" aimed at improving students' learning and teachers' frequent recognition of students' learning process. The study was designed as an ethnographic case study of four middle school teachers and their students at a local charter school. The data of the study included (a) teachers' responses to history of teaching questionnaire (b) video and audio records of teachers' assessment practices during two different scientific projects (c) video and audio records of ethnographic interviews with teachers during their reflections on their practices, and (d) field notes taken by the researcher to understand the assessment culture of the school. The analytical tools from sociolinguistics (e.g., transcripts and event maps) were prepared and discourse analysis based in an ethnographic perspective was used to analyze the data. Moreover, Cultural-Historical Activity Theory (CHAT) was also introduced as an alternative data analysis framework for understanding the role of division of labor among the elements of the community on the challenges and the outcomes of IFA practices. The findings from the analysis of the classroom discourse showed three different types of IFA cycles: connected, non-connected, and repeating. The analysis of the teachers' reflections showed that the effectiveness of these cycles did not only depend on whether the cycles were connected, but also on other variables such as the phase of the lessons and student's identities and abilities. Teachers' reflections during researcher-teacher meetings on the concept and the aims of IFA

  6. Microvascular versus macrovascular cerebral vasomotor reactivity in patients with severe internal carotid artery stenosis or occlusion.

    PubMed

    Zirak, Peyman; Delgado-Mederos, Raquel; Dinia, Lavinia; Martí-Fàbregas, Joan; Durduran, Turgut

    2014-02-01

    In patients with severe internal carotid artery steno-occlusive lesions (ISOL), impaired cerebrovascular reactivity (CVR) is predictive of future ischemic stroke (IS) or transient ischemic attack (TIA). Therefore, the evaluation of CVR in ISOL patients may be a means to evaluate the risk for IS/TIA and decide on an intervention. Our aim was (1) to explore the feasibility of concurrent near-infrared spectroscopy (NIRS-DOS), diffuse correlation spectroscopy, and transcranial Doppler for CVR assessment in ISOL patients, and (2) to compare macrovascular and microvascular CVR in ISOL patients and explore its potential for IS/TIA risk stratification. Twenty-seven ISOL patients were recruited. The changes in continuous microvascular and macrovascular hemodynamics upon acetazolamide injection were used to determine CVR. Oxyhemoglobin (HbO2, by near-infrared spectroscopy), microvascular cerebral blood flow (CBF, by diffuse correlation spectroscopy) and CBF velocity (by transcranial Doppler) showed significant increases upon acetazolamide injection in all subjects (P < .03). Only macrovascular CVR (P = .024) and none of the microvascular measures were significantly dependent on the presence of ISOL. In addition, while CBF was significantly correlated with HbO2, neither of these microvascular measures correlated with macrovascular CBF velocity. We demonstrated the simultaneous, continuous, and noninvasive evaluation of CVR at both the microvasculature and macrovasculature. We found that macrovascular CVR response depends on the presence of ISOL, whereas the microvascular CVR did not significantly depend on the ISOL presence, possibly due to the role of collaterals other than those of the circle of Willis. The concurrent microvascular and macrovascular CVR measurement in the ISOL patients might improve future IS/TIA risk assessment. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  7. Inertial Sensors to Assess Gait Quality in Patients with Neurological Disorders: A Systematic Review of Technical and Analytical Challenges

    PubMed Central

    Vienne, Aliénor; Barrois, Rémi P.; Buffat, Stéphane; Ricard, Damien; Vidal, Pierre-Paul

    2017-01-01

    Gait disorders are major causes of falls in patients with neurological diseases. Understanding these disorders allows prevention and better insights into underlying diseases. InertiaLocoGraphy (ILG) –the quantification of gait by using inertial measurement units (IMUs) –shows great potential to address this public health challenge, but protocols vary widely and normative values of gait parameters are still unavailable. This systematic review critically compares ILG protocols, questions features extracted from inertial signals and proposes a semeiological analysis of clinimetric characteristics for use in neurological clinical routine. For this systematic review, PubMed, Cochrane and EMBASE were searched for articles assessing gait quality by using IMUs that were published from January 1, 2014 to August 31, 2016. ILG was used to assess gait in a wide range of neurological disorders – including Parkinson disease, mild cognitive impairment, Alzheimer disease, cerebral palsy, and cerebellar atrophy – as well as in the faller or frail older population and in people presenting rheumatological pathologies. However, results have not yet been driving changes in clinical practice. One reason could be that studies mainly aimed at comparing pathological gait to healthy gait, but there is stronger need for semiological descriptions of gait perturbation, severity or prognostic assessment. Furthermore, protocols used to assess gait using IMUs are too many. Likely, outcomes are highly heterogeneous and difficult to compare across large panels of studies. Therefore, homogenization is needed to foster the use of ILG to assess gait quality in neurological routine practice. The pros and cons of each protocol are emphasized so that a compromise can be reached. As well, analysis of seven complementary clinical criteria (springiness, sturdiness, smoothness, steadiness, stability, symmetry, synchronization) is advocated. PMID:28572784

  8. LUNGx Challenge for computerized lung nodule classification

    PubMed Central

    Armato, Samuel G.; Drukker, Karen; Li, Feng; Hadjiiski, Lubomir; Tourassi, Georgia D.; Engelmann, Roger M.; Giger, Maryellen L.; Redmond, George; Farahani, Keyvan; Kirby, Justin S.; Clarke, Laurence P.

    2016-01-01

    Abstract. The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants’ computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. Ten groups applied their own methods to 73 lung nodules (37 benign and 36 malignant) that were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists’ AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. The continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community. PMID:28018939

  9. Capability Gap Assessment - Blending Warfighter Experience with Science

    DTIC Science & Technology

    2013-02-15

    This technical report describes the gap assessment method and the results of using it. 15. SUBJECT TERMS capability gap assessment, operational risk ...29 Challenges ...approach that blends warfighter experience with science. This paper describes the process, challenges , and opportunities associated with this technique

  10. Community challenges in biomedical text mining over 10 years: success, failure and the future.

    PubMed

    Huang, Chung-Chi; Lu, Zhiyong

    2016-01-01

    One effective way to improve the state of the art is through competitions. Following the success of the Critical Assessment of protein Structure Prediction (CASP) in bioinformatics research, a number of challenge evaluations have been organized by the text-mining research community to assess and advance natural language processing (NLP) research for biomedicine. In this article, we review the different community challenge evaluations held from 2002 to 2014 and their respective tasks. Furthermore, we examine these challenge tasks through their targeted problems in NLP research and biomedical applications, respectively. Next, we describe the general workflow of organizing a Biomedical NLP (BioNLP) challenge and involved stakeholders (task organizers, task data producers, task participants and end users). Finally, we summarize the impact and contributions by taking into account different BioNLP challenges as a whole, followed by a discussion of their limitations and difficulties. We conclude with future trends in BioNLP challenge evaluations. Published by Oxford University Press 2015. This work is written by US Government employees and is in the public domain in the US.

  11. A reflective teaching challenge to motivate educational innovation.

    PubMed

    Edwards, Roger A; Kirwin, Jennifer; Gonyeau, Michael; Matthews, S James; Lancaster, Jason; DiVall, Margarita

    2014-06-17

    To describe a teaching challenge intended to increase faculty use of evidence-based and student-centered instructional strategies in the demanding school of pharmacy context with technology-savvy students. A teaching challenge was created that required faculty members to incorporate a "new-to-you" innovative teaching method in a class, course, or experiential activity. The method was linked to at least 1 of 7 evidence-based principles for effective teaching. Faculty members were exposed to colleagues' teaching strategies via brief voluntary presentations at department meetings. A post-challenge survey provided assessment data about the challenge. Responses to a baseline survey provided additional information about what faculty members were already doing (52% response rate). Eighty-one percent of faculty respondents completed the challenge. A wide array of new strategies (13 categories such as flipped classrooms and social media) was implemented and 75% included the use of technology. Nearly all respondents (96%) thought that participation in the challenge was worth the effort and planned to participate again the following year. All faculty members intended to continue using their new strategy and 56% planned additional modifications with future implementations. The challenge demonstrated how multiple goals of curricular improvement, faculty development, and student-centered instruction could be achieved together. The teaching challenge motivated most of the faculty members to try something new to them. Links between evidence-based principles and day-to-day activities were strengthened. The new-to-you design placed the challenge within reach of faculty members regardless of their background, subject, or experience.

  12. Innovations in Computerized Assessment.

    ERIC Educational Resources Information Center

    Drasgow, Fritz, Ed.; Olson-Buchanan, Julie B., Ed.

    Chapters in this book present the challenges and dilemmas faced by researchers as they created new computerized assessments, focusing on issues addressed in developing, scoring, and administering the assessments. Chapters are: (1) "Beyond Bells and Whistles; An Introduction to Computerized Assessment" (Julie B. Olson-Buchanan and Fritz Drasgow);…

  13. Nasal Ketorolac Challenge Using Acoustic Rhinometry in Patients With Aspirin-Exacerbated Respiratory Disease.

    PubMed

    Quiralte-Castillo, J; Ávila-Castellano, M R; Cimbollek, S; Benaixa, P; Leguisamo, S; Baynova, K; Labella, M; Quiralte, J

    Safer and less time-consuming alternatives to single-blind placebo-controlled oral challenge (SBPCOC) have been sought for the diagnosis of aspirin-exacerbated respiratory disease (AERD). Nasal challenges with various nonsteroidal anti-inflammatory drugs and assessment methods have been developed. Objective: Our objective was to evaluate the utility and safety of nasal ketorolac challenge (NKC) using acoustic rhinometry in patients with suspected AERD. The study population comprised 36 patients with suspected AERD. NKC was performed with placebo (saline) and 13 mg of ketorolac sprayed as aerosol into both nostrils. A positive challenge result was defined as an increase of ≥30% in nasal symptoms (recorded using a visual analog scale) and a 30% drop in the sum of the volumes of both nasal cavities at 2-8 cm. Patients with a negative NKC result underwent SBPCOC with aspirin (cumulative dose of 750 mg). A naso-ocular reaction during NKC was detected in 21 patients. Four patients also developed mild asthma exacerbations (although only 1 experienced a decrease in FEV1 >15%). No other significant adverse events occurred. The remaining 15 patients with a negative NKC result had a negative response during aspirin SBPCOC. NKC assessed using acoustic rhinometry is a reliable method for the study of patients with AERD. We suggest that NKC assessed with acoustic rhinometry was useful and safe for selection of candidates for safe oral aspirin challenge.

  14. Challenges in Postgraduate Studies: Assessments by Doctoral Students in a Swedish University

    ERIC Educational Resources Information Center

    Ezebilo, Eugene E.

    2012-01-01

    The success of research students largely depends on their relationship with supervisors. If the students encounter lot of problems it may impinge on their academic potentials. This study examines the challenges facing doctoral students and how they have coped over time. How supervisor-student relationship could be improved is discussed. The data…

  15. Review of GEM Radiation Belt Dropout and Buildup Challenges

    NASA Astrophysics Data System (ADS)

    Tu, Weichao; Li, Wen; Morley, Steve; Albert, Jay

    2017-04-01

    In Summer 2015 the US NSF GEM (Geospace Environment Modeling) focus group named "Quantitative Assessment of Radiation Belt Modeling" started the "RB dropout" and "RB buildup" challenges, focused on quantitative modeling of the radiation belt buildups and dropouts. This is a community effort which includes selecting challenge events, gathering model inputs that are required to model the radiation belt dynamics during these events (e.g., various magnetospheric waves, plasmapause and density models, electron phase space density data), simulating the challenge events using different types of radiation belt models, and validating the model results by comparison to in situ observations of radiation belt electrons (from Van Allen Probes, THEMIS, GOES, LANL/GEO, etc). The goal is to quantitatively assess the relative importance of various acceleration, transport, and loss processes in the observed radiation belt dropouts and buildups. Since 2015, the community has selected four "challenge" events under four different categories: "storm-time enhancements", "non-storm enhancements", "storm-time dropouts", and "non-storm dropouts". Model inputs and data for each selected event have been coordinated and shared within the community to establish a common basis for simulations and testing. Modelers within and outside US with different types of radiation belt models (diffusion-type, diffusion-convection-type, test particle codes, etc.) have participated in our challenge and shared their simulation results and comparison with spacecraft measurements. Significant progress has been made in quantitative modeling of the radiation belt buildups and dropouts as well as accessing the modeling with new measures of model performance. In this presentation, I will review the activities from our "RB dropout" and "RB buildup" challenges and the progresses achieved in understanding radiation belt physics and improving model validation and verification.

  16. [An assessment of the Family Health Program in municipalities of Northeast Brazil: old and new challenges].

    PubMed

    Rocha, Paulo de Medeiros; Uchoa, Alice da Costa; Rocha, Nadja de Sá Pinto Dantas; Souza, Elizabethe Cristina Fagundes de; Rocha, Marconi de Lima; Pinheiro, Themis Xavier de Albuquerque

    2008-01-01

    This article presents part of the results from the Baseline Studies, an evaluative research conducted in 21 municipalities with more than 100,000 inhabitants each, in three States of Northeast Brazil. The overall objective was to assess experiences in the implementation of the Family Health Program (FHP), with a focus on inductions in the PROESF. An implementation analysis was performed, using the case study method. The analysis focused on these dimensions: political-institutional, health organization, and comprehensive care. Outstanding advances included: prioritize the FHP in high-risk areas; institutional learning, with qualification of managers and teams; definition of institutional levels for regulating the FHP; and health team-user bonds and positive perceptions concerning the program. Challenges included: strengthening of local policy and decision-making capacity; allocation of primary care resources; greater employment security for human resources; effective implementation of the health care network; strengthening of social participation; upgrading of monitoring and evaluation for decision-making; receptivity; waiting lines for tests, appointments, and hospital admissions; implementation of teamwork; health promotion and inter-sector activities.

  17. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    Sam Ortega, NASA program manager of Centennial Challenges, watches as robots attempt the rerun of the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  18. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    Sample Return Robot Challenge staff members confer before the team Survey robots makes it's attempt at the level two challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  19. Towards an optimal adaptation of exposure to NOAA assessment methodology in Multi-Source Industrial Scenarios (MSIS): the challenges and the decision-making process

    NASA Astrophysics Data System (ADS)

    López de Ipiña, JM; Vaquero, C.; Gutierrez-Cañas, C.

    2017-06-01

    It is expected a progressive increase of the industrial processes that manufacture of intermediate (iNEPs) and end products incorporating ENMs (eNEPs) to bring about improved properties. Therefore, the assessment of occupational exposure to airborne NOAA will migrate, from the simple and well-controlled exposure scenarios in research laboratories and ENMs production plants using innovative production technologies, to much more complex exposure scenarios located around processes of manufacture of eNEPs that, in many cases, will be modified conventional production processes. Here will be discussed some of the typical challenging situations in the process of risk assessment of inhalation exposure to NOAA in Multi-Source Industrial Scenarios (MSIS), from the basis of the lessons learned when confronted to those scenarios in the frame of some European and Spanish research projects.

  20. Challenges and opportunities in developmental integrative physiology☆

    PubMed Central

    Mueller, C.A.; Eme, J.; Burggren, W.W.; Roghair, R.D.; Rundle, S.D.

    2015-01-01

    This review explores challenges and opportunities in developmental physiology outlined by a symposium at the 2014 American Physiological Society Intersociety Meeting: Comparative Approaches to Grand Challenges in Physiology. Across animal taxa, adverse embryonic/fetal environmental conditions can alter morphological and physiological phenotypes in juveniles or adults, and capacities for developmental plasticity are common phenomena. Human neonates with body sizes at the extremes of perinatal growth are at an increased risk of adult disease, particularly hypertension and cardiovascular disease. There are many rewarding areas of current and future research in comparative developmental physiology. We present key mechanisms, models, and experimental designs that can be used across taxa to investigate patterns in, and implications of, the development of animal phenotypes. Intraspecific variation in the timing of developmental events can be increased through developmental plasticity (heterokairy), and could provide the raw material for selection to produce heterochrony — an evolutionary change in the timing of developmental events. Epigenetics and critical windows research recognizes that in ovo or fetal development represent a vulnerable period in the life history of an animal, when the developing organism may be unable to actively mitigate environmental perturbations. ‘Critical windows’ are periods of susceptibility or vulnerability to environmental or maternal challenges, periods when recovery from challenge is possible, and periods when the phenotype or epigenome has been altered. Developmental plasticity may allow survival in an altered environment, but it also has possible long-term consequences for the animal. “Catch-up growth” in humans after the critical perinatal window has closed elicits adult obesity and exacerbates a programmed hypertensive phenotype (one of many examples of “fetal programing”). Grand challenges for developmental physiology

  1. 76 FR 41526 - Centennial Challenges 2011 Strong Tether Challenge

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-14

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (11-063)] Centennial Challenges 2011 Strong... scheduled and teams that wish to compete may register. Centennial Challenges is a program of prize... NASA Centennial Challenges Program please visit: http://www.nasa.gov/challenges . General questions and...

  2. A cross-cultural survey of residents' perceived barriers in questioning/challenging authority.

    PubMed

    Kobayashi, H; Pian-Smith, M; Sato, M; Sawa, R; Takeshita, T; Raemer, D

    2006-08-01

    To identify perceived barriers to residents' questioning or challenging their seniors, to determine how these barriers affect decisions, and to assess how these barriers differ across cultures. A written questionnaire was administered to residents in teaching hospitals in the US and Japan to assess factors affecting residents' willingness to question or challenge their superiors. The responses were analyzed for statistical significance of differences between the two cultures and to determine the importance of issues affecting decisions. Questionnaires were completed by 175 US and 65 Japanese residents, with an overall response rate of 71%. Trainees from both countries believe that questioning and challenging contribute to safety. The perceived importance of specific beliefs about the workplace differed across cultures in seven out of 22 questions. Residents' decisions to make a challenge were related to the relationships and perceived response of the superiors. There was no statistical difference between the US and Japanese residents in terms of the threshold for challenging their seniors. We have identified attributes of residents' beliefs of communication, including several cross-cultural differences in the importance of values and issues affecting one's decision to question or challenge. In contrast, there was no difference in the threshold for challenging seniors by the Japanese and US residents studied. Changes in organizational and professional culture may be as important, if not more so, than national culture to encourage "speaking up". Residents should be encouraged to overcome barriers to challenging, and training programs should foster improved relationships and communication between trainers and trainees.

  3. An Assessment of Business Schools' Student Retention, Accreditation, and Faculty Scholarship Challenges

    ERIC Educational Resources Information Center

    Cavico, Frank J.; Mujtaba, Bahaudin G.

    2010-01-01

    Business schools' curriculum, faculty and graduates have become a target for many critics as they link the ethical lapses of senior executives to major scandals that have partially led to the financial challenges that the world is facing today. Some claim that business faculty research is not practical and mainly theoretical. This paper discusses…

  4. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    Team KuuKulgur waits to begin the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  5. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    The NASA Centennial Challenges prize, level one, is presented to team Mountaineers for successfully completing level one of the NASA 2014 Sample Return Robot Challenge, from left, Ken Stafford, WPI Challenge technical advisor; Colleen Shaver, WPI Challenge Manager; Ryan Watson, Team Mountaineers; Marvin Cheng, Team Mountaineers; Alexander Hypes, Team Mountaineers; Jarred Strader, Team Mountaineers; Lucas Behrens, Team Mountaineers; Yu Gu, Team Mountaineers; Nick Ohi, Team Mountaineers; Dorothy Rasco, NASA Deputy Associate Administrator for the Space Technology Mission Directorate; Scott Harper, Team Mountaineers; Tanmay Mandal, Team Mountaineers; David Miller, NASA Chief Technologist; Sam Ortega, NASA Program Manager for Centennial Challenges, Saturday, June 14, 2014, at Worcester Polytechnic Institute (WPI) in Worcester, Mass. Team Mountaineers was the only team to complete the level one challenge. During the competition, teams were required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge was to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  6. 78 FR 19742 - Centennial Challenges: 2014 Night Rover Challenge

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 13-032] Centennial Challenges: 2014 Night... Centennial Challenges 2014 Night Rover Challenge. SUMMARY: This notice is issued in accordance with 51 U.S.C.... Centennial Challenges is a program of prize competitions to stimulate innovation in technologies of interest...

  7. Software Assurance Challenges for the Commercial Crew Program

    NASA Technical Reports Server (NTRS)

    Cuyno, Patrick; Malnick, Kathy D.; Schaeffer, Chad E.

    2015-01-01

    This paper will provide a description of some of the challenges NASA is facing in providing software assurance within the new commercial space services paradigm, namely with the Commercial Crew Program (CCP). The CCP will establish safe, reliable, and affordable access to the International Space Station (ISS) by purchasing a ride from commercial companies. The CCP providers have varying experience with software development in safety-critical space systems. NASA's role in providing effective software assurance support to the CCP providers is critical to the success of CCP. These challenges include funding multiple vehicles that execute in parallel and have different rules of engagement, multiple providers with unique proprietary concerns, providing equivalent guidance to all providers, permitting alternates to NASA standards, and a large number of diverse stakeholders. It is expected that these challenges will exist in future programs, especially if the CCP paradigm proves successful. The proposed CCP approach to address these challenges includes a risk-based assessment with varying degrees of engagement and a distributed assurance model. This presentation will describe NASA IV&V Program's software assurance support and responses to these challenges.

  8. The Terawatt Challenge

    NASA Astrophysics Data System (ADS)

    Haegel, Nancy

    In response to concerns about accelerating climate change, the world is uniting to both envision and enable a global energy system that supports a sustainable environment and broad economic prosperity. Growth in the technology and the deployment of renewable energy has been dramatic. Evidence can be seen in the growth of photovoltaics (PV) and wind as contributors to worldwide electricity production over the last decade. PV and wind provided 1.2% and 3.7% of global electricity production in 2015, compared to 0.1% and 1.3% respectively in 2005. These numbers indicate both the rapid increase in the rate of deployment, as well as the remaining work to be done to extend this trend to transform a massive energy system and provide a significant fraction of the world's future energy demand with renewable energy. Based on recent trends, it is highly likely that global cumulative PV installation will reach terawatt scale in the next few decades. The challenges, as well as the resulting impact, vary greatly depending on whether we envision 1 TW ( 15% of 2015 global electricity capacity), 3 TW ( 50% of 2015 global electricity capacity) or 10 TW, a level that could drive electrification of transportation and industrial sectors and production of solar fuels. This presentation will draw upon the work of the 2016 GA-SERI (Global Alliance of Solar Energy Research Institutes) Terawatt Workshop to assess the feasibility and summarize the challenges for PV as a primary energy source. These challenges include the continuing demand for improved efficiency and reliability, the required magnitude of capital expenditure, the need for a sustainable industry (both financially and environmentally), as well as needs for grid modernization and consistent policies that support global climate goals. Physicists can play important roles in addressing this full range of challenges, from materials science to public policy, as well as in education of the public and its future leaders.

  9. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    Russel Howe of team Survey speaks with Sample Return Robot Challenge staff members after the team's robot failed to leave the starting platform during it's attempt at the level two challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  10. Aspiring Pain Practitioners in India: Assessing Challenges and Building Opportunities.

    PubMed

    Bhatnagar, Sushma; Patel, Anuradha; Raja, Srinivasa N

    2018-01-01

    Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers. Face-to-face interactive sessions were held with 60 aspiring pain physicians of India who were chosen as registrants to an International Association for the Study of Pain-Indian Society for Study of Pain multidisciplinary evidence-based pain management program conducted at Delhi and Mumbai. The available opportunities, practical issues and the hurdles in becoming a pain specialist were analyzed and summarized in this commentary. The major barriers identified were: (1) Inadequate knowledge and absence of structured, educational and training courses, (2) bureaucratic hurdles, and (3) concerns of opioid misuse and addiction. The opportunities for personal growth and that of the specialty that could be utilized include the creation of a pain resource team, increasing community awareness, changing attitudes of other physicians toward pain specialty, and research and evidence building of the effectiveness of pain management strategies. India needs a structured teaching and training program in the area of pain medicine that is affiliated by the Medical Council of India or other reputed boards of medical education and certification. There is an urgent need to include pain management in the undergraduate and postgraduate medical curriculum. Enhancing community level awareness by public health education campaigns, developing networks of pain physicians, and appropriate marketing of the specialty is needed to make pain medicine recognized and utilized as a valuable specialty.

  11. Time dependent data, time independent models: challenges of updating Australia's National Seismic Hazard Assessment

    NASA Astrophysics Data System (ADS)

    Griffin, J.; Clark, D.; Allen, T.; Ghasemi, H.; Leonard, M.

    2017-12-01

    Standard probabilistic seismic hazard assessment (PSHA) simulates earthquake occurrence as a time-independent process. However paleoseismic studies in slowly deforming regions such as Australia show compelling evidence that large earthquakes on individual faults cluster within active periods, followed by long periods of quiescence. Therefore the instrumental earthquake catalog, which forms the basis of PSHA earthquake recurrence calculations, may only capture the state of the system over the period of the catalog. Together this means that data informing our PSHA may not be truly time-independent. This poses challenges in developing PSHAs for typical design probabilities (such as 10% in 50 years probability of exceedance): Is the present state observed through the instrumental catalog useful for estimating the next 50 years of earthquake hazard? Can paleo-earthquake data, that shows variations in earthquake frequency over time-scales of 10,000s of years or more, be robustly included in such PSHA models? Can a single PSHA logic tree be useful over a range of different probabilities of exceedance? In developing an updated PSHA for Australia, decadal-scale data based on instrumental earthquake catalogs (i.e. alternative area based source models and smoothed seismicity models) is integrated with paleo-earthquake data through inclusion of a fault source model. Use of time-dependent non-homogeneous Poisson models allows earthquake clustering to be modeled on fault sources with sufficient paleo-earthquake data. This study assesses the performance of alternative models by extracting decade-long segments of the instrumental catalog, developing earthquake probability models based on the remaining catalog, and testing performance against the extracted component of the catalog. Although this provides insights into model performance over the short-term, for longer timescales it is recognised that model choice is subject to considerable epistemic uncertainty. Therefore a formal

  12. Hybrid governance of aquaculture: Opportunities and challenges.

    PubMed

    Vince, Joanna; Haward, Marcus

    2017-10-01

    The development of third party assessment and certification of fisheries and aquaculture has provided new forms of governance in sectors that were traditionally dominated by state based regulation. Emerging market based approaches are driven by shareholder expectations as well as commitment to corporate social responsibility, whereas community engagement is increasingly centered on the questions of social license to operate. Third party assessment and certification links state, market and community into an interesting and challenging hybrid form of governance. While civil society organizations have long been active in pursuing sustainable and safe seafood production, the development of formal non-state based certification provides both opportunities and challenges, and opens up interesting debates over hybrid forms of governance. This paper explores these developments in coastal marine resources management, focusing on aquaculture and the development and operation of the Aquaculture Stewardship Council. It examines the case of salmonid aquaculture in Tasmania, Australia, now Australia's most valuable seafood industry, which remains the focus of considerable community debate over its siting, operation and environmental impact. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Families of returned defence force personnel: a changing landscape of challenges.

    PubMed

    Berle, David; Steel, Zachary

    2015-08-01

    This paper aims to identify the key challenges experienced by the families of defence force personnel following deployment. We undertook a selective review of four post-deployment challenges to the families of defence force personnel: (1) changes to relationships; (2) changes to family member roles and responsibilities; (3) adjustment of children and parenting challenges; and (4) anger, family conflict and violence. Emerging issues in the area of post-deployment adjustment are also discussed. Empirical studies of post-deployment family adjustment are lacking. Each of the reviewed challenges can contribute to psychological difficulties and precipitate contact with mental health services. The challenges faced by defence force personnel when returning from deployment arise within a family context. Clinicians should thoroughly assess these factors in families following deployment, but also recognise family strengths and resilience to these challenges. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  14. NASA's post-Challenger safety program - Themes and thrusts

    NASA Technical Reports Server (NTRS)

    Rodney, G. A.

    1988-01-01

    The range of managerial, technical, and procedural initiatives implemented by NASA's post-Challenger safety program is reviewed. The recommendations made by the Rogers Commission, the NASA post-Challenger review of Shuttle design, the Congressional investigation of the accident, the National Research Council, the Aerospace Safety Advisory Panel, and NASA internal advisory panels and studies are summarized. NASA safety initiatives regarding improved organizational accountability for safety, upgraded analytical techniques and methodologies for risk assessment and management, procedural initiatives in problem reporting and corrective-action tracking, ground processing, maintenance documentation, and improved technologies are discussed. Safety issues relevant to the planned Space Station are examined.

  15. World Class: The Global Challenge to Canadian Education.

    ERIC Educational Resources Information Center

    Stewart-Patterson, David

    2002-01-01

    Globalization challenges governments to improve the quality of and access to postsecondary education while limiting their ability to raise revenue. By stimulating savings and expanding student loans and scholarships, Canada can improve access to postsecondary education. Educational quality can be improved through more effective assessment and…

  16. Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic.

    PubMed

    Braverman, Genna; Bereknyei Merrell, Sylvia; Bruce, Janine S; Makoul, Gregory; Schillinger, Erika

    2016-11-01

    Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development. Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered. Open-ended written responses were collected through a mandatory post-clerkship survey. Responses were qualitatively coded using an a priori framework for teaching and assessing communication skills (The SEGUE Framework for Teaching and Assessing Communication Skills) with data-derived additions to the framework, followed by a team-based thematic analysis. We collected 799 reflections written by 518 students from 2007-2014. Three dominant themes emerged from the analysis: challenges with (1) effectively exchanging information with patients, (2) managing emotional aspects of the patient encounter, and (3) negotiating terms of the encounter. Communication curricula focus on content and process of the medical interview, but insufficient time and energy are devoted to psychosocial factors, including aspects of the encounter that are emotionally charged or conflicting. While gaps in students' communication skillsets may be anticipated or observed by educators, this study offers an analysis of students' own perceptions of the challenges they face.

  17. A dietary cholesterol challenge study to assess Chlorella supplementation in maintaining healthy lipid levels in adults: a double-blinded, randomized, placebo-controlled study.

    PubMed

    Kim, Sangmi; Kim, Joohee; Lim, Yeni; Kim, You Jin; Kim, Ji Yeon; Kwon, Oran

    2016-05-13

    Previous animal studies suggested that Chlorella, a unicellular green alga, has a preventive role in maintaining serum cholesterol levels against excess dietary cholesterol intake. This study aimed to conduct a pioneering investigation to clarify this issue in healthy subjects by adopting a dietary cholesterol challenge, which has not been used previously in similar studies of Chlorella in hypercholesterolemia. In this double blind, randomized, placebo-controlled study, 34 participants ingested 510 mg of dietary cholesterol from three eggs concomitantly with a usual dose of Chlorella (5 g/d) or a matched placebo for 4 weeks. The dietary cholesterol challenge induced consistently higher concentrations of serum total cholesterol (TC, P < 0.001), LDL-C (P = 0.004), and HDL-C (P = 0.010) compared with baseline values, suggesting that the challenge was reliable. Thus, we observed a preventive action of Chlorella in maintaining serum TC versus placebo levels (3.5 % versus 9.8 %, respectively; P = 0.037) and LDL-C versus placebo levels (1.7 % versus 14.3 %, respectively; P = 0.012) against excessive dietary cholesterol intake and in augmenting HDL-C versus placebo levels (8.3 % versus 3.8 %, respectively). Furthermore, serum α-carotene showed the best separation between the placebo and Chlorella groups (R(2)X and R(2)Y > 0.5; Q(2) > 0.4). The results suggest that a fully replicated dietary cholesterol challenge may be useful in assessing the effectiveness of dietary supplements in maintaining the serum lipid profiles of adults whose habitual diets are high in cholesterol. WHO International Clinical Trials Registry Platform ( KCT0000258 ).

  18. Assessing the Trends and Challenges of Teaching Marketing Abroad: A Delphi Approach

    ERIC Educational Resources Information Center

    Kelley, Craig A.

    2007-01-01

    The past 20 years have seen a growth in the teaching of marketing in business schools around the world. This article reports the trends and challenges that will face U.S. marketing educators teaching abroad over the next 10 years. Predictions are from a Delphi panel of U.S. marketing educators experienced in teaching marketing abroad to non-U.S.…

  19. LUNGx Challenge for computerized lung nodule classification

    DOE PAGES

    Armato, Samuel G.; Drukker, Karen; Li, Feng; ...

    2016-12-19

    The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants’ computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. We present ten groups that applied their own methods to 73 lung nodules (37 benign and 36 malignant) thatmore » were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists’ AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. Lastly, the continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community.« less

  20. LUNGx Challenge for computerized lung nodule classification

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Armato, Samuel G.; Drukker, Karen; Li, Feng

    The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants’ computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. We present ten groups that applied their own methods to 73 lung nodules (37 benign and 36 malignant) thatmore » were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists’ AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. Lastly, the continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community.« less

  1. Using health technology assessment to support optimal use of technologies in current practice: the challenge of "disinvestment".

    PubMed

    Henshall, Chris; Schuller, Tara; Mardhani-Bayne, Logan

    2012-07-01

    Health systems face rising patient expectations and economic pressures; decision makers seek to enhance efficiency to improve access to appropriate care. There is international interest in the role of HTA to support decisions to optimize use of established technologies, particularly in "disinvesting" from low-benefit uses. This study summarizes main points from an HTAi Policy Forum meeting on this topic, drawing on presentations, discussions among attendees, and an advance background paper. Optimization involves assessment or re-assessment of a technology, a decision on optimal use, and decision implementation. This may occur within a routine process to improve safety and quality and create "headroom" for new technologies, or ad hoc in response to financial constraints. The term "disinvestment" is not always helpful in describing these processes. HTA contributes to optimization, but there is scope to increase its role in many systems. Stakeholders may have strong views on access to technology, and stakeholder involvement is essential. Optimization faces challenges including loss aversion and entitlement, stakeholder inertia and entrenchment, heterogeneity in patient outcomes, and the need to demonstrate convincingly absence of benefit. While basic HTA principles remain applicable, methodological developments are needed better to support optimization. These include mechanisms for candidate technology identification and prioritization, enhanced collection and analysis of routine data, and clinician engagement. To maximize value to decision makers, HTA should consider implementation strategies and barriers. Improving optimization processes calls for a coordinated approach, and actions are identified for system leaders, HTA and other health organizations, and industry.

  2. Solving a methodological challenge in work stress evaluation with the Stress Assessment and Research Toolkit (StART): a study protocol

    PubMed Central

    2013-01-01

    Background Stress evaluation is a field of strong interest and challenging due to several methodological aspects in the evaluation process. The aim of this study is to propose a study protocol to test a new method (i.e., the Stress Assessment and Research Toolkit) to assess psychosocial risk factors at work. Design This method addresses several methodological issues (e.g., subjective vs. objective, qualitative vs quantitative data) by assessing work-related stressors using different kinds of data: i) organisational archival data (organisational indicators sheet); ii) qualitative data (focus group); iii) worker perception (questionnaire); and iv) observational data (observational checklist) using mixed methods research. In addition, it allows positive and negative aspects of work to be considered conjointly, using an approach that considers at the same time job demands and job resources. Discussion The integration of these sources of data can reduce the theoretical and methodological bias related to stress research in the work setting, allows researchers and professionals to obtain a reliable description of workers’ stress, providing a more articulate vision of psychosocial risks, and allows a large amount of data to be collected. Finally, the implementation of the method ensures in the long term a primary prevention for psychosocial risk management in that it aims to reduce or modify the intensity, frequency or duration of organisational demands. PMID:23799950

  3. Assessment of Critical-Analytic Thinking

    ERIC Educational Resources Information Center

    Brown, Nathaniel J.; Afflerbach, Peter P.; Croninger, Robert G.

    2014-01-01

    National policy and standards documents, including the National Assessment of Educational Progress frameworks, the "Common Core State Standards" and the "Next Generation Science Standards," assert the need to assess critical-analytic thinking (CAT) across subject areas. However, assessment of CAT poses several challenges for…

  4. The Challenges of Measuring Glycemic Variability

    PubMed Central

    Rodbard, David

    2012-01-01

    This commentary reviews several of the challenges encountered when attempting to quantify glycemic variability and correlate it with risk of diabetes complications. These challenges include (1) immaturity of the field, including problems of data accuracy, precision, reliability, cost, and availability; (2) larger relative error in the estimates of glycemic variability than in the estimates of the mean glucose; (3) high correlation between glycemic variability and mean glucose level; (4) multiplicity of measures; (5) correlation of the multiple measures; (6) duplication or reinvention of methods; (7) confusion of measures of glycemic variability with measures of quality of glycemic control; (8) the problem of multiple comparisons when assessing relationships among multiple measures of variability and multiple clinical end points; and (9) differing needs for routine clinical practice and clinical research applications. PMID:22768904

  5. Using Beta-Version mHealth Technology for Team-Based Care Management to Support Stroke Prevention: An Assessment of Utility and Challenges.

    PubMed

    Ramirez, Magaly; Wu, Shinyi; Ryan, Gery; Towfighi, Amytis; Vickrey, Barbara G

    2017-05-23

    Beta versions of health information technology tools are needed in service delivery models with health care and community partnerships to confirm the key components and to assess the performance of the tools and their impact on users. We developed a care management technology (CMT) for use by community health workers (CHWs) and care managers (CMs) working collaboratively to improve risk factor control among recent stroke survivors. The CMT was expected to enhance the efficiency and effectiveness of the CHW-CM team. The primary objective was to describe the Secondary Stroke Prevention by Uniting Community and Chronic Care Model Teams Early to End Disparities (SUCCEED) CMT and investigate CM and CHW perceptions of the CMT's usefulness and challenges for team-based care management. We conducted qualitative interviews with all users of the beta-version SUCCEED CMT, namely two CMs and three CHWs. They were asked to demonstrate and describe their perceptions of the CMT's ease of use and usefulness for completing predefined key care management activities. They were also probed about their general perceptions of the CMT's information quality, ease of use, usefulness, and impact on CM and CHW roles. Interview transcripts were coded using a priori codes. Coded excerpts were grouped into broader themes and then related in a conceptual model of how the CMT facilitated care management. We also conducted a survey with 14 patients to obtain their perspective on CHW tablet use during CHW-patient interactions. Care managers and community health workers expressed that the CMT helped them keep track of patient interactions and plan their work. It guided CMs in developing and sharing care plans with CHWs. For CHWs, the CMT enabled electronic collection of clinical assessment data, provided decision support, and provided remote access to patients' risk factor values. Long loading times and downtimes due to outages were the most significant challenges encountered. Additional issues

  6. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    Sam Ortega, NASA program manager for Centennial Challenges, is seen during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  7. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The Retrievers team robot is seen as it attempts the level one challenge the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  8. Challenging behavior and co-morbid psychopathology in adults with intellectual disability and autism spectrum disorders.

    PubMed

    McCarthy, Jane; Hemmings, Colin; Kravariti, Eugenia; Dworzynski, Katharina; Holt, Geraldine; Bouras, Nick; Tsakanikos, Elias

    2010-01-01

    We investigated the relationship between challenging behavior and co-morbid psychopathology in adults with intellectual disability (ID) and autism spectrum disorders (ASDs) (N=124) as compared to adults with ID only (N=562). All participants were first time referrals to specialist mental health services and were living in community settings. Clinical diagnoses were based on ICD-10 criteria and presence of challenging behavior was assessed with the Disability Assessment Schedule (DAS-B). The analyses showed that ASD diagnosis was significantly associated with male gender, younger age and lower level of ID. Challenging behavior was about four times more likely in adults with ASD as compared to non-ASD adults. In those with challenging behavior, there were significant differences in co-morbid psychopathology between ASD and non-ASD adults. However, after controlling for level of ID, gender and age, there was no association between co-morbid psychopathology and presence of challenging behavior. Overall, the results suggest that presence of challenging behavior is independent from co-morbid psychopathology in adults with ID and ASD. Copyright 2009 Elsevier Ltd. All rights reserved.

  9. Sulfonamide inhibition studies of two β-carbonic anhydrases from the ascomycete fungus Sordaria macrospora, CAS1 and CAS2.

    PubMed

    Vullo, Daniela; Lehneck, Ronny; Pöggeler, Stefanie; Supuran, Claudiu T

    2018-12-01

    The two β-carbonic anhydrases (CAs, EC 4.2.1.1) recently cloned and purified from the ascomycete fungus Sordaria macrospora, CAS1 and CAS2, were investigated for their inhibition with a panel of 39 aromatic, heterocyclic, and aliphatic sulfonamides and one sulfamate, many of which are clinically used agents. CAS1 was efficiently inhibited by tosylamide, 3-fluorosulfanilamide, and 3-chlorosulfanilamide (K I s in the range of 43.2-79.6 nM), whereas acetazolamide, methazolamide, topiramate, ethoxzolamide, dorzolamide, and brinzolamide were medium potency inhibitors (K I s in the range of 360-445 nM). CAS2 was less sensitive to sulfonamide inhibitors. The best CAS2 inhibitors were 5-amino-1,3,4-thiadiazole-2-sulfonamide (the deacetylated acetazolamide precursor) and 4-hydroxymethyl-benzenesulfonamide, with K I s in the range of 48.1-92.5 nM. Acetazolamide, dorzolamide, ethoxzolamide, topiramate, sulpiride, indisulam, celecoxib, and sulthiame were medium potency CAS2 inhibitors (K I s of 143-857 nM). Many other sulfonamides showed affinities in the high micromolar range or were ineffective as CAS1/2 inhibitors. Small changes in the structure of the inhibitor led to important differences of the activity. As these enzymes may show applications for the removal of anthropically generated polluting gases, finding modulators of their activity may be crucial for designing environmental-friendly CO 2 capture processes.

  10. Challenges in Assessing Seismic Hazard in Intraplate Europe

    NASA Astrophysics Data System (ADS)

    Hintersberger, E.; Kuebler, S.; Landgraf, A.; Stein, S. A.

    2014-12-01

    Intraplate regions are often characterized by scattered, clustered and migrating seismicity and the occurrence of low-strain areas next to high-strain ones. Increasing evidence for large paleoearthquakes in such regions together with population growth and development of critical facilities, call for better assessments of earthquake hazards. Existing seismic hazard assessment for intraplate Europe is based on instrumental and historical seismicity of the past 1000 years, as well some active fault data. These observations face important limitations due to the quantity and quality of the available data bases. Even considering the long record of historical events in some populated areas of Europe, this time-span of thousand years likely fails to capture some faults' typical large-event recurrence intervals that are in the order of tens of thousands of years. Paleoseismology helps lengthen the observation window, but only produces point measurements, and preferentially in regions suspected to be seismically active. As a result, the expected maximum magnitudes of future earthquakes are quite uncertain, likely to be underestimated, and earthquakes are likely to occur in unexpected locations. These issues in particular arise in the heavily populated Rhine Graben and Vienna Basin areas, and in considering the hazard to critical facilities like nuclear power plants posed by low-probability events.

  11. Quantifying the ventilatory control contribution to sleep apnoea using polysomnography.

    PubMed

    Terrill, Philip I; Edwards, Bradley A; Nemati, Shamim; Butler, James P; Owens, Robert L; Eckert, Danny J; White, David P; Malhotra, Atul; Wellman, Andrew; Sands, Scott A

    2015-02-01

    Elevated loop gain, consequent to hypersensitive ventilatory control, is a primary nonanatomical cause of obstructive sleep apnoea (OSA) but it is not possible to quantify this in the clinic. Here we provide a novel method to estimate loop gain in OSA patients using routine clinical polysomnography alone. We use the concept that spontaneous ventilatory fluctuations due to apnoeas/hypopnoeas (disturbance) result in opposing changes in ventilatory drive (response) as determined by loop gain (response/disturbance). Fitting a simple ventilatory control model (including chemical and arousal contributions to ventilatory drive) to the ventilatory pattern of OSA reveals the underlying loop gain. Following mathematical-model validation, we critically tested our method in patients with OSA by comparison with a standard (continuous positive airway pressure (CPAP) drop method), and by assessing its ability to detect the known reduction in loop gain with oxygen and acetazolamide. Our method quantified loop gain from baseline polysomnography (correlation versus CPAP-estimated loop gain: n=28; r=0.63, p<0.001), detected the known reduction in loop gain with oxygen (n=11; mean±sem change in loop gain (ΔLG) -0.23±0.08, p=0.02) and acetazolamide (n=11; ΔLG -0.20±0.06, p=0.005), and predicted the OSA response to loop gain-lowering therapy. We validated a means to quantify the ventilatory control contribution to OSA pathogenesis using clinical polysomnography, enabling identification of likely responders to therapies targeting ventilatory control. Copyright ©ERS 2015.

  12. Quantifying the ventilatory control contribution to sleep apnoea using polysomnography

    PubMed Central

    Terrill, Philip I.; Edwards, Bradley A.; Nemati, Shamim; Butler, James P.; Owens, Robert L.; Eckert, Danny J.; White, David P.; Malhotra, Atul; Wellman, Andrew; Sands, Scott A.

    2015-01-01

    Elevated loop gain, consequent to hypersensitive ventilatory control, is a primary nonanatomical cause of obstructive sleep apnoea (OSA) but it is not possible to quantify this in the clinic. Here we provide a novel method to estimate loop gain in OSA patients using routine clinical polysomnography alone. We use the concept that spontaneous ventilatory fluctuations due to apnoeas/hypopnoeas (disturbance) result in opposing changes in ventilatory drive (response) as determined by loop gain (response/disturbance). Fitting a simple ventilatory control model (including chemical and arousal contributions to ventilatory drive) to the ventilatory pattern of OSA reveals the underlying loop gain. Following mathematical-model validation, we critically tested our method in patients with OSA by comparison with a standard (continuous positive airway pressure (CPAP) drop method), and by assessing its ability to detect the known reduction in loop gain with oxygen and acetazolamide. Our method quantified loop gain from baseline polysomnography (correlation versus CPAP-estimated loop gain: n=28; r=0.63, p<0.001), detected the known reduction in loop gain with oxygen (n=11; mean±SEM change in loop gain (ΔLG) −0.23±0.08, p=0.02) and acetazolamide (n=11; ΔLG −0.20±0.06, p=0.005), and predicted the OSA response to loop gain-lowering therapy. We validated a means to quantify the ventilatory control contribution to OSA pathogenesis using clinical polysomnography, enabling identification of likely responders to therapies targeting ventilatory control. PMID:25323235

  13. U.S. Team Green Building Challenge 2002

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    2002-09-01

    Flier about the U.S. Team and its projects participating in the International Green Building Challenge. Along with many other countries, the United States accepted the Green Building Challenge (GBC), an international effort to evaluate and improve the performance of buildings worldwide. GBC started out in 1996 as a competition to determine which country had the greenest buildings; it evolved into a cooperative process among the countries to measure the performance of green buildings. Although the auto industry can easily measure efficiency in terms of miles per gallon, the buildings industry has no standard way to quantify energy and environmental performance.more » The Green Building Challenge participants hope that better tools for measuring the energy and environmental performance of buildings will be an outcome of their efforts and that these tools will lead to higher and better performance levels in buildings around the world. The ultimate goal is to design, construct, and operate buildings that contribute to global sustainability by conserving and/or regenerating natural resources and minimizing nonrenewable energy use. The United States' Green Building Challenge Team '02 selected five buildings from around the country to serve as case studies; each of the five U.S. building designs (as well as all international case studies) were assessed using an in-depth evaluation tool, called the Green Building Assessment Tool (GBTool). The GBTool was specifically created and refined by international teams, for the GBC efforts. The goal of this collaborative effort is to improve this evaluation software tool so that it can be used globally, while taking into account regional and national conditions. The GBTool was used by the U.S. Team to assess and evaluate the energy and environmental performance of these five buildings: (1) Retail (in operation): BigHorn Home Improvement Center, Silverthorne, Colorado; (2) Office (in operation), Philip Merrill Environmental; (3

  14. Analysis of Transportation and Logistics Challenges Affecting the Deployment of Larger Wind Turbines: Summary of Results

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    J. Cotrell, T. Stehly, J. Johnson, J. O. Roberts, Z. Parker, G. Scott, and D. Heimiller

    The objectives of this study were to identify the transportation and logistics challenges, assess the associated impacts, and provide recommendations for strategies and specific actions to address the challenges.

  15. Perfusion CT to assess angiogenesis in colon cancer: technical limitations and practical challenges.

    PubMed

    Dighe, S; Castellano, E; Blake, H; Jeyadevan, N; Koh, M U; Orten, M; Swift, I; Brown, G

    2012-10-01

    Perfusion CT may have the potential to quantify the degree of angiogenesis of solid tumours in vivo. This study aims to identify the practical and technical challenges inherent to the technique, and evaluate its feasibility in colorectal tumours. 51 patients from 2 institutions prospectively underwent a single perfusion CT on 2 different multidetector scanners. The patients were advised to breath-hold as long as possible, followed by shallow breathing, and were given intravenous buscopan to reduce movement. Numerous steps were explored to identify the challenges. 43 patients successfully completed the perfusion CT as per protocol. Inability to detect the tumour (n=3), misplacement of dynamic sequence co-ordinates (n=2), failure of contrast injection (n=2) and displacement of tumour (n=1) were the reasons for failure. In 14 cases excessive respiratory motion displaced the tumour out of the scanning field along the temporal sequence, leading to erroneous data capture. In nine patients, minor displacements of the tumour were corrected by repositioning the region of interest (ROI) to its original position after reviewing each dynamic sequence slice. In 20 patients the tumour was stable, and data captured from the ROI were representative, and could have been analysed by commercially available Body Tumor Perfusion 3.0® software (GE Healthcare, Waukesha, WI). Hence all data were manually analysed by MATLAB® processing software (MathWorks, Cambridge, UK). Perfusion CT in tumours susceptible to motion during acquisition makes accurate data capture challenging and requires meticulous attention to detail. Motion correction software is essential if perfusion CT is to be used routinely in colorectal cancer.

  16. Challenges in conducting psychiatry studies in India

    PubMed Central

    Kharawala, Saifuddin; Dalal, Jeroze

    2011-01-01

    A large number of psychiatry studies are conducted in India. Psychiatry studies are complex and present unique challenges in the Indian setting. Ethical issues pertaining to the risk of worsening of illness, use of placebo and validity of informed consents are commonly faced. Site selection can be difficult due to the relative paucity of ICH-GCP (International Conference on Harmonisation - Good Clinical Practice) trained psychiatry investigators in India. Recruitment can be challenging due to issues such as strict eligibility criteria, (lack of) availability of caregiver, illness-related considerations, etc. Assessment of the consent capacity of patients is not simple, while structured assessments are not commonly employed. As the illness fluctuates, the consent capacity may change, thus requiring continued assessment of consent capacity. Study patients run the risk of worsening of illness and suicide due to exposure to inactive treatments; this risk is counterbalanced by use of appropriate study designs, as well as the indirect psychotherapeutic support received. Psychiatry studies are associated with a high placebo response. This necessitates conduct of placebo-controlled studies despite the attendant difficulties. Also, the high placebo response is often the cause of failed trials. Rating scales are essential for assessment of drug response. Some rating instruments as well as some rater training procedures may not be suitable for the Indian setting. Technological advancements may increase the procedural complexity but improve the quality of ratings. Psychiatry studies present monitors and auditors with unique scenarios too. Utilization of psychiatry specific training and expertise is recommended to ensure successful conduct of these studies in India. PMID:21584176

  17. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    The team Survey robot retrieves a sample during a demonstration of the level two challenge at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  18. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    The University of California Santa Cruz Rover Team prepares their rover for the rerun of the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  19. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    Team Cephal's robot is seen on the starting platform during a rerun of the level one challenge at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  20. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    A robot from the Intrepid Systems team is seen during the rerun of the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  1. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    A team KuuKulgur robot is seen as it begins the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  2. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The team Mountaineers robot is seen as it attempts the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  3. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The Stellar Automation Systems team poses for a picture with their robot after attempting the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  4. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    The team Survey robot is seen as it conducts a demonstration of the level two challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  5. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    All four of team KuuKulgur's robots are seen as they attempt the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  6. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    Spectators watch as the team Survey robot conducts a demonstration of the level two challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  7. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    Team Middleman's robot, Ro-Bear, is seen as it starts the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  8. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    The team Mountaineers robot is seen after picking up the sample during a rerun of the level one challenge at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  9. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    Two of team KuuKulgur's robots are seen as they attempt a rerun of the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  10. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    A robot from the University of Waterloo Robotics Team is seen during the rerun of the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  11. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    Members of team Survey follow their robot as it conducts a demonstration of the level two challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  12. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The entrance to Institute Park is seen during the level one challenge as during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  13. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    Sam Ortega, NASA Centennial Challenges Program Manager, speaks at a breakfast opening the TouchTomorrow Festival, held in conjunction with the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  14. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    A team KuuKulgur robot approaches the sample as it attempts the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  15. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    The team survey robot is seen on the starting platform before begging it's attempt at the level two challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  16. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The Mountaineers team from West Virginia University, watches as their robot attempts the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  17. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    The team Survey robot is seen as it conducts a demonstration of the level two challenge at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  18. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    Team Survey's robot is seen as it conducts a demonstration of the level two challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  19. Using Challenging Tasks for Formative Assessment on Quadratic Functions with Senior Secondary Students

    ERIC Educational Resources Information Center

    Wilkie, Karina J.

    2016-01-01

    Senior secondary mathematics students who develop conceptual understanding that moves them beyond "rules without reasons" to connections between related concepts are in a strong place to tackle the more difficult mathematics application problems. Current research is examining how the use of challenging tasks at different levels of…

  20. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    Ahti Heinla, left, and Sulo Kallas, right, from Estonia, prepare team KuuKulgur's robot for the rerun of the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  1. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    A sample can be seen on the competition field as the team Survey robot conducts a demonstration of the level two challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  2. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    Jascha Little of team Survey is seen as he follows the teams robot as it conducts a demonstration of the level two challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  3. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The University of California Santa Cruz Rover Team poses for a picture with their robot after attempting the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. is one of eighteen teams competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  4. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    The University of California Santa Cruz Rover Team's robot is seen prior to starting it's second attempt at the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  5. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The Oregon State University Mars Rover Team poses for a picture with their robot following their attempt at the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. is one of eighteen teams competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  6. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The University of Waterloo Robotics Team, from Canada, prepares to place their robot on the start platform during the level one challenge at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  7. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    Sam Ortega, NASA program manager for Centennial Challenges, is interviewed by a member of the media before the start of level two competition at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  8. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    Jerry Waechter of team Middleman from Dunedin, Florida, speaks about his team's robot, Ro-Bear, as it makes it attempt at the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  9. Exposure Assessment at 30 000 Feet: Challenges and Future Directions

    PubMed Central

    Grajewski, Barbara; Pinkerton, Lynne E.

    2015-01-01

    Few studies of cancer mortality and incidence among flight crew have included a detailed assessment of both occupational exposures and lifestyle factors that may influence the risk of cancer. In this issue, Kojo et al. (Risk factors for skin cancer among Finnish airline cabin crew. Ann. Occup. Hyg 2013; 57: 695–704) evaluated the relative contributions of ultraviolet and cosmic radiation to the incidence of skin cancer in Finnish flight attendants. This is a useful contribution, yet the reason flight crew members have an increased risk of skin cancer compared with the general population remains unclear. Good policy decisions for flight crew will depend on continued and emerging effective collaborations to increase study power and improve exposure assessment in future flight crew health studies. Improving the assessment of occupational exposures and non-occupational factors will cost additional time and effort, which are well spent if the role of exposures can be clarified in larger studies. PMID:23818455

  10. Guiding Principles to Impact an Institution-Wide Assessment Initiative

    ERIC Educational Resources Information Center

    Heinerichs, Scott; Bernotsky, R. Lorraine; Danner, Loretta Rieser

    2015-01-01

    Institutions of higher education are faced with challenges when implementing an assessment initiative. These challenges include constraints on time and resources, the demands of specialized accreditation, and faculty motivation to comply. In addition, the communication of the expectations around assessment must be clear to all constituents in…

  11. 78 FR 49296 - Centennial Challenges 2014 Sample Return Robot Challenge

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... Return Robot Challenge AGENCY: National Aeronautics and Space Administration (NASA). ACTION: Notice of Centennial Challenges 2014 Sample Return Robot Challenge. SUMMARY: This notice is issued in accordance with 51 U.S.C. 20144(c). The 2014 Sample Return Robot Challenge is scheduled and teams that wish to...

  12. Meeting CCS communication challenges head-on: Integrating communications, planning, risk assessment, and project management

    USGS Publications Warehouse

    Greenberg, S.; Gauvreau, L.; Hnottavange-Telleen, K.; Finley, R.; Marsteller, S.

    2011-01-01

    The Midwest Geological Sequestration Consortium, Schlumberger Carbon Services, and Archer Daniels Midland has implemented a comprehensive communications plan at the Illinois Basin - Decatur Project (IBDP), a one million metric tonne Carbon Capture and Storage project in Decatur, IL, USA funded by the U.S. Department of Energy's National Energy Technology Laboratory. The IBDP Communication Plan includes consortium information, funding and disclaimer citations, description of target audiences, media communications guidelines, paper and presentations guidelines, site visit information, crisis communication, on-site photography regulations, and other components. The creation, development, and implementation processes for the IBDP Communication Plan (the Plan) are shared in this paper. New communications challenges, such as how to address add-on research requests, data sharing and management, scope increase, and contract agreements have arisen since the Plan was completed in January 2009, resulting in development of new policies and procedures by project management. Integrating communications planning, risk assessment, and project management ensured that consistent, factual information was developed and incorporated into project planning, and constitutes the basis of public communications. Successful integration has allowed the IBDP to benefit from early identification and mitigation of the potential project risks, which allows more time to effectively deal with unknown and unidentified risks that may arise. Project risks and risks associated with public perception can be managed through careful planning and integration of communication strategies into project management and risk mitigation. ?? 2011 Published by Elsevier Ltd.

  13. Aggressive challenging behaviour and intellectual disability.

    PubMed

    Benson, Betsey A; Brooks, Whitney T

    2008-09-01

    The aim of this article is to review reports of aggressive challenging behaviour in individuals with intellectual disability from September 2006 to March 2008. Studies continued to demonstrate the prevalence and significance of aggressive challenging behaviour in persons with intellectual disability. Over half of the population engages in some form of aggression, but only a small number is responsible for frequent or severe acts. A publication that identified aggression profiles offered a promising new approach. Aggressive behaviour in adults often has multiple functions. The most frequently studied interventions were either behavioural or somatic. Parents learned skills to effectively intervene with their aggressive preschool child. Reviews of medication efficacy studies concluded that there was insufficient evidence to recommend a single medication. Psychiatrists agreed that medication should not be the first treatment option. In one study, a class of medication was found to reduce aggression, but not aggression with self-injury, or self-injury alone. Research on aggressive challenging behaviour requires assessment instruments that address the topography and severity of aggression. Identifying aggression types may clarify mixed results of previous research and improve treatment effectiveness. Greater access to effective, nonmedication treatments is needed.

  14. The skin in psoriasis: assessment and challenges.

    PubMed

    Oji, Vinzenz; Luger, Thomas A

    2015-01-01

    The coexistence of psoriasis arthritis (PsA) and psoriasis vulgaris in about 20% of patients with psoriasis leads to a need for rheumatologic-dermatologic team work. We summarise the role of dermatologists in assessment of the skin in psoriasis. Chronic plaque psoriasis must be differentiated from other subtypes such as generalised pustular psoriasis (GPP) or palmoplantar pustulosis (PPP). Therapeutic management is based on the evaluation of the disease severity. Quantitative scoring of skin severity includes calculation of the Psoriasis Area and Severity Index (PASI), body surface area (BSA) as well as the Dermatology Life Quality Index (DLQI). These scoring systems do not replace the traditional dermatologic medical history and physical examination of the patient. The skin should be examined for additional skin diseases; moreover, patients should be monitored for comorbidity, most importantly PsA and cardiovascular comorbidity.

  15. A MODIS-based burned area assessment for Russian croplands: mapping requirements and challenges

    USDA-ARS?s Scientific Manuscript database

    Although agricultural burning is banned in Russia it is still a widespread practice and the challenge in mapping cropland burning has led to a wide range of burned area estimates. Accurately monitoring cropland burned area is an important task as these estimates are used in the calculation of cropla...

  16. Obstetric team simulation program challenges.

    PubMed

    Bullough, A S; Wagner, S; Boland, T; Waters, T P; Kim, K; Adams, W

    2016-12-01

    To describe the challenges associated with the development and assessment of an obstetric emergency team simulation program. The goal was to develop a hybrid, in-situ and high fidelity obstetric emergency team simulation program that incorporated weekly simulation sessions on the labor and delivery unit, and quarterly, education protected sessions in the simulation center. All simulation sessions were video-recorded and reviewed. Labor and delivery unit and simulation center. Medical staff covering labor and delivery, anesthesiology and obstetric residents and obstetric nurses. Assessments included an on-line knowledge multiple-choice questionnaire about the simulation scenarios. This was completed prior to the initial in-situ simulation session and repeated 3 months later, the Clinical Teamwork Scale with inter-rater reliability, participant confidence surveys and subjective participant satisfaction. A web-based curriculum comprising modules on communication skills, team challenges, and team obstetric emergency scenarios was also developed. Over 4 months, only 6 labor and delivery unit in-situ sessions out of a possible 14 sessions were carried out. Four high-fidelity sessions were performed in 2 quarterly education protected meetings in the simulation center. Information technology difficulties led to the completion of only 18 pre/post web-based multiple-choice questionnaires. These test results showed no significant improvement in raw score performance from pre-test to post-test (P=.27). During Clinical Teamwork Scale live and video assessment, trained raters and program faculty were in agreement only 31% and 28% of the time, respectively (Kendall's W=.31, P<.001 and W=.28, P<.001). Participant confidence surveys overall revealed confidence significantly increased (P<.05), from pre-scenario briefing to after post-scenario debriefing. Program feedback indicates a high level of participant satisfaction and improved confidence yet further program refinement is

  17. PHARMACOLOGIC PROBING OF AMPHOTERICIN B-INDUCED RENAL DYSFUNCTION IN THE NEONATAL RAT

    EPA Science Inventory

    Pharmacologic Probing of Amphotericin B-Induced Renal Dysfunction in the Neonatal Rat. Gray, J.A., and Kavlock, R.J. (1988). Toxicol. Appl. Pharmacol. 93, 360-368. Acetazolamide, furosemide, chlorothiazide, and amiloride pharmacologic agents that act primarily in the proximal tub...

  18. Stigma and mental health challenges in medical students

    PubMed Central

    Hankir, Ahmed Khaldoon; Northall, Amy; Zaman, Rashid

    2014-01-01

    Despite the perception that medical students and doctors should be ‘invincible’, mental health challenges are common in this population. Medical students and doctors have low levels of help seeking for their own psychiatric problems often only presenting to mental health services once a crisis arises. Fear of exposure to stigmatisation is a crucial factor contributing to symptom concealment and is a barrier to accessing mental health services. Autobiographical narratives of the ‘Wounded Healer’ are gaining popularity among medical students and doctors with mental health challenges both as an effective form of adjunctive therapy and as a means to campaign against stigma. Indeed, the results of a randomised controlled trial to assess the efficacy of Coming Out Proud with mental illness revealed immediate positive effects on stigma stress-related variables. We provide an autobiographical narrative from a medical student who has first-hand experience with mental health challenges. PMID:25183806

  19. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    Kenneth Stafford, Assistant Director of Robotics Engineering and Director of the Robotics Resource Center at the Worcester Polytechnic Institute (WPI), verifies the location of the target sample during the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  20. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    Members of the Mountaineers team from West Virginia University celebrate after their robot returned to the starting platform after picking up the sample during a rerun of the level one challenge during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  1. Motivation in Group Assessment: A Phenomenological Approach to Post-Graduate Group Assessment

    ERIC Educational Resources Information Center

    Hannaford, Liz

    2017-01-01

    Whilst group work has many benefits for enhancing collaborative learning, it can cause anxiety in summative assessments when group members do not contribute equal effort. Increasing understanding of student perceptions of group assessment, and in particular their motivation to persevere to overcome the challenges, has the potential to lead to…

  2. Accessibility Principles for Reading Assessments

    ERIC Educational Resources Information Center

    Thurlow, Martha L.; Laitusis, Cara Cahalan; Dillon, Deborah R.; Cook, Linda L.; Moen, Ross E.; Abedi, Jamal; O'Brien, David G.

    2009-01-01

    Within the context of standards-based educational systems, states are using large scale reading assessments to help ensure that all children have the opportunity to learn essential knowledge and skills. The challenge for developers of accessible reading assessments is to develop assessments that measure only those student characteristics that are…

  3. New Challenges in 21st-Century Dance Education

    ERIC Educational Resources Information Center

    Kassing, Gayle

    2010-01-01

    To become competent in today's society, individuals need multiliteracies. The 21st-century dancer needs to be an artist, choreographer, educator, and researcher who can meet challenges and make an impact within the profession, as well as across education, the arts, and society. As dance professionals assess how to utilize their resources better…

  4. Organizing a Community "Biggest Loser" Weight Loss Challenge

    ERIC Educational Resources Information Center

    Jensen, Kirstin D.

    2013-01-01

    The program described here shows how Extension can be a strong collaborative partner in a rural setting in improving the overall health of the community by organizing a three month "Biggest Loser" Weight Loss Challenge. A pre-and post-fitness assessment and bi-weekly weigh-ins were administered. Three healthy lifestyle educational…

  5. Replacement Behaviors for Identified Functions of Challenging Behaviors

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Shoemaker, Mary E.; Sipes, Megan; Horovitz, Max; Worley, Julie A.; Kozlowski, Alison M.

    2011-01-01

    Functional assessment has become a major feature of learning-based research. A critical element of the majority of these studies includes not only methods and procedures to identify the cause of the challenging behavior, but to establish replacement treatment methods. By far the most common intervention in the 176 studies we reviewed was…

  6. Needs and challenges for assessing the environmental impacts of engineered nanomaterials (ENMs)

    PubMed Central

    Romero-Franco, Michelle; Godwin, Hilary A; Bilal, Muhammad

    2017-01-01

    The potential environmental impact of nanomaterials is a critical concern and the ability to assess these potential impacts is top priority for the progress of sustainable nanotechnology. Risk assessment tools are needed to enable decision makers to rapidly assess the potential risks that may be imposed by engineered nanomaterials (ENMs), particularly when confronted by the reality of limited hazard or exposure data. In this review, we examine a range of available risk assessment frameworks considering the contexts in which different stakeholders may need to assess the potential environmental impacts of ENMs. Assessment frameworks and tools that are suitable for the different decision analysis scenarios are then identified. In addition, we identify the gaps that currently exist between the needs of decision makers, for a range of decision scenarios, and the abilities of present frameworks and tools to meet those needs. PMID:28546894

  7. 75 FR 47316 - Centennial Challenges 2010 Strong Tether Challenge

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION Centennial Challenges 2010 Strong Tether Challenge... teams that wish to compete may register. Centennial Challenges is a program of prize competitions to..., please visit: http://www.spaceward.org/elevator2010-ts . For general information on the NASA Centennial...

  8. The Promises and Challenges of Implementing Evidence-Centered Design in Large Scale Assessment

    ERIC Educational Resources Information Center

    Huff, Kristen; Steinberg, Linda; Matts, Tom

    2009-01-01

    Presented at the Annual Meeting of National Council on Measurement in Education (NCME) in San Diego, CA in April 2009. This presentation provides an overview of ECD. In addition, the presentation describes the benefits of, as well as the challenges that were faced, in implementing ECD in the Advanced Placement Program.

  9. Use of Lactobacillus johnsonii in broilers challenged with Salmonella sofia.

    PubMed

    Olnood, Chen G; Beski, Sleman S M; Choct, Mingan; Iji, Paul A

    2015-09-01

    The effects of Lactobacillus johnsonii (L. johnsonii) on gut microflora, bird performance and intestinal development were assessed using 288 one-day-old Cobb broilers challenged with Salmonella sofia ( S . sofia ). The experiment was a 3 × 2 factorial design which consisted of three treatments, a negative control (NC) with no additives, a positive control (PC) containing antimicrobials (zinc-bacitracin, 50 mg/kg) and a probiotic group (Pro), and with the two factors being unchallenged or challenged with S . sofia . A probiotic preparation of L . johnsonii (10 9 cfu/chick) was administered to chicks individually by oral gavage on days 1, 3, 7 and 12. Chicks were individually challenged with S. sofia (10 7 cfu/chick) by oral gavage on d 2, 8 and 13. Results showed that the challenge itself markedly reduced ( P < 0.05) bird performance and feed intake. And, transient clinical symptoms of the infection with S . sofia were observed from the second time they were challenged with S . sofia in the negative challenge groups. The novel probiotic candidate L . johnsonii reduced the number of S . sofia and Clostridium perfringens in the gut environment, and improved the birds' colonization resistance to S . sofia .

  10. Rethinking and Restructuring an Assessment System via Effective Deployment of Technology

    ERIC Educational Resources Information Center

    Okonkwo, Charity

    2010-01-01

    Every instructional process involves a strategic assessment system for a complete teaching-learning circle. Assessment system which is seriously challenged calls for a change in the approach. The National Open University of Nigeria (NOUN) assessment system at present is challenged. The large number of students and numerous courses offered by NOUN…

  11. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    Russel Howe of team Survey, center, works on a laptop to prepare the team's robot for a demonstration run after the team's robot failed to leave the starting platform during it's attempt at the level two challenge at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  12. Treatment of challenging behavior exhibited by children with prenatal drug exposure.

    PubMed

    Kurtz, Patricia F; Chin, Michelle D; Rush, Karena S; Dixon, Dennis R

    2008-01-01

    A large body of literature exists describing the harmful effects of prenatal drug exposure on infant and child development. However, there is a paucity of research examining strategies to ameliorate sequelae such as externalizing behavior problems. In the present study, functional analysis procedures were used to assess challenging behavior exhibited by two children who were prenatally exposed to drugs of abuse. Results for both children indicated that challenging behavior was maintained by access to positive reinforcement (adult attention and tangible items). For one child, challenging behavior was also maintained by negative reinforcement (escape from activities of daily living). Function-based interventions were effective in reducing challenging behavior for both children. Implications for utilizing methods of applied behavior analysis in research with children with prenatal drug exposure are discussed.

  13. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  14. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-12

    during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Thursday, June 12, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  15. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    The NASA Centennial Challenges prize, level one, is presented to team Mountaineers for successfully completing level one of the NASA 2014 Sample Return Robot Challenge, from left, Ryan Watson, Team Mountaineers; Lucas Behrens, Team Mountaineers; Jarred Strader, Team Mountaineers; Yu Gu, Team Mountaineers; Scott Harper, Team Mountaineers; Dorothy Rasco, NASA Deputy Associate Administrator for the Space Technology Mission Directorate; Laurie Leshin, Worcester Polytechnic Institute (WPI) President; David Miller, NASA Chief Technologist; Alexander Hypes, Team Mountaineers; Nick Ohi,Team Mountaineers; Marvin Cheng, Team Mountaineers; Sam Ortega, NASA Program Manager for Centennial Challenges; and Tanmay Mandal, Team Mountaineers;, Saturday, June 14, 2014, at Worcester Polytechnic Institute (WPI) in Worcester, Mass. Team Mountaineers was the only team to complete the level one challenge. During the competition, teams were required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge was to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  16. Multicultural development in human services agencies: challenges and solutions.

    PubMed

    Hyde, Cheryl A

    2004-01-01

    Comprehensive multicultural organizational development (MCOD) is increasingly necessary in human services agencies. This article presents results from an exploratory study that identified challenges and solutions to MCOD, against the backdrop of daily realities of agency life. The author conducted interviews with 20 consultants and 20 practitioners experienced in MCOD. Qualitative analysis revealed four challenges--socioeconomic environment, organizational dynamics, conceptualization of the change effort, and consultant competence; and four solutions--collaborative environmental relations, leadership development, assessment and planning, and consultant selection. Results suggest the complexities of MCOD and ways that human services agencies can sustain such efforts.

  17. Precision Medicine and PET/Computed Tomography: Challenges and Implementation.

    PubMed

    Subramaniam, Rathan M

    2017-01-01

    Precision Medicine is about selecting the right therapy for the right patient, at the right time, specific to the molecular targets expressed by disease or tumors, in the context of patient's environment and lifestyle. Some of the challenges for delivery of precision medicine in oncology include biomarkers for patient selection for enrichment-precision diagnostics, mapping out tumor heterogeneity that contributes to therapy failures, and early therapy assessment to identify resistance to therapies. PET/computed tomography offers solutions in these important areas of challenges and facilitates implementation of precision medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Data Challenges of Leveraging a Simulation to Assess Learning

    ERIC Educational Resources Information Center

    Gibson, David; Jakl, Peter

    2013-01-01

    Among the unique affordances of digital simulations are changes in the possibilities for targets as well as the methods of assessment, most significantly, toward integration of thinking with action, embedding of tasks-as-performance of knowledge-in-action, and unobtrusive observational methods. This paper raises and briefly defines key data…

  19. Assessing the strength of cardiac and sympathetic baroreflex controls via transfer entropy during orthostatic challenge

    NASA Astrophysics Data System (ADS)

    Porta, Alberto; Marchi, Andrea; Bari, Vlasta; De Maria, Beatrice; Esler, Murray; Lambert, Elisabeth; Baumert, Mathias

    2017-05-01

    The study assesses the strength of the causal relation along baroreflex (BR) in humans during an incremental postural challenge soliciting the BR. Both cardiac BR (cBR) and sympathetic BR (sBR) were characterized via BR sequence approaches from spontaneous fluctuations of heart period (HP), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and muscle sympathetic nerve activity (MSNA). A model-based transfer entropy method was applied to quantify the strength of the coupling from SAP to HP and from DAP to MSNA. The confounding influences of respiration were accounted for. Twelve young healthy subjects (20-36 years, nine females) were sequentially tilted at 0°, 20°, 30° and 40°. We found that (i) the strength of the causal relation along the cBR increases with tilt table inclination, while that along the sBR is unrelated to it; (ii) the strength of the causal coupling is unrelated to the gain of the relation; (iii) transfer entropy indexes are significantly and positively associated with simplified causality indexes derived from BR sequence analysis. The study proves that causality indexes are complementary to traditional characterization of the BR and suggests that simple markers derived from BR sequence analysis might be fruitfully exploited to estimate causality along the BR. This article is part of the themed issue `Mathematical methods in medicine: neuroscience, cardiology and pathology'.

  20. E-Assessment: Challenges to the Legitimacy of VET Practitioners and Auditors

    ERIC Educational Resources Information Center

    Callan, Victor J.; Johnston, Margaret A.; Clayton, Berwyn; Poulsen, Alison L.

    2016-01-01

    This research examines what practitioners in vocational education and training (VET) organisations and external auditors judge to be the key issues in the current and future use of e-assessment. Applying the framework of legitimacy theory, the study examined the tensions around the use and growth of e-assessment in training organisations, and…

  1. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    Team KuuKulgur watches as their robots attempt the level one competition during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  2. Access. Challenge for Change/Societe Nouvelle Number Twelve.

    ERIC Educational Resources Information Center

    Prinn, Elizabeth, Ed.; Henaut, Dorothy Todd, Ed.

    This issue of Access, the journal issued periodically by Challenge for Change/Societe Nouvelle, contains two groups of articles. The first focuses upon the Skyriver Project, relating how a project was developed which used film and video tape as a means of helping Alaskan communities to assess their own needs and to advocate for themselves the…

  3. Early Childhood Education in Pakistan--Progress and Challenges

    ERIC Educational Resources Information Center

    Shami, Pervez A.

    2009-01-01

    This paper is on Early Childhood Education (ECE)--a goal of Education For All (EFA), assesses the progress of Pakistan's efforts and strategies mainly during post Dakar period 2001-02 to 2005-06 and the major challenges being encountered. The information includes analysis of National Educational Data on ECE in the light of policies and plans, EFA…

  4. Challenges to Native American health care.

    PubMed

    Noren, J; Kindig, D; Sprenger, A

    1998-01-01

    Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment.

  5. The challenges of exposure assessment in health studies of Gulf War veterans

    PubMed Central

    Glass, Deborah C; Sim, Malcolm R

    2006-01-01

    A variety of exposures have been investigated in Gulf War veterans' health studies. These have most commonly been by self-report in a postal questionnaire but modelling and bio-monitoring have also been employed. Exposure assessment is difficult to do well in studies of any workplace environment. It is made more difficult in Gulf War studies where there are a number and variety of possible exposures, no agreed metrics for individual exposures and few contemporary records associating the exposure with an individual. In some studies, the exposure assessment was carried out some years after the war and in the context of media interest. Several studies have examined different ways to test the accuracy of exposure reporting in Gulf War cohorts. There is some evidence from Gulf War studies that self-reported exposures were subject to recall bias but it is difficult to assess the extent. Occupational exposure-assessment methodology can provide insights into the exposure-assessment process and how to do it well. This is discussed in the context of the Gulf War studies. Alternative exposure-assessment methodologies are presented, although these may not be suitable for widespread use in veteran studies. Due to the poor quality of and accessibility of objective military exposure records, self-assessed exposure questionnaires are likely to remain the main instrument for assessing the exposure for a large number of veterans. If this is to be the case, then validation methods with more objective methods need to be included in future study designs. PMID:16687267

  6. Clinical Laboratory Evaluation of Electronic Cigarettes/Electronic Nicotine Delivery Systems: Methodological Challenges.

    PubMed

    Blank, Melissa D; Breland, Alison B; Cobb, Caroline O; Spindle, Tory; Ramôa, Carolina; Eissenberg, Thomas

    2016-10-01

    Evaluating electronic cigarettes (ECIGs) in the clinical laboratory is critical to understanding their effects. However, laboratory evaluation of ECIGs can be challenging, as they are a novel, varied, and evolving class of products. The objective of this paper is to describe some methodological challenges to the clinical laboratory evaluation of ECIGs. The authors gathered information about challenges involved in the laboratory evaluation of ECIGs. Challenges were categorized and solutions provided when possible. Methods used to study combustible cigarettes may need to be adapted to account for ECIG novelty and differences within the class. Challenges to ECIG evaluation can include issues related to 1) identification of ECIG devices and liquids, 2) determination of short -term ECIG abstinence, 3) measurement of use behavior, and 4) assessment of dependence. These challenges are discussed, and some suggestions to inform ECIG evaluation using clinical laboratory methods are provided. Awareness of challenges and developing, validating, and reporting methods used to address them aids interpretation of results and replication efforts, thus enhancing the rigor of science used to protect public health through appropriate, empirically-based, ECIG regulation.

  7. Self-Assessment: Challenging Students to Take Charge of Learning

    ERIC Educational Resources Information Center

    Harada, Violet H.

    2010-01-01

    Students are frequently unaware that they hold the power of learning in their own hands. Their ability to figure out what they are doing and where they are heading are crucial keys to consciously applying learning strategies, developing effective work habits, and assessing their own performance. The ability to regulate one's own learning means…

  8. Opportunities, Challenges and Questions: Continual Assessment in Year 9

    ERIC Educational Resources Information Center

    Cain, Karl; Neal, Christina

    2004-01-01

    Our means of assessment might pose a problem. History teachers regularly set specific targets, with implicit or explicit reference to National Curriculum Levels, which are designed to move our pupils on and make them better historians. How, though, are we to prevent them from achieving their targets in a rather mechanistic way, ticking the boxes…

  9. Personality: individual differences and clinical assessment.

    PubMed

    Butcher, J N; Rouse, S V

    1996-01-01

    Research in clinical personality assessment continues to be produced at a high rate. The MMPI/MMPI-2 remains the most popular instrument for both clinical application and psychopathology research. Two other clinical personality instruments, the Rorschach and TAT, continue to find a place in research and clinical assessment. Some new instruments have surfaced recently to deal with areas, such as personality disorders, that have been considered inadequately addressed. There is a growing recognition that the Five-Factor Model is too superficial for clinical assessment that requires more refined and broadened patient information. Clinical personality assessment has successfully survived a number of past challenges. The newest challenge stems from the health-care revolution, in which managed-care providers are reluctant to pay for assessment because of shrinking funds. Psychologists need to develop models for incorporating assessment information into the treatment process. The future is likely to see more extensive research and theoretical development in this endeavor.

  10. The Promise and the Challenge of Technology-Facilitated Methods for Assessing Behavioral and Cognitive Markers of Risk for Suicide among U.S. Army National Guard Personnel.

    PubMed

    Baucom, Brian R W; Georgiou, Panayiotis; Bryan, Craig J; Garland, Eric L; Leifker, Feea; May, Alexis; Wong, Alexander; Narayanan, Shrikanth S

    2017-03-31

    Suicide was the 10th leading cause of death for Americans in 2015 and rates have been steadily climbing over the last 25 years. Rates are particularly high amongst U.S. military personnel. Suicide prevention efforts in the military are significantly hampered by the lack of: (1) assessment tools for measuring baseline risk and (2) methods to detect periods of particularly heightened risk. Two specific barriers to assessing suicide risk in military personnel that call for innovation are: (1) the geographic dispersion of military personnel from healthcare settings, particularly amongst components like the Reserves; and (2) professional and social disincentives to acknowledging psychological distress. The primary aim of this paper is to describe recent technological developments that could contribute to risk assessment tools that are not subject to the limitations mentioned above. More specifically, Behavioral Signal Processing can be used to assess behaviors during interaction and conversation that likely indicate increased risk for suicide, and computer-administered, cognitive performance tasks can be used to assess activation of the suicidal mode. These novel methods can be used remotely and do not require direct disclosure or endorsement of psychological distress, solving two challenges to suicide risk assessment in military and other sensitive settings. We present an introduction to these technologies, describe how they can specifically be applied to assessing behavioral and cognitive risk for suicide, and close with recommendations for future research.

  11. Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough.

    PubMed

    Oh, Angela Jinsook; Lanzman, Bryan Alexander; Liao, Yaping Joyce

    2018-06-01

    Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Examination revealed a 1-2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500-3000 mg per day. We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition.

  12. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-10

    A team KuuKulgur Robot from Estonia is seen on the practice field during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Tuesday, June 10, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Team KuuKulgur is one of eighteen teams competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  13. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    Worcester Polytechnic Institute (WPI) President Laurie Leshin, speaks at a breakfast opening the TouchTomorrow Festival, held in conjunction with the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  14. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The team AERO robot drives off the starting platform during the level one competition at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  15. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-14

    David Miller, NASA Chief Technologist, speaks at a breakfast opening the TouchTomorrow Festival, held in conjunction with the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Saturday, June 14, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  16. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    The Oregon State University Mars Rover Team's robot is seen during level one competition at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  17. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-10

    Jerry Waechter of team Middleman from Dunedin, Florida, works on their robot named Ro-Bear during the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Tuesday, June 10, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Team Middleman is one of eighteen teams competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  18. 2014 NASA Centennial Challenges Sample Return Robot Challenge

    NASA Image and Video Library

    2014-06-11

    Members of the Oregon State University Mars Rover Team prepare their robot to attempt the level one competition at the 2014 NASA Centennial Challenges Sample Return Robot Challenge, Wednesday, June 11, 2014, at the Worcester Polytechnic Institute (WPI) in Worcester, Mass. Eighteen teams are competing for a $1.5 million NASA prize purse. Teams will be required to demonstrate autonomous robots that can locate and collect samples from a wide and varied terrain, operating without human control. The objective of this NASA-WPI Centennial Challenge is to encourage innovations in autonomous navigation and robotics technologies. Innovations stemming from the challenge may improve NASA's capability to explore a variety of destinations in space, as well as enhance the nation's robotic technology for use in industries and applications on Earth. Photo Credit: (NASA/Joel Kowsky)

  19. Challenges in conducting research in pediatric long-term care facilities.

    PubMed

    Larson, Elaine L; Cohen, Bevin; Murray, Meghan; Saiman, Lisa

    2014-10-01

    Children residing in long-term care facilities (LTCFs) have complex medical problems and unique care needs, yet research in this setting is rare. As part of an intervention study to improve patient safety (Keep It Clean for Kids [KICK]), we describe the challenges encountered and recommend approaches to build a successful and sustained collaborative relationship between pediatric LTCFs and the research team. We implemented a program with 5 components: leadership commitment, active staff participation by the creation of KICK teams, workflow assessments, staff training in the World Health Organization's "5 Moments for Hand Hygiene," and electronic monitoring and feedback to staff regarding hand hygiene practices. Major challenges encountered were establishing trust, building research teams, enhancing staff participation, and engaging families and visitors. Approaches to deal with these challenges are discussed. Conducting research in pediatric LTCFs requires sustained commitment to dealing with challenges and establishing collaborative relationships with administrative and frontline staff. © The Author(s) 2014.

  20. Ecological Equivalence Assessment Methods: What Trade-Offs between Operationality, Scientific Basis and Comprehensiveness?

    PubMed

    Bezombes, Lucie; Gaucherand, Stéphanie; Kerbiriou, Christian; Reinert, Marie-Eve; Spiegelberger, Thomas

    2017-08-01

    In many countries, biodiversity compensation is required to counterbalance negative impacts of development projects on biodiversity by carrying out ecological measures, called offset when the goal is to reach "no net loss" of biodiversity. One main issue is to ensure that offset gains are equivalent to impact-related losses. Ecological equivalence is assessed with ecological equivalence assessment methods taking into account a range of key considerations that we summarized as ecological, spatial, temporal, and uncertainty. When equivalence assessment methods take into account all considerations, we call them "comprehensive". Equivalence assessment methods should also aim to be science-based and operational, which is challenging. Many equivalence assessment methods have been developed worldwide but none is fully satisfying. In the present study, we examine 13 equivalence assessment methods in order to identify (i) their general structure and (ii) the synergies and trade-offs between equivalence assessment methods characteristics related to operationality, scientific-basis and comprehensiveness (called "challenges" in his paper). We evaluate each equivalence assessment methods on the basis of 12 criteria describing the level of achievement of each challenge. We observe that all equivalence assessment methods share a general structure, with possible improvements in the choice of target biodiversity, the indicators used, the integration of landscape context and the multipliers reflecting time lags and uncertainties. We show that no equivalence assessment methods combines all challenges perfectly. There are trade-offs between and within the challenges: operationality tends to be favored while scientific basis are integrated heterogeneously in equivalence assessment methods development. One way of improving the challenges combination would be the use of offset dedicated data-bases providing scientific feedbacks on previous offset measures.